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Author Topic: Painful Popping in Knee during Rehab Following Lateral Tibial Plataeau Fracture  (Read 740 times)

Offline PGHMichael

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I had a fall on 6/1/2012 that resulted in a non-displaced Lateral Tibial Plateau Fracture of my left knee.

MRI results:
IMPRESSION:   
1. There is a nondisplaced fracture of the posterior most corner of
the lateral tibial plateau. There is no obvious displacement or
articular surface depression, though the fracture does extend to the
articular surface. There is no obvious cartilage abnormality
overlying this fracture.
2. There is a 2nd area of bone edema of the posterior most aspect of
the lateral femoral condyle. This could represent an additional bone
contusion.
3. This bone contusion possibly indicates that edema overlying the
medial collateral ligament complex could indicate MCL strain injury.
There is also a significant amount of edema posterolateral to the
knee, though the major posterolateral corner structures to include
the fibular collateral ligament and popliteus appear intact.
4. There is also some edema in the proximal ACL region, though the
ACL appears intact. Stability of the ACL and MCL should be confirmed
during clinical follow up.
5. There is no demonstrated evidence of a lateral meniscal tear. The
medial meniscus also appears intact.

My Doctor sent me to Physical Therapy on Tues 7/17/12. I was at -20 degrees when trying to straighten, and 90 degrees when bending. Things went fairly well, with some minimal pain. She gave me some take home exercises to do, which I did, as directed.

I went back on Thurs 7/19/2012. I was at -15and 100 degrees. While I was there, doing the "Knee and Hip Flexion -Heel Slide" (Where you lay with your good leg straight, and slide your bad leg back to your butt), My knee suddenly popped on the outside (left side) of my knee. It hurt pretty bad.

When I forced myself to do the exercises on Friday, I felt as though my knee was going to pop again, so I stopped that exercise for the day. On Saturday, I tried again, and just went slower, and didn't try to go as far back. All was going well until while I was holding it in that position for the 10 seconds as directed, and suddenly, without warning, it popped even harder on the inside side of my knee (near wear the break was) and my knee jerked all the way back towards my hip and got "stuck" there for a few seconds!

It hurt so bad that I thought I would cry! I went to the doc today to get an X-ray again to be sure that I didn't re-break it or something. He said all is fine and that I will have a difficult 6 weeks or so as I try to regain my ROM.

I knew there would be pain, and I was fully prepared for muscular pain and soreness/pain, but definitely not this! I am finding it hard to find the courage to keep doing that exercise, even though I know I have to. The biggest issue I am having now is the sheer terror of the anticipation of the next pop, which I can tell is imminent. It's very hard to do, knowing that sometime during the exercise, somebody is going to come hit you with a baseball bat, lol!

 My questions are:
1. Is this normal? Has anyone else experienced either the pain or the horrible anxiety?
2. If so, did it go on for an extended time or did it just happen a few times to break up scar tissue or something?

Thank you in advance for your help/advice.

 

Offline jlk2011

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Hi Michael,

I had a similar injury in March.  My injury was missed at first (they did not do an Xray on my first visit) and they did not discover that it was actually fractured until almost a month after the injury.  Non displaced, non depressed lateral fracture of the tibial plateau with a minor PCL sprain and a lot of bone edema.  My doctor then instructed me to take it easy and not doing anything strenuous to my knee for the next two months.  I started physical therapy in June because I now have tendonitis in the injured knee (I've had full ROM the whole time).

My knee has been popping (very painfully!) since March.  The popping noise is different than the noise I heard when I first got hit and it broke (the pop I heard when it broke sounded like I hit two large rocks together).  This new popping noise sounds like a very loud knuckle cracking.  It pops a few times a day when I straighten it all the way or bend it quickly.

I asked my doctor and PT about it and they both dismissed it and said it would go away over time....
I did PT for two months and I have been doing the exercises on my own for the last month or so and it still doesn't feel better.  My PT said it takes time...

TIME, more time, it takes time, time, time, time..

That is all they ever say!  Now it has been almost 7 months since my injury and it is still swollen, it still hurts and it still pops.

I am going to see a new orthopedic surgeon this week.  I'm tired of waiting and at this point I think there has to be something else wrong with my knee/leg.  My advice would be the same to you.  Get a second opinion if you can.  You don't want to have lingering issues 7 months later.

Best of luck!  Hopefully your knee rebounds quickly!