Jessica patella cartilage lesion story - De novo surgery pending

[Jwin138]

hmm.. not sure how to move this over to the post op diary section? help?

A little over 2 weeks post op now and doing better every few days.
- the nausea and headaches seem to be gone, as well as the blood rushes when getting up from bed.
- I used to have nightmares about accidentally bending my knee too far and damaging the work, but now i have moved on to dreams of walking on 2 feet instead of my crutches again.
- the pain in the medial side of the knee which plauged me daily... seems to have subsided. The knee doesnt really hurt that much anymore just feels sore
- i have a visiting nurse come by once a week (2x so far) to check out my incision and take temp and such,. and a visiting PT guy come by 2 x a week and we do butt squeezes, SLRs! yes i can do them! hip work and practice using my 15 steps down to the door and 15 other steps down to the sidewalk using the bannisters. Its nice to have him for 3 more vistis and will start to do outpatient PT after those expire
- i am using the CPM 6-8 hours a day to 30 degrees. as per my docs protocol I will start to increase once i hit week 3
-I go back for my recheck in 3 weeks
- I just started working from home 2 days ago and that is a little more difficult than i thought. Just tryinig to find a comfy place to type and think and take phone calls - while cpming or icing or elevating.
- the knee is still swollen and the scar is too long for my liking, BUT if it gives me a healthy happy knee I am all for it.
thats it for now.. hope all are well

[Jwin138]

a little over 3 weeks post op -
-the medial side (where it hurt before surgery) seems to have that dull ache back- which makes me a bit sad. When i tell ppl my concerns they reassure me that it is still early in the game. but it is disheartening.
-still doing light PT 3x a week -
-CPM set to 30degrees 6-8 hours a day until next week where protocol says to increase 5-10degrees a day. i thought week 3 started after  surgery, but turns out week 3 is after the first post op visit. confusing i know!
- 2nd post op visit is 3.26
- I measured my scar... a tough 7.5-8inches long. ok maybe it is 8 but 7.5 makes me feel better. it is healing nice and thin
- fighiting some defeated feelings.. just spend 23/24 hours of the day sitting on my butt - either CPMing, Icing, Elevating and working...I went out into the yard yesterday to watch my BF play with the dog.. on the way back up i stumbled and landed on the surgery leg for a second. a quick shock ran thru my leg - but i think HOPE I will be ok!

i dont know if anyone is reading this! caw caw! hope all are having a good knee day.

[scmba]

Hi Jessica

Thanks for your updates, they are very useful and informative as I'm on a similar recovery timeline (at day 21 tomorrow for patella DeNovo also).  I guess that means I'm entering  the start of week 4.  My protocol says to get to 90 degrees by week 3.  I'm assuming that means by the end of week 3.  I'm at 75; not concerned because following a hybrid protocol which is a bit more conservative.  My biggest fear is to sheer the graft off from the CPM, but most people tell me that is unlikely.  I'm guessing the CPM is more for cartilage stimulation instead of ROM.  Just don't know what it feels like if I did sheer the graft off- like would there be constant pain?

I get weird pains all over the place.  The entire knee has various numb spots on the surface, but also get intermittent sharp pains underneath the patella while doing nothing at all.  I also get sensitivity/pain on TOP of the patella after CPM when touching it thru the skin- can't tell if that is the bone or the skin.  I have medial soreness because that is where he made the incision.

Don't have ant tips about preventing accidents, but keep that brace or immobilizer on and keep your BF near at any precarious spots.  I'm fairly sure you'd be feeling residual pain if you has a fracture or graft delamination from your fall.  Also, don't worry about the incision length- i know easy for me to say because i'm a guy with a smaller incision, but if this works that is the last thing to worry about.  Some people try Mederma, but most scars heal nicely without much. 

How is the pain?  Are you taking any meds anymore?

Oh, yea, I'm on my butt/back 23 hrs a day also.  Went to my kids baseball game yesterday (1st time out to a "fun" event since surgery) and crutched around a ton.  Woke up tired today, but it was good to see and talk to people face to face, have some junk food and breath fresh air.

[Jwin138]

Hey There! - yes I am still taking pain meds - but usually one a day - sometimes another pain med after PT.
I would say the pain slides from 2-5/10 at times.
I am still at 30degrees on the CM until next week - I am NWB and I do not dangle my leg off of the side of the bed like some ppl here do.
so I guess my doc is ultra conservative!

I keep the brace on almost at all times besides the shower - and i sleep with the gameready ice machine on - it does 30min ice and compression and then 30 mins off and cycles thru the night. I have to pay out of pocket for it.. and I probably shoulve given it back last week - but i couldnt say goodbye. $150 per week.

I am not too worried about the slip yesterday. I am more concerned about the constant dull pain - but reading on here that can last til about 12 weeks, although others say they are pretty much pain free.

i do not have any interm sharp pains, but that may chainge once I up the CPM - i am at 30 you are at 75
Once the scar scabs off i will use Bio Oil and Vitamin E oil. I used it for a previous surgery and it worked pretty well.
Did you have a TTO or AMZ as well?

[scmba]

No, didn't have TTO.  I know, big debate, and Cole, Minas do it religiously on patellas.  But my doc, who does a ton of ACI and DeNovo and is friends with Cole ( and they talk regularly) was very confident said I didn't need it and said he's had lots of success without them. He used to do TTO/AMZ's a lot more and has a published a decent amount also.  We'll see. . . Yes I do think about it a lot and knew it was a big decision for you early on.  You TTOer's probably did the safe thing. . .hope mine works.

I turned my Gameday in after week one.  I couldn't feel it as I was clueless and had TED hose and ACE bandage on and couldn't really feel it.  Now I have an ice machine a friend loaned me and I put it directly on the knee.  Much better.  Swelling takes forever to come down, like a softball in the a.m.

Feel free to also email me directly.

[cdubb]

Hey, I'm here....I see you were "caw caw ing" me earlier in a posting...but you reached out to me via email... Sorry, I don't log in here very often any more.  Glad you and scmba connected!  Your surgeries are close...and I've been emailing both of you.  Should have thought to connect you two earlier. 

[scmba]

Do you guys have numbness around your knee?  The majority of my knee surface/skin is partially numb. . I'm guessing that is normal due to the incision cutting some nerves, but just wanted to check.

Thanks

[surfbum]

Do you guys have numbness around your knee?  The majority of my knee surface/skin is partially numb. . I'm guessing that is normal due to the incision cutting some nerves, but just wanted to check.

Thanks

Hell yeah my knee is numb, hahaha...this is my 3rd knee surgery though. After my second, I never got any sensation back on the surface and I'm not planning on it. I got used to it though.

[Jwin138]

haha CDUBB!! i wasnt Caw Cawing at you! i email you daily i know to go right to the source ! i was just being silly..
Scmba - I also have numbness -mostly on the lateral side
surfbum - hope you are continuing to get better and stronger! I was checking out ur board before I went in for this surgery.

Ill update my post op status in a few days to be consistent

[Jwin138]

A little over 4 weeks post op
- I finally gave back the gameready ice machine, and I may not need it anymore, but i miss it at night!
- as per doc's orders, I started increasing the CPM 5-10 degrees per day and am currently at 60-65 degrees
- I get some under thigh muscle pain, and ITband pain. I asked my BF to try to roll it out with a roller and it felt good but it hurt! i cant want to bend my knee on my own!
- I do PT 2-3x a week inpatient (visiting nurse) and am supposed to start outpaitient PT but my job just switched insurance so I am in the 'waiting for my ID #' limbo, good news is tht the exercises i can currently do as PT is pretty limited.
- I dont feel much pain in my knee, I do feel some soreness - its too early for me to celebrate just yet!
- my scar is long but its healing pretty nice and thin so far.. its still too early to put any lotions and stuff on it since it still has some scabbing.
- I see the doc next week for my 2nd Post op

right now im working from home in bed, hooked up to the CPM and watching lots of netflix.

[Jwin138]

A little over 5 weeks post op
- the pain is minimal- just soreness here n there.
- took a week off of formal PT due to an insurance company switch - and did my PT at home. Finally did a SLR with no brace on. I have been doing them with the brace ok, I think without the brace is tougher since there's blunt there to keep ur leg straight for you.
- knee is still pretty swollen, I will try to attach a pic.
- Im using the CPM up to 75degrees now, I can't seem to get comfortably past that point. I believe the goal is to be @ 80-90 degrees by week 8. (some ppl have the CPM for 6 weeks I believe I will have it for I wish I was further than 75 but I don't want to force it.
- I see the doc tomorrow morning for the 2nd post op appt and have to find an outpatient PT spot that I like for this week.
- when I stand or sit with my leg down for 30mins + I noticed my knee gets red/blue and it goes away as soon as I elevate.

Ok that's it for now! Still on the road to recovery! Looking forward to

[Jwin138]

back from the 2nd Post op visit..turns out im WAY behind on my ROM.. i am about 40-50 degrees actively and 70-75 on CPM>> but it seems i may have cheated without knowing it.. by moving around.
 i am now full weight bearing but on 2 crutches, soon to be one crutch.  Iwear the brace mostly unlocked but still to wear it at night.

I cant lie - I am super bummed that i am so behind on my ROM.. my next PT appt is on Thursday.. the soonest i could get an appt with my new insurance. in the meantime, i will hang my leg over the bed (seems to stop at 40 with feeling of lots of pressure) 3-5x a day and work on heel slides and continue CPM and SLRs..

it scares me not to be able to bend my knee much at all.. my doctor seemed to have a conservative protocol so i was confused as to why he would think i would be able to bend sooner.

well wish me luck i got a refil of pain meds and glad i did bc this does not feel good.

thanks for listening! jess

[surfbum]

Don't sweat it...I was behind on my ROM too early in the game, but have full ROM now. It'll come.

[Jwin138]

a little over  6 weeks post surgery -
- was working on hanging the knee off of a table 3-5 x a day.. slightly stretching as much as I could.
- started outpatient PT this past Thursday (has a visiting PT & one week off due to insurance woes) she said my ROM is around 70-75 (which is strange since it was around 50degrees that Monday at the docs office)
- overall soreness has returned to the knee the most uncomfortable time is in the morning as soon as i wake up.
- im still using the CPM as the docs protocol and m doing the best to do my PT at home daily.. the quad doesnt really fire too well.. but i can do SLRs without much problem - i have to do more SLRS at home than i do now.. where does the time in a day go? im alwasy bending, stretching, icing, Cpming, working, or keeping up with my hygiene loll

so in closing -I am behing in my ROM.. but am working on it.. the PT said she doesnt feel any blockage and my patella moves well.. so she beleives its just a matter of stretching and doing ROM exercises..

thanks Surfbum! Im usually ahead of the game, so to be behind and not in control is really throwing me off. Trying to focus on what  I can control and just doing the PT> silly me, I thought the difficult part was getting thru the first 2 weeks after surgery..

hope all are well and check in soon,

JEss

[blueices]

Hey! Sounds like you're doing well!  Don't worry too much about the ROM.  I found that it came back mostly on its own.  Just keep up with your PT and at home exercises and it will come.

I found in fact, that once I was weigh-bearing again, the ROM improved more readily.  I think the increased movement and circulation may help the swelling at the knee go down.

Finally, continue the icing and take your anti-inflammatories!