Situation IS getting better:)

[emergRN]

 Hi All,
I am really in need of some advice from others who have had trouble after ACLr with hamstring autograft.  I am now 3 months post op, and have been experiencing quite a bit of medial knee pain with joint line tenderness.  I had an MRI pre op which did not identify any meniscus tears, and I had a 2nd MRI Oct. 25th, which was negative as well.  I have a persistent joint effusion, which my OS does not think is infectious.  I have been on NSAIDS longer than I have off of them since I had this done, and now my physio has been reduced because of pain issues.  I had a steroid injection in my knee last week, which did not help.  My OS is now booking me for another arthroscopy.  I have brought us the possiblity of plica syndrome, as my symptoms seem to fit this better than anything else I can find(right down to the annoying click), but he really doesn't think that that is the issue.  He is a wonderful surgeon, and has been very up front and honest about the fact that he is unsure of what the problem is.  His best guess is a medial meniscus tear according to my symptoms.  I am getting highly frustrated with all of this.  HELP!  Oh, and tibial incision is very inflamed and scaly.  I thought I had a reaction to the vit e oil, but that was over a month ago, and there is no drainage.  Can you have a reaction to the bioabsorbable screw??  There is too much going on here.  I didn't anticipate all of this.  I thought I would be jogging this week

emerg RN

[tez27]

The symptoms you describe sounds pretty much like mine I am 4 months post aclr with hamstring as well and have been having medial pain and joint line tenderness but only for the last few weeks, before that things were going ok I  had some swelling and pain but nothing like as bad as it feels now, I stand all day at work [hairdresser] and find by the end of the day I have a lot of pain I am still taking the tramadol I was on after surgery. I went to see my P.T last night and he thinks the problem is pateller femoral syndrom, has that been mentioned to you? he has given me some excersises to do that target the vmo and we will see if that helps, if not I shall go back to see my surgeon and take it from there.
I hope things improve for you and if you come across any answers please pass them on to me.
Take care Tez   

[emergRN]

PFS did come up, but he thought that my pain would be more anterior if that was the case.  I am having a difficult time building up my VMO, but the pain I am having is keeping me from increasing my resistance exercises.  It really hurts when they put valgus stress on my joint.  Oh my!  I have never taken so many meds in my life.  This really sucks!!

[tez27]

This does indeed suck sorry for being a bit dense but what is valgus just trying to get as much info as possible about what could be going on with me, I know when I put any inward pressure on my knee it hurts a lot so wondered if its the same thing, like for instance if I stand with my feet together and put any pressure even slightly on my heels moving my knee inwards it get very painfull, sorry I feel as if you have come on asking for some ideas of what is going on with your knee and you get me giving you 20 questions about what could be going on with my knee but its 3.44am and I yet again cant sleep and am getting a bit frustrated with this whole thing.
Take care Tez

[emergRN]

Tez..you have probably googled "valgus" by now if you are anything like me.  How can I explain..Say the doc puts pressure on your thigh above your knee pushing toward your body, but pressure is applied to the opposite direction on your lower leg.  I feel pain right in my medial joint space with this motion..UGH!  Do you have a joint effusion as well?  I guess I won't have any answers until Dec. 20th, and I really hope I get some then.  If the scope comes up "normal", I still won't have a cause or a treatment for that matter.  It is pretty bad when you want them to find something, so they can hopefully fix what is causing the pain. I feel your frustration.  I too was awake at 0400h, and had to get up to go to work all day.  I am dreaming about pain when I am asleep. Keep me in the loop if you find out what your problem is, and if you find some resolution to your pain issues.  What country are you in??  Oh I just realized that I picked a really stupid screen name.  I will just initial!

W

[Lottiefox]

Hiya

When you originally damaged your ACL did you do anything else as far as you know? Meniscus, bone bruising, cartilage (articular type) brusing/damage at all? 3 months isn't *long* after ACLr but I'd expect things to be moving upwards rather than static or even regressing as you say......a persistant effusion could mean that your joint space is compromised and things just pinch and hurt with certain actions...do you have any locking or catching at all? I think it is good news that the MRI in October didn't show anything although they don't always spot all things...as Tez can testify when it missed her ACL rupture! Have they actually checked that there isn't an infection in the knee? One of the other ACLr-ers on here (Ouch09) had a sudden swelling and pain increase a few weeks after ACLr and went through various tests etc for infections etc, but things did settle. Are you able to just spend a few days icing, doing basic quad work and trying to elevate to see if things improve?

I'm not an ACL person but I hang around there somehow by default back from 12 months ago.....as they are a friendly bunch  ...pop down to the Cruciate section and you may find someone else recognises what you've got going on.

Good luck and hope things improve

Lottie 

[emergRN]

Hi Lottiefox,

I have seen you on here quite a bit.  I had a chronic ACL tear for a very long time.  I was initially diagnosed with an arthroscopy.  I finally had a job where I wasn't on my feet all of the time, and could actually have this done without missing months from work.  I did not have any meniscus damage amazingly.  I did twist my knee while grocery shopping about three weeks after I had the surgery, and probably didn't have enough quad control to be off my crutches.  My surgeon said that most people are off of them by 2 weeks post op, so i was going to be off of them in two weeks no matter what.  It probably wasn't the brightest thing I have ever done.  I actually iced my knee quite a bit.  I have pretty much stopped my entire exercise program except for my physio, which I still attend 3x week.  I saw my OS last week, and was told I was going to have an arthrocentesis and blood work, but when I got there, he ended up giving me a steriod injection instead.  I don't have the hot, red, swollen joint usually associated with a septic knee, and I can walk on it.  I think the pain would be much worse if that were the case.  I cannot take any more time off work until I get the scope done AGAIN!  I feel like I am on a big rant about all of this, but I think all of my friends are sick of hearing about it.  I am so glad to have somewhere to talk about all of this.  I am thankful for all and any input.  I will check out the cruciate section.  I didn't really even know that was on here!  Oh, and you asked if they found anything else.  When I had my ACLr performed, he found grade 1(mild) chondromalicia(excuse spelling).  He did have to shave this down, but that was on the lateral aspect of the joint.  I do feel an ache there sometimes, but nothing like the medial pain that I am having.  My OS is concerned enough to book me for another scope.  He said the pain I am having is not normal in his experience.  Merry Christmas to me    Dec 20th here means snow and ice..ugh!

[tez27]

Hiya W thanks for the info re the valgus tests, and yes I felt the exact same pain when my physio did that the other night, the thing that worries me is the pain I am having now is very like the pain I had for the 2 years since my acl rupture and up untill my aclr in July, I am now starting to wonder if something was missed when I had my initial scope in Jan and also when I had my aclr, possible because when I had the scope in Jan the acl rupture was found and that was then diagnosed as my only problem apart from some wear and tear of the cartiledge, but I continued to have a lot of medial pain throughout the time befor the reconstruction 6 months later, and even though I was told by 2 different O.S's and a few different physios that the pain I was experiencing was pretty unusual for an acl rupture,
Sorry I know I am having bit of a rant but I am feeling pretty frustrated about it all, and like you feel my friends and family must be fed up of my knee woes, I just want a knee that is painfree, that I can use to walk the dog and stand in work all day
I really hope for your sake your o.s finds a problem that is fixable when you have your scope, and even though it means being laid up over christmas it will be worth it to find a solution to your knee woes.
Oh yes nearly forgot I am in Scotland so am dealing with the wonderfull NHS
Take care Tez

[emergRN]

Hi Tez27,
Gee, I have to say that our stories sound amazingly similar.  I too had some medial pain with that maneuver prior to this being fixed, but not as bad as now.  When I had my consultation pre op, my OS was pretty sure I had a meniscal tear, but alas the MRI didn't show it.  Well, I found out today that my arthroscopy is now going to be on Dec. 23rd.  It just keeps getting better.  On a good note, I had to go back on NSAIDS two weeks ago, and decided to try Arthotec(same ingredient as voltaren), but it did not work.  I got switched back to Naproxen 550 twice a day, and today was not so bad.  I had to stand up to do a presentation at work, and had to sit down half way through it.  That was a little rough.  Are you taking any anti inflammatories??  I will certainly keep you in the loop on what I find out, or for that matter don't find out.  I just hope my OS doesn't think that I am a nut job!!  BTW..I am in Canada.  I have been to Scotland a couple of times....LOVE the place and the people!

[tez27]

Oh poor you having your scope on the 23rd I really hope it dosn't spoil your christmas, at least you will have an excuse to sit on your butt and do nothing while everyone runs round after you
At the moment I am taking Tramadol, Ibuprofen and Paracetamol as needed, the ibupfrofen being the anti inflamatory, I was on Declofenic a while ago before the surgery but really didn't think it was much good. One of the problems I have is that my O.S discharged me at 3 months post op because I had no more instability and full flex and extension in my knee so in his eyes his job was done, so I would have to get re referred to see him again, which is why I am praying that my physio can help me at the moment, but I may try to see my G.P and see if there is anything he can do to help for now re the pain meds.
I am sure yout O.S dosn't think your a nut job he must think there is a problem or he wouldnt be doing another scope.
Poor you having to sit down during your presentation, I am starting to get worried about how my knee will cope with the busy period we are starting at work, 9 hours a day 5 days a week with no lunch hours or tea breaks so it is a solid 9 hour standing for the 4 weeks running up to christmas.
Where abouts in Scotland have you visited?
Take care Tez   

   

[emergRN]

Hi Tez27,
Well, I have only been to Edinburgh and surrounding area.  I used to go there to visit a nursing friend who used to work here.  She is from Scotland.  I have had the most fun I have ever had there.  Crazy fun!!  The diclofenac is the same drug that I mentioned when I said Arthrotec.  It did not work for me either.  Ibuprofen is a great drug, but you have to take it too often.  The Naproxen Sodium I mentioned only has to be taken twice a day.  Gee, they discharged you awfully soon.  I have a regular f/u appt in January.  That would put me at the 4 month mark.  I thought they were supposed to follow you for at least 6 months, as to determine if you are fit to return to some sports..ie downhill skiing.  I know that I cannot go skiing until at least March 1st, and then I will have to be cleared.  I think you should get referred again.  If it is anything like here, you may have to wait awhile for your appt, so at least if you get the referral, you have the ball rolling.  Well, I found a friend who is willing to do the trip for the scope with me, so it isn't that bad.  The only bad part is that Dec. 23rd is an all out party night here, and won't be able to partake because of the general anaesthesia.  Oh well!  I feel for you having to stand up for 9 hours a day.  If I were still doing 12 hour shifts in ER, I would not be back to work yet!  I guess your good leg will take the brunt of that.  Try to take your breaks or you won't be doing yourself any favours.  Well, I am off to a birthday party..I hope I don't get silly and think I can dance or something.  I would definitely pay for that tomorrow.  Let me know how your long days go.  Take care and remember to look after yourself, so you don't end up off work all together.

W

[Rknees4]

EmergRN
Hey another Crazy Canuck.
Sorry to hear you have to have another scope.  That is a drag!! especiallyso close to Christmas.
Hope they can fix the problem without too much more messing around in an already kneegeekish knee.
Take Care,
Rknees from ON

[emergRN]

Rknees,

I am in NL!  Well, I narrowly missed catastrophe last night.  I was on my friend's patio, and didn't realize that it was two levels.  Walked right out into thin air, and down I went.  I was just like the roadrunner going off the cliff!  Thankfully, I came down on my left leg.  Well, I guess I will be limiting the cheer until this is all settled down.  I have to say that the knee is not happy with it's owner this morning!!

W

[Rknees4]

EmergRN
You do not want to be visiting where you work that way.  Glad you didn't totally kill yourself.
Teach you to party hardy.
Well if you made it worse at least it won't be long and someone will be having a peek inside.
Hang in there erRN only place to go is up.
Me I ran around all day and paying the price once more.  The left knee is getting worse by the day.
I am almost to the point where Feb can't come soon enough.
Take Care,
Rknees4

[emergRN]

Hi Again,
Had a crappy Monday and Tuesday.  Resorted to the T3's last night.  I went back to see my private physio today, as I knew there must be some option for pain control besides narcotics.  She did a brief assessment on my knee, and feels that it is very "meniscus tearish".  She did a massage treatment for the swelling, and then did a 30 minute compression therapy.  MAGIC!!  I did a big sigh when it was done.  I think I may actually get more than 2 hours sleep tonight.  Going for a full knee assessment in the AM.  I will still keep doing my hospital based physio though, as that is free.  Never under estimate the value of a good PT

EmergRN