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Author Topic: My tips for recovery after a Lateral Release  (Read 7141 times)

Offline OSuzanne

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My tips for recovery after a Lateral Release
« on: January 13, 2007, 11:08:31 PM »
I am writing this diary 5 days post-op from a right knee lateral release, chondroplasty and lateral meniscectomy.  After worrying so much about it, I can say that my recovery is going much better than I expected.  I was dreading this surgery since I had a lateral release done in March '05 on my left knee.  After that surgery I needed two crutches for two weeks and one crutch for a week and was unable to drive for 10 days since I couldn't bend my leg far enough to fit into the front seat.  I was out of work for 3 1/2 weeks and had 18 PT visits over 7 weeks.  My left quad is still "skinny" almost 2 years later although the patellar pain is significantly improved.  I thought I would share my lessons and tips and to tell you that sometimes the anticipatory anxiety is worse than the actual event.

Day 1: Surgery

I can say that having surgery at 8:30 AM is much preferred to 2 PM.  Luckily I was able to be a morning patient this time.  It's very hard to wait at home all morning not eating while the husband has breakfast and drinks his coffee.  I think what was worse for me was the not drinking part and the worrying that my breath would be horrible as they went to knock me unconscious.  Heehee.  TIP: Find out which day of the week your OS does early surgeries and sign up on that day.   I went in at 7 AM, surgery was at 8:30 and I was on the way home by 11:30 AM.  This was with general anesthesia.  TIP:  Tell your anesthesiologist if you get nauseous so they can inject anti-nausea meds during surgery.  Tell the surgical nurse if you are nervous and maybe he or she will rub your arm and talk nice to you while you go to sleep.  Ask them what music they will be playing during surgery and laugh a little.  Above all remember, this is their profession, trust them to do their job and allow them to care for you.  It's normal to be scared.  Even though I try to fight the drugs, they always win and sleep (and peace) came to me.  If you hate going under, just remember that soon you will be awake and they will be feeding you peanut butter toast and juice and your family will be back at your side.  I was only unconscious for one hour and within 30 minutes of waking up I was eating and drinking.  I actually felt pretty alert on the way home too.  Take some pillows for the backseat to prop your leg. 

At Home Tips:  Know how to use your crutches before surgery day.  Have a PT or nurse teach you how to walk, sit, stand and use stairs if you have them.  Have your couch ready with extra pillows, TV remote and cordless phone handy.  Plan on sleeping a lot if you are taking pain meds and go easy on the type of food you eat since pain meds can make you constipated.  Drink lots of water!!  Above all, have at least 3 or 4 cold packs ready in the freezer.  You must stay on top of the swelling that comes with the lateral release!!

  I woke up after surgery with 4/10 pain and it stayed pretty much the same all day.  I am taking Hydrocodone and Advil.  I peeked under the wraps to check things out.  My knee is pretty swollen and bruised looking.  The top of my knee is kind of numb.  My shin looks a little blue.  My quad is pretty sore from the cuff they use to control bleeding during surgery and it's painful to sit and stand.  I've had ice on all day (constant).  My husband changes it every hour or so with a fresh pack.  I walked to the bathroom with one or two crutches.  Not bad.  I can bend my knee to about 90 degrees and sitting is OK.  I find 4 EKG patches that they left on my chest and back.  My neck and jaw are sore from having my mouth propped open and being intubated.  I do have a great appetite and decided that having food prepared yesterday was a good idea.  Time for bed...

Day 2:

Morning:  I kept up the pain meds through the night, waking up to have some food with the pills and back to the couch.  Husband helps with keeping fresh ice on my knee.  I plan on spending much of the first 48 hours on the couch with my leg elevated and iced.  I feel pretty good this morning.  Walking really well with a crutch (or not).  I took my wraps off and did wall slides lying on my back with both feet flat on the wall, sliding my foot down as far as needed to comfortably stretch the knee.  I am also doing quad sets, straight leg raises and heel slides.  It feels good to stretch!  My motion this morning is about 110 degrees and the pain is 3/10.  I am black and blue around the knee and about half way up the lateral thigh.  I am very pleased this far and doing much better that I thought I would.  Feeling tired and out of it due to the meds.

Evening:  The honeymoon is OVER!  Whatever they inject into your knee during surgery is wearing off!!  I am crabby and sore and sick of the couch and ice already.  My quad is spasming and tight and sore.  It is really hard to sit down on the toilet.  I feel like an old lady.  I am still on the pain meds about 3 times a day and alternating with Advil to control swelling.  I just want to rest now.

Day 3:  First PT visit

Morning:  I left the couch at 3:45AM wanting my own bed.  I warn the husband to avoid kicking into my leg.  He keeps his distance!  I took my first shower since surgery but keep it short to avoid too much swelling.  I went to my favorite PT today.  I feel better just having him look at my knee and telling me that it looks as it should 2 days after surgery.  He measures my ROM at 95 degrees.  He reviews my home exercises and makes sure I am using my crutches correctly.  Then he gives me this awesome foam pad to wear under my wraps to help with the swelling.  It is "U" shaped and I wear it all the time on the lateral side of my knee.  I can tell you that it has made a big difference with keeping the swelling away from the joint line so I can get better motion.  We end with my FAVORITE treatment, the GAME READY cryo machine.  I spend 20 minutes hooked up to the pressure cuff and the cold water circulates through the cuff and it squeezes your leg too.  It's the best.  I love that machine.  TIP:  If possible, preschedule your first PT visit before you have your surgery.  If you are already working with a PT talk to them and see when they would like to see you and get it on the schedule.  If you wait until after surgery you might have to wait a week to get in.  I like to go on day 3.  That's the day that I have the most pain. 

Evening:  It hurts more to straighten out the knee.  It feels like a lot pf pressure under the kneecap.  Gravity SUCKS!  Getting up off the couch and standing really hurts.  All the blood flows down the leg once you stand up and the pressure hurts.  I'm getting bored watching tv and sleeping on my back all day.
Left knee: Lateral release, Medial meniscus repair & cyst removal - 03/05
Left knee: Medial meniscectomy - 12/06
Right knee: Lateral release, lateral meniscectomy, chondroplasty - 01/07
Right knee: ITBS - 07/07

Offline OSuzanne

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Re: My tips for recovery after a Lateral Release
« Reply #1 on: January 13, 2007, 11:45:02 PM »
Day 4: 

I am just so tired today.  I fatigue easily and find myself crashing on the couch, sleeping hard!  My stomach is killing me.  I think I ate too much the first few days.  I took a shower after lunch.  It feels so good to get the wraps off for a while.  After I shower I do my exercises while my muscles are warmed up.  I notice that my quad contraction is a little weaker today and my motion is back to about 90 degrees.  Still, that's pretty good compared to my first lateral release done on the left knee.  It took me a lot of work to get that far.  I really struggled with getting my motion back the first time.  I recall having trouble just sitting in a chair and having to prop my foot up since I couldn't bend far enough to touch the floor.  I really think using the pad that my PT made me is making a big difference.   It hurts to extend my leg.  I am getting black and blue on the lateral knee and quad.  All my muscles ache from lying around so much and from using crutches. 

Day 5:  PT visit #2

My PT tells me I am doing really well!  He measures my flexion at 127 degrees.  I can't believe it!  I think it took me 10 days to get that far with my left knee LR.  I remember him warning me in 2005 that I'd better get my motion back or the OS would send me back to the OR for a manipulation.  I told him to just help me get my swelling down and that my motion would follow.  I think I am better about elevating and icing this time and also changing positions every 2 hours or so, getting up and walking a bit to help with the circulation.  Luckily my quad is contracting really well.  I had more trouble with the other quad shutting down.  Don't be surprised if yours does that.  When you have swelling in the knee it tends to inhibit the muscle control and force of contraction. 

I have some more brusing today.  My IT band is really tight.  The PT tells me to massage the area (lateral thigh) to help increase the circulation and to alleviate pain.  He thinks the brusing is due to the pressure cuff used during surgery.  I got to go out into the gym today and use the NuStep (recumbant stepper).  He thinks I have too much swelling to use the bike though.  He watches me use my crutches going up and down the stairs and tells me to add side leg lifts this weekend.  Then I get rewarded with 20 minutes on the Game Ready cryo machine!!  I go home tired and crash on the couch again.  My quad is fatigued tonight from doing stairs and and the new exercises.  I hate my crutches and try using a walker in the house.  It works pretty well, gives my hands and arms a break.







Left knee: Lateral release, Medial meniscus repair & cyst removal - 03/05
Left knee: Medial meniscectomy - 12/06
Right knee: Lateral release, lateral meniscectomy, chondroplasty - 01/07
Right knee: ITBS - 07/07

Offline OSuzanne

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Suzanne's Post Op Lateral Release Diary
« Reply #2 on: January 15, 2007, 04:33:01 AM »
Day 6:

I'm depressed.  I woke up more colorful today; purple, red, yellow.  Looks like someone took their favorite crayons and marked up my leg.  I don't know why exactly but seeing myself all bruised like that just flipped a switch and I cried for over an hour.  It's just temporary I know but I couldn't help feeling a little bit sorry for myself.  Then just to validate my feelings of self pity, I went and watched the videotape of my surgery.  Does anyone want to comment on watching a lateral release being done?  It's so gross.  You have to wonder how the doctor knows when it's time to stop already!!  Yuck, yuck, yuck.  It really should come with an "R" rating.
Left knee: Lateral release, Medial meniscus repair & cyst removal - 03/05
Left knee: Medial meniscectomy - 12/06
Right knee: Lateral release, lateral meniscectomy, chondroplasty - 01/07
Right knee: ITBS - 07/07

Offline OSuzanne

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Re: My tips for recovery after a Lateral Release
« Reply #3 on: January 15, 2007, 04:49:11 AM »
Day 7:

Is this when things start going downhill?  I feel like I'm regressing.  Maybe it's because I made Husband take me out of the house today.  I am getting cabin fever pretty bad and haven't had an outing since my PT visit last Friday.  It's pretty cold out today at -7 degrees but what the heck, I had a driver and the mall was my target.  I lasted about an hour.  Try shopping with a heavy winter coat, two crutches, and a purse.  Then add three sweaters over your arm and see how fast you can make it to the fitting room.  People look at you weird when you use crutches and some of them roll their eyes at you and some have the nerve to ask you what's wrong with you.  I'm a nice person but sometimes I want to make up a wild story just to see what they'd say.

I have this giant, GIANT, lump above my knee on the lateral side now.  It is uncomfortable and is making it harder for me to bend the knee.  We'll see what the brilliant PT says he can do about that tomorrow.  (Yeah, another outing).  Plus it is my first recheck with the OS.  I want to ask him how he decides when he's "released" enough.
Left knee: Lateral release, Medial meniscus repair & cyst removal - 03/05
Left knee: Medial meniscectomy - 12/06
Right knee: Lateral release, lateral meniscectomy, chondroplasty - 01/07
Right knee: ITBS - 07/07

Offline LighthouseFan

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Re: My tips for recovery after a Lateral Release
« Reply #4 on: January 15, 2007, 05:10:48 AM »
Thank you so much for posting your experiences with a Lateral Release.  I am scheduled for a lateral release and medial patellofemoral ligament reconstruction surgery on this Thursday (1-18-07) and am nervous  :-\ about the procedure (not knowing what to expect, etc.).  I appreciate being able to read about your experiences as it helps me to get a better idea about what to expect.  I'm ready for this whole process to be over (I injured my knee Oct.16, 2006 and have been off work since Oct.31, 2006), but the closer it gets to surgery day the more anxious I am.  I've been trying to do everything I can to get ready for recovery time (i.e., making sure I've got music, books, movies close by to help pass the time and getting things packed to stay with my grandmother for about a week post-op).  However, if it hadn't been for reading your post, I never would have thought to take pillows along on surgery day so that I could prop my leg up on the way home.  Thank you for the tips.  Any other tips you have would be greatly appreciated.  :) 

Please know that you are in my thoughts and I hope that each day finds you feeling better and less colorful.  I know I like rainbows, but not when they are on my skin and I doubt you like them on your skin either.  :P  Anyways . . . take care and I look forward to reading more about how you are doing.

Heather
Numerous subluxes/dislocations of R knee - 1991 to 1997
R knee arthroscopy (removal of plica band and some cartilage) - 1997
L foot surgery (removal of accessory navicular) - 1999
Numerous subluxes/dislocations of L knee - 1991 to present
L knee LR and MPFL reconstruction - 1/18/2007

Offline lilrosie06

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Re: My tips for recovery after a Lateral Release
« Reply #5 on: January 15, 2007, 07:19:33 AM »
Heather....Good luck with your surgery on Thursday. Please keep me posted as to how it goes. I am having a LR/debridement on Tues., 1-23-07. It has helped to read your diary, Suzanne. No one likes going into surgery, and at this point, I am nervous. However, Im hopeful this will help me. I twisted my knee at work on 1-3-05 and have been on workmans comp ever since. I sublux all the time, and have bone on bone arthritis laterally. Do either of you have this? Please keep in touch, both of you. I would love to share recoveries with you both.It helps so much to be able to share with people who can relate to what you are going through. I will look forward to hearing from you.

DONNA
(9 days)
LEFT KNEE INJURY-1-05
SCOPE 4-05, LR 1-07, TKR 6-07, MUA 7-07, REVISION 10-07, INFECTION CLEANOUT 11-07, REVISION 4-08, EXPLANT 2-09 ANTIBIOTIC SPACER PUT IN, AND PICC LINE FOR 6 WEEKS
REPLACEMENT 5-09

BACK IN PT NOW....HIP AND FOOT PAIN, POSSIBLY SCIATIC

Offline n_mcard;e

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Re: My tips for recovery after a Lateral Release
« Reply #6 on: January 15, 2007, 08:13:32 PM »
Hi Suzanne,

Thanks for the tips on the lateral release...I guess I was a little naive in thinking that this wuld be a case of having the surgery & going back to work a few days after...I should've listened to the consultant when he said that this would be a rather invasive procedure!!!

I appreciate reading how you're doing, it's definately reassured me :) It helps to share stories with people! I'm not particularly bothered about going in for the surgery on Wednesday (17th January) but I'm more concerned with being unable to eat for 6 and a half hours prior, especially as my op is at 1:30pm :(

I'll keep you posted in my progress, take care xx
Athroscopy & right knee lateral release - Jan '07

Offline OSuzanne

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Re: My tips for recovery after a Lateral Release
« Reply #7 on: January 15, 2007, 11:02:36 PM »
Good luck to all three of you as you prepare for your surgeries and let me know how you are doing afterwards!

Heather, just trust the professionals to do their job that day.  Lean on them for support if you need to and let them know you are nervous.  Ask them to tell you about their kids or something.  Distraction is good.  Bring in your favorite music to listen to before surgery or bring a wordgame to work on. 

I too had a work related injury to this knee.  I fell at work in July '06 and after first being denied for surgery I was finally approved with the help of my OS.  I first had to get through a scope to the opposite knee (not related to the fall) which was done on Dec 8, 2006.  Then Jan 8th 2007 was the lateral release and chondroplasty on the other knee.  I worked pretty hard those 30 days in between to get the first leg strong enough to support the second surgery.  All I can say is that falls are BAD for you!!  I am meeting with an OS hand specialist this Thursday to discuss possible surgery for a partially ruptured distal (elbow) biceps tendon.  Hello....enough is enough already!!

Nat, don't worry too much about going in at 1:30pm.  That was my time for surgery back in December.  I was allowed to eat until midnight and could drink water and 7-Up until 9:30 AM.  I would check with your surgery center and see what they recommend but I know that being able to drink soda (sugar...calories!!)  was what helped me.  Then I slept in late, took a shower and before I knew it it was noon and time to leave the house.  Just remember...you have a reason to wake up that much faster after surgery.  That's what did it for me...pb toast!!!!!!!  Are you doing general anesthesia?  If so, be careful and don't eat too heavy of a meal the night before.

Suzanne
Left knee: Lateral release, Medial meniscus repair & cyst removal - 03/05
Left knee: Medial meniscectomy - 12/06
Right knee: Lateral release, lateral meniscectomy, chondroplasty - 01/07
Right knee: ITBS - 07/07

Offline OSuzanne

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Re: My tips for recovery after a Lateral Release
« Reply #8 on: January 16, 2007, 04:33:09 AM »
Day 8: 1 Week post-op , Pt Visit #3, OS Recheck

Don't sleep well at night.  Pain or stiffness will wake me up.  Maybe I should be taking a stronger pain reliever before bed.

I thought I'd better shave my legs this morning since I'll have two people looking at my leg today.  I get exhausted in the shower though trying to bend over to reach my ankle and even to stand straight without falling over.  I give up on the razor.  Heck, I'll still be wearing those cute TED compression socks up to the knee anyway.  The shower wiped me out and there I am crying again...I should just cut myself some slack and realize that I don't have all my energy back yet.  I asked my husband for a chair to sit on to finish getting ready.

Brrrr, 15 degrees below zero this morning on the way to PT.  I think my PT thought my leg looked pretty cool.  He couldn't say enough about the bruises and he was quite fascinated by the giant lump of swelling.  He said all his LR patients end up with that so not to worry.  He did encourage me to keep up with the ankle pumps, icing and elevating.  He said we should add the bike today and I said OK but will I scare anyone out in the gym with my "Monster leg"?  He said "probably".  Of course the curious workout man had to stop over and ask me if I'd had a total knee replacement surgery.  I said no, "just a scope". (Does it look that bad?) TIP  Get on the bike as soon as you can.  You may not be able to get all the way around right away but I have found that once I start the bike, the knee motion, swelling and function really start to improve.  I told my PT that my IT band and hip joint have really been bothering me so he stretched my quad with me lying on my stomach and my opposite foot on the floor as far forward as possible.  I'm 41 years old, do I look that flexible??  He also did an ultrasound treatment over the lumpy lump and over the lateral thigh area on the bruise.  He said that it would help to speed up the healing there. 

Later today I met with my OS for the one week post-op visit.  He seemed very pleased with my motion at 125 degrees.  He said he'd have been happy with 80 degrees at this point.  Just lucky this time I guess.  He said I could start to wean off the crutches now and that I could start driving too.  This knee has definately been easier to rehab than the other LR.  I'm sure I've been better about icing and elevating this time around.  I asked him about how the procedure went and he said my patellar tilt was significant and that it was causing damage to the underside of the patella.  He did a complete, full release down to the joint and that when he did the release my kneecap "jumped over" (it really wanted to be released...)to a more normal position.  Sounds like a fun time in the OR!  He said all the bruising and swelling was normal and due to bleeding from the LR.  He said the bruising travels up the thigh due to elevating the leg and that the quad and IT band/hip area are sore from blood getting into the muscles there.  OK, I can deal with that.  At least it's not shorts weather here!
Left knee: Lateral release, Medial meniscus repair & cyst removal - 03/05
Left knee: Medial meniscectomy - 12/06
Right knee: Lateral release, lateral meniscectomy, chondroplasty - 01/07
Right knee: ITBS - 07/07

Offline LighthouseFan

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Re: My tips for recovery after a Lateral Release
« Reply #9 on: January 16, 2007, 04:52:04 AM »
Suzanne -

Thank you for the words of encouragement!  I think I'm going to take a handheld Yahtzee game to the hospital to help keep me distracted and pass the time before surgery.  I would take the MP3 player, but the paperwork I have from the hospital warns to leave all valuables at home (and MP3 player is specifically included on that list), so to be safe I decided to take the Yahtzee game since I could afford to lose that (it's less than US $8 to replace). 

I'm glad to hear that your OS and PT seem to be pleased with your progress!  Keep up the good work!  I can only hope to do that well post-op, but since I am having MPFL reconstruction at the same time I know that recovery will be a slow, tough process.  However, if that is what it takes to get my knee functioning so that I can get back to my normal life again, then that is what I am going to do.  There are too many things that I want to do in life and am tired of my knee having me on the sidelines right now.  I will post on my surgery and post-op as soon as possible, but it will be at least a week after surgery before I will have access to a computer and internet.  I'm going to take notes in a notebook in the meantime so that I can post the experiences once I am back in my own apartment with internet access.

Please know that I will continue to keep you in my thoughts.  Take care.

Heather
Numerous subluxes/dislocations of R knee - 1991 to 1997
R knee arthroscopy (removal of plica band and some cartilage) - 1997
L foot surgery (removal of accessory navicular) - 1999
Numerous subluxes/dislocations of L knee - 1991 to present
L knee LR and MPFL reconstruction - 1/18/2007

Offline OSuzanne

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Re: My tips for recovery after a Lateral Release
« Reply #10 on: January 17, 2007, 03:40:27 AM »
Day 9:

I wake up at least once a night with terrible pain.  I can't stand sleeping on my back.  I like to sleep on my side with my knee bent but when I wake up I am almost screaming because I can hardly move it.  My PT told me to sleep with my leg flat now to make sure I keep my full extension motion but I just can't do it.  I've tried using all kinds of pillows to prop my leg but it doesn't help.  Guess I'd better get Husband some ear plugs.

I decided to try driving today.  Made Husband ride along as I drove around the neighborhood.  I can say that getting into the driver's seat was interesting leading with my surgical leg.  It hurt too much shifting my foot from pedal to brake so Husband told me to brake with the left foot and accelerate with the right.  Now he's a farm boy who had driven clutch all his life but this was a new game for me!  It actually worked OK.  I think I will drive myself to PT tomorrow.

I went for a girls night out for Mexican food and margaritas....yum.  You really have to watch out in public because people do not pay attention to you when you have crutches.  I got kicked into by a waiter when I was walking in and it's just so surprising how people cut in front of you and nearly side swipe you to get ahead of you.  I sat with an empty chair across from me and used it several times to elevate and rest my leg.  It still hurts to sit with my knee bent for long periods of time.  When I got home my knee was HUGE and I took to the couch immediately with ice in tow. 
Left knee: Lateral release, Medial meniscus repair & cyst removal - 03/05
Left knee: Medial meniscectomy - 12/06
Right knee: Lateral release, lateral meniscectomy, chondroplasty - 01/07
Right knee: ITBS - 07/07

Offline n_mcard;e

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Re: My tips for recovery after a Lateral Release
« Reply #11 on: January 17, 2007, 10:37:12 AM »
Hey Suzanne,

Well its the day of my surgery & reading your diary I'm starting to get slightly more nervous!!! Like I said previously, I really thought this would be a simple case of having the op & walking outta the hospital!!! I did take your advice & phoned ahead to ensure they had crutches available if I require them, thankfully they said they did have & it wouldn't be an issue if I was unable to walk unaided!

I'm having a general so couldn't eat from 7am this morning & can only drink clear fluids now up till 11:30am...Black tea tastes awful!!!

I had a new sofa delivered yesterday & also have had sky tv fitted again this week so my stake out is all prepared for when I arrive home later!!

How are you doing anyway, hows the recovery process?

Nat x
Athroscopy & right knee lateral release - Jan '07

Offline Treathouse

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Re: My tips for recovery after a Lateral Release
« Reply #12 on: January 17, 2007, 05:56:21 PM »
I love reading your daily posts Suzanne!  I am scheduled for my 5th surgery on Tues January 23rd.  It is a scope with a possible lateral release.  I am a bit nervous, but am also looking forward to the possiblity of this helping with the daily pain I have now.  Best of luck to you!

Lisa
1987-scope partial medial meniscectomy and plica  1991 scope medial meniscus (recurrent tear)  2000 Reconstruction anteromedial rotatory instability for recurrent meniscal tear. 2004 scope partial medial meniscectomy and now another debridement with possible LR 1/23/07

Offline lilrosie06

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Re: My tips for recovery after a Lateral Release
« Reply #13 on: January 17, 2007, 08:50:30 PM »
Lisa...Im having my surgery the same day as you. A LR/debridement. Please keep in touch so we can support one another through the recovery.

Donna
LEFT KNEE INJURY-1-05
SCOPE 4-05, LR 1-07, TKR 6-07, MUA 7-07, REVISION 10-07, INFECTION CLEANOUT 11-07, REVISION 4-08, EXPLANT 2-09 ANTIBIOTIC SPACER PUT IN, AND PICC LINE FOR 6 WEEKS
REPLACEMENT 5-09

BACK IN PT NOW....HIP AND FOOT PAIN, POSSIBLY SCIATIC

Offline Treathouse

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Re: My tips for recovery after a Lateral Release
« Reply #14 on: January 17, 2007, 10:17:55 PM »
Donna,

What a wonderful idea!  How did you injure your knee?  What # surgery is this for you?

Lisa
1987-scope partial medial meniscectomy and plica  1991 scope medial meniscus (recurrent tear)  2000 Reconstruction anteromedial rotatory instability for recurrent meniscal tear. 2004 scope partial medial meniscectomy and now another debridement with possible LR 1/23/07

 















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