The WAITING ROOM => GENERAL KNEE QUESTIONS and comments (good for new threads) => Topic started by: shaush1977 on November 16, 2013, 06:55:42 AM

Title: MRI Results
Post by: shaush1977 on November 16, 2013, 06:55:42 AM
I got the results of my MRI today and it is what I thought. The findings were:
1. Anterior Cruciate Ligament disruption
2. Extensive Marrow contusion involving the medial central and lateral tibial plateau regions (Does this mean "bone Bruise?")
3. Large Knee effusion/hemarthrosis (Swelling?)

I have been referred to an OS (still waiting for an appt.), but the GP said I would need surgery for the ACL. Are items 2 and 3 of any concern, or are they just a result of the ACL Tear?

Title: Re: MRI Results
Post by: IHMK on November 16, 2013, 01:14:58 PM
Shauna, the bone contusions (bruises) are the likely cause of the ACL disruption rather than the other way around - or rather, the impact of femur against tibia meant your ACL didn't have much of a chance. If there is no break, or at least no displacement, that's all to the good.

They are of concern in that they can take a while to heal, but they don't need surgical intervention. I'm guessing that weight-bearing is painful right now?  How long ago was your accident?

Take care of yourself!
Title: Re: MRI Results
Post by: shaush1977 on November 16, 2013, 04:03:31 PM
The accident was 2 weeks ago. Weight bearing has not been a problem for about 10 days now; however, I am still unable to fully straighten the leg. If/when I do(accidentally), it is extremely painful. Right now that is my only problem. I've been doing ROM stretches, but they don't seem to be helping (I only need about 5 more degrees, but it just seems stuck.)

Thanks for your reply.
Title: Re: MRI Results
Post by: IHMK on November 17, 2013, 03:46:22 PM
Have you been referred to a physical therapist yet? Typically if the patient does not yet have full ROM, the goal is to get it by the time of surgery, unless it is felt by your doctor/PT that there is an impediment to regaining it without surgery (e.g., there is torn cartilage or other debris in the way). Although there are lots of good exercises you can do to regain extension (prone hangs are my favorite), I'd want to be sure there isn't an obstruction. But as I recall, extension was pretty painful for a long time.  It does get better.

You should look through the post-op diaries to see if any of them are actually pre-op diaries as well.  I started my blog about 3 weeks after my injury (had surgery 3 months after the injury) so there might be something in my experience that you would recognize in your own progress, and that would be of use to you.
Title: Re: MRI Results
Post by: shaush1977 on November 17, 2013, 05:52:21 PM
Thanks IHMK,
No PT yet. This is a workers comp case, which makes me think that it is moving slower than it should. I have been reading the diaries, but have not started researching pt exercises  for pre-op.
My MRI report didn't mention torn cartilage, but from looking a the actual films, I think there is a tear. I'm not a dr, so I'm probably wrong--but it really looks like it to me. The report also mentioned a small bakers cyst. Could this be preventing full extension?

I'm going to go research pre-op stretches now. Hopefully I'll have full range before my appt with the OS. I just want to get the surgery done already. I don't do well with waiting or with inactivity.

Thanks again,
Title: Re: MRI Results
Post by: IHMK on November 17, 2013, 08:22:42 PM
Baker's cyst is often associated with meniscus damage; I would think the cyst would be more of an impediment to flexion than extension but I'm not a medical doctor either.

My PT always says that the rule of pain should be that as long as the pain stops when you stop the activity, or shortly thereafter, it's okay. So I would think it would be okay to experiment with the very basic exercises for regain of ROM, carefully.

Before my ACL surgery I would do an extension exercise every hour during the day - and it would hurt every time  (and ease up after a few repetitions). If you decide to give it a try, just be careful.

I'm sorry you have to wait.  Is this the sort of thing where you have absolutely no control over the timing of things, or can you make a phone call every day until they get so sick of you they fast track you just to get you out of their hair?
Title: Re: MRI Results
Post by: shaush1977 on November 17, 2013, 09:08:02 PM
Unfortunately, I have no control over the timing. I have to wait for authorization. I'm in California, so I think they only have 5 business days to approve the request. So, by Next Friday, I should have an appointment date with the OS; but who knows how far out he is scheduling right now.

I checked out your blog and went to the Mass General website you linked to to check out the exercises. I started from the top and tried to work my way down. Some were easier than others, but the Quad sets and leg lifts had me in tears. I can't believe how mushy my Quads feel! I contacted my personal trainer and I'm setting up some sessions to get back into the gym so that the rest of my body doesn't atrophy. He's really good at isometric-type workouts, so I think I should be ok once I get going. As far the the pre-hab exercises, I'll just keep at it until I can do them efficiently.

After being able to fully extend my leg after the quad sets, I thought I'd give it a shot while standing--huge mistake! I thought I was going to pass out from the pain! Maybe I'm not ready to walk like a normal person yet ???

Title: Re: MRI Results
Post by: IHMK on November 17, 2013, 09:41:09 PM
Don't get discouraged - no matter what! Your accident was very recent, and you are already in much better shape, for the short time that has passed, than many at the same time point. You need time to heal, but I'll bet you'll come through it with flying colors.

Yeah, I'll bet that did hurt, standing up!  Just give it time :)