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Author Topic: trouble with extension 9 weeks post op partial menisectomy  (Read 989 times)

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Offline kosmo

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HELLO ALL...NEW HERE.
   I AM 9 WEEKS POST OP FROM A BUCKET HANDLE FLAP TEAR PARTIAL MENISECTOMY ON THE MEDIAL SIDE OF MY RIGHT KNEE. I AM A VERY ACTIVE 41 YEAR OLD WITH CONCERNS THAT I AM STILL LIMPING. I HAVE SWELLING AND AM ON MY SECOND ROUND OF STERIODS. I HAVE TROUBLE WITH INFLAMMATION. DOCTOR SEEMS TO THINK EVERYTHING IS ON TRACK AND TO TAKE IT A BIT EASIER WITH THE PT. PT THINKS THERE IS SOMETHING WRONG BECAUSE I SWELL UP WHEN I GET MY LEG STRAIGHT AND THAT I CAN'T KEEP IT STRAIGHT. PT IS HARD WORK AND IT HURTS BUT I DO WHAT THE PT SAYS.  I AM CONFUSED AND HAVE BEEN TRYING TO LOOK UP INFORMATION ON MY OWN TO SEE WHAT THE NORMAL HEALING TIME IS. I WAS INJURED 3 MONTHS AGO AND HAVE BEEN LIMPING SINCE THEN AND CONCERNED THAT I AM LEARNING UNHEALTHLY HABITS BECAUSE OF THE TIME IT IS TAKING TO GET FULL EXTENSION. ANYONE?
KOSMO FROM THE CAPE

Offline Heather M.

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Re: trouble with extension 9 weeks post op partial menisectomy
« Reply #1 on: June 01, 2006, 07:20:40 AM »
I think your instincts are telling you that something is going on.  Some people do have swelling for prolonged periods of time, but after a straight-forward menisectomy, I really would expect to have my extension back at over 2 months post op!  I've often had full extension back within a few days of surgery.  That's because I have a really bad problem with forming scar tissue and getting crazy swelling after surgery, so extension is always my top priority.

If you are getting serious pain during and after PT, then you may want to consider finding a new therapist or working with a new philosophy...the pain and pushing hard in PT may be actually causing further inflammation and swelling in the knee...it's a vicious circle, and sometimes if the patient is able to break that circle early enough in the rehab process, they are able to get back on track.  Check out posts in the soft tissue healing problems - arthrofibrosis section==especially the ones from kneegeek "youngblood."  He had a nazi-like PT who pushed way too hard, and by backing off and doing nothing to cause pain or irritate the knee, he was able to make some dramatic improvements.  There are lots of other posts in that section which detail the PT philosophy for scar tissue patients.  This philosophy calls for doing nothing that causes pain or swelling, even if it means stopping PT, going back to the 'day after surgery' basics, and using crutches to ease problems caused by early weight-bearing. 

The following article is about rehabbing after ACL surgery (ligament in the center of the knee), but it was written by a doctor with lots of experience with scar tissue...and he knows a great deal about the PT philosophy I am talking about.  The exercises for extension and flexion in the first few 'phases' of ACL recon that are described in this article may actually be very helpful to you.  I'm specifically thinking of quad sets, straight leg raises (done sitting up with your back against a wall for now), wall slides (done lying down), patellar mobilizations, and VERY gentle spinning on an exercise bike.  These can all be done within the first few days following a surgery like yours because they are non-weight-bearing and very easy.  But it's always good to check, so you may want to print the article and ask your doctor if you can do the stuff listed.  I did the exercises listed above about 4-6 times a day at a minimum, and always iced afterwards.  And I made sure to keep my leg in full extension when in bed or resting on the couch--don't put a pillow under your leg/knee or sit with it bent, try to keep it in full extension all the time.

It's likely that you are limping because you don't have full extension yet.  This is a pretty big deal, but as long as you are showing some signs of progress I wouldn't hit the panic button.  But I wouldn't be put off by the doctor, either--ask him if he would be so complacent if his child were having your issues at 9 weeks post-op--personalize it, let him know what an impact this is having on your life.  Ask him what could be preventing you from getting full extension--what are the complications that might cause this?  I can think of a few...scar tissue and a new meniscal tear.  Swelling would do it as well, but then the question is WHY you have such severe swelling despite two doses of steroidal anti-inflammatories....

If you aren't comfortable, you may want to get a second opinion.  If you want to post the general area where you live, someone may be able to recommend a good doctor.

Here is the article.   http://www.drmillett.com/image/59/acl.doc  The exercises are on the first 5 pages or so, and more follow after the discussion of surgery.  Hope this information helps.

Heather
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Offline queenie90247

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Re: trouble with extension 9 weeks post op partial menisectomy
« Reply #2 on: June 01, 2006, 09:20:10 AM »
hi 9 weks ago i had surgery   tore  meniscus lateral and  medil and also tore  acl   swelling  right after surgery and still very swollen 6 weeks afer surgery pain started coming back  no idea why waiting for naother mri to rule out reinjury but pain still there      ad for swelling i dnt know    when will goawya ive bee told sometimes the swelling will never go away

Offline moonbeam

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Re: trouble with extension 9 weeks post op partial menisectomy
« Reply #3 on: June 02, 2006, 08:10:27 AM »
Dear Kosmo

I'm in the same boat only was able to  get more extension after the first cortizone  shot. Did you have any numbness or hardness in the spot where he injected? My outer knee felt like a stretched band of tissue. I still felt like the mechanics of my knee were not working properly and the whole almost 8 weeks I've had a lower backache. I finally paid for my own chiropractic help. I would have done anything to feel better. That and lower back exercises did not solve the problem.
I have also recieved a 2nd cortizone shot to try to allieviate the frontal knee pain. Any weakness in your legs? I got worried about scar tissue so I went to my pt and asked to try some IBT exercises . He didn't think I was at that point with scar tissue. I seemed to have good range of motion. I thought the point was to not let scar tissue form at all. My OS says he dosen't know why I'm not back to all normal duties so when I come back he'll take another x-ray and get a second opinion. How encouraging is that? I think if you can communicate with your OS I'd discuss the possible causes like scar tissue or pain issues. Where is your pain located? I am hoping you find some help soon!

Offline kosmo

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Re: trouble with extension 9 weeks post op partial menisectomy
« Reply #4 on: June 03, 2006, 02:24:07 PM »
KOSMO HERE...........THANK YOU FOR ALL YOUR POSTS. I AM NOW 10 WEEKS POST OP AND FEELING A TAD BETTER. I AM STRAIGHTER AND MY LIMP NOW SEEMS MORE LIKE A WADDLE. I THINK THAT PERHAPS I OVERDID IT WITH THE STRETCHING AND STRAIGHTENING EXERCISES AND THAT MAY HAVE BEEN WHAT CAUSED THE SWELLING. WHEN MY KNEE SWELLS IT FEELS STUCK AND THAT IS NOT A COMFORTING FEELING, SINCE I HAD A LOCKED KNEE TO START WITH. AT THIS MOMENT THE PT HAS SAID TAKE IT EASIER UNTIL THE NEXT OS APPOINTMENT. IT JUST SEEMS LIKE SUCH A LONG PROCESS AND I DO THINK THAT BOTH MY OS AND PT HAVE BEEN DOING THEIR BEST TO GUIDE ME TO WELLNESS. I KNOW I PUSH IT AND MADE PROGRESS WHILE PUSHING IT THEN LATER I WOULD HAVE SWELLING AND PAIN AND WOULD GO BACKWARD. NOW THAT I HAVE GONE WITH A MORE SLOW APPROACH TO STRETCHING AND BENDING I FEEL LIKE I AM SLOWLY MAKING PROGRESS. SO FOR THE MOMENT ALL IS WELL. DARE I SAY THAT OUT LOUD. HA   I JUST WANT TO BE LIKE I WAS BEFORE, I WANT MY OLD LIFE BACK. AGAIN I THANK YOU FOR LISTENING AND RESPONDING IT IS A GREAT COMFORT TO BE ABLE TO SHARE MY STORY. AND TO ANSWER THE QUESTIONS THAT SOME HAVE ASKED, MY KNEE PAIN WAS AT THE SITE OF THE SURGERY AND THE KNEE CAP. SOME INSTABILITY AGAIN AT THE SITE OF THE SURGERY BUT IT SEEMS WITH PRACTICE IT GETS BETTER. HAVE A GOOD DAY ALL.

KOSMO FROM THE CAPE















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