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

6 months post op ACL, PLC - - Posted by Philip (Philip), 27 October 2004

Hey there, (and hi Grudier sorry for this late reply - also thought of starting a new thread...)

just a quick (well not really) report on my recovery:

Overall I think I am doing okay. My ROM (active) is about 135-140 pretty much comparable to my good one (145) although passive ROM is still not good enough to sit on my knees and I was told that I might have long term problems with sitting on my knees (although I manged to touch my butt with my heels (wearing shoes though   ))

I saw my OS 2 weeks ago - well I did not really has he had to rush off to a surgery - anyway his assistant was pleased with the progress although my knee was slightly swollen when I was there (did too much excercise that week) and I still - from time to time - have some fluids in my knee, although it is getting less and less. I started icing my knee again after each excercise...

I am by now biking more than an hour without problems and run for about 20-25 min 2 to 3 times a week without much problem and I am also back doing climbing excercises (my main sport) (I started toproping 4 months after my injury). I still feel my knee especially the postlateral side when jogging (I think my ITB is a bit tight) but it's not too bad. I wear a brace whenever I climb, but not while running and biking. Last week I started Plyometrics in my PT - it feels pretty good although it is hard work and sometimes I  am worried about jumping around too much.  Also, I was told that while running I lift my left arm  as if to relieve my right (involved) leg, as well in my plyometrics I often bend my leg, while landing medially, which I should try to avoid.

I am also taking part in a research for postlateral corner injuries, and they measured 6 months post op between 10-25 % lack of strength compared to my univolved leg (depending on the excercise) - my harmstring is coming along quite well and the discrepancy between quad/harmstring is less in my involved leg. They used a Biodex machine and I have loads of data at home, pretty fascinating that stuff actually...

The surgery as such involved ACL reconstruction using my Patellar of my involved leg, the PCL remained intact luckily - it was merely strained and needed no reconstruction, my LCL luckily popped off the bone including a piece of bone, so the rupture was fairly clean and thus they managed (somehow I don't know how though) to suture it back together again (they call that an evoltion I think if the ligament comes of with the bone) so I needed no reconstruction. Phe whole PLC was referred to by the surgeon as mere tissue and they managed to suture the ITB and the biceps femoris tendon together. I also have a nail in my tibia plateau due to a fracture in my plateau, I was therefore 6 weeks in a full brace and was allowed minimal weight bearing - I lost basically all muscles in my leg and thus I am really glad to have some strength back...

As said it feels fairly stable although it is still stiff in the morning (need to do my stretches every day) and to be honest despite the fact that last week I started with Plyometrics I still dont have my confidence back - but it is getting there....i am on the mend....

Anyway, hope you guys are doing well and Grudier how are things with you? It sounded pretty promising in your other post.

all the best,

cheers,
Philip
Posted by grudier (grudier), 29 October 2004

Hello Phillip, good to hear from you, glad to hear of your progress. Just to remind everybody, I'm coming up on a year post op. I'm in the army, and just had a five mile run this morning, felt pretty good, but the leg muscles are pretty tired, as they haven't caught up yet. I tore my ACL, LCL, PLC, tore my lateral meniscus, and ruptured the illiotibial band. They took a hamstring graft from my injured leg and a hamstring graft from the contralateral leg. Unfortunately because of the severity of the ruptured IT Band, PLC, and LCL, they placed me in a full leg cast for 6 weeks. Even more unfortunate for me I was still bleeding out five weeks post op, and started getting high grade fevers, went to the OS and got readmitted to the hospital. I had to be opened up again and had two debridements, turns out I had a resistant strain of Staph infection. Lost 25 lbs of bodyweight, and then got placed in a splint for two more weeks. To make a long story short, I lost 80% of the muscle on my right leg, and didn't get to start any Physical Therapy until I was 3 months post op. I'm now at approximately 80% strength, feels very stable no complaints there, don't worry about it too much, and never wear my brace unless I'm specifically moving over uneven terrain. I have been getting a lot of knee pain on the front right side of the injured knee, not sure what it is, possibly nerve damage, maybe scar tissue, will ask my OS about it on 3 NOV 04. I want to get a bike soon, I walk, run, or do the elliptical trainer, as an avid bike rider does it help? I'm thinking it would as the legs do 90% of the work, and I get my aerobic out of the way at the same time. Stationary exercises drive me crazy anyways, boring. I have been doing plyometrics, mandatory program for us army types, designed to make us more comfortable moving athletically. Lots of jumping, pivoting, sprints I enjoy it, and I can now touch the basketball rim again (not bad for a hobbled 5'11" 210 lb, 33 year old white guy) and can squat 215 lbs for 3 sets of 10, without the brace, so I'm feeling very blessed. After a self imposed ban on organized sports I am chomping at the bit to start again, I can't wait, well guess that's long enough if you ever want to compare notes or progress drop me a line, I enjoy hearing about different rehab exercises, til next time enjoy.
Posted by mike_motor (mike_motor), 4 January 2005

Well I guess there's three of us in this ACL/PLC/LCL boat.  

I think I've swapped info with each of you in the past, but it's been 3-4 months since I've been here.  I'm just over 9 months post op from ACL reconstruction with patella tendon, LCL/PLC recon. with hamstring, medial meniscus repair and lateral meniscus trim (40% taken off).  

I was non-weightbearing for 4 weeks, in my lcoking brace for 6 weeks.  I played golf for the first time exactly 8 weeks post-op.   Running still causes pain in the LCL/PLC area as do most activity-based movements.  Entire area between patella harvest site and LCL recon. on the side is still completely numb.

As for progress, I guess I can tell two stories and it confirms my confidence.  First, I was put through a functional test at 3 mos. which involved jumping, hopping, lateral cutting, etc.  My repaired leg was 18-20% deficient in comparison to my "normal" one.  I went back 3 weeks later and I was at  6%.  Scholarship athletes return to practice & contact at 10%, although normally around 6-9 months.  

Second story is embarassing but tells me a lot.  I was out in a restaurant a week and a half ago.  I should preface with the fact that my ankles are terrible and roll all the time.  Well I was carrying two plates of food, one for me, and one for my daughter.  When I turned to head toward the table, my left ankle rolled all the way to the floor and "stuck" out of place as it commonly does, I reacted by trying to catch myself with my repaired leg but I was too late I was headed down.  My repaired leg turned underneath me and then I landed with all my 230 lbs. right in the middle of my kneecap on concrete tile floor.  Of course, I smashed both plates of food (side point of the story was the mess I made).  I hit the floor and immediately felt the pain from just landing on the knee and thought the worst.  However, I got nothing more than a bruise and a scrape out of the fall, the twisting, and the landing etc. so I'm now pretty confient. in the knee.

I'm going on Sat. to play basketball for the first time since it all blew up just under a year ago.  I probably shouldn't do this but I went through the surgery, the PT, etc. so I could do this again, so here goes.  I'll try and remember to come back with a report.  I was fully cleared by my O/S who is one of the best around here so if he's happy, I'm happy.

Good luck to you fellow "gimpy legs", hopefully we'll all get back to normalcy in due time.
Posted by KJ (KJ), 4 January 2005

4 in the boat actually!

although I'm 3 years ahead of you all I think I'm still a bit behind when it comes to running and jumping (perhaps it's the 8 surgeries or perhaps I'm just a wimp)

However at last 15 months after my revision ACL/PCL recons with PCL reconstruction and osteotomy, I can actually hop on my bad leg now. I can't properly run yet but listening to your stories I shall aim for that in 3 months!
KJ

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