Cruciate ligaments :

ACL 3 days ago - progress - - Posted by nick157 (nick157), 24 January 2005

Well, others seem to like sharing their ACL experiences, so here's another one! Opinions on some of the things I mention would be nice.

Had the surgery on Friday evening in London. Patella tendon autograft. Just got back home. The femoral nerve block was pretty damn uncomfortable, but I was prepared for the whole anesthetic thing from my scope 4 months ago.

The first thing that suprised me was the state of me when I woke up - I was shivering voilently almost to the point of fitting, no joke.   not much fun

The pain was fairly bad but not that bad so I guess I'm one of the lucky ones. The second thing that suprised me was that apparantly my surgeon doesn't "do" ice  . Maybe that's because he placed a fluid drain into my knee (almost a pint of blood and gunk came out throughout the following day!) but the pain when they removed the drain was HORRIBLE. very strange feeling having something pulled through the middle of your leg! ouch  

I'm partial weight bearing now, but VERY partial! My leg is reasonably swollen but probably no worse than it was with the scope. I have about 80 degress of flexion and almost full extension.

My scar is much longer than I anticipated and I have these strange clips holding the wound together - not sure when it's coming out.

Have not been put in to a knee brace so very much a case of left to my own devices! I do have full faith in my surgeon's decisions though

Not really sure of the exercises I should be doing in the next few weeks until I see the physio, so if anyone would care to post a summary that would be great.  
Posted by Marek_Bowman (Marek_Bowman), 24 January 2005

Good to hear you have come though the surgery ok, I can concur with your feeling of how you were when you came round.

If I remember correctly the first couple of days after surgery I spent doing quad firing exercises, sitting on the my bed attempting to tense my quads, I would tense, hold for 2 seconds then release, 30 times every two hours or so.  I also would do flexion exercises to try to get to 90 degrees.  would do 10 - 15 of these every two hours.

Im sure someone else will chip in sooner or later.
Posted by FunkyWalker (FunkyWalker), 25 January 2005

I had the same experience in terms of waking up shivering like mad.  The whole knee draining thing is new for me, never heard of that?  So are you icing now?  I remember lying in bed on a CPM and icing every hour or so with a cryo-cuff followed by the same quad tensing and flexion exercises Marek mentioned.  I was instructed to start weight bearing as soon as possible while in a splint.

Good luck with the recovery.  It might seem pretty slow just getting a few inches of flexion and strength back in the leg but the more you work at it the better you'll feel.
Posted by nick157 (nick157), 25 January 2005

I was never put on a CPM machine. It seems to me, many of the op/post op features are specific to each OS.

I was not told to use ice so I don't plan to. I'm not really feeling any pain and the swelling is subsiding nicely so shouldn't really need it

Have to say it's pretty tough keeping up the exercises, once an hour is pretty frequent but as you say I'm sure it will be worth it in the end.

I have about 100-105 degrees of flexion now, I'm fairly happy with that. The dependency on the crutches is starting to get fairly annoying but only a few more days now I guess.
Posted by Gab (Gab), 25 January 2005

Hiya, welcome to the recovery train!  

Chalk another one up for mad shivering when waking up, it was horrible..

You should seriously consider icing it. It can't hurt you. Is your knee hot at all? Especially over the patellar tendon area, mine was on fire for 6 weeks, crazy inflammation...I ended up building scar tissue in there as a result, which required a scope to clean it out.

Also, if you don't have a CPM machine, keep moving your knee around, you don't want to leave it 'locked' in the same position for too long, stiffeness sucks lol

All in all, it sounds like you're doing great! Keep up with your ROM and keep us posted.

Cheers,
Francois
Posted by nick157 (nick157), 25 January 2005

well, just had a mini crisis! While trying to get a bit of extra flexion I managed to open to wound up - loads of blood. Needless to say I panicked!

Just been seen by the nurse at my local GP who redressed the wound and gave me my first decent look at it since the surgery. WOW.

about 6 inches long with loads of staples in there. Apparantly the blood isn't a problem but I'm now VERY reluctant to try and get any more flexion until the wound has healed more. It's really not that closed up at all - only 4 days post op I guess.

One question though - I have no idea how long these staples should stay in for - does anyone have any idea? I'm not seeing my OS for another two and a half weeks and have no idea what the situation is with the wound.

Can anyone advise? Thanks
Posted by nas (nas), 26 January 2005

Yeah, I was careful my first 2 days with flexion.  but keeping all the bandages on it kept it from opening up.  Luckily, my scar is about 3-4 inches, and just thread--no staples.  Today, when I took off the bandages for my first shower (yeah I know, gross, 2.5 days later), there was some portion that started bleeding, but nothing that a bandage couldn't stem.  Since then, I've worked my way up to 120 degrees on my CPM with minimal pain/discomfort, and no bleeding due to redressing the wound.  If you have a larger wound are tending to bleed, though, I'd take it easy for a few days and just keep flexing but not too much.
Posted by Gab (Gab), 26 January 2005

6 inches??! Christ, mine looks long and it's 3 inches exactly. Just don't push the flexion over the next few days, the extension is what's the most important. Serioulsy, learn from my mistake, flexion will come in due time, focus on extension..

Hang in there!
Posted by nick157 (nick157), 26 January 2005

Thanks nas and gab - I didn't appreciate that extension was more important than flexion. I think I have pretty much full extension, but I'll keep pushing it.

Unfortunately I'm in that frustrating situation now where I really want to work on the extension but am constantly in fear of the wound opening up again.

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