KNEEtalk

The WAITING ROOM => GENERAL KNEE QUESTIONS and comments (good for new threads) => Topic started by: yebba on June 27, 2020, 11:29:37 PM

Title: ACL reconstruction, cyclops lesion, now MORE scar tissue???
Post by: yebba on June 27, 2020, 11:29:37 PM
Hi everyone, hoping for some advice! Iím a 24 yo female who, before tearing my ACL and lateral meniscus in February 2019, was very active (college soccer player). I had a meniscectomy and a patellar tendon autograft in April 2019.

PT was going well until I realized I hit a plateau sometime in the fall of 2019. I was having issues with extension, pain when extending, achiness, stiffness, and sensitivity on and around my scar. My surgeon said everything was normal and I was still within the standard timeframe for ACL recovery.

I pushed him on it and got an MRI in December, which showed a cyclops lesion. I had a knee arthroscopy to remove the cyclops lesion (and one of my screws that was bothering me) in late February 2020, and immediately felt much better. However, due to a sterile suture abscess, I had to put a halt to physical therapy, which I then resumed once the abscess healed. A couple months later, when I should've been "healed," I was starting to develop a similar pain to what I had had before the second surgery.

Admittedly, I think I pushed a little too hard on physical therapy - I thought that I perhaps had developed the cyclops lesion due to not being aggressive enough in my therapy and didn't want to develop scar tissue again. I now realize that sometimes being too aggressive can lead to chronic inflammation --> arthrofibrosis, but it's hard for me (and my doctors) to say if that's true. Either way, I am now seeing a new doctor and got another MRI a few days ago. I was told that the scar tissue had come back and there may be a problem with the integrity of the reconstructed ACL itself.

For personal reasons, it's not a good time to do an ACL revision surgery (I also would want to get a second opinion on that), but I'm wondering if it makes sense to do yet another surgery to remove the scar tissue. On the one hand, this could "interrupt" the inflammation cascade that could be contributing to the scar tissue development and pain I still have; on the other hand, I'm thinking it could lead to more scar tissue formation and potentially other, serious issues down the line (e.g. osteoarthritis). Iím not sure if the scar tissue I have can be fixed with physical therapy alone (and if so, what that would entail) or if surgery is really my best bet here.

Another potentially important thing to mention is that someone in my family went through a very similar progression (ACL surgery, then surgery to remove scar tissue, and now has continual pain and stiffness and problems with his fat pad), so there may be some genetic component in addition to the possibility of issues with physical therapy. (Or maybe none of these things actually impact recovery????)

If anyone has any thoughts or advice, I would greatly appreciate it! I am currently scheduled for the knee arthroscopy this coming week so I need to make a quick decision!
Title: Re: ACL reconstruction, cyclops lesion, now MORE scar tissue???
Post by: The KNEEguru on June 28, 2020, 09:19:52 AM
What is your current range of motion?

Do you know of our Facebook group? https://www.facebook.com/groups/AFwhatsthat/
Title: Re: ACL reconstruction, cyclops lesion, now MORE scar tissue???
Post by: The KNEEguru on June 28, 2020, 09:30:51 AM
Also this might be useful, although it is now a bit old - https://www.kneeguru.co.uk/KNEEnotes/courses/arthrofibrosis-12-part-course