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Author Topic: unable to get knee straight after ACL replacement  (Read 4895 times)

Offline campo74

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unable to get knee straight after ACL replacement
« on: February 18, 2011, 05:55:30 AM »
I am three weeks post op from acl replacement and im am no place close to getting me knee straight. I thnk at pt they said im at 15%. I am worried that I will not be able to go back to work in my job as a police officer. Pt and my DOC are telling my it might be stuck for good.

Offline campo74

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Re: unable to get knee straight after ACL replacement
« Reply #1 on: February 18, 2011, 06:44:19 AM »
Has anyone else been in a similar situation

Offline Kaputt_Knee

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Re: unable to get knee straight after ACL replacement
« Reply #2 on: February 18, 2011, 07:50:18 AM »
Three weeks out is not very long, although it may seem like an age at the time.

Depending very much on your surgeon's rehab protocol/regime, will may still have considerable post-operative swelling in and around the joint. This can prevent full extension. Work on gaining this passively by one of two ways, but run both past your handling physiotherapist(s) first.

The first involves you lying on your stomach with your leg hanging off the bed/sofa from the shin downwards. The weight of the over-hanging foot and lower leg is all that is needed to help straighten the leg.

The second is even more passive use of gravity! Simply raise your operated leg and support it under the heel and ankle, leaving the knee completely unsupported. If you combine this with having your leg raised, you can not only passively work on your extension, you can also do ankle pumps to help reduce the swelling.

The swelling is your body's natural reaction to the trauma of the operation. Unfortunately the leg has no mechanism for pumping the fluids produced away from the trauma site, other than walking (the squeezing actions of the contracting and expanding muscles actually squeezes the lymphatic fluids back up the leg into the lymph nodes in the groin where they are re-absorbed by the body. By raising your leg, you are immediately helping; by adding ankle pumps to the equation, you are simulating the natural manner in which they would be taken care of. Think about what happens to your hands if you leave them hanging, without any movement for a prolonged period and how you then counter the ensuing swelling.

Beware of the comfortable cushion/pillow under the knee - it is a false friend  ;D It feels great, but it actually works against the healing process. Believe me I wish I had known that when I had my first ACL reconstruction. I ended up having to have an MUA to break up the scar tissue that had "solidified" in there! so much for comfort  ;)

Be as mobile and pro-active as you can while resting is my best advice: heel slides using a plastic bag are also a neat idea for working on mobility. Too long in one position and the knee will stiffen up even more than usual.

There is an excellent article in the Information Hub which shows you different videos of each of the different exercises at various stages in a typical ACL rehab protocol. HOWEVER, do not try anything until you have OK'ed it with your PT &/or your surgeon. Each and every operation is unique and has it's own peculiarities. Only your handling doctors and therapists know the whole picture for YOU.

Good luck

Sue  ;)
1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline campo74

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Re: unable to get knee straight after ACL replacement
« Reply #3 on: February 18, 2011, 08:49:18 AM »
Thanks they kinda just got me a little freaked out today with the possibly of permanent loss of use talk. They did order a new brace today I thinks it is called a dyna splint. It is supposed to make my knee go straight. Sounds painful

Offline Kaputt_Knee

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Re: unable to get knee straight after ACL replacement
« Reply #4 on: February 18, 2011, 10:10:46 AM »
It's Way too early for that sort of thing!

Where on earth in the world are you?

Get the swelling down and work hard on the passive extension!

Try paying for some real deep tissue massage and some proper Lymph Drainage massage to get the swelling down. A Dyna-Splint is usually used for people who have been diagnosed with and are being treated for Arthrofibrosis. At only 3 weeks out from your operation there is no way on this earth that someone has come up with that diagnosis.

[edited to correct a typpo and to add some information]

Good luck - I'm out of regular contact now for 3 weeks - I hope that you have better news when I'm back online  ;)


Sue  :)
« Last Edit: February 18, 2011, 11:22:08 AM by Kaputt_Knee »
1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline Skiier Jo Jo

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Re: unable to get knee straight after ACL replacement
« Reply #5 on: February 18, 2011, 10:58:06 AM »
My injury is very different from yours, but after 8 weeks my leg won't straighten.  I have to do a lot of work strenthening quads and with my physio pushing down on it and making me scream.  I'll get there in the end but it's goning to take sometime.

In terms of you job, it sounds like it's going to take some time.  Can you get transferred to a back office position for a while?  I know my sister always does when she's pregnant, so that kind of thing is possible in the police.  Also, is there an occupational health PT you can see to get a second opinion?...unless that's who you are already seeing.  Not being able to straighten your leg is pretty major in the long run as you will always have weakness in it and risk falling down strairs, not being able to stand for long, etc.

Sorry to be a bit dramatic, but sounds like you need some help and suggestions.

Skier JoJo

Skiier Jo Jo

Aged 33
Fractured tibial tubercle (plus other bits sloughed off!) and displaced meniscus on 24th Dec 2010
Emergency surgery - Zimmer plate and 10 screws (8 permanent). Straight leg brace
Physio started on day 6. 
Feb 2011 - almost fully straighten leg, with up to 85 degree bend

Offline Lottiefox

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Re: unable to get knee straight after ACL replacement
« Reply #6 on: February 18, 2011, 11:56:57 AM »
Did you have full extension PRIOR to your reconstruction? Kaputt Knee gives really sensible advice for working WITH your leg to regain extension. It does sound a tad early for a Dyna Splint 3 weeks after surgery. How much swelling do you have?

Lottie
Bilateral patella OA since 2009, no surgeries.
Euflexxa working well x3 to current
Right forefoot CRPS post fusion surgery 2011
Refusing to let the ailing parts stop me....

Offline Kimberly 77

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Re: unable to get knee straight after ACL replacement
« Reply #7 on: February 18, 2011, 03:06:23 PM »
I was given a progressive tension splint to help bend and straighten my knee and I am only 4.5 weeks post op. I had chondral defects though. Is it bad to use the braces so soon after surgery? Anyway I feel your fustrations my knee will not bend past 82 with force and it will not starighten past -15 with force. I am in pt 4 days a week and have a electrical stim unit at home and now the brace, I am doing tons of stretches at home and at theraphy and to no avail the knee won't move. Wish I had better advice!
Right leg amputee.
Osteoarthritis in left knee.
Medial femoral condyle defect, arthoscopy 8-2-10
Grade 3 defects, patella, medial femoral condyle, tibia scoped1-12-2011
Physical theraphy and awaiting microfrature 2-1-12

Offline kerrylaser

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Re: unable to get knee straight after ACL replacement
« Reply #8 on: February 18, 2011, 10:20:22 PM »
it takes time.. i am in the same situation.. EXCEPT i havnt had my ACL surgery yet.. my surgeon wants me to have full extension and flexion before he will do the surgery. its been 5 months.. and im getting closer to full flexion.. my bend is my problem. i am almost at 90 degrees.. but not enough for surgery.. its been a long road.. and very tough. i just want this surgery. but he is worried if he does the surgery now i will not get my full range of motion afterwards. any ideas?

how was your range of motion prior to surgery?

Offline campo74

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Re: unable to get knee straight after ACL replacement
« Reply #9 on: June 10, 2011, 02:19:11 AM »
Well im now 5 removed from the surgery and im still not abole to get my knee totally straight. I just worried I will never get it all back.

Offline Kaputt_Knee

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Re: unable to get knee straight after ACL replacement
« Reply #10 on: June 10, 2011, 07:29:18 AM »
At 5 months it is now time to get another opinion.  :(

An inability to get full extension is one indication that the graft is faulty - either placed incorrectly or too tight. This happened to me with my last ACL rupture. The doctor who operated basically made a pig's ear of the job and I had to undergo a full revision.

The OS who operated is not the person to review your knee, nor probably anyone who works with them. If you can go to a completely independent surgeon at another hospital if necessary. I did no tell my second surgeon who had operated on my knee but the guy recognised the "work" - apparently I was not the first revision he had done from that person's work. The first surgeon blamed me for not working at the rehab, but my therapists were actually saying I was working too hard trying to get the extension. As my injury was being dealt with under the German equivalent to Worker's Comp, it was critical that I got good reports.

After the revision I was back skiing within 5.5 months, so don't give up hope now.

Where are you based and how easy is it for you to get to a completely different hospital/surgeon? Don't give up trying to get what is right for your knee, your job and your life!

Sue  ;)
1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee