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Ligament damage / ACL reconstruction help and advice please
« Last post by Joedy123 on November 17, 2017, 11:10:12 PM »
Hi all
So a little bit of history.... 10 years ago I ruptured my plc, plc and acl plus tore my mcl. I had my plc and pcl reconstructed but still suffered pain. My surgeon was going to do a a further diagnostic op n sent me for pre op n I waited for a date n nothing happened so got lost in the system, I just carried on with life with a limp and in pain. However about two years ago this got much worse so I went to my gp who sent me for an MRI and with the results back to the surgeon. After having the diagnosis arthroscopy it was confirmed the acl required replacing and I had grace 3 arthritis.

Anyway 5 weeks ago today I had my acl reconstructed. Initially the pain had gone from inside my knee so was thrilled and I'm able to now lift my leg up when stood so have more flexion which I haven't been able to do for 10 years, I'm really thrilled. However I've noticed in the last week that a pain at the front bottom of my knee has started with every step. I still haven't started physio either so my brace is locked at 90 degrees. I had a referral from hospital to say that this should start within 4 weeks after my op but I've just received a letter today say that physio has a 6 week weighting list. I'm due back to work next week so I'm very concerned. Does anyone have any advice please?
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Post-op diaries (<50 posts) / Re: Medial PKA 22 Sept 2017
« Last post by millen on November 17, 2017, 10:47:12 PM »
Apologies for the infrequent update!
Anyway, it's now 8 weeks to the day since my op.
The local hospital physio referred me to a lower limb exercise class.  This has been useful, though patients have a variety of conditions and some are not very mobile but try hard.  I'm in two minds about the chap leading the class - sometimes he pushes me to severe pain levels on range of motion exercises (saying there's a limited window of opportunity to regain motion) and several of the class exercises (eg leg press, rower, trampette, deep lunges) are frowned upon by a Bonesmart article on 'exercises not to do after knee replacement'. Anyway, just one class left now.

I saw the surgeon for my follow-up at week 5 (standard protocol is follow-up at week 2 and week 6 but we didn't do week 2 due to the 100 mile traveling distance).  I was pretty apprehensive beforehand, eg concerned that swelling and numbness were not reducing much, so maybe I'd overdone something and damaged the implant, and pain at night times was still troublesome.   To my great relief, the surgeon allayed these fears and wrote in his report to the GP "Simon is doing remarkably well following his surgery".  He did though recommend that I ease off a fraction as that should lead to a quicker overall recovery - some things just cannot be rushed.  He suggested another follow-up at 12 months.

Positive developments:
Most weeks I was hitting new milestones, which boost confidence.
Resumed outdoor cycling (extremely tentatively!) on day 23.
Rejoined cycle club at week 7 (beginners group though!).
Unsolicited comments from friends that I'm walking more naturally than before the op.
Discovery that I can walk pain free further than before.
Can now make an ungainly attempt to descend a flight of stairs unaided by bannisters.

Frustrations:
Realisation that range of motion will be slow to recover until swelling finally goes.  Still only 115 deg flexion - though it was just 120 deg pre-op, which is very poor.
Trial and error shows that if I over-exercise one day the knee heats up (new fangled infra red thermometers are really good for comparing the two knees) and I tend to pay for it the next day.
Striking the best balance between under- and over-doing things.  'A little but often' seems a good motto.
Complete lack of consistency between web articles on how much activity to do and crucially how far to push the pain barrier.
Very hard to find guides as to what progress post-op is normal - most relevant I found was on the Stoneclinic site.  I suspect the answer is that everyone's different.
Conflict between the physio's and the surgeon's advice on rehab exercises.

Conclusion:
I'm more optimistic now for a good outcome and glad I had the replacement when I did. There was a subtle realisation about a week ago when I said to a friend "For most activities, the 'bad' knee and the 'good' knee are now reversed". 


3
Hello All,
I'm new to the forum.  I have Total Knee Replacement surgery scheduled fory left knee. Here is the MRI for my right knee.  I'm hoping the right knee doesn't need Replacement surgery.  Can anyone help me with my MRI reading? Sure would appreciate it. Thanks in advance.

FINDINGS: Extensive susceptibility artifact from the screw in the lateral femoral condyle partially limited the examination. Patient returned for additional images 11/9/2017 to try and reduce the amount of artifact. Artifact persisted, mildly decreased, and here was less motion artifact.

Joint Fluid and Surrounding Soft Tissues: Small joint effusion. Small amount of fluid is present where a Baker's cyst typically forms.

Patellar tendon: Intact.

Quadriceps tendon: Intact.

Patellofemoral joint: Severe chondromalacia along the lateral patellar facet with chondral thinning and articular surface irregularity, likely mild subchondral sclerosis and a 3 mm focus of marrow edema or cyst formation. Suspect mild medial patellar facet chondromalacia.

Patella is mildly laterally subluxed and tilted laterally in relation to the trochlea in the extended position, about 9 mm. There is susceptibility artifact through the trochlea from the lateral femoral condyle screw. Trochlear groove appears to be about 4 mm deep on axial image 9 series 17 and the TT-TG distance about 15 mm. Trochlear hyaline cartilage is not evaluated well due to the artifact.

Cruciate ligaments: There appears to be a diminutive intact, taut, anterior cruciate ligament (ACL) on oblique sagittal 4 through 8 of series 19. No discrete ACL anchors noted however. Posterior cruciate ligament is intact.

Collateral ligaments: Medial collateral ligament is intact.

The lateral femoral screw may involve the IT band but indeterminate. IT band is intact distal to the screw but not seen in the region of the screw. Fibular collateral ligament and conjoined tendon are intact.

There is mild edema in the soleus muscle posterior to the fibular head.

Medial compartment: Minimal thin oblique linear grade 3 signal posterior horn medial meniscus on sagittal PD image 17 series 18 may relate to prior meniscal surgery or a small tear. Hyaline cartilage appears intact.

Lateral compartment: Lateral meniscal posterior horn free edge is hazy mildly irregular at the junction with the body on sagittal images 7 through 9 of series 8, which may also relate to a tear or prior meniscal surgery. Hyaline cartilage appears intact.

IMPRESSION: Partially limited due to susceptibility artifact from screw in the lateral femoral condyle.

Severe lateral patellar facet chondromalacia with underlying mild osteoarthritis.

Small joint effusion.

Meniscal signal abnormalities detailed above.
4
I've had 3 surgeries on my left knee back in the late 70s-80s.  Two surgeries on the right. Left knee is scheduled for Total Knee Replacement.  Just had MRI on the right. I'm hoping it doesn't need a replacement, too. Can anyone help me understand the MRI reading?  Thanks in advance.   :)

FINDINGS: Extensive susceptibility artifact from the screw in the lateral femoral condyle partially limited the examination. Patient returned for additional images 11/9/2017 to try and reduce the amount of artifact. Artifact persisted, mildly decreased, and here was less motion artifact.

Joint Fluid and Surrounding Soft Tissues: Small joint effusion. Small amount of fluid is present where a Baker's cyst typically forms.

Patellar tendon: Intact.

Quadriceps tendon: Intact.

Patellofemoral joint: Severe chondromalacia along the lateral patellar facet with chondral thinning and articular surface irregularity, likely mild subchondral sclerosis and a 3 mm focus of marrow edema or cyst formation. Suspect mild medial patellar facet chondromalacia.

Patella is mildly laterally subluxed and tilted laterally in relation to the trochlea in the extended position, about 9 mm. There is susceptibility artifact through the trochlea from the lateral femoral condyle screw. Trochlear groove appears to be about 4 mm deep on axial image 9 series 17 and the TT-TG distance about 15 mm. Trochlear hyaline cartilage is not evaluated well due to the artifact.

Cruciate ligaments: There appears to be a diminutive intact, taut, anterior cruciate ligament (ACL) on oblique sagittal 4 through 8 of series 19. No discrete ACL anchors noted however. Posterior cruciate ligament is intact.

Collateral ligaments: Medial collateral ligament is intact.

The lateral femoral screw may involve the IT band but indeterminate. IT band is intact distal to the screw but not seen in the region of the screw. Fibular collateral ligament and conjoined tendon are intact.

There is mild edema in the soleus muscle posterior to the fibular head.

Medial compartment: Minimal thin oblique linear grade 3 signal posterior horn medial meniscus on sagittal PD image 17 series 18 may relate to prior meniscal surgery or a small tear. Hyaline cartilage appears intact.

Lateral compartment: Lateral meniscal posterior horn free edge is hazy mildly irregular at the junction with the body on sagittal images 7 through 9 of series 8, which may also relate to a tear or prior meniscal surgery. Hyaline cartilage appears intact.

IMPRESSION: Partially limited due to susceptibility artifact from screw in the lateral femoral condyle.

Severe lateral patellar facet chondromalacia with underlying mild osteoarthritis.

Small joint effusion.

Meniscal signal abnormalities detailed above.
5
Hi all,

My UK surgeon says that while I am making anticipated recovery from my meniscus transplant and oats graft, he is interested in me having a lipogems stem cell injection to assist with some settling of the joint (still some inflammation, and presumably more healing still needs to occur as only been 4 months).  He would be new to the procedure and has quoted approx. 4k.  Reading on their site, Pulsmed seem to offer what those who understand the separation techniques, an excellent standard of injection for approximately a quarter of the price.  Since repeat treatments seems to be key, having 4 of these vs one in the UK is a tempting prospect, if I am not taking unreasonable risks by doing so.

Has anyone had treatment here?  Or seriously considered it?  The link to the website seems to be:
https://translate.google.co.uk/translate?hl=en&sl=pl&tl=en&u=http%3A%2F%2Fpulsmed.com.pl%2Fcennik.html&anno=2

Regards
JT
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GENERAL KNEE QUESTIONS and comments (good for new threads) / Re: Loose kneecaps
« Last post by emm on November 17, 2017, 03:47:32 AM »
I had a very similar problem growing up and into high school. My kneecaps would 'sublex' (doctor''s word for slightly dislocate) when I walked or anything like that. I didn't do anything about it until it began to cause me lots of pain. It wasn't all at once, but more gradual. I eventually went to the doctor and ended up needing surgery. The good thing is, however, is that there's a possibility that it could be helped/corrected with some exercises specific to the muscles that hold your knee cap in place. I know my doctor had me to months of PT to try to fix it before surgery. I'd say keep an eye on it and do what you can to prevent surgery. In case you wonder, the type of surgery is MPFL reconstruction surgery. It's not too invasive, but recovery is very painful. Hope this helped!
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Hey y'all. I had MFPL recon surgery about a year and a half ago and it has always been kinda painful. I expected as much seeing as it had been operated on and went to PT for nearly 6 months and continue to work out regularly, as was recommended by my doctor. But recently its been hurting more and more and becoming more and more like the pain I was having before the surgery. It doesn't look like its tracking incorrectly, but it does crackle a lot if I have to bend down, along with a great deal of pain most of the time. I've been icing it regularly and even stared wearing my braced again to see if maybe it was because of the weather. I'm nervous that something might be wrong and didn't know if anyone else had had a similar experience.
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GENERAL KNEE QUESTIONS and comments (good for new threads) / Broken patella recovery
« Last post by Braden w on November 16, 2017, 11:34:25 PM »
I shattered (5 peices, displaced fracture)my knee cap in a motocross accident. The injury was a on a Saturday and surgery the Following Tuesday. I have 4 screws and a plate. My OS said he would usually take the patella out for a injury like mine but the only reason he put it back together is my age. IM ONLY 15.  Im 6 weeks post op. And have 2 more weeks of immobilization then start PT. all I want to do is play basketball but i know that is out of the picture for a while. Im hoping for a full recovery but I️ just want to know why my future holds. People tell me youre young , youll be fine but idk . Any advice?
 
i want to be able to sprint,jump as do normal stuff i use to do
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GENERAL KNEE QUESTIONS and comments (good for new threads) / Re: what are my options
« Last post by Vickster on November 16, 2017, 11:19:32 PM »
How old are you? Sounds like you have some mild arthritis and degenerate fraying meniscus? The ligament strain is presumably the result of an injury and separate?

You could have a clean up of the bone spurs and tidy of the meniscus, only a temporary fix probably as the arthritis will probably continue to develop.  or conservatively a hyalutonic acid injection might help with inflammation and make the knee move more smoothly. Id avoid cortisone steroid though (as can damage cartilage)

Good luck

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Quizzes, games & fun contests / Re: Word game
« Last post by 60schld on November 16, 2017, 10:59:57 PM »
pie
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