The WAITING ROOM => GENERAL KNEE QUESTIONS and comments (good for new threads) => Topic started by: peterwww on January 22, 2008, 01:27:28 PM

Post by: peterwww on January 22, 2008, 01:27:28 PM
Hey, I have been doing research on this site ever since I have been having knee trouble and have found it very useful but now I really need some help/answers so this is my first post!! Any advice is very welcome...

On November 14 2007, after carrying a frayed lateral meniscus for 11 weeks, I had a knee arthroscopy to sort out the meniscus. When the surgeon  went in with the scope, not only did he see the frayed meniscus (which he trimmed),he also discovered a piece of articular cartilage tearing away (a flap) at the back of the back knee cap (not sure was the flap on the back of the patella or on the femur). So he did an 'extensive chondroplasty'/shaved away the flap. Thta's all fine. I expected to recover properly and did EVERYTHING my physio told me to do vis-a-vis rehabilitation. After 4 weeks I still had the same symptons as before the op (i.e I couldnt get much further past 90 degrees when trying to get full flexion) so the surgeon gave me a cortisone injection which brought on my ROM from 90 to about 120 degrees.

4 weeks later and I still coudnt get past 120 degrees (without pain) so I had another cortisone injection. That however made no difference to the pain at the back of my knee when I try to squat down on my 'honkers' (arse to heels). I can achieve full flexion but with very uncomfortable pain at the back of the operated  knee when I do try. It is now 10 weeks from the op and I am wondering Is the pain im experiencing at the back of the operated knee when I try to squat down all part of the natural rehabilitation after a chondroplasty or is that I have developed arthofibrosis or maybe even damaged nerves as a result of the surgery???? If you think it my be arthofibrosis (extensive scar tissue), how do I treat this? If you think my pain is just part of the rehab process after a chondroplasty, how long does it take to fully recover after a chondroplasty? If you think it is neither of the above, can you suggest what it may otherwise be??? (a damaged nerve resulting from the op perhaps???) any thoughts welcome


Post by: austinknee on January 23, 2008, 12:39:55 AM
Im not exactly sure on your reason for pain.  I had shaving of my chondromalacia and trimming of my meniscus as well as some other things.  I do have some scar tissue issues...and other things......BUT....I can tell you that a couple of the doctors that I have seen along the way say that I may have pain from my shaved chondromalacia for a long time.  One said it may never quite go away.   I have been doing lots of PT for my other issues....and one of the things that they have me do at the PT office is this leg thing where my legs swing back and forth. There are no weights or anything, I just sit on this elevated chair, my legs over these pads and flex, extend, just gentle movement back and forth. They call it "tail gaters" probably b/c it is like sitting on the back of a truck and swinging your legs, just more technical.   At home....they have me use this flat "furniture move"r know the plastic on one side and rubber on the other thing you move your furniture around wtih on carpet?  They have me sit on the chair, put my foot on the rubber side, with the slippery plastic side down and move my leg back and forth over and over and over for 10-20 minutes....supposed to do it 3 times a day.....(its sort of a flexion./ extension type movement), over time.....the burning I had under my patella seemed to get better.    I guess the easy repetitive movements are supposed to help the cartilage get better.  I think it helped.   I still cant squat, etc.....but that is due to another issue that I have.....

It could be you can read, it happens to lots of hopefully they will post too....but, it could very well be the place where they shaved the cartilage.

hope that helps some!
Post by: kathat on January 23, 2008, 02:03:53 AM
Hi there,

The cartilage in your joints is what keeps them moving well. If you are missing some behind your patella then there is going to be irritation when you move through the range that involves that particular part of the joint. There is huge amounts of pressure on the patella during loaded flexion, especially in a deep squat, so I imagine that's why you are having problems with that movement in particular. I am not ever allowed to squat deeply for that reason - I have missing cartilage on the back of my kneecaps and bone is exposed. I get pain when I start to squat and it intensifies the deeper into the squat I go and it's worse on the way up! I can only manage 30 degrees or so with no pain. I would ask how much cartilage is missing behind your patella, and I would also avoid doing anything that causes pain - take your knee through its full range of movement but don't do it with load (so do quad stretches but no deep squats).


Post by: peterwww on January 23, 2008, 04:31:24 AM
Thanks guys. Its not that im doing dep squats as an exercise regime - its that im using a slow deep sqaut (1 a day) to test my knee - i even do this supported (holding something as i drop down) to take the load of my knee. The cycling i find good, after an hour on a stationery bike, i can do a slow deep squat (unsupported) without hardly any pain. I suppose my question is, after 10 weeks post-op, is my knee likely to improve further or will it always be like this?
Post by: austinknee on January 23, 2008, 04:49:13 AM
I cant say for sure that at 10 weeks you can tell. Im 14 months out. I still have problems (different problems)....but that pain you have DID get better for me over is a good sign that it gets better after you cycle.     Have you asked your doc about it or your PT?
Post by: peterwww on January 23, 2008, 05:01:48 AM
ya well the physio gave me an exercise regime for the 4 weeks after surgery including the stationery bike but after the 4 weeks i stopped, the advice from people on this board seems far better than the physio!! Ill keep up with the bike and will sit on a high stool swinging my leg back and forth (extension/flexion) on the days I cant get to the gym...thanks for that tip. How long did it take you before the pin subsided?
Post by: peterwww on January 23, 2008, 05:02:51 AM
... typo...i meant before the pain subsided!!
Post by: kathat on January 23, 2008, 05:44:22 AM
By keeping your quads strong you are supporting your knees and you may find the pain improves as time goes by. It sounds like you had a physio who wasn't so good, but you may want to try another one for a few visits, just to get some more exercises to do, as you should be given different exercises as you make progress. For example, I started with straight leg raises, stretches, and calf raises, then had cycling added, and walking (for slowly increasing distances). I haven't progressed any further, but my PT says that as I progress (if I do!!) he will add weights to some exercises or increase the loading by changing the exercise a bit to suit stronger muscles. So, it's worth a try, even if you only go once every month to get more exercises as you progress. Good luck!

Post by: austinknee on January 23, 2008, 02:19:13 PM
I totally agree.  My first PT (post op) was terrible. They never had time for me...were shuffling several patients around at the same waste of time. The new one is much better...but, doesnt progress me very fast based on my pain level.  They have me do many many many repititions of things at low resistance or weights...for instance...on a Total Gym machine...I do these up and down first it was just 3 it is up to 10 minutes...and they ahve gradually added a higher level. At first I was practically level with the ground. It was embarrasing as others were running etc.  If it hurt at all...even a slight burn..I was told to stop.  They had me walking, but with this machine that puts a vest around my weight and lifts me I was walking much lighter than I actually was...eventually..they lowered me more and more where I was just walking with my own weight. Then they started to ahve me walk backwards and forwards a VERY slow speed on the back way.  Like Kathy said...quad sets....and side lying "hip burners" they call them where you do side lying leg lifts to isolate the hip muscle....leg lifts with the foot turned out a bit......

My knee cap burning pain got better over time....probably in about a month........when it flairs up again...I do those "sliders" with the furniture mover thing....just lay on the couch with my leg hanging off the side of hte couch and move my leg back and forth while watching TV....seems so funny...but it helps. The knee should be at a 90 degree angle so Im not how sure the bar stool will work for you unless your leg is supported with a 90 degree angle between your thigh and your calf.....

hope that helps....I know there are tons of folks who might have quad exercise pointers for could start a new thread with that in the title and I bet you would be lots of replies.

Post by: gigi67 on January 23, 2008, 03:17:29 PM
weeeell. heres m,y take. ill advice you the same as i have can consider it or not. if you have access to a local indoor pool nearby...go there. hydrotherapy is virtually pain free. after breaking my knee cap in 3 pieces 8 monhts ago i also had broken my foot but they didnt know until 6 wks later when i was still complaining of foot the time i was out of a wheelcahir and on crutches 2 n half months later i couldnt bear weight on my foot due to such excruciating pain 4 months later would wake me up at night. I was diagnosed with RSD....went to a podiatrist he said it was a trapped nerve. My PT folks said" walk in the swimming pool" just walk from end to end. i started off on two crutches. barely inching through that pool so stiff and slow barely able to walk.... months later i was actually able to kick through the water. while in the water outside of walking from end to end i woaul bend my leg was soooo much easier than trying to bend it out of water. i would bend it backwards. i would raise it oout in front of me and bend it at the knee..i would raise it out in front and simply push down straight to strengthen the  leg with resistance. eventually i was able to hold onto the side of the pool and kick..just kick forward and it definitely got me walking again with a disorder alot of people say they never recover fromRSD so whether it was that or the trapped nerve whatever it was... hydrotherapy made me walk again..just a suggestion tho.