New ACL with allograft - 1 Dec 2010

[sherwooa]

Congrats on the progress so far.  Amazing that you go home with no brace and no crutches, and already have walked so far.  That's great.  I was told to use crutches for the first 3 days (though quite honestly, I felt like I could have ditched the crutches on day 2) and to keep my leg locked in full extension while walking for the first 2 weeks.

Keep up the icing and elevation and the exercises and you'll be flying along in PT!

Cheers, and sorry about the World Cup.

[lwillson]

Snowy, it would certainly seem the allograft gang have an easier time post surgery, all things equal of course!  The actual pain directly related to incisions/bone tunnel seem to be relatively small considering what has actually been done to the poor knee and local structures.  Oddly, I found the original arthroscopy in July harder to cope with from a point of pain (thing he had a good poke and trim everywhere) and with weak quads beforehand found the post op first few days incredibly difficult to move around.  Not quite sure whether to laugh or cry at the term "uncontrolled newbie"!!

Day 6
Not quite sure what to make of today.  On the upside, had another shower, changed the bandages, had a quick peep under the incision steri-strip (tiny hole), and have had leg up properly above the heart.  Usual rounds of SLRs, knee extensions, heel slides, 90-100 deg rom etc.

On the downside, popped two codeine last night after the walkies yesterday and am nervous I overdid it too much and may have damaged something.  Don't think anything significant has happened i.e. stretched the poor little graft, but lots of general aching as a consequence .  Suspect I was simply a little over-enthusiastic too soon and suffering from house boredom so went a little too far outside.  Will get back to being a good boy until Wednesday when I get to see the physio for the first time and see what is "good rehab" at this stage.

General moral of the story - I need to remember this is hard surgery deep inside the knee and recovery time at home in the first few weeks is meant to be gentle and slow.

[hibiscus_tea]

Yea, you probably just overdid it with all that walking.  I'm jealous, though!! hahaha. 

I'm sure your knee is fine.  You should probably just take it a little bit easy, though.

My PT has to keep reminding me that I need to be patient and that ACL reconstruction is major surgery that requires time for healing. 


Your recovery sounds like it's going great otherwise!!

[lwillson]

Hi Tea - thanks for the good words.  Knee feels happier today after doing diddly zero yesterday, except for lots of SLRs and all the other PT stuff.

Day 7 - Week 1!!
Wow, would never believe it.  Today is officially week 1 post surgery    So, one week on, I went out for a special treat - drove (yes, could get in the car safely with 90 degree ROM) into the local town to pick up supplies from the local supermarket.  In itself the act is hardly exciting, but what FREEDOM  Not to be done too often, knee felt a bit stiff after and so back on the couch for the afternoon.

Stopped the codeine again owing to evil effects on ones' bowels.  Or more precisely, no effects    So currently only on the diclofenac for 5 more tablets and then onto nurofen. 

First PT tomorrow, as well as removal of stitches / bandages etc.  There seems to be a strange click in my knee at about 20-30 degrees bend, hopefully not more flappy cartilage in the wrong place.  Fingers crossed...

Knee still very swollen and not going down but this seems to be par for the course.  And one rather psychedelic bruising gently creeping down my shin bone area - thought it was the theatre scrub liquid but suspect it is simply bruising from the various holes and tunnels making itself known.

[pinotlover]

Hey Lawrence, I know exactly what you mean about the bruising! Had a green shin and calf which went yellow/blue/purple and has been slowly working it's way down my leg and I now have a black foot ! can't believe you drove I am going to give it a go tomorrow which will 21 day post op.

Jen

[Snowy]

Oh yes...the rainbow bruising. Here are a couple of memories from this summer:

http://flickr.com/gp/26786061@N00/98tuvh (Entire leg turned deep yellow; look at other leg for contrast)
http://flickr.com/gp/26786061@N00/372u44 (Haematoma draining into foot)

It seems to be a bit of a luck (genetic?) issue whether this is a big problem or not. For Cosmic and I, it was huge; the other folk in the ACLr class of 2010 seem to have had an easier time with it. My PT did a lot of drainage massage to try and speed its movement down my leg up; it worked in that it did clear more quickly, but felt BRUTAL (each time he worked on it, the faster movement was absolutely excruciating.) Honestly don't know whether it's better to try and move things along or just suck it up.

If it helps, I was completely taken aback by how long the swelling took to go down after surgery. I had horrible swelling after the injury, but it resolved relatively quickly. I thought surgery would be the same - hah! When the Tensor bandage came off the knee was bigger than the thigh above it. Two weeks after surgery I still looked worse than most people do the next day:

http://flickr.com/gp/26786061@N00/61xxeX (One week)
http://flickr.com/gp/26786061@N00/5N0e54 (Two weeks)

I still don't have full flexion due to a minor amount of residual swelling, although my PT doesn't think it's a big problem - he says it will get there in the end.

Hope this helps reassure you. Sounds like general capabilities are coming along well.

[lwillson]

Hi Snowy - thanks for the funky pictures. think mine is not quite so bad but will report back in a few weeks time as it develops.  Minor amusement is somewhere during surgery someone took blood from my elbow join area and left a whopping bruide approx 5*5cm in nice dark black in the middle of the elbow skin area - caused more grief there than on my knee!  Looks quite scary.

Day 8
Saw the nurse - bit of a wasted trip really since I was too early to have the stitch (singular!) removed and will have to revisit next Monday.  But it was nice to be poked about by a medical person and checked for progress.  Was given fresh steri strips and plasters, and told to keep my TED on for a while. She felt the swelling was quite large, but given I had a similar reaction post arthoscopy was not overly surprised.

Saw the PT for the first time - bear in mind I have been with her for a few months post athroscopy so we know each other and what my knee likes and doesn't like.
She saw the knee – officially at 90 deg ROM which is good for week one.  Swelling was confirmed as OK, with lots of massage coming up to get that down.  Bit short on hyperextension so various things to get that sorted.  Good news – allowed out for 1-2 short walks a day (500m or so), need to try the staircase with both legs, and simple treat each leg as an equal and stop trying to get up and down on the good leg only.  Bad news – the long walk earlier in the week was a bit too far and PT wasn’t overly impressed, so punishment duly taken…

[hibiscus_tea]

Glad you got to see the nurse and PT.     and glad you got some instructions about what you can and shouldn't do. 

I had only minor bruising.  A bruise the size of my knee cap appeared on my shin about a week after the surgery and I had a TINY bruise behind the knee.  It went away pretty quickly, too.  Now if only my incision would heal... :/ 

I'm still swollen a little bit.  It went down a lot initially and then came back last week (which is probably from the infection or the allergic reaction I'm having).  It's starting to go down again. phew.

Ah, the adventures of the post-op knee.  :p

[lwillson]

Hi Tea - seems like you got away quite lightly on the brusising front which is really good.  Trust you reaction to the steri-strips is slowly sorting itself out as well.

Day 9
Little to add today - uneventful.  Usual PT, and a slow but happy walk to the post box to get some fresh air and remind myself how to walk.  Bruising is drifting gently down my shin, not too wild in colour but a little delicate to the touch.  Strange tingling sensations up and down my leg last night - not painful, just "odd".  And gentling going up the staircase on the new ACL leg - can't call it the "duff" leg any more    Perhaps the "new" knee needs a name?

[lwillson]

Day 10

Another mini-milestone today - officially into double digits on number of days post-surgery    So at 30 days per month, and 9 months, that means I am 10 days down and 260 days to go (1/27 complete).

Latter end of this week has been a bit of a nightmare - I volunteered to do a little work whilst lying on my back with my legup ('tis possible).  Got embroiled in some messy bid and have ended up picking up the pieces from all and sundry.  So...good news...time has flown.  Bad news, not sure if this is good for mental stability whilst convalescing??  Anyway, week has zoomed by.

Additional milestone - got to Pizza Express last night - first trip outside to dinner in 12 days.  Yippeeee.

On the knee front - seems like swelling might be doing down a little, but calf muscle feels like it is cramping up all the time - wonder if this is the bloodh/fluids leaking down the calf?  Went out for a brief walk today, knee felt a little more tender - PT commented that as the swelling goes down, the pain might go up a bit.  Anyone else found this? 

And got a full night's sleep last night for the first time since surgery.  Went to bad at 11, woke up at 9am this morning without disruption.  Must be getting better.

Have a good weekend all,

Now got Flashdance playing on telly, dated film but some very funky dance routines.  Now could I do that???

Lawrence

[lwillson]

Day 11
Little extra to report.  Did the 2.5km walk to the other side of village again - found the area where OS trimmed the meniscus seems to be the most troublesome, but in the scheme of things everything was working almost fine - still struggling to get the final bit of extension which makes walking that much more natural.  But walking feels far more solid than pre-surgery where the foot/lower leg seemed to be shaking all over the place, so surely progress,

ROM seems to be shifting towards 100 degrees more reliably - 90 is very achievable, and 100 starts to feel a bit achy.

Taking both points, this would suggest the swelling is (very) slowly starting to come down and whatever "feeds" the swelling has perhaps stopped and now is the time for the body to gently start absorbing all the gunk and fluid in the joint.  At least it doesn't feel like I have a lump of lead attached to my knee when I move around.

No particular pain to report and long since off the painkillers.  Still on the NSAIDs to help with swelling, but not from a pain perspective.

So all in all this is progress.  And it's nearly the end of week 2, hooray.

[lwillson]

Day 12

Went for my favorite walk up the road to the railway bridge where knee seems happier with the idea now.  Also, ROM is certainly improving as well as holding out as the day wears on, so probably around the 100 degrees or so.  Presume swelling must be every so slowly coming down.  Usual slaving away on cuffing and PT exercises.  Have disbanded the tasty stocking today as was hindering motion - really nice to be rid of it! 

Big trip tomorrow - 10 mins with the nurse to get stitch out and have another peep under the steri-strips.  May bump into OS and say hello.

Oh, small note on driving - in the UK, car insurance will only cover driving after 3 weeks for RHS knees.  Confirmation from the OS yesterday, and it is to do with reaction times post surgery (not ROM!).  So the count down to  Tues 21st Dec is underway...  (fyi, LHS is good after a week, when ROM returns, and when off the painkillers)

[lwillson]

Day 13

Well, the end of week 2 is nearly in sight.  Wouldn't have believed this two weeks ago, but here we are.  I wouldn't say that time flies...  I think the biggest frustration is now the lack of driving and the whole house-bound thing with my leg-up is starting to get a bit dull.  One week to go and I am officially free to drive    Kind of ironic the first legitimate drive will be to see the OS.

May have to solicit a little more work from my employer to help while away the hours.  Certainly worked last week, if a little hassling at times.

Usual PT....VMO side of quads seems reasonably strong and well-defined which is a pleasant surprise, quads in general are active, and going up a staircase is quite do-able.  Going down stairs remains banished by PT.  Sleeping is now normal.  Went for 2.5km walk and cam back fine - will consider stretching the distance out a little further, perhaps another 500-1000m.  So from a strength perspective, for just under two weeks, this feels pretty good.

Knee plasters are leaking ever so slightly - little dark read patch on the calf incision and with one of the athroscopy holes.  Hope all is well under there.

Didn't get to the nurse today, will go tomorrow instead.  Sounds like an escape outing in the making 

[lwillson]

Day 14
Two weeks have passed post-op    Wow, finally feels like the operation date is fading into history, and the reality of daily life is starting to return.  Really missing driving as we live in a little village and it is impossible to do anything of interest if (1) walking is restricted (2) driving is banned and (3) public transport is pants.  Otherwise I'd be off to the coffee shop in a shot.  Ah well.

On the upside, visited the nurse today.  About an hour in the local train service and an escape trip near Windsor Castle so all in all quite nice to be out.  Had 5 mins with nurse.  One arthro hole is now down to a fabric plaster to help the hole dry out a bit more; the other two are still a little "wet" (not in a negative way) and need a little more time to close up fully - they are nearly there, perhaps a few more days, and then should start to dry and scab up properly.  Holes are teeny weeny - even the calf incision is only about 1.5cm long  Walked from the train station to the surgery (approx 1.3km each way) without issue - gait seems reasonably balanced and certainly more stable that pre-surgery - even had a cup of coffee whilst waiting for the train.  Noticed knee doesn't like being down for too long - train seats, dinner tables etc and the knee gets a little stiff quite quickly - so a long afternoon of cuffing and knee up is in order.

[hibiscus_tea]

Good to hear that the incisions are healing nicely.
My knee doesn't like it when I keep it down for too long, either.  I try to keep it up as much as I can, but there are situations where the leg just has to be down... and I can definitely tell the difference. 

Have fun "cuffing".