New ACL with allograft - 1 Dec 2010

[Snowy]

Wow, that's a pretty big difference in the incision size compared to an autograft - I'd say mine is about 4cm, although it's shrunk a bit as it healed.

Glad to hear all continues to go well. Do you have any idea when you'll be able to drive again?

Hope the knee is feeling good after its afternoon of cuffing and elevation.

[lwillson]

Hi Snowy, yes, definitely a teeny weeny hole where they got the drill going...  Guess you needed a bigger hole to allow for a super-large ligament to enable all the mogul-jumping-skiing you have lined up for your new ACL sometime soon-sih    That, and the hamstring raid, and the general surgery stuff of course...  Driving is legitimate for me next Tuesday, thought may sneak a quiet escape trip in before subject to need for a trip to the stores.  First official visit is to the OS, of all destinations, to have the first outpatient visit.

Day 15
Wow, now into week 3.  Doesn't time fly - seems to be moving quicker again now, first 7-10 days were pretty sluggish and seriously dull, but there is the beginnings of life again.  Managed a 4km walk to the next village without complication - walking felt fairly straight and natural, with the odd niggle every so often.

Saw the PT again - general emphasis on calves, bum, and quads to ensure muscle flexibility and a little strength.  General message was to keep things gentle, but get back to normal – treat both legs/knees as equals, go up and down stairs in a balanced manner, just go about life without mentally trying to protect the new knee from any knocks and bumps.  Usual raft of PT exercises, and visiting her on a once-a-week basis.  ROM is hovering around 100 degrees (better in the morning, worse in the evening), and hyperextension just a few degrees off the good knee.  Little bit of VMO action so haven’t completely lost that one just yet.

So…more PT, more patience, and of course one or two mince pies for company

[roo222]

Congrats on the progress! I know what you mean about the first couple weeks going so slowly, the good news that the worst of it is probably over now. Once you can drive and get back to normality, the days wont drag as much, that's certainly how i found it! Im seriously impressed by how far you can walk so soon post op, i wasnt even off my crutches fully until 3 weeks.

Keep it up.
Roo

[lwillson]

Hi Roo - yes, the driving will really help bring a sense of normality again - next Tuesday is the first official outing and I am counting down already.  For some reason, walking has been fairly straightforward and just need to be a little careful not to over do it.

Day 16

Uneventful day.  Nice to have a bit of variety from the PT yesterday to work on.  But I think it is the way of this recovery that each day will be just a few more inches and degrees in the right direction.  Patience....

Next week gets much better - driving, Xmas visits, and of course Xmas day coming up soon 

[lwillson]

Day 17

Plasters finally fell off today and all three holes are fully healed, just scar tissue left behind.  All looks well.  Got the ruler out to measure the holes - 8mm apiece for the arthroscopy tools, and 13mm for the tunnel & screw entrance - absolutely amazed with what modern surgery can achieve through such small entry holes    Can't say I'm too fussed about the scars - already have an 8 inch line with good old fashioned stitches from open knee surgery 20 years ago, so a few more holes is going to make little difference now 

Usual rack of PT today - quads, hamstrings, gluts, calves and stretches.  Hyperextension is almost there, perhaps a few degrees out, and ROM the other way is around 120 degrees or so.  Swelling is starting to really come down, with my knee shape re-emerging from the mists.  All the weeks of sofa rest is helping now.

Off out for dinner & drinks tonight as my wife (Sonia) has finally finished work at long last for the Xmas break.  So I get someone to interact with during the day again, yippee - we have three cats who do their utmost to sleep on me all the time but it's not quite the same thing.

Happy weekend all

Lawrence

[hibiscus_tea]

After reading your post, I got curious and got out my ruler, too. hahaha!  I have 3 holes that are 8mm long or smaller (one of them is 5mm).  I have another one lower down that's about 13mm long.  My friend has this one, too, so we totally match.  Then, I have the one on my knee cap where she threaded the graft through.  That one is 11mm long.  I have a total of 5 small holes.  Is that a lot? My friend says she only has 3 scars, but I wonder if some of hers just "disappeared" (This is the same friend that said she never had a cryo-cuff... but her mom says she did. haha).  2 of my scars looks like it's gonna disappear, which would leave me with 3 visible scars. 

Also, did you have stitches that were visible to the eye? Am I the only one that didn't get stitches that I can see? 

Good to hear that you healed nicely!  Have a great weekend!

[lwillson]

Tea - how many holes???    Kind of curious as to what the one on your knee cap was for.  I had two arthroscopy holes (to the left and right of the knee cap), the main point of assault high on the shin bone, and a teeny weeny "nick" up my thigh which is where the endo button and thread was attached to the femur (lord knows how they got the screwdriver in there - it is absolutely tiny).   The nick will disappear, leaving 3 official scars for the experience. 

I had one stitch running the length of the scar incision which is apparently pulled tighter  if the hole is struggling the close - fortunately the pulling wasn't required...  Other than that, no stitches in sight at all - all the holes were covered in steri-strips and that was it.  Oh, and there are deeper stitches inside the main incision and these apparently dissolve over time. 

Day 18
Argh, it has snowed here (Oxfordshire, England).  We went to the curry house last night in the nearby town and left the car there overnight.  Woke up this morning with snow all around and had to rescue the car – highly nervous walking down the high street towards the car…  Really really didn’t want to hit the deck with my knee up my rear    Anyway, got the car back safe and sound, and now snuggled on the lounge sofa with the fire on, and of course cuff attached too 

Knee seems achy today, guess that’s just the way of it.  Had a look at the incisions – all have scarred up and look fairly sealed to the incompetent eye so perhaps the pool may be in sight sometime soon.  Yay.

[lwillson]

Day 19

Snowed in - well, by english standards anyway (approx 8 inches or 20 cm lying outside).  Plus don't really want to go out and skid across the ice    Got down to minus 9 degrees C last night, hovered at minus 3 or 4 all day.  Same again tomorrow...  Bit annoyed with the weather because I really enjoyed the time and dry paths to go out for a walk and help normality return - now house bound again because of the snow 

Knee swelling is certainly coming down - can sit on a chair and gently bend my knee squite some way back now.  Hyperextension similarly coming along well.  Knee still looks puffy but certainly not the football size it was post-surgery.  More cuffing and perhaps an indoors cocktail night tonight 

[lwillson]

Day 20

Well, big day today, managed to get to London for a festive carol concert in the Albert Hall - helps to make Xmas come more to life and makes the holiday feel, well, more holidayish.  Downside of course is time in the train with the knee at 90 degrees, coupled with a few hours in the stalls in a similar position.  So, back home now with cuff on, knee feels a bit stuff and grumpy, but for the escape trip that is worth it.

There was a plan to visit the OS tomorrow but dates have got confused and it seems to have slipped his diary.  So will meet up again in the new year now.  Oh well, wasn't sure about a 60 min drive in the ice and snow, so perhaps better to be at home after all.

Am noticing the loss in walking time at the moment - got going down the train platform and it was noticeable that knee was out of practice on walking - will seek PT permission to go to a treadmill for 20-30 mins to slow walk at 2-3km per hour to help shake the knee out and keep in walking practice.  Will see her on Wednesday and see what she has to say.

[hibiscus_tea]

FIVE holes!!!! I'll have to ask her what each one was for next time I see her (in 2 weeks). 
The deeper stitches aren't dissolving for me!!! They're starting to "surface". ACK! 

Sitting with the knee at 90 degrees for a long time is harsh!  I hope the cryo-cuff will take care of it!!

It doesn't snow here, so I'm a little jealous! :p 

[lwillson]

Hi Tea, am intrigued as to what all your holes are for.  The idea of stitches surfacing all sounds a bit erm    if you see what I mean.

Day 21 - 3 weeks 
Feeling a bit hassled today - got man flu (god knows from where if I have been locked inside for 3 weeks), went to London yesterday and now knee is aching like blinkin wotsits, and the snow is not melting so cannot walk outside and therefore stuck inside for another day.  Grrrrrrrrr.

Am feeling rather stressed that I have muddled the graft about after yesterday's outing, even though I am sure it's probably tight hamstrings which are causing the murder at the moment. 

So, usual PT drills, leg up properly all day today, lots of RICE, and will try and stop fretting 

Good news (1) ROM is around 130 degrees (2) OS secretary just rang and will be meeting him tomorrow which will help on the worries above (3) three weeks have passed since surgery!!

[lwillson]

Day 22 - into week 4 

Feeling much happier today.  Had a real sulk going yesterday which is not normal behaviour 

Man flu is diminishing and head feels a lot clearer. 

Saw both PT and OS today - both did Lachman & pivot glide shifts to check the graft and all came out well.  Basically, short of tripping and doing something really daft, the graft has enough strength to cope with almost any up and down activity - it is just the wider knee structure can get quite grumpy if over-hassled.

PT went well - basic quad/glut/calve/hamstring exercises are the plan until the 6 week mark.  May be allowed on the exercise bike but no rush.  May also be in the pool early in the new year...  ROM is around 130 degrees.  Hyperextension is nearly there, now hanging weights off my knee to assist gravity a little more...

OS poked and prodded - he is happy with status.  Had an X ray taken to confirm things are where they should be, and all is well.  PT is broken down into four key stages:
•   up to 6 weeks – get surgery hassles out the way, get ROM/hyperextension back, and walk properly
•   then on to 4 months – proprioception (“learn to be a ballerina” said the OS…)
•   then on to 6 months – get the power down big-time
•   then on to 9 months – train towards preferred sport(s)

So feeling much happier
 

[hibiscus_tea]

That's good news that everything came out good with your knee check with the OS!  I won't get checked until January 3rd... hopefully my knee will be as good as yours! 

I'm surprised you're not on the bike yet.  But then again, there doesn't seem to be a universal protocol with anything related to ACL recovery (like how some people get the CPM, brace, crutches, cryo-cuff, and some people don't).  If your ROM is at 130, you'll have no problems once you're on it.

I'll definitely let you know what all the holes were for... I'm very very curious, too.

[lwillson]

Hi Tea - we can compare notes after your OS visit on 3rd jan and see what approach he took to get your graft in.  Am sure you will be fine.  PT is wary of letting me on the bike just yet - mainly because I had a meniscus trim as well and she didn't want to put too much pressure on that just yet.  Am missing cycling since I seem to be padding out and becoming a serious couch potato at the moment 

Day 23

Off to see the in-laws this afternoon as part of the run up to Xmas and I wil be the driver - very excited to be allowed in the car now.

Usual PT. only exception is a new exercise to improve hyperextension - get an old cooking glove (the type with two hand-holes) and drape over the knee, then add two tins of baked beans into each hole (so 4 tins in total, approx 1.8kg), and let both gravity and the tins pull the knee down further.  Doesn't really ache doing this, and is certainly dragging more extension out which must be a good thing.  Makes walking tonnes easier and more natural.

[pinotlover]

Hey Lawrence,

Love the cooking glove idea!!! Hope the recovery is going, well certainly sounds like it is. Just wanted to say hi, not managed to get on here for a while due to shopping and stuff but I am going to update my diary now as have managed to move on a little bit!

Jen