Cruciate ligaments :
PCL rehab - - Posted by wouter (wouter), 12 January 2005
Hi all, great board full of info.
I am currently 3 weeks post-op for a PCL recon (hamstring autograft). Just wanted to check if any of you have experience concerning the rehab.
I'm off crutches, back to driving and work since last week, still some swelling and some dull pain sometimes.
According to my OS and PT I will have to wear a brace until 14 weeks post-op and would have to wait till that time before flexing more than 90° - to avoid tearing the graft. This seems a bit conservative to me, so I would like to hear your experience/opinion.
Of course I don't want to go overdoing my knee, but on the other hand I'm a bit frightened that such a long time of not flexing more than 90° will make the knee very in-flexible indeed.
All opinions are welcome...
Posted by Michele_TX (Michele_TX), 21 January 2005
I am currently 14 week post PCL surgery. I find it interesting that you're off of crutches, but on the other hand, he wants you to wear a brace for 14 weeks. Sounds like conflicting information.
I was on crutches for 8 weeks (at 6 weeks, I was told to start weaning myself off of them.) Flexion was extremely limited, and because of that, I couldn't get past 90 degrees for awhile- but I definitely hit it before today (like I said, I'm at exactly 14 weeks.)
2 weeks out of surgery, I could get 30 degrees with a lot of work. By the third week, I was at 75 degrees. 4th week was 80 degrees (definite stall in progress.) I can't recall exactly when I hit 90 degrees, but once I did, I was stuck there until the end of December! At that time, something broke free and I pushed it to 107. I'm currently at 120 degrees, and my OS and PT tell me that I should aim for 135-140. My good knee is around 150. Always make sure to practice flexion passively (i.e. sitting on a table and letting your leg drop naturally.) I was told over and over again not to engage the hamstring muscle. In fact, I don't think you can do any hamstring work until 6 months post op.
I just had a follow up appointment with my OS on Wednesday, and he was pleased with my flexion. He told me that some of his patients (and he does more PCL reconstructions than any surgeon I spoke with) push flexion too fast and end up stretching the graft a bit. He would actually prefer that PCL patients not achieve complete flexion in the long run since it tugs on the PCL a lot. He'd rather they have better stability at the expense of a few degrees of motion.
As for the brace, I went from a full leg brace to a simple knee hinged knee brace at the beginning of November. I wore that one for a few weeks and completely dropped it by Thanksgiving.
Sorry for the lengthy post but flexion was something I worried about for a loooong time. With PCL surgery, you feel like your knee is going to break in two... but the motion will come eventually.
Posted by ATsoccergirl (ATsoccergirl), 21 January 2005
Wouter-
Do you have a full thickness or split graft?
Posted by wouter (wouter), 24 January 2005
Thanks for the replies! I'm wearing a knee hinged brace all the time probably (just some 40cm long, 4straps at the back and 2 in front) as it hinges at the knee, so maybe that explains the 'off crutches' thing.
Wow working on that flexion must have been a hell of a job (i had 90 flexion all the time so that was easy up to now). Hearing your OS's words, I guess I'll be a good boy and limit the flexing for now. I don't really have an enormous desire to go back to Knee Instability Land.
@soccergirl: I have no idea on the graft type (I'm even only really sure about the 'auto' part, the hamstring is an educated guess). Wednesday I'll probably see my OS, it's definitely one of the things to ask for, I'll let you know then.
Posted by missylizzyelucy (missylizzylucy), 25 January 2005
It's good to get all this information about PCL rehab! I have my surgery coming up in March and I am kinda freaked out about it. My OS told me that he expects me walking without crutches by week 4, but that some people can walk without crutches by just 10 days post op! (I am hopeful that I fall into that catagory, I really do not do well on crutches, as I carried the ones perscribed by the ER doc, into my appointment with the OS just 3 days after injury)
I have read so many conflicting things on the internet about PCL reconstruction, that I am not sure what is what, and what is going to happen with me.
All I know is my OS is gonna use an allograft achilies tendon (cadavar) and reinforce it with my hamstring... he said something about twisting them for tensil strength.... I dunno! And that he is gonna bring in another surgeon so that they can all "keep their skills sharp."
Should that worry me?
He also said that it wouldn't be until November that I could return full force to sports and activities (arg!!!) So that also has me freaked!! I know it'll all be worth it... considering I feel as if I have no stability in my right knee right now, what so ever.
It's just nice to know that other people have gone through what I am going through!
Lucy
Updated Sat Nov 21 2009
