Collateral Ligaments and other non-cruciate tendons & ligaments around the knee :

How long do you usually have to be in a fibreglass - - Posted by Lizzie (Lizzie - UK), 24 June 2003

leg cylinder cast from my thigh to my ankle.?

I've been in my cast for over 5 weeks now and my OS has said that he will see me on 9th July.  Is this usual to be in a cast for so long?  I've damaged both my MCL and LCL on my left knee as well as a suspected medial meniscal tear and a maltracking patella.

I've also damaged my MCL on my right knee and have a Donjoy 4titude brace on, with also osteoarthritis.

You help and advice would be greatly appreciated.

TIA
Lizzie xxx
Posted by ATsoccergirl (ATsoccergirl), 25 June 2003

Any time is too long.  As I have said before, casting is an unacceptable form of treatment for ligament injuries of the knee.  It is extremely detrimental to the long term stability of the ligaments.  In order for proper healing, the ligaments must be stressed, and without this they do not heal right and will predispose you to further knee problems.     I have dealt with total MCL tears with very little immobilization.  Usually they are in an immobilizer for a couple of days, and then start aggressive rehab.  I normally return an athlete in a month.

I would be highly cautious with your OS, as he is not only negatively affecting your recovery, but is going against the standard of care.  I once had an intern cast a knee of an athlete I had referred, needless to say he did not pass that portion of his internship.  
Posted by Lizzie (Lizzie - UK), 25 June 2003

ATsoccergirl

Thanks for your reply.  I've actually worked it out that I will have been in a cast for 9 weeks before I get it taken off.  I presume my leg and knee will need a lot of physio - what should I expect?  Will I be in more pain out of the cast once it has been removed?  Will I have to be pwb?  or fwb?  Do you know how long it will take till I get my knee into fairly good condition?

Sorry for all the questions, but you have got me wondering a lot about rehab etc.

Do you think that he has left my left knee in the brace whilst I get my right knee sorted?  I was supposed to be having a scope of my left knee on 16th June for a suspected medial meniscal tear and a proposed LR, but that was before my other knee gave way and I fell to the floor and damaged my MCL and ?meniscus.  

BTW, I have HMS - I'm not usually as accident prone, but since my initial accident in December '01 when I damaged my syndesmosis of my left ankle, tore my medial meniscus in my left knee and further damage to my right knee which was in rehab for a scope in October '01.  I also injured the ligaments in my right thumb, wrist and shoulder as well as twisting and injuring my ligaments and muscles in my back, thoracic and lumbar areas!  

Name a joint I didn't damage!!!  

I've got a big personal injury claim going on at the moment and I hope that I get something for all the aggravation, pain, stress and darn horrible times that I've been going through.  

Not that money is going to help me, but it might make things less tense, especially financially as I've been signed off as sick since December '01 and have not been paid a penny from work other than sickness benefit.
Sorry to go on, but it helps me get rid of the negative vibes in my body.

Thanks for listening - that's if you have got this far.

Take care

Love
Lizzie xxx

PS - I think I might change my name to Calamity Lizzie!!  
Posted by Shazinoz (Shazinoz), 25 June 2003

HEy Lizzie,
I wonder if your OS has put you into the cast to try to help things OVER tighten (this would happen in a "normal" person, I think with a casting) but in us HMS/EDS'ers may help you get back on track to somewhat "normal" ligament strength. I have just spent 6 weeks in a cast and now an still immbolised (most of the time) in a  rigid "Procare Nextep Contour Walker (NOT CONTOUR 2) on this darn foot of mine and ina "Normal" person they would be at MOST in a shoe thing (a cast shoe) for about 2 weeks, and I still have a few more weeks at MINIMUM  in this brace and am NON weightbearing when NOT  int the brace. I think he is being conservative due to you having HMS, which can infact be a good thing (I had this also after my shoulder surgery in 2001 and wasn't allwed to do the noral PT as this would have loosened up my shoulder to pre-surgical state (or COULD have). You will probably have to be careful with PT as well (and make sure you tell your PT you have HMS) so as NOT to undow what has been done. You will probably need a LOT of PT (on the joints above and below as well (as us HMS'ers etc seem to stess these badly by the way we compensate).
I know this isn't really a help but I do know the frustrations. My knee is SHOCKING as this brace (from before my toes to just below my knee) is stressing my ACL+ deficiant knee and HURTING.
Good Luck and I hope everything goes well for you.
Sharon

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