Hi! I've been lurking these boards starting few weeks prior to my knee surgery, so it's been about a month now... but now that I'm actually in need of some advice, I decided to post and see what comes up!

Anyway, I had an ACL reconstruction using a patellar tendon autograft and a partial meniscectomy on my left knee on June 21. Today is 2 weeks and 1 day post-op. I had MASSIVE swelling right after my surgery (and ended up bleeding through all my gauze and ACE bandages on the first night!), and I've been having a lot of difficulty with my ROM. I should also mention that my pain medication didn't work, and I was unable to switch my prescription until about a week later, so I've pretty much had no aid in assisting with pain since my surgery, other than ice and elevation.

5 days post-op, I went in for an evaluation with the PT and my extension was at 0 (not quite sure if this was measured correctly...) and my flexion was at 40 degrees. I saw my surgeon yesterday for my first post-op appt and he said the new ligament looked fine. I then had my first "official" PT today, and my measurements were at a meager 7 degrees for extension and 42 degrees for flexion.

I've been doing quad sets, gravity assisted leg straightening, heel slides, and seated knee bends. They've been painful! Yet I still can't do leg raises, and I'm just extremely frustrated with my "progress". When I went in for my first evaluation with the PT, I was there with another girl who had the same surgery minus the meniscectomy one day before me, and she was already at about 75 degrees of flexion.

Why am I having such a hard time with this? It was extremely discouraging to find out today that after about 1.5 weeks of painfully tugging on my leg to get it to bend and straighten, I was only able to get 2 more degrees of flexion. I should note that I'm stuck with Kaiser for insurance, otherwise I'd definitely choose to be somewhere else for rehab. Does anybody have some input or advice?

You have obviously read way too much on the boards if you are worried about arthrofibrosis already! It is a very rare condition.

A lot of what you have described is simply lack of use - the less you use a limb for whatever reason it will stiffen up and you will lose muscle. Although every doctor has their own rehab there is a common theme through - move your knee as frequently as possible. With some that may be actively and aggressively with others that is passively and as gently as possible, but keep the knee MOBILE some how.

Start by putting a plastic bag over your foot and gently sliding the flattened foot back and forth over the floor. If you do not have carpets, then a sock and wooden floors works just as well. While elevating and icing, raise your legs and rest them against the wall and then let your feet gradually slide down the wall. Also while icing and elevating the knee point your toes down then bring your foot back up. do that as often as you can and it helps reduce the swelling.

Of course your leg and knee will hurt, it has been through a huge trauma, but the more you use it the better and less painful the movement gets. With the SLRs work on it slowly, lift the foot a little bit, that is more than enough to engage the quads.

Wimping out will just prolong the agony and possibly lead to other problems. Take your pain meds and do the exercises prescribed. The more you do them, the easier they get.

 

Well, thought I should update this, so here it is!

At 5 weeks I left my original PT clinic with 82 degrees. I finally switched my insurance which meant I could choose to go where I wanted for PT. I went to my new clinic last week, left the first session with 110. Three days later, left my second session with 118. My new PT has also gotten my extension from 5 down to 1 within the four days I saw her.

Apparently, what my old PT failed to tell me and seems to have neglected altogether is that there was quite a bit of scar tissue at my incision site that was keeping my knee from bending any further. However, she said I came to her just in time because my knee wasn't completely frozen from the scar tissue (when she pushes down on my knee into extension, it straightens out compliantly, which makes both of our lives easier). With some massage and patellar mobilization, my knee has loosened up quite a lot, even though it's not gliding as nicely as she wants it to be.

My PT was actually in shock at what my old PT sessions consisted of.
I have no doubt that if I had been able to come to her sooner, my recovery would have gone a lot smoother. My old PT never actually worked on my knee like my new PT does-- sessions just consisted of showing me 3 or 4 exercises!

I thought I should update this since, WOW, so much has happened since.

I went in for my 8 week post-op check up on Monday... so yesterday. It was with a different surgeon since I am now covered by a different insurance.
The surgeon noticed a lot of grinding on the outer edge of my knee. I paid it no attention since there is still some swelling, and you know, swelling can make your knee pop and click and whatnot. Well, the surgeon thought otherwise and took a look at the x-rays that I had gotten about 20 minutes ago, and found that the screw in my tibia was protruding out.

I went ahead and got an MRI right after I left her office. She squeezed me in for surgery the next day (so today) just in case the screw was hitting other structures (ie cartilage on femur) in the knee and causing damage. Turns out the screw was 5-6 mm out of the bone-- so it wasn't hitting the cartilage. There was also a bony bit sticking up from my tibia next to it, and I'd also somehow gotten a small meniscus tear as well

She gave me the option to wait to get surgery later in December, but both her and my original surgeon and I agreed that it'd probably be best to do it the next day (today) for various reasons. Yes, 2 months out of ACL reconstruction is very early to be having hardware removal, but we had good and valid reasons-- plus because I had a patellar tendon autograft, so m new graft itself was holding just as well as my good knee.

I went into surgery today for a "left knee arthroscopy, possible meniscectomy, and debridement/chondroplasty". Before I went in though, my surgeon added "possible ACL retensioning" and "possible screw removal" to the list. I don't really quite know what exactly went down in the OR since all the verbal information was given to my mom (who has not an inkling about medical terms whatsoever) and my report got sent back to my surgeon's office. But according to a nurse, one of my screws were either trimmed down or removed, and according to my mom, there was a lot of scar tissue that my surgeon ended up removing. I guess the important thing though is that I have my post-op instructions.

The aftermath of the surgery itself is definitely so much more tolerable than the actual ACL surgery. The pain definitely isn't nearly as bad, and I can easily dangle my knee over the bed/chair. That being said, I'm so glad we chose to do this today and not in December. Can't imagine what it would've been like if we had waited