MPFL reconstruction....What was I thinking??

[yc_angel]

Hey Cjlynn,

My mpfl surgery was 7 weeks ago and i concur that recovery sucks...though i did my research and read up on everything at times during the first few weeks when things got rough i still got a bit antsy and depressed by how hard things are....every OS has different protocols and so do the PT's i hope you get a nice one and start working your quads and ROM to regain mobility and trust back in your knee.

Don't try to force your knee to much you'll do more damage than good....and just follow your PT instructions. It's hard, seriosly hard work but now that i'm getting some results just a few weeks after surgery i'm happy i stuck trough all that pain ....It doesn't get easy but as many people keep saying it's worthed in the end....

I find that having short term goals help me focus more on recovery and rewarding my self accordingly too....like getting to bend it to certain degrees....like the first time it goes to 30 or 50 or 70 or 90 degrees ROM....or the first time an SLR goes right with help and then without....things like that....or the first time you can walking with cructhes normaly and then without....or that you spent a day being busy without it buckling on you......
It might sound weird but those small achievements are what are getting me trough....
Worrying is normal, god knows i still think about my knee 24/7 haha but i'm hoping at some point to regain total trust back in my knee....and with the progress i'm making now i don't think that's going to be a problem...

MPFL is a hard surgery and its not done lightly but the outcome of it never dislocating again is very appealing and it what i'm going for in the long term cuz this pain versus those pains everytime is dislocates doesnt quite compare....so grin and bearing it is just the motto for this surgery....in a few months you can look back and laugh about it.....cuz even though i'm only 7 weeks out i'm already laughing at what i can do now versus a few weeks ago...

Don't worry too much about the muscle loss....cuz mine is also significant but with PT and tons of hard work it will come back...it might not look the same but it will come back

Xx

Angel

[Cjlynn]

Thank you to everyone for the encouragement. I had my first PT session today, and wow, I have some work ahead of me! I knew it, but now its reality!!

When my ROM was measured today, it was 46, with some encouragement from her, we were able to read 53! I need to work on triggering the quad muscle and getting my calf to stretch and release. I'm sore this afternoon, took some pain pills to help relieve the discomfort. 

She is hoping to have me off crutches in 2 weeks (thank goodness) and using a cane. She bumped up my physio to everyday this week, then 3x every week after that.

I'm going to take the pain of physio with a smile on my face. Well maybe a grimace once or twice...But I am going to try to remember that each step of recovery big or small is still a step forwards.

[Tiggs1986]

Way to go Cjlynn! PT is most of the struggle but you will not believe what you'll be able to accomplish in a few weeks time with some hard work! It seems kinda like all you do is PT, and I've joked with some friends that once this is all done I'll have a wonderful booty from all the different glute and quad exercises I've been doing day in and day out!  As for PT pain, are you taking (or have a driver so you can take) prescription medication about and hour before PT? The first couple of weeks(at least!) it makes a big difference in how much you will be able to tolerate. Good luck!

[Cjlynn]

So here I am, one month post op.... And here's where I am at....

Still on crutches and weight bearing as tolerated, trying to put more and more weight on it every day.
Going to physio 3x week, ROM is still limited to about 55 degrees, and it's a huge challenge to get it that far!! It feels so tight when bending.
Trying to do more SLR's with assistance...there's no chance of one alone quite yet!
My PT uses electrical stimulation for triggering the quad muscle.
As I continue to do my exercises at home as well.

Never would I have dreamed that a month post op and I'm still struggling with the recovery. I was able to get myself in and out of the drivers seat of my car, yah!!

I know that Rome wasn't built in a day, but this knee seems to be taking its time!!

[Teacher2Many]

I was reading through your diary and want to thank you for sharing your experiences!  I have had many extensive orthopedic knee/hip surgeries over the last five years and am undergoing (what is hopefully the final one) at the end of July which will be bilateral MPFL reconstruction using hamstring allograft.  I am told this should be no worse than the others but am also aware of how painful it can be.  My OS is putting me in bilateral knee braces that will be locked in extension for two weeks, unlocked to 30 degrees for the next two weeks, then unlocked to 45 degrees for the next two, and then hopefully removed at the six week mark.  I am also getting the Game Ready machine for about three weeks or so to help with swelling and pain-I had it with my bilateral ACI surgery and it was amazing.  Not sure if either of those two would be options for you or not.

PT works wonders from ultrasound to stim to manual massage/stretching/ROM, etc.  I've been in PT since 10/2006 with only a few breaks for surgery (a total of 10 surgical dates and 18 surgical procedures done over those 10 dates) and know how critical it is to now only build strength, etc. prior to surgery but more importantly get you up and running afterward.  It can be painful and a bit frustrating when the muscles don't seem to be doing what the brain tells them to do but trust me, it does get better.  Some heal faster than others so try not to compare your progress with others.  Each one of my surgeries has left me with different recovery times in regards to strength, ability to do a SLR, how quickly ROM returns, and how soon I get back to where I was prior to surgery.

Hang in there and I hope things continue to improve and just remember....slow and steady wins the race!

[Cjlynn]

Thank you teacher2many for your words of encouragement! I am 5 weeks post op, and still struggle with the decision to go thru with the surgery.
My PT program is intense, no question there, I just feel defeated after working so hard and still being in crutches and having so little ROM.

I am frustrated with myself and the lack of knowledge I had for the recovery process. Although my PT has informed me that I won't be returning to my job before September (I stand and pivot as a bank teller for 8 hours a day) so on the flip side, having the summer off isnt such a bad idea! 

Today I will do more heel slides, laying on my stomach and doing hamstring curls and triggering the quad muscle, Friday has a goal set date of 70 degrees of ROM! Determination to get me off crutches should help achieve that!

[Cjlynn]

It never ceases to amaze me that what seemed to be such a simple surgery can take so long to recover from, BUT.....today I was able to get 70degress in ROM, and was able to do one single leg raise!! Yah!!

As my quad continues to strengthen I can finally start to feel positive!!

My pt and I have set a goal of 80 degrees for next Friday, and I'm hoping and praying to be off crutches, I will gladly except a cane at this point.

How long was everyone else on crutches for? Im surprised that I am still using them 6 weeks post op!

[Chellie1992]

Good job on your ROM! 

My OS originally told me in February that I will be NWB for 3 weeks, but when I went in for surgery last Friday, he said that I will be NWB for at least 6 weeks.

Good luck getting 80 degrees by next Friday!

[Cjlynn]

Week 6 has arrived.....

I am still using crutches although I am weight bearing, I keep them with me just in case the knee is fatigued and for the additional support.  My goal for Friday is 80 degrees and down to using one crutch.
My 8 week post op appt is booked for July 28, and I will be using a cane by then!!

I am still finding that the joint can become quite tight feeling, from mid quad to ankle. But after every treatment of PT, I can notice the improvement in the knee. PT is simply unbearable at times, it's no walk in the park.

I still question why I wasn't prepared for the recovery of this surgery.

[allyd]

Sounds like you doing great – good, steady baby steps at PT is the way to go. Hang in there and focus on the little ‘wins’ in your progress. I always liked to tell people about the new ‘tricks’ I’d learn each week.  You know, all that simple stuff you took for granted before? Like putting your shoes on like a normal person. Bending over to pick something up.

Crutches, everyone is different. So many factors: your doctor’s protocol, pre-surgery strength, how quickly you progress, pain levels. My doctor warned me it’d be 4-6 weeks, WBAT from day one. I had low pain levels, was strong pre-surgery and progressed well off the bat, so I was able to build enough strength/ROM to ditch all together by week 5 I’d say.

[Cjlynn]

Yeah for me!! Today I left physio and was given the ok to go to one crutch, and I am able to use a cane!! Success is measured in the little things, and this is huge!!

I am still struggling with ROM, it's a challenge to get it past 70, this is where I feel like I've hit a wall. The joint seriously does not like bending.
My quad strength is better and better every day, today I was able to accomplish 6 SLR's on my own.

I am refusing to look back now! Nothing but forward momentum from here on out!

[Chellie1992]

Down to one crutch, that's great!

ROM can be difficult.  Have you tried heat to loosen it up before bending?  That seemed to help me a lot after my LR last summer.

[Cjlynn]

So I post today defeated and sad....
Yesterday I had my 8 week post op, OS was quite happy with the muscle firing in the quad, but this is as far as it went for good news. My ROM is only at 83 degrees and it's a struggle to get that.  His solution is now a MUA. Sigh~~

I am scheduled for the MUA on July 17.

I have no idea what the outcome of this procedure will be. Pain??  Recovery after?? I'm so frustrated.
Back to square one and regretting this surgery.

[Teacher2Many]

Hopefully the MUA goes well!  I have never had one (luckily) but do know of many people in my PT clinic that have had them (usually for shoulder issues after rotator cuff surgery) and they are always amazed at their ROM afterwards.  Please keep updating on your progress as well as how things go after the MUA. 

Stay positive...those first few months (maybe even first year) after ortho surgery can be full of many regrets, why did I, etc. but once all is said and done, recovery is over, and pain is gone...it'll all be a distant memory!  :-)

[oohheykate]

Cjlynn,

The MUA I had after my MPFLr was one of the best things I ever did! It helped me gain so much ROM and, I think, after about a month, I was almost at full ROM. I was actually right where you are! I had about 80 degrees ROM at eight weeks so my OS decided to schedule the MUA for the next week. I posted about it in my diary (check the post-op diaries >300 section). And, trust me, it was a breeze compared to the MPFLr. I did not take any pain meds for it until three days after and I was walking mostly by myself the next day.