Jessica's TTO and MPFL 1/25/11

[JessicaO]

Wow you are waiting till summer 2012!!!? Girl im getting my left one way before that!!

When were you able to drive? I am hoping i can drive 6 weeks post op. Bent my knee is 75 degrees at PT yesterday. Didnt even hurt that much!

Got the ultra sound today and no blood clot. So hopefully this foot pain subsides soon! Off the pain meds for a fews days now and still getting crazy night sweats! I was in sooooooo much pain this morning probably from tousing and turning all night my mom wanted to give me pain meds and i refused. i am off those forever!! (I hope) i rather be in pain than have these night sweats. they are truly killing me.

OK so has anyone gotten their screws removed? If not, can anyone kneel with them in? i know i shouldnt be worrying bout that now...but i am!

[nmf3]

Once I had gotten off the pain meds most of the way sometimes I would take half....you might trrryyyy that!! I know you do not want to but I found at least taking them at night was very beneficial bc of the disrupted sleep and God knows what we do to our knee in the middle of the night. 

I already wrote you an email asking about this...I should of read here first...THANK GOD there is no blood clot!! I am so relieved to hear that.  I think that was my biggest fear.  I just knew I was going to get one and it would go to my lungs and I would die bc of my damn knee! hahaha lol

I am glad you asked about the knee screws and kneeling.  Like I told you in my email the other day, when I "attempt" to kneel (using some weight but not all) it feels weird.  There is still quite a bit of nerve displacement around my incision and therefore a lot of numbness so it feels all squishy and dead feeling...if that makes any sense.  I guess only time will tell!!!

[JessicaO]

Post Op Day 25

Hey everyone, post op day 25, damn! Cant wait to get off these damn crutches. Still experiencing that weird foot numbness, tingling needle feeling in my foot. It gets worse in the middle of the night and I dont sleep much. If it wasnt for this foot i would be feeling really great. I havent heard from anyone that experience this same problem unfortunately. ....Anyone???

Other than that, two days ago at therapy she got me to 85 degrees.

My exercises i do at therapy are pretty simple...heel slides, SLR's, straight leg raises to the side, and then when i lay on my stomach, kinda like a backwards SLR. Alot of ankle exercises with have significantly helped with my ankle tightness. Then the PT pretty much just rubs on my knee and foot for a while and bends it too. then i get ice and done. Hopefully this is sufficient for my recovery. Im by no means sore by the end of it...which kinda worried me. But i guess i will talk to my doc about that when i go see him in a few weeks.

Im STILL experiencing night sweats! ugh its so annoying and uncomfortable. sheets and clothes soaked. it really sucks. im not even on pain meds anymore either.

other than that im doing great. minimum pain on the knee. hoping after my next doctor visit ill be ok'ed to drive and walk?!

I feel like a loser having my mom drive me around and i hate walking around bringing attention to myself on these crutches.

[mermaids]

For the first few weeks, PT was very slow for me.  As my team put it.... you have a broken bone that has to heal before you get to aggressive with the PT. Did you have your right or left knee done?  If it is the right, driving could be a while.  When I broke my right foot, I was told your leg (foot) needs to be strong enough to stomp on the break quickly and forcefully in case you need to stop suddenly.  If it is your left leg and you don't drive a stick shift, you should be good to go as soon as you can physically get behind the wheel and are no longer on pain meds during the day.  I drove within a week of my surgery. 

[Runner1993]

Hi JessicaO, just stopping in to see how things are going. Did your PA ever email you back about any ROM limitations you have?

Your ROM is great! Does it cause a lot of pain and take a lot of pushing to get to 85 or is it fairly easy?

I don't have any foot numbness; I hope that is getting better for you. Are you taking Lyrica still? I was on it for a few months to see if I could help my chronic pain after my first surgery as we thought it might be nerve related or RSD, but once the instability became worse, I knew that was the problem. I didn't see improvement with Lyrica for my knee pain and it was very costly even with insurance so I stopped it, make sure to wean off though, I'm sure your doctor will guide you off it when it is time.

[JessicaO]

Hey Runner,
Yes my limitations are the physical therapist is only allowed to push me to 90 degrees. im not even sure until when. i think probably until i go back to the doctor on March 3rd. When she pushes my knee it just feels like a stretch to get it to 85 degrees. They dont push it enough to hurt it.

Today it was still at 85 though I am still taking the lyrica but my pain in my foot still hasnt subsided. today in therapy she was really like massaging my foot and trying to desensitize it so that helped. right now my foot doesnt really bother me.

How are you doing?

[JessicaO]

Post Op 5 weeks

Went to the doctor today. They gave me a smaller brace that will fit under my pants. I am now allowed to put 100 percent weight on my leg. I think everything is healing great but my doctor said the MPFL takes 12 weeks to heal fully. So i have to be careful till then. I went to PT later in the day, and i walked around with one crutch. I even tried walking a little without the crutches. I looked like frankenstein but overall im pretty sure it was a success! I told my mom and she flipped. she like noooo dont do that! and im like oK?

Anyways, ive been getting to 90 degrees since last week. got to 92 degrees today. Overall i dont think im allowed to do much strengthening yet. but at least i will soon be off those damn crutches.

Also still experiencing that damn foot / nerve pain. eventually it will go away i am told.

Hopefully im not doing any damage to my knee because i toss and turn at night like its my job. also slept on my stomach a few times!

[cdubb]

Hey Jessica,
Popping in on your thread since I see you have one posted.  Hang in there with the nerve pain...it will subside.  At 17 weeks, mine is still there, but very negligible.  Crazy we both have the same doc and that we both have the same nerve issues in the foot/ankle post op....

Walking without crutches takes time. I was given the okay to fully weight bear at 6 weeks and then work on ditching the crutches over the next 2 weeks...I tend to rush, so I was done in about 5 days.   I still walked very slowly for awhile, but by 8 weeks post op, I walked much better and at 10 weeks post op, I had to travel for work and managed the airports just fine. 

[mermaids]

Jessica,
Sounds like you are doing great for 5 weeks!  You do sort of have to learn to walk again.  I concentrated very hard on not limping, tried to have a normal gait, even it meant walking more slowly.  Loved the line "toss and turn at night like its my job."    I doubt you are doing any damage at night. 

[JessicaO]

SIX WEEKS POST OP

So here I am six weeks post op! Today at PT I bent my knee to 98 degrees. It hurt a bit but definitely not that bad. My doc told them to not push me too hard and only as tolerated. I assume this is because of the MPFL reconstruction. Started walking on the treadmill at 1.5 miles per hour for about 7 minutes. Could have done a lot more. The only thing that is bothering me is my foot. This is because i am still having the nerve issues. Also my ankle is so tight and weak. The dorsiflection is still bad.

Then i did an exercise where i step up on a step. that was pretty easy for me. I did 30 of them. then i tried to sit on the bike but my knee doesnt bend enough to make it all the way around. so i just used it to stretch my knee.

So ive been walking around without the crutches too. In the morning my leg is so stiff though. it really hurts to walk. my calf and tendon in my foot is so tight. Sorta walk with a bit of a limp. not too bad though. im a lot further than i thought i would be at 6 weeks post op. im dying to find out if this surgery worked...because i really dont want to go through this again but i really want to get my other knee done too. its awesome to see my knee and improved knee not completely pop out of place when i straighten it and bend it. its kind of amazing it you ask me. my doc said he had an extremely hard time getting it to start in there and he had to keep tightening it. hes very worried about the MPFL and said he wont worry as much when its 12 weeks post op.

Hopefully im not pushing myself too far and not damaging anything

[Pieter]

Hiya Jessica!

To be honest, I think you are doing awesome. Too bad about that the nervesissue is still there, I did some readin on it and some other had it too - went away between the 3- and 5 month post op period. Most people are scheduled to ride bikes in week 8 post op so you're doing pretty well on that matter too.

I guess -besides the sitting alone in the beginning - the hardest part about this revalidation is living with the fear that we are damaging our knees. Also the fact that, when it goes terribly bad, it will come without any warning. But the only thing we can do, and should is trust our doctors. Can also confirm that it takes 12 weeks to make the MPFL heal perfectly, I marked that date in my diary .

I'm proud of you for hanging in so strong, keep it up you're doing great!

[cdubb]

congrats on hitting 6 weeks! You sound like you're doing really well!  That's great you're walking (even with a limp) crutchless.  My limp slowly faded over about 2 weeks. 

Hang in there with the nerve issues.  I still at 18 weeks have some very slight residual symptoms.  At 12 weeks, they were about where they are still at.  Be forewarned...they'll probably increase when you return to your normal activities for a bit. I found that mine did.  They really flared up big time when I returned to work because my foot was down much of the day and my swelling increased in my ankle a lot and I had a total cankle.  Weeks 5-8 were kind of rough with nerve issues.

I'm glad I didn't have the MPFL reconstruction since I never dislocated at all,so my MPFL is perfectly fine,  but having the patella ACI really slows up everything.  How was your cartilage at the time of your surgery? Knowing the doc you're with (since he's mine too)....he'd be all over any cartilage restoration if you had any issues with it....

[JessicaO]

CDUBB: well i have grade four arthritis since the age of 14 (Probably from the hundreds of dislocations i experienced with both my knees) and this is my third surgery on this knee. I asked about the cartilage and he said unless i have a problem with pain then he doesnt want to do it....

He didnt tell me about what he saw in there or what..guess i should have asked more about it. He didnt even want to really talk about it so i guess i just dropped it. I would think i do have damage considering all the trauma this knee has gone through. What kind of activities can you engage in right now 18 weeks post op?

[lisa424]

I've had 100+ subluxations also. I was lucky to have no cartilage damage!

[cdubb]

Jessica,
My PT protocol is still pretty restricted.  It wasn't until 12 weeks that I was allowed any sort of step ups.  I do 4 inch box step ups and 2 inch step downs and dips.  I was doing swiss ball squats, but they were extremely painful under the kneecap (both knee since I have bilateral grade 4 defects, but you can only do one knee at a time with an ACI/AMZ).  I backed off those.  A lot of people on the ACI boards were kind of surprised that my PT had me doing them.  Some docs that do a lot of ACI do not allow squats of any kind (even the 1/2 swiss ball kind) until 9 months post op.  I am allowed closed chain as tolerated and no open chain (short arc/long arc quads).  So, a lot of what I do is more balance and proprioception activities and now I'm progressing to one legged on a dynamic surface (blue foam mat).

Ask for your op note or if they took any pics.  I have my op note and some pics that one of his PA's e-mailed me.  I know I was told that they only take pics of the cartilage defects pre graft and then with the patch sewn on because I wanted more of the TT.  If you can handle op photos, I can e-mail them to you.  One of them shows the osteotomy cut with my patella fliipped upside down and the cartilage damage and the other one is with the ACI patch sewn on just before closure.

Lisa...crazy to have no cartilage damage..you're super lucky!!  I on the other hand have never dislocated and have had grade 4 damage down to subchonral bone with spurring just from maltracking.... weird how that happens.