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Author Topic: An insight into the medial patello femoral ligament reconstruction!!  (Read 13170 times)

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Offline daffy

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Well,

Had a Medial patello femoral ligament recontruction two days ago and i just thought i would write down my experinces as this operation is not one that it done all the time, but is slowley becoming more popular for dislocating patellas!!!

Operation day - Had a general anaesthetic and injections into my spine which wernt to bad. This numbed me from the waist down so was really good for pain managment.Think my operation took about 2 hours, which isnt to bad.
The pain was not to bad for about 5 hours after, as the injection had still not worn off, but by the night time it started to get really uncomfotable, and by the next morning well i couldnt get off the bed. I was taking antibiotics, parecetemol and morphine. This did help some what!!

Ive been fitted with a full leg donjoy brace, restricted to 45 degrees movement for two weeks and then 90 degress for two weeks after that. I also have crutches but am allowed to fully weight bear which is good. Ive been told i can ditch the crutches as soon as i feel comfortable doing so.

Exercises at the moment just consist of little heel slides and contracting the qudriceps, am going to have my first physio session in two weeks, so that should be intersting.

Thats about all from me for the moment, hopefully this will give those of you who are down to have this operation a little insight as to what may be in store for you, after the first couple of days it does get easier.

If any one has got any questions, dont hesitate to get in touch would be pleased to share my experiences.

Will let you no how i progress over the next couple of days.

Daffy x
March 06 -  (L) Patella tendon debridement and microfracture

July 06 - (R) MPFL Reconstruction

Offline doublea21

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Re: An insight into the medial patello femoral ligament reconstruction!!
« Reply #1 on: July 13, 2006, 12:00:48 PM »
Daffy,

Good Luck with your recovery.  I am having the MPFL reconstruction today so we will have to compare notes on the recovery. 

Amy
Dec 98 - R and L knee LR and VMO advancement
Dec 00 - L knee TTT
May 02 - R knee TTT and VMO advancement
Dec 04 - R knee screw removal
still too many subluxations and dislocations
July 06 - R knee MPFL Reconstruction

Offline shade

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Re: An insight into the medial patello femoral ligament reconstruction!!
« Reply #2 on: July 13, 2006, 12:26:09 PM »
Daffy and Amy,

Hope you both have speedy recoveries. 

Found this article....   http://www.orthoclinic.co.za/art_mpfl.html

Good luck with your upcoming physio sessions.  ~Shade

July '05 (RK) - LR/debridement
Mar '06 (RK) - Open LR + Allograft w/OBI TruFit Plug + Fulkerson TTT
 Feb '07 (LK) - LR + Fulkerson TTT

Offline Amanda82032

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Re: An insight into the medial patello femoral ligament reconstruction!!
« Reply #3 on: July 13, 2006, 04:43:36 PM »
Daffy & Amy,

Good luck with your surgeries! You'll both be in my thoughts!!

Daffy : I'm having a reconstruction of all of my ligaments around my patella. I've also had a VOM advanc. When I had the VOM done, every movie of my leg seemed like I was pulling a muscle. Is that what it is like for you? Just curious. Keep up with the excercises. They are bound to get you moving sooner!!  :P

Amanda
18yo
Jan. 04=LR=R
Mar. 04=VMO Adv=R
Jul. 04=VMO Adv=L
Jan. 05=Chondroplasty=R
Jul. 05=TTT=R
Nov. 05=TTT=L
Jan. 06=Goodbye staple=R
Jul. 06=Patella ligament recon&shortened patellar tendon=R
Dec. 06=Goodbye staple=L
May 07=diagnosed w/EDS
Jul. 07=MPFL recon=R&L

Offline daffy

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Re: An insight into the medial patello femoral ligament reconstruction!!
« Reply #4 on: July 14, 2006, 03:42:47 PM »
Hiya Amanda,

Yup thats what it pretty much feels like. I have alot of discomfort on the inside where the reconstruction was done, and i do get pain in my hamstring from where the graft was taken. I sometimes get this really bad buring sensation which is pretty intense and is not to plesent, but hopefully that wont last for much longer. Just wish i could ice my knee, but ive got a huge bulky bandage and a brace on so theres no way the colds going to get through!!!

When are you having your reconstruction?, i hope it all goes well for you.

Right im going to have a lil sleep, this operation has really knocked me for six!!!, i can harldy keep my eyes open......


Daffy x
March 06 -  (L) Patella tendon debridement and microfracture

July 06 - (R) MPFL Reconstruction

Offline Amanda82032

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Re: An insight into the medial patello femoral ligament reconstruction!!
« Reply #5 on: July 14, 2006, 09:17:24 PM »
Daffy,

Thanks for the insight into your surgery! I just wondered if it was the same feeling. I'm sure the pain will subside soon. Plus, the pain meds must help! I would still try icing the knee though. You never know! It might go through the bandages!!

My reconstruction is on Wednesday of next week. I'm having a little more done than just the recon. Im having my patellar tendon shortened & my trochlear groove deepened.

Good luck! Keep us updated!!

Amanda
18yo
Jan. 04=LR=R
Mar. 04=VMO Adv=R
Jul. 04=VMO Adv=L
Jan. 05=Chondroplasty=R
Jul. 05=TTT=R
Nov. 05=TTT=L
Jan. 06=Goodbye staple=R
Jul. 06=Patella ligament recon&shortened patellar tendon=R
Dec. 06=Goodbye staple=L
May 07=diagnosed w/EDS
Jul. 07=MPFL recon=R&L

Offline daffy

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Re: An insight into the medial patello femoral ligament reconstruction!!
« Reply #6 on: July 17, 2006, 09:54:09 AM »
So,

Its day 6 today and not feeling to bad. My knee still has its sore moments, and a few blood rushes but i can see an improvment already which is good.
My ROM is getting better too, i can manage to get my knee to 40 degrees with only a little discomfort, so hopefully it will not be to much of a struggle for me to then progress onto 90 degrees in another week.

My main pain site in the knee, is medially where the graft was harvested to the femur, havnt felt much over the actual patella itself. Where abouts is your pain amy, same kind of place or just everywhere???

I can now walk around the house, without the aid of crutches which is good, although i still definatley need them when i go out.
I get to take the bandages and stitches out tommorrow which will be cool, just hope my knee dosnt look to much of a mess!!. Ill try and post some pictures to show you all.


Amy, how are you doing hun?, your knee still causing your lots of pain?. Keep me updated on your progress, be good to compare to see where we both are in terms of recovery.

Amanda, all i can say is WOW!!!, that is some major surgery your getting yourself there, i really hope it all goes ok for you, let us no how u get on.

Right im offski, actually getting out of the house today!!, cant wait

Daffy x x x
March 06 -  (L) Patella tendon debridement and microfracture

July 06 - (R) MPFL Reconstruction

Offline doublea21

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Re: An insight into the medial patello femoral ligament reconstruction!!
« Reply #7 on: July 17, 2006, 10:18:33 AM »
Here has been my experience with this surgery:  A little background for people who don't know me.  I have had problems with dislocations/subluxations since I was 8 years old (i'm 23 now).  I have had several surgeries on both knees to try and fix the problem and I considered the TTT to be a success with some subluxations but no dislocations for both of my knees for 5 years on my left leg (and still continuing) and 2.5 years on my right knee.  That was until about a year and a half ago when I slipped on metal stairs and dislocated my right knee.  Since then my right knee continued to deteriorate until it was as bad if not worse than it was before the TTT.  I had a lot of trouble finding a new surgeon who would touch my knee since I moved and could not go back to my original OS.

Surgery Day:  I arrived at the hospital at about 9:45 and was taken into surgery at about 12.  I had an MPFL reconstruction using hamstring tendon and had the cartilege shaved down on my patella and trochlear groove.  The damage to the cartilage was not as bad as my OS expected which was good.  When I woke up in the recovery room I did not have much pain which was surprising but I did have a femoral nerve block.  I was released at about 5 and then went home.  All of a sudden I had very severe pain which I could not get under control until around 11 pm.  My mom thought about taking me to the ER because the pain was out of control but the thought of trying to get back down the 3 flights of stairs was pretty scary so I tried to tough it out.  Once the pain got under control it has not been too bad.  Making sure I stay on top of the pain meds and have the cryocuff on the hole time.

I am in a brace locked at full extension for the next 2 weeks until I see my OS again.  I am touch down weight bearing.  I don't start PT until after I see my OS again and he doesn't want me to start to bend my knee until that point so that the new ligament will start to scar down a little to make the graft stronger since I have very loose joints and have almost no trochlear groove.

Day2 was not too bad pain wise as I finally got the pain under control, that is until last night when the nerve block wore off and I ended up with spasms in my knee and a lot of pain that was once again out of control.  My mom called my OS office yesterday and talked to his nurse who increased the frequency of the pain meds but would not give me anything more.

It is now the morning of Day 3 and I have not gotten very much sleep because my pain is only controlled for the 1st hour after taking the meds and then it is back to extreme pain for the next 2 hours before I can take anything.  I always thought that I had a high pain tolerance but this is more than I can deal with.  I have never had this much pain post op from all of my other surgeries.

Daffy,

Glad  to hear that your pain is gettting better too.  I am off to PT today to meet with them and probably get a TENS machine to help with some of the pain so that I can switch back to lighter pain meds that don't knock me out as much as my current ones.

Amy
« Last Edit: September 07, 2006, 01:24:23 AM by doublea21 »
Dec 98 - R and L knee LR and VMO advancement
Dec 00 - L knee TTT
May 02 - R knee TTT and VMO advancement
Dec 04 - R knee screw removal
still too many subluxations and dislocations
July 06 - R knee MPFL Reconstruction

Offline Amanda82032

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Re: An insight into the medial patello femoral ligament reconstruction!!
« Reply #8 on: July 17, 2006, 11:12:17 PM »
Daffy,

Thats awesome that you're walking around the house without crutches! You're making so much progress!! Keep up with the good work, just don't push it! Things have to heal. Pics would be great, though! I haven't seen pics from anyone who has had this surgery.

Keep us updated.

Amanda
18yo
Jan. 04=LR=R
Mar. 04=VMO Adv=R
Jul. 04=VMO Adv=L
Jan. 05=Chondroplasty=R
Jul. 05=TTT=R
Nov. 05=TTT=L
Jan. 06=Goodbye staple=R
Jul. 06=Patella ligament recon&shortened patellar tendon=R
Dec. 06=Goodbye staple=L
May 07=diagnosed w/EDS
Jul. 07=MPFL recon=R&L

Offline daffy

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Re: An insight into the medial patello femoral ligament reconstruction!!
« Reply #9 on: July 27, 2006, 05:38:58 PM »
Day 17 - Well had my first session of physio yesterday and didnt do alot really. Infact got the impression he was quite useless and didnt really no what he was doing with me really, but ill see how it goes next week i suppose and if not ill have to pay for private treatment i reckon.

Saw my surgeon today for the first time since the op, and went really well actually. So far have had a brace on at 40 degrees on for two weeks, and then increased it yesterday to 90 degrees and was told i would have to wear he brace for another two weeks. Well surgeon saw me today and said i was doing really well and that he thought i did not need to wear the brace anymore and he wants me to really work hard on getting my quad strength back and increasing my rom. Think he thought the brace was hindering my progress so thought i was best to get rid, which is fine with me as its absolutley boiling weather at the moment and this and a big bulky brace dont mix!!!! I got just over 90 degrees today, with quite a bit of discomfort by the surgoen really pushing it back, and then really straightneing my leg which also was not plesent!!!

But saying that felt better almost immedialtey walking on it, becuase some of the scar tissue had broken down. Going to keep bending and straightening to prevent any further build up.
I am on one crutch at the moment, just until i sort my walking out but he wants me off it by 48 hours, which is cool. Just hope my knee dosnt give way or anything.

I also asked about driving and he said when i can get my knee to at least 90 degrees comfortabley and i would be able to do an emergency stop then i would be able to stary driving, so thats the goal im setting myslef this week and hopefully ill reach it.

Sorry didnt manage to post pics, my camera is broken. There not alot to see any more though really. Am really impressed by how neat every thing is. I had two tiny scope lines on the outside of my knee which you cannot see at anymore. I have one 2cm line across the knee cap, about a 3cm line on the inside of my knee and about a 2 inch scar where the graft was harvested just below the knee cap.

Right well just thought id let everyone know the latest, think im doing alright really, hopefully things will keep improving.

Amy how are you doing?,Hopefully you have managed to control your pain.

Have loads of questions:
Have you started physio yet?
What are your scars like?
ROM?
Let me know how your doing. Hope your well anyway and your knees not getting you down to much.Try and stay positive.

Daffy x
March 06 -  (L) Patella tendon debridement and microfracture

July 06 - (R) MPFL Reconstruction

Offline doublea21

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Re: An insight into the medial patello femoral ligament reconstruction!!
« Reply #10 on: July 30, 2006, 08:28:34 PM »
Daffy,

My pain is now much better and really only hurts when I do too much.  I went back to the OS on DAY 10 and had the stitches removed and was allowed to start to bend my knee but my brace is still locked in extension when I am up and walking.  I was given the ok to try and go down to 1 crutch but I have had some trouble trusting my knee enough to get rid of one of them yet.  I started PT on day 10.  It is now DAY 17 and I have about 40 degrees of motion when doing my exercises.  I have some pictures of my knee that I will try and post but I need to find the connector for my digital camera to my computer.  I only have 1 added incision as my OS opened previous scars again but I have the long incision at the bottom of the patella for the graft harvest and then an incision on the inside 2 scope holes and one small 1/2 inch scar on the outside of my leg from where the graft was achored.   I am going to try to go back to work tomorrow for the first time so we will see how that goes.

Amy
Dec 98 - R and L knee LR and VMO advancement
Dec 00 - L knee TTT
May 02 - R knee TTT and VMO advancement
Dec 04 - R knee screw removal
still too many subluxations and dislocations
July 06 - R knee MPFL Reconstruction

Offline doublea21

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Re: An insight into the medial patello femoral ligament reconstruction!!
« Reply #11 on: July 30, 2006, 09:36:29 PM »
Here is a link to some pictures of my knee.

http://s93.photobucket.com/albums/l71/doublea21/

Amy
Dec 98 - R and L knee LR and VMO advancement
Dec 00 - L knee TTT
May 02 - R knee TTT and VMO advancement
Dec 04 - R knee screw removal
still too many subluxations and dislocations
July 06 - R knee MPFL Reconstruction

Offline doublea21

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Re: An insight into the medial patello femoral ligament reconstruction!!
« Reply #12 on: August 04, 2006, 05:25:38 PM »
Yesterday was 3 weeks post op for me and my brace was finally unlocked to 40 degrees.  I can have it unlocked when inside places but when walking around the city I am still supposed to keep the brace locked and I am still on both crutches because I have no confidence in my knee after years of problems.  I have about 60 degrees of motion when the brace is off at PT.  I am supposed to start to go down to one crutch to get more strength and confidence in my leg but haven't gotten down yet.  I will be in the brace for probably close to 3 months. 

I have been back to work for a week now and I am very tired when I get home but have not had any problems getting back.  I arragned my work schedule so that I can be sitting during most of the day for the first 2 weeks that I am back before having to do more that requires me to be on my feet for long periods of time.

Daffy, how is your recovery comming? It is interesting to see the different rehab protocols for surgery.  I know my OS was going to be very conservative with the rehab for me because of all the problems that I have had in the past with my knee. 

Amy
Dec 98 - R and L knee LR and VMO advancement
Dec 00 - L knee TTT
May 02 - R knee TTT and VMO advancement
Dec 04 - R knee screw removal
still too many subluxations and dislocations
July 06 - R knee MPFL Reconstruction

Offline daffy

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Re: An insight into the medial patello femoral ligament reconstruction!!
« Reply #13 on: August 06, 2006, 02:27:02 PM »
Hey,

Well things are starting to go quite well for me. Had a little set back with an infection in my knee which was causing me to have calf pain and cramping but that is healing up nicely now, thank god!

Im at physio twice a week, and doing lots of exercises at home for it, really trying to increase my range over 90, hopefully ill do it this week.
Ive started driving again now which is soooooo good, i can finally get out of the house and go the gym and go swimming and things. The four walls of my house were killing me, going to be a little while until i can start back at work becuase i still cant walk properly as i have trouble with straightening my leg peoperly when i walk and i work in a resteraunt.

Sounds like your doing well, feels so good to have the brace to 40 i bet!. Know what you mean about the crutches it is hard to wean yourself off them. I was just strict with myself and gave the crutches back to the hospital so i had no choice!!!
Be carefull with yours though, as you had more done than me, and sounds like your surgeon wants you to be extra carefull. It will all be worth it in the end when your all fixed.

Saw the piccies, there awesome. Yours are alot more impressve than mine i must add, i will try and post some of mine soon once i sort out how to it!

Right well im off for now, hope your ok.

Daffy x x
March 06 -  (L) Patella tendon debridement and microfracture

July 06 - (R) MPFL Reconstruction

Offline doublea21

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Re: An insight into the medial patello femoral ligament reconstruction!!
« Reply #14 on: August 21, 2006, 09:05:25 PM »
Daffy,

I am doing much better now.  I am at 5 weeks post op and am now off of my crutches.  I have had some problems with my ROM after this surgery and after being stuck at 60 degrees for 2 weeks, massage and ultrasound has allowed me to get to 90 degrees and it is not nearly as tight and stiff as it has been.  My hamstring is also starting to wake back up which helped my walking tremendously by allowing me to bend my leg up behind me when standing.  I had a serious difference in my passive ROM and active ROM for a while but they are now about equal at around 90. 

Hope you are doing well and that you are all healed from your infection.  I have been back to work for a few weeks but it is now finally starting to feel normal because I am moving around withtout thinking about the proper way to wallk all of the time.  I am still in the ROM brace and will be for a while still most likely.  It is now set at 90 although I have a very hard time getting it to the stop on the brace.

Amy
Dec 98 - R and L knee LR and VMO advancement
Dec 00 - L knee TTT
May 02 - R knee TTT and VMO advancement
Dec 04 - R knee screw removal
still too many subluxations and dislocations
July 06 - R knee MPFL Reconstruction















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