Cruciate ligaments :

JUST CAME BACK FROM SCOPE - - Posted by Gab (Gab), 21 January 2005

Hiya peeps! Well it is done, had the scope this morning. I have no clue what my OS did as I didn't see him at all but there are 3 holes in my knee and I had FULL extension in the recovery room as well as no more clunking and grinding!! The knee feels so smooth! So whatever my OS did, I hope it stays that way...  

Right now I have no pain at all and I have a prescription of vicodin and I'm taking Celebrex like I have a purpose. I'm walking around with a crutch and will be icing the knee on and off and working from home for the next 2 weeks. So if inflammation is the mother of scar tissue, I'll do my best to minimize it.

I'll keep you posted  

Francois
Posted by njgino (njgino), 21 January 2005

good to know!
pls keep us posted on progress.
Posted by shadehawk (shadehawk), 21 January 2005

Congratulations on the rom.  Hope your rehab goes well and you don't get that darn scar tissue back again.

Good luck!  Keep us posted.
Posted by jbluestein (jbluestein), 21 January 2005

good luck gab, I hope it continues to go well. keep posting.


Posted by Wookster (Wookster), 21 January 2005

Good luck Gab.
Posted by Gab (Gab), 21 January 2005

Thank you very much to all of you  

So I slept this afternoon since I didn't sleep much last night. Now my incisions won't seem to stop bleeding...so I took some tissues, folded them tight and wrapped the whole thing up.

And I've experienced something different. I guess I must have gotten used to my knee not fully extending and developped the habit of pushing it inside as much as I can when walking. Well surprise surprise, there's no more resistance! That knee extends fully, it's simply unbelievable!  

I'm trying to stay off of it as much as I possible, hence why I'm using both crutches partial weight-bearing to move around the house. I just ordered some pizza and will watch some movies tonight  

Have a good evening everyone.
Posted by Rebagrl (Rebagrl), 22 January 2005

Thats great Gab!!! So happy to hear it went well. Curious to hear what your Dr. found in there. Keep us posted and ice ice ice.
Posted by thkaa (thkaa), 22 January 2005

So glad to hear the good news from you. I have nearly the same problem as you and I'll have the surgery on Mon. Would you tell me how long did the operation take?

What's your anesthesia? Local or General?

Take care and get well soon
Posted by Gab (Gab), 22 January 2005

Hey, so it swell pretty badly overnight. I've got this huge lumps in the synovial membrane area..at least my wounds are almost closed by now, they barely bleed anymore.

I think the op took about 20-30 minutes and I was under general anasthesia..
Posted by Gab (Gab), 22 January 2005

Oh but on the other hand, I have no pain...!? Just swelling.. So I'm taking celebrex and ibuprofen, and icing it.. least weight-bearing possible.

Surgery sucks..  
Posted by hmaxwell (Heather M.), 22 January 2005

Gab,

I really urge you to go to NWB status if you are getting swelling.  You don't want that, trust me!  No swelling, no irritation, no heat.

I imagine the pain will come when you are weight-bearing again, or when you start doing active extension work (weight-bearing extension, as walking).  Or, it could be that the chunk of scar tissue that was removed was so painful for you that now your knee feels FANTASTIC with it gone--this could absolutely be the case.

Be nice to your knee.  If you had no swelling, then started walking around with one crutch and experienced swelling after....go to NWB for a day or two.  Ice, ice, ice.  Elevate the foot above the knee and the knee above the heart.  Take your Celebrex.  Also, consider the vicodin (in halves or quarters) as it has a good bit of tylenol--we don't want you stiff-upper-lipping it and gritting through pain!  If you really have no pain, consider some extra strength tylenol--for some reason it works synergistically with a lot of other meds and boosts effects.  I don't know, it's worth a try....

Hang in there, and be nice to that knee.  It's been scraped and debrided and released from its prison--it's going to take a few weeks to get back to normal...or better than normal!

Heather
Posted by Gab (Gab), 22 January 2005

Thanks Heather, you're really giving me hope...Even through this swelling my extension is so much easier to reach now (standing partial weight-bearing on the leg). I'm really worried about it coming back. I guess I'll have a better idea once I put my hands on the surgery protocol...

So NWB, Celebrex, tylenol, RICE while moving the knee every once in a while. I had 120 degree of flexion and complete extension yesterday but my wounds started to bleed. I'm sticking to maximum 100 degree flexion today.

Will keep you updated..
Posted by hmaxwell (Heather M.), 22 January 2005

Francois,

Does extension work cause the wounds to seep?  

It's an unfortunate fact that you will get seepage from the incisions as you move--this is normal as long as it's clear fluid tinged with brownish or red blood.  It's housekeeping going on under the skin and outside the knee capsule, I was told.  Your body wants the gunk out to heal better, so it drains through the ports.  You might want to ask the OS if you can put STERILE, individually wrapped gauze pads over the seeping area and then hold them on with a CLEAN ACE bandage.  That can provide some mild compression (the C part of the RICE equation) and you can also monitor the dischage when you change the pads (usually once or twice a day) to make sure there are no signs of infection.  If the gauze pads are adhered to the skin by dried seepage, put a warm and wet washcloth over the knee and soak it a bit until you can slowly peel the gauze off without tearing any scab that has formed.

I wouldn't worry too much, though, because as you said the ROM work can pump this leftover junk out of the knee through the incisions.  It's what your body wants to do.  So Just go with it  

You may find that you get seepage by doing patellar mobilizations and extension work (especially if you hyper-extend gently).  My mom did my mobes after my last procedure, and she had to wear gloves to keep me from getting an infection and to keep her hands from getting ooky.  Ya gotta love mom, doing the dirty work!

I'm going to list my instructions for the immediate post op period, but ALWAYS check with your OS and follow his regimen.  I'm just putting this out for information and discussion with the PT or OS when next you talk.  Anyway, I was told to do GENTLE extension work each hour--I just made slight hyper-extension the final step to the easy quad sets I and doubtless you were told to do.  Roll a washcloth under the knee, legs out straight in front of you.  Contract your quad muscles, then press the back of the kneecap into the rolled washcloth while you maintain the quad contraction at the same time.  Then, while holding these first two steps, very slowly and gently lift your heel off the floor--just a little.  Be prepared for some pain.  Go half an inch--almost an isometric thing rather than real motion.  If that feels okay, lift a bit higher.  Be sure to maintain the quad set and the pressure of the back of the knee into the washcloth--this helps protect the knee joint and limit any sharp pain.  

It's no fun, I'll tell you, but this type of exercise is usually critical for those who have had an extension deficit so that any fluid that is accumulating behind the patellar tendon and patella gets pumped out by the GENTLE hyper-extension motion.

As always, check with your doctor or PT before starting anything new.  But if you had a cyclops lesion removed, I'm sure your doctor already told you to do the exercise I listed above, along with patellar mobes.  They are standard for this problem.  The best thing is that they are very simple things that the patient can do to work toward his or her own recovery--I like that!

As for the weight-bearing, Dr. S. usually has people with severe arthrofibrosis add it incrementally following surgery.  Some others got to weight-bear as tolerated right away.  I wasn't one of them  I did about 10 days of ZERO WB, then 10%, then 25%, then 50%, then 75%, then FWB on crutches, then one crutch, then crutches only for outside the house.  It took over five weeks to get off the crutches inside the house.  Increments are important.  You've got to fool your knee into thinking it hasn't been traumatized--into thinking it's had something wonderful happen to it!  Okay, that might be pushing it, but you get the idea.

Hope this information helps ease your mind--it sounds like things are going really well, considering what your knee went through!

Heather
Posted by Gab (Gab), 23 January 2005

Thanks again Heather! Well I'm having problem doing quads contractions...I'm not kidding my synovial membrane is SO swollen (although not hot at all) it looks like a double-bumb over and behind my knee at extension so it really hurts in my quads if I try to push beyond the zero degree.

As far as wound seepage, I had never seen it that way, I put some 'square' plasters over them because the only thing I can think of is 'infection' 'infection' 'infection'.

To tell you the truth, I have no clue what my OS wants me or does not want me to do..I know it sounds very sketchy but the only instructions I got (before the op) were his general knee arthroscopy rehab protocol, i.e. weight-bearing allowed, quads sets, ankle pump focusin on reducing swelling and pain etc. I actually got the celebrex through my dad...(a doc) so I'm pretty much following the knee geek arthrofibrosis protocol on my own..it's more conservative so I'm sure it can't hurt.  

Also, I've been wearing an ACE bandage over my knee to get some compression going. It seems to help...

Ok, more quads sets and ice regimen for me tonight..
Posted by Gab (Gab), 23 January 2005

All right good news this morning. The swelling has started to go down, so is the inflammation and so is the pain (when I do my quads settings, I've had no pain before that). I'm going to keep RICE'ing it today as well as keep doing my quads set and passive ROM exercices and not put weight on it.

Anyway I'm not going anywhere, we're in the middle of a big snow storm in Boston and there's some football to watch this afternoon (American football for the European peeps out there!  )

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