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Author Topic: Capsular Repair Anyone have experience with this?  (Read 1201 times)

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Offline wyeth

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Capsular Repair Anyone have experience with this?
« on: June 23, 2017, 04:41:52 PM »
Hi all,

I had arthroscopic surgery October 2016 to remove excessive scar tissue in my left knee. Months later, when I was still in considerable pain, I found out that the joint capsule had never closed around one of the portals, so there was a hole allowing fluid to go where it shouldn't and cause mayhem and inflammation in the joint. I had arthroscopic surgery March 30, 2017 to repair the joint capsule in which the capsule was successfully repaired, but while he was in there the doctor found "thousands of floating pieces of cartilage." Very strange.

I am still in a lot of pain and not able to do return to any activity. LI'm nearly 13 weeks out and the joint is constantly hot and bothered, regardless of how often I ice it and how inactive I am.

Has anyone had experience with a capsular repair? There isn't a lot of information that I can find online, and even my doctor (Dr. Sterett @ Vail Summit Orthopedics) said it was a pretty rare and complicated procedure.

Thank you for any help you can provide! Would love to hear from others who've gone through this. Thank you.


-Emily
4/16/2016 MCL sprain, meniscal tear while skiing
10/6/2016 Scope to remove excessive scar, triggering arthrofibrosis
4/30/2017 Capsular repair + scope
8/10/2017 Scope

Offline Markova33

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Yes! Right now - - Re: Capsular Repair Anyone have experience with this?
« Reply #1 on: March 09, 2018, 08:50:24 PM »

Yes - Hi, Wyeth/Emily.

I am new to this Board and Forum. 
I've lurked for a while, but, your post is what made me officially sign up so I could reply to you.

I suffered my first real bodily injury on April 19th, 2017.  Left knee. (Ha, I wonder if most of the posters on here also recall the day of their injury). 

All I did was move wrong.  I lowered myself to pick something up off of the floor, but, I think my posture was affected by the garment I was wearing and when I lowered myself...(it's hard to explain...think bad form on a lunge position. Dumb. Anyway)...I heard the dreaded 'POP' and immediately felt my knee was different. I could still walk on it for about 72 hrs after the incident - - but not after that.

The MRI I took in early May showed a torn medial meniscus (left knee) about the posterior horn; slight tear on the gastrocnemius muscle (calf); slight joint effusion annnd a mysterious, almost glossed-over  "meniscocapsular separation". 

I had never heard of the latter. 

In fact, like you, most of my online searches came up empty save for some academic articles.  The first ortho doc never even mentioned that. He just sorta focused on the torn meniscus part and said it would probably heal on its own.  He suggested PT.  I tried that for a few months. I liked PT. I even tried Aqua Therapy.  But I never progressed beyond my crutches. 

Then I got a second opinion. This time, this second doctor did express a bit more concern about the capsular separation, but he still thought my symptoms of pain/immobility were pretty extreme. Truth be told, he thought I might even be a CRPS case. (Chronic Regional Pain Syndrome). (!)  So, he too suggested the conservative route of PT.  I did that. For months. And I was still on crutches or a cane.

It was a very trying time.  I was surprised at how quickly my leg muscles were wasting away.  I had been healthy and active all my life and boOm, things totally changed. I was getting depressed. I missed out on gigs, on summer, on my birthday, life was passing me by....

Finally, on Nov 17th 2017,  I went ahead with arthroscopic surgery (my first surgery ever!) to repair the meniscus tear and hopefully...to repair the capsular junction. 

As I was having so much trouble with walking, etc., my doctor/surgeon also thought he'd find damage beneath the kneecap.  We were talking potential 2/3 surgeries, microfracture (at a future visit), all kinds of scary stuff. 

But, after the surgery, he told my family that my cartilage actually looked great. I didn't need any other surgeries, my knee was 'structurally sound,' that they really looked in there for other problems but didn't find any, and I should make a full recovery. He also said that the meniscus had pretty much already scarred over and that the capsular junction required two absorbable sutures as, where the lesion occurred, it had already stretched rather thin. (I think that's how he explained it).


Anyway...recovery was going along well, when, in early January, (eighth week, post-op) I suffered my first setback.  I left a PT session of doing single-leg squats (reclined on the total gym! not standing!) Hours later, I had pain, swelling, limping - almost as if I had never had the surgery!!! I was scared. I didn't know what this was. I was still going to PT, too.  My therapist told me 'a setback should last a few days, not a month'.  (welp) Then it started to quiet down. 

Then, not too long after, a week, maybe: BoOm. Setback #2.  After a PT session. Lasted about 2 wks.  (Pain/Swelling/Limping/Icing/Elevating/Etc).

Saw my doctor again and suggested maybe I take a two-week break from all the PT and see how I fared. And you know what? I was starting to feel great! 

Then, just this week, I was sitting on the couch, (I think I had my knees propped up) and then boom, next morning, Setback #3.

And this time, I can't blame it on PT.

Annnnnd I'm supposed to start up with PT again on Monday.


(yikes)

So, now I'm at a frustrated loss.  It's not like while I'm doing my exercises, I'm having problems with them. Nope. The problems present themselves hours later.

I don't know what the heck is going on.

I can't tell if what I'm going through is "normal". 

So many thoughts go through my head:
Are so many frequent setbacks to be expected? Do they ever finally just stop?  Or will this be my ''new normal''? :(  Do I just need to be patient? Or...is there a problem with the repair itself? Is the issue my body - - as in, it's not healing properly? Should I get a new MRI done - maybe with dye this time?  I know I need to strengthen my knee/leg, and I feel like it is stronger, but, how do I strengthen it while not repeatedly slamming right up against the Setback Wall???   Will I ever wear anything beyond flats/ortho shoes? lol...that's the vanity talkin'.


So yeah. My doctor, my PT Staff and myself are....all a bit confused/concerned.

And I'm getting frustrated/scared. People keep asking me "haven't you healed yet?"  :-\ :-\

I found myself wishing I could visit the clinic in Vail, CO, as I read they had experience with this type of rare injury, I think it's also called an 'avulsion'.  But......that's where you went!

What makes mine even weirder, is, supposedly, I didn't injure any of the ligaments inside - - and I think those two injuries typically go hand-in-hand. :o

But, (siiigh), like all of us here in the Bad-Knees-Club, I guess we just have to keep on truckin' some how right? :-\

Anyway. Sorry for the long ramble.

Just wanted to reach out to the only other Capsular Repair person I know.

And if anyone else wants to chime in, I welcome ya!

I wish best healing to us allllllll!!!! :-* :)


-Suzanne