Rick's LCL and Posterolateral Corner Rebuild (LARS open surgery) - 2nd Dec 2011

[LancashireRL]

Hi - had a hyperextension lateral movement injury to my right knee about 18 months ago playing rugby, pain was instant but I thought it was just meniscus injury (had 2 previous scopes for meniscus tears).  Instability when the swelling went down was terrible, very lax to lateral side and very painful on the medial side.  Referred to one of the UK's leading knee OS's who diagnosed after MRI and clinical exam that the posterolateral corner was damaged and LCL needed replacing.  He specialises in LARS work so I was happy with his suggestion of this rather than graft.

Day 1+2 post surgery were in hospital.  OS warned that it is an extremely painful surgery to have due to proximity to peroneal nerve and I struggled with pain control until oxycontin commenced during day 2.  Could toe touch weight bare theoretically but honestly the pain was too great at that stage.  Came home with both cricket splint and also a custom fitted PCL / LCL post op brace (well worth the £120 it cost pre-op).  Cricket brace great for sleeping in but useless for mobilility and the other brace useless for sleeping in but better for mobility!

Days 3-10 - gradually more comfortable for partial weight bearing with elbow crutches, still on strong pain relief though due to the intense pain in my lower leg (screws and tunnel in fibula are the worst part of this surgery). 

Day 11 - here I am today, get the stitches out this Friday from the arthroscope wounds on front and top of knee, the main wound (15cm or so on LCL) is subcutaneous stiches so no need for removal.

Will blog how it goes, if anyone has a similar proceedure planned dont hesitate to message me.

[LancashireRL]

Day 13 - having to ice every 2 hrs for 30 mins to keep on top of the burning inflammation on the lateral side of my knee over the area where knee joins calf. Difficult to sleep for more than a hour at a time, very difficult to find a comfortable position with cricket splint on.

[LancashireRL]

22 days into the recovery now, pain is basically gone aside from when slightly twisting on the joint (very limited amount of rotation possible due to still being in post op hinged brace) and then the pain is straight from the area of the rebuild.  Overall far, far less painful than before sugery. Can manage about 100 yrds with partial weight bearing crutches, after which it starts to ache a lot.  Anyone having this surgery contact me if you have any questions etc.

[LancashireRL]

Day 26 - all good apart from a slight fall in my kitchen today which made me swear, a lot! Tramadol has sorted it out though. 

range of movement still locked at 90 degrees in the brace but this is a pain free 90 degrees. I struggle a little with getting the back of my knee onto the floor / bed when trying extensions but usually get there after a few minutes and a lot of stretches.

Hoping to get the 90 degree brace setting relaxed 6/1/12 when I see the surgeon then at least I can start resistance free movement on the exercise bike and some swimming pool movement etc.

Happy new year all of you.

[LancashireRL]

Day 43 and moving on pretty well - up to 110 degree flexion with the brace and that's pain free - only remaining problems bending are from swelling.  Swelling is a major problem, cant seem to disperse it effectively by elevation or icing ; I get a lot of pain from icing and PT thinks this is from the peroneal nerve disruption caused by the operation.

Scar / wound is behaving and the hard tissue is breaking down well - can really recommend Bepanthen nappy cream for massaging into the scar for softening it.

Have lost my quads, vastus medial obliques and calf muscles from 6 wks of bracing - started some closed chain kinetic isometric work with PT yesterday like pushing on a wall with my heel whilst lying horizontal etc ; the muscles all 'fire' but they wobble and twitch like a 90 yr olds leg rather than a 36 yr olds!

The hardware is so tight too - right foot will only rotate about 15 degrees inwards, loads less painful than pre-op and a massive improvement but it has significantly affected my gait / walk which the PT warned will need me to 'reprogramme' my brain as to the new balance and gait.

Overall very positive experience this far, certainly compared to having a knee that was pushing laterally all the time and causing my huge pain for a couple of months prior to the op.

[LancashireRL]

Well, 6 months since surgery and it was all progress until maybe a month ago when ive started to notice a bit of laxity in the graft etc ; tturning with weight through the joint makes it feel like its going to give way or actually does give way. Fair amount of lateral side swelling by end of each day too.  Not sure whether to seek rereferral to the surgeon or whether the current situation is as normal as it can be.  Kind of dont want to go back and find it's back to square one!

[medchir]

hey mate. hows the knee doing now.

i'm 6 weeks post op after acl, pcl, lcl, mcl reconstruction.

my 5th op in 3 years. nightmare injury. i have had 2 repairs to my lateral side. still nobody has put a graft in there. and it still feels loose. wondering how your ligament is holding up? lateral instability is a nightmare. its so disabling its unreal.

[LancashireRL]

Hi mate - to be honest its not too bad again, just had a flare up for a couple of weeks but it's settled a bit.  Still occasionally getting that 'whoa, going to fall over' sensation when shifting my weight laterally across the joint.

Sorry to hear you've had so much hassle with yours ; if it goes bad again maybe see if your surgeon will look at LARS reconstruction - I can only speak from personal experience but it's been fairly plain sailing over the last 6 months aside from some crap with the scar tissue on the lat side but that's open surgery for you. 

[medchir]

cool, glad you arr doing better. i'm going to see thr surgeon again in a few days so i'll see what he thinks about it. my knee is full of scar tissue too, but in some ways the stiffness hlps with the stability. i'll let you now how i get on with the surgeon.

stick i there