anyone had PLC surgery?

[roze87]

Hi Kate

thanks so much for your info.Very interesting, and relative, as sounds very similar to what i will be going to have. I am currently waiting on my results for the ct scan to see when the operation (to take the graft from my hip) will be.

Am i right in thinking you have had BOTH surgeries? Or are u are still in rehab for the hip graft? Question...how is your hip? Do you have weakness there as well? Oh i am so pleased to find someone who has had the same surgery, i feel very alone. Also, very pleased to hear how succesful it all seems to be going very well for you, thats great for you, and very encouraging. How is your pain? Does it feel more stable? I hope you have a good physiotherapist? I have had such bad experience with physio's in the past, without trying to sound arrogant, I feel that i am my own expert these days, and will be taking complete control over my own physiotherapy this time.

Well done, best of luck, keep at it,we will get there!

rose

[kpoppy]

Hi Rose-

I did already have both surgeries.  Stage 1, the bone grafting of the tunnels and debridement of scar tissue was in January of this year.  It takes 4-6 months for adequate healing of the bone in the tunnels for the reconstruction.  I had the "reconstruction" surgery ~6 weeks ago.

Hope I can answer as many questions as you may have...  First, the bone graft surgery was not supposed to be too big of a deal.  However, my surgeon ran into a ton of scar tissue/patellar contracture that extended the overall procedure time to ~5 hours.  I was told it was arthrofibrosis but I've been fortunate that the scar tissue has not reformed to that degree.  Anyway, post-operatively, I was restricted to 50% wt bearing for 3 weeks, no brace.  The hip pain was fairly intense initially, mostly with coughing, laughing, and rolling onto that side, but tolerable.  Pretty much all the pain in the hip was gone by 6 wks and is no issue at all.  I was given a functional brace at 6 wks and cleared for all tolerable activity.  I was concerned about not having an ACL, but it turned out, the instability was about the same as what I was used to as my previous ACL had failed anyway.  I actually didn't use the brace as much as I thought I would.

As far as after my reconstruction surgery last month, it's too soon to tell how much more stable my knee feels.  My surgeon seems pleased when he tests it manually.  He has said I have a 90% chance of a successful outcome.  I am hopeful and excited to have a stable knee finally.  Overall, not as much pain as I expected.  I think going into this whole process, I prepared myself that I didn't care how much pain was involved, it was worth it and I was ready...  However, the first week I did have my share of pain medication. But again, it was never unbearable.  I still get some aching and some weird brief pains, but not bad at all.  My biggest issue, I can see, will be controlling the edema (and boredom..!)  I agree with you regarding therapy.  I have been going to my surgeon's center (out of state) periodically since the surgery; his therapist updates my program.  I just work at home on my own and plan to go to a gym eventually.  I guess I have developed a trust issue with local therapists/doctors over the years.  At this point, with my history, I trust only my current surgeon and his team.
 
Let me know if you have any other questions. Take care. 

Kate

[roze87]

Thanks again, really helpful. I have been told my OS is going to use allograft for my recon as my 2 previous ACL autograft has not worked. They took your own graft for your ACL, what about your PLC aswell? Do you think I could go back to office based work after a couple of weeks after (either) surgery? Do you wear your brace permanently, as in bed, shower, exercises etc? How long were you in hospital for? Did you lose any muscle strength to your hip with the initial surgery and/or need physio to your hip to regain its strength? Did they take the hip graft from same the bad leg or the good one? Sorry to bombard you with questions, please do not feel any pressure to answer them, i am just so curious   

Also you mentioned E-stim. DO you think it would be worth me purchasing one, as the NHS over in UK do not provide them, you just have to try and buid the quads with exercise, they are very expensive. But I think it might help...

thanks again, happy recovery

[kpoppy]

Good Morning (or afternoon in UK)-

I certainly don't mind attempting to answer your questions as best as I can. I can empathize completely with your concerns and anxiety as this process affects every aspect of your life (work, financial, social, family, psychosocial...).  Preparation is key.

I think going back to a desk job at 2 wks is possible with the 1st surgery, but unlikely after the 2nd depending on your job duties, flexibility for ice/elevation breaks.  I work on my feet all day.  Depending on what your surgeon finds at the 1st surgery, it could vary widely, but better to prepare for the worst scenario.  Expect 4-6 wks on crutches, possible post-op brace, and restricted wt bearing, then long-term functional brace use.  You will also need to keep up with ice, elevation, rest, good nutrition, and your exercises.  You don't want to jeopardize the healing of the bone grafts; I've met patients that have had the bone grafts in the tunnels fail and their only option became a total knee replacement.  After the reconstruction, I would think maybe more realistic to return to work at ~4 wks after the "maximum protection" phase.  Check your surgeon's protocol.  I've made the regrettable mistake in the past of putting work ahead of my health out of guilt, finances, obligation to coworkers.  This time around (these last 2 surgeries), I took more time off and I will tell you, the rehab has been smoother than ever/no complications.  However, the downside is, I may lose my job this time if off more than 10 weeks, which is probable.  But at this point, I feel like this is my only and last chance to have a functional knee, which is truly priceless.  So, if possible, try to prepare to be off as long as you can afford.

The same side hip (iliac crest) was used.  I did hip exercises (the same ones you do in knee rehab any
 

[kpoppy]

Not sure why I get booted out...

To answer more of your above questions...  Hip strengthening/flexibility is a part of knee rehab anyway, so nothing special needed.  I did not have any "formal" therapy- but diligent home exercise program.  My quads maintained their strength and hip musculature strength returned quickly.  No residual hip weakness noted.  The graft harvesting at the iliac crest should be done without disturbing the muscle attachments.  As far as your question on e-stim to maintain quad function,  I think it is definitely beneficial for quad re-education, but more importantly you want to PREVENT shutting down the quads by good edema control and getting that quad firing as soon after surgery as possible.  It only takes a small amount of fluid in the knee to "shut down" the quads which may take weeks to regain, estim or not.   I did not need e-stim after the 1st surgery, but have used it >3 times per day since the 2nd surgery, and despite having a good contraction, have noticed significant atrophy due to the functional restrictions (brace locked at 10 degrees, and restricted wt bearing 6+ wks).  I know it will bounce back when I am cleared for more effective quad strengthening (hopefully next week).  Fortunately, we don't have national health care (yet) here in the USA, so my insurance did cover the estim unit.  Keep your eye out for a used one?  I think there is a section on this site for equipment.

My 1st surgery was done on an oupatient basis.  The second, an overnight stay.  For the 2nd, I was told to prepare for 2 nights in case of pain management issues, but my pain was managed sufficiently with medications.  I also had a femoral nerve block that lasted ~18 hours.  I am still currently in the long post-op brace- only allowed to take off for exercises, showering, and icing.  Frustrating for sleep.  Soon, when the swelling stays down, will transition to functional brace.

A patellar tendon graft from my other knee was used for my new ACL.  An achilles allograft was used for the posterolateral ligament reconstruction (hyperextension block).  Hope this all is helpful.  Kate

[roze87]

Thanks ever so much you answered my questions so thoroughly. I really feel for you with regards to your work. I definitely went back to work too soon after my revision ACL and i regret that, I know it still would have failed anyway but i still regret that i did not put my health first, as it was a physical job, that i have had to quit entirely now after finally admitting to myself that i was simply not up to the job Also had to drop out of uni as a student nurse and get an office based job. So this is a huge commitment for me and i have realised now that i have to get it right this time and do everything i possibly can to give myself the best chance of getting my life back no matter what. My boyfriend (bless him he's great) will have to pay the rent etc and everything til im better and i have to be selfish about things now. Gutting, when you have no choice but to depend on others and do what your knee tells you eh! I really hope you dont lose your job, but you have the right attitude, your health comes first. There are other jobs out there, but there is not many more options with your knee after this, and if they wont employ you after this then they are not people you want to be working for.

I am very grateful for your honest answers. It is really good to hear some advice from someone other then a medical professional who know what it is really like and who is ahead of me. I am sure i will have many more in time as the date gets closer! Im sorry i dont have any advice or words of reassurance for you but i hope that you have some sort of satisfaction knowing that you have helped me alot. Again, the best of luck with your rehab, soon this will all be over and you will be able to look forward to doing normal things again!

Also I wanted to ask you about how you had this original injury?

Rose

[kpoppy]

I am happy to help.

Nothing exciting about my initial injury.  I was in a co-ed basketball league about 4 years ago, probably in the best shape of my life, (was 32 y.o at the time) and had a simple, noncontact "wobble" injury.  It's hard to believe a 1-time sports injury has lead to these ongoing problems... Soooo important to choose the right doctor from the beginning, isn't it?   I probably should have quit playing years ago, but I don't regret playing at all.  However, I do miss it.  I now enjoy coaching a 10-12 year old girl's basketball team.  My 2 daughters play, so we have a blast.

Did you get your surgery scheduled? 

Take care,
Kate

[fultonius]

Hi Rose,

Sorry I've not been in touch recently, I'm glad to say it's because I've been busy living life and not worrying so much about my knee for a change!

That's me at 4 months post-op and I'm still progressing well and still having no problems (other than my legs reluctance to get past about 130° flexion. I'm up to 5 miles on the bike (outside, going quite quick) and can walk as far as I want without any issues. I've managed a few games of golf and the exercises I'm on from the physio are:

Straight-Leg Deadlifts (to work my hamstrings and glutes. Up to 20kg now.
Squats - Up to 20kg
Single leg plyometrics (basically hopping forward, sideways and backwards on my bad leg)
Various gym ball hamstring and glute exercises.

I went climbing the other day, indoors, for the first time in 7 months. The physio said I could do anything except running. I'm not quite sure if that meant climbing, but I'm pretty in tune with my limits so I don;t see it being an issue. 

A lot of the time now I don't actually think about my knee, whereas for the first 3 moths I couldn't even move without thinking about it!

I'm glad you've finally found a surgeon you think you can trust - it's definitely worth getting all the ops done, but only if you put the work in afterwards! Good luck x

P.S. I took 4 weeks off work, then worked form home for 2 and I still think I went back a bit too soon. Living alone on crutches is hell!

[roze87]

thanks alot fultonius, thats really great you're doing so well, well done and be careful with that knee now!

[leicester84]

Hi there

I am in need of some help, basically i am facing my bigges opeartion to date in a few months its a pcl corner reconstruction with using my left patellia and left thigh muscle also a pcl ligmaent reconstruction and an acl reconstruction at the same time.

It started 12 years ago.

ive had 6 acl reconstructions on right knee
4 carlidge opeartions
also a emergency opearion when a bolt in my leg came lose and came through my shin
i have been having alkl these troubles for the past 12 years having to give up most oy my sporting life and has affected my work life too, i have never really know anyone or spoken to anyone with injuries like mine so if you dont mind it would be good to talk about things and know some bits and bobs.

Russell

email is russell.paterson@btinternet.com

[rugbyhutchy]

i had my acl and plc done in august last year i also had a knee re aligement as it was not joined right

but to give a bit off hope im back playing rugby had 10 games back and its all good, so plenty of hard work and you will get there, but u need to push your self i went to the gym every day either doing weights or on the cyling machines

[bethknvygrl24]

I am currently 6 1/2 weeks post op myself. I just started weight barring last week at 50lbs and this week it is 70lbs.

My profile is that 2 years ago, I ruptured my ACL and tore my medial meniscus playing basketball. Refused surgery because the military isn't all that forgiving on it and decided to do rehab. After a year or so of physical therapy, my surgeon told me that I had over stretched my LCL to the point that the surgery was eminent. I received all donor grafts for the ACL and LCL. The only real pain came from my LCL but now being 6 weeks post op, I have almost no pain in my knee, only when I am doing slow flexing and when I have to straighten it.

When I walk, I am still with crutches but I do feel pretty good. I did have nerve problems from where the PLC incision is. The numbness has not improved much since the surgery. The scares have healed nicely. My surgeon is very pleased with the strength in my ligaments now as before, he could pull my knee out of the socket!

I wish you luck on your surgery and I hope my story has helped some. I'll also try to give you a little update as I never seem to hear or read about this kind of reconstruction!

NAVY GIRL

[hwhitsett]

Kate, I couldn't help but notice you have been through several acl issues and then stated you went to Cincy. Who did you see there? I tore my acl 11 years ago, first reconstruction failed within 6 months, revision lasted about 10 years and it stretched when being hit by a wave at the beach. That was Sept '09. Since that time I had another revision in Oct. '09,  which failed by April '10, we proceeded with staged revision, using bone graft in tunnels. In Nov'10 I had my revision AGAIN,  I'm currently 10 weeks post op and it has officially failed again as well as the microfracture procedure I had done. I have been referred to Cincy and have an appointment in less than a week,  Feb. 8th.  I'm very concerned it maybe PLC issues since I've had so many failures.  I know the surgery is pretty extensive, what about incisions and such? where are they? how big? Right now my knee looks like its been butchered.

[kpoppy]

Hi hwhitsett-

Sorry to hear of your ACL woes.  Hopefully you find an answer to why your grafts have been failing.  I travelled to Dr. Noyes in Cinci and have been nothing but satisfied.   I have been through many doctors and was very anxious about another.  But, Dr. Noyes and his staff erased all those fears.  I'm about 7 months out of my 3rd ACL/PLC reconstruction and I have no instability.

Wish you well,
Kate

[DaVinche14]

Hi Kpoppy

What levels of activity are you at now and how does the knee feel in comparison to the 'normal' one? I had surgery for ACL + PLC 23rd March. It really is amazing how rare it is to meet people in the same boat with the PLC.