laterial/medial ligament replacement

[rangerr18]

I'm having a laterial/medial patella/femoral ligament replacement on 7/11/03,with a cadaver tendon relplacing the ligaments, and can find NO information on anyone having had this procudure. This will be my forth surgery, and the third and final in an attempt to resolve my chronic sublutation problems. Prior I have had an LR, soft tissue realginment w/ another LR, and a scope in January to repair damage done in a sports injury (torn patella and femoral tendon, torn meniscus, and fractured tibia plateau)
Has anyone had this replacement procudure? How was the post-op recovery? How long until there was any weight bearing? Total rehab period?.
Any info would be helpful!!
Thanks-
Bill

[daisey]

Bill,
    I did not have a replacement of my medial patellofemoral ligament,  but had a repair.  I could not find any information about this procedure either.  It seems that this is not a popular surgery.  I was on crutches for a little over 10 weeks and in physio for 6 months.  Non-weight bearing for 7 or so weeks and then progressed to weight bearing and no crutches.  I had a ROM brace from the time I came out of surgery until ten weeks post-op.  It was set a various ranges thru out the recovery.  It has been seven months and I still am not fully recovered.  I was told it would take a long time to recover from this procedure.  I though long time was 6 months,  not a year.  I am assuming that your procedure will be open,  I had about a 5-6 inch incision down the front of my knee.  I also had the surgery for chronic dislocations and really bad tracking.  My OS wanted to try this procedure before moving on to other procedure like TTT.   So far the patella has not dislocated,  but I have had some problems with tracking.  They assure me this will get better as the muscles strengthen.  Feel free to email me with any questions and look up my post.

Daisey

[Riosilia]

Bill,
Like Daisy I also had a patellofemoral ligament repair (not reconstruction).  I'm 3 weeks post op today and it sounds like my recovery is going a lot faster than Daisy's.  

Mine was also open and I also had a lateral retinaculum repair (I had a previous lateral release 2 years ago), and a patellar chodroplasty.  I stayed in the hospital overnight and was given a hinged knee brace and crutches.  For the first week I was partial weight bearing.  By the end of week 1 and beginning of week two I was no longer using crutches.  Now, I'm allowed to walk around the house without the brace on and when I'm out and about I use the brace that is no open to 120.  

Right now in PT I'm doing mostly open chain exercises (like straight leg raises, quad set, abduction and adduction).  For ROM I do bike but my therapist just told me to slow down because my ROM is 130 when I'm still suppose to be at 90.  I just started on some close chain stuff (leg press, mini squat, theraband).  

Hope this helps.  BTW, are you absolutly sure they will need to do a reconstruction?  Pre-op my doctor warned me that I might need a cadaver graft if my own tissue wasn't good enough but I guess I got lucky and they just repaired it.  

              ~Riosilia

[rangerr18]

Thanks for the info! My surgery was moved up to Monday the 7th, so I'm getting ready for whatever comes my way. Yes, I do need a replacement as there is nothing left to work with, and they are using a cadaver tendon for replacement. Only good part of the open procudure is they will cut along my existing scar!
Will post "post-op" and pass along the events  
Thank you both for your posts

Bill

[daisey]

Bill,
    Wishing you Good Luck and a speedy recovery.  Hope everything goes really well.  Keep us posted on how things are going.

Daisey

[rangerr18]

I am back home and 3 days post-op. My OS ended up using my own tendons rather then cadaver tendons. So far so good. The procudure took about 3 hours and increased my scar to about 10", but he used tape and sub-q stitches, so maybe the scar will be less pronounced then before.
I received an epidural (SP?) along w/ sedation for the operation and they left the epidural in for about 18 hours for pain control. What a GREAT way to go. With my last open operation in '97 I had a general, and pain control was a challange. Not so this time. Between the epidural, IV Motrin and an IV morphine for the first 12 hours, I was pain free. Since I came home, pain control is an issue, but with RICE and Tylonal 3 I am OK.
On the down side, swelling is an issue, but should begin to improve in 7-10 days.
I am full weight bearing in a full leg immobilizer (no ROM while weight bearing), and have about 90 deg ROM while seated. I will remain restricted to no ROM weight bearing for 6-8 weeks until the bones heal were the new tendons are anchored.
All in all I feel pretty optimistic.

Thanks to Daisey and Riosilia for your encouragement

Bill