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Author Topic: JB's ACL, Allograft (Anterior tibialis tendon), meniscus trim post-op diary  (Read 39116 times)

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Offline jb-knee-geek

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Day 0 - night prior to and day of surgery:

anxious night for my wife and I.  Slept about 4-5 hours, perhaps less. Arrived 7:15 AM at the surgery center, filled out  and went through necessary pre-op forms, answered first of series of repetitive questions regarding medicine allergies, and  procedures from a variety of nurses. (a good thing).

Went in to pre-op area, met with a couple of nurses, went over similar questions, re: allergies, meds, procedures again, very professional, made me feel comfortable as I was hooked to an IV and got my knee area shaved.

Last I remember was injection of anti-biotic, other(?), speaking with an Anesthesiologist, an aide and my OS.  I don't remember being wheeled out of the pre-op room.

The next I remember I was in the recovery room, nurses monitoring my pain levels which I registered in the 4-5 range, nurses adjusted intravenous meds. One nurse said "let's keep it in the 3-4 range".

This was a busy recovery room, getting busier as I was recovering. I was dazed but thrilled to hear my OS tell me things went well and I would be able to return to all my prior activities, in a flash he was gone. I think he had several surgeries that day.

My wife was soon at my side, we were together while the nurses moved around taking care of 6-8 patients in the post-op recovery room.

After an hour or so, I was prepped with instructions for discharge, my shorts didn't fit over the soft cast and bandages so I was wheeled out in the gown through the crowded waiting room.  My pain levels were tolerable since the femoral pain block was fresh. 

A quick stop at the nurses station to speak with my OS who ws reviewing something on the computer, we reviewed the cross-pin tecnique and some activities to stay away from: basketball, marathon training/running, work which requires kneeling, deep squats. None of which are in my repetoire, I was feeling good as they wheeled me towards the exit in my hospital gown.

I think this is similar to the cross pin technique he used: http://www.biomet.com/sportsMedicine/getFile.cfm?id=1060&rt=inline

Luckily, I have a car with a back seat I can lay down in. My wife brought the car around and I was able to use the crutches to get into the rear of the vehicle looking out as we approached a California freeway at lunch hour. I soon felt nauseous, and reached for napkins and an empty paper bag. Thankfully it wasn't needed, nausea was probably due to the anaesthesia.

About 30 minutes later we pulled into our garage, about 2 PM, pretty much as planned.

Crutches proved to be no problem, I've been beefing up my upper body/arms for years. Started the ibuprofen, pain meds and kept the ice on top of the bandages pretty much through the night, not sure this was wise, but I couldn't feel a thing due to the nerve block. I began the icing routine of 20 minutes every couple hours the next day.

The rest of Day 0 was spent in bed making/recieving calls, resting, getting comfortable with my new ACL/meniscus reality.

The anaesthesia caused some problems with balance, urinating (took a little while), feeling dazed.

Day 0 keywords: PATIENCE, THANKFUL
« Last Edit: July 16, 2009, 05:55:59 AM by jb-knee-geek »
torn RK ACL March 2001, surgery Aug. 14 2006, after 4 knee sprains since Oct. '05.  Allograft, ~40% medial meniscus removed, some wear in the trochlear groove. Everything else looks good.

Post-op diary: http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=29749.

Offline jb-knee-geek

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Day 1: Got about 5-6 hours sleep, I was thrilled considering the pain meds and fact was leg was propped up on a pillow.

Femoral nerve block was still active so my mood was pretty jubilant until about 5PM. Kept the ice on throughout the night and most of the day, not sure this was a good idea, but I couldn't feel it through the bandages.

I tried the cryocuff but it was useless through the bandages, perhaps when they are removed I'll use it for overnight or when lying around resting. Otherwise it may be useless to me, ice packs seems to get it done.

Spent the day with my lovely wife, who is taking good care of me, taking calls from friends and family, recovery room nurse called to check in, asked about the wounds and how I was managing. All is well, I thanked her and her team for taking good care of me. Made an appointment for PT next week. Started to keep track of the meds I'm taking, when I'm icing, etc. Got the laptop powered up, watching TV, reading, bathroom trips are getting a little easier, I think due to the anathesia wearing off. Did a couple rounds of phase #1 passive rehab. I kept checking the photos of inside my knee capsule, before and after images are SO COOL! Looks like he left a nice chunk of meniscus where it's needed, thankfully.

Day 1 wrapup: Last of the femoral nerve block, start of phase 1 rehab, started the routine of meds, and icing. Lucky to be married to a beautiful angel.
« Last Edit: August 17, 2006, 09:40:24 PM by jb-knee-geek »
torn RK ACL March 2001, surgery Aug. 14 2006, after 4 knee sprains since Oct. '05.  Allograft, ~40% medial meniscus removed, some wear in the trochlear groove. Everything else looks good.

Post-op diary: http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=29749.

Offline jb-knee-geek

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Day 2 post-op: Femoral nerve block wore off yesterday around 5PM, first night of uncomfortable pain.

Pain meds every 4 hours, little sleep, maybe 3-4 hours. Up every hour taking meds & icing.

Heard some owls screeching, the highlight of the evening. I definitely do not like the neighbors wind chimes.

Made it through the night, taking pain meds throughout the day, trying to put more time between them, seems to be working.

Napped during the day, watched TV, pain subsiding, keeping up with the ibuprofen, icing, by the evening of day 2 pain was subsiding, last pain med at 8:15 PM.

Did 4 sets of rehab, more weight bearing than prior days. Not bad considering the pain levels from the wee early morning hours.

Starting day 3, no pain meds yet. Continue ibuprofen and icing throughout.
torn RK ACL March 2001, surgery Aug. 14 2006, after 4 knee sprains since Oct. '05.  Allograft, ~40% medial meniscus removed, some wear in the trochlear groove. Everything else looks good.

Post-op diary: http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=29749.

Offline jb-knee-geek

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day 3: no pain meds, able to put more weight on the AClr'd leg, spent more time out of the soft velcro-laden brace. 

Slept well considering the knee is propped up. Steady routine of icing, week 1 rehab, ibuprofen 600mg 3/daily. Taking a stool softener too, that may be too much information, but it may help someone out there.

Lots of TV, reading. I'm officially bored now.
torn RK ACL March 2001, surgery Aug. 14 2006, after 4 knee sprains since Oct. '05.  Allograft, ~40% medial meniscus removed, some wear in the trochlear groove. Everything else looks good.

Post-op diary: http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=29749.

Offline celinenj03

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Sounds pretty familiar JB! You're doing really great. Just be careful with keeping that pain at bay. Someone here told me days 4-5 were most painful and it really proved to be true. I think that's when all the drugs, femoral block and the shock from surgery really start to wear off. So just be mindful if you feel anything creeping in. You know I was a HUGE fan of the anti-inflammatories. Took mega doses, and I had no real problems with swelling as a result. I wonder if your OS says no basketball or deep squats because of the method of ACLR or is that a general rule of thumb? I am doing deep squats daily (as a mom and homemaker) and have no problems, but hopefully not hurting myself without knowing it.
Terrible Triad - 1/16/06 - Basketball
3/15/06 - Scope/Cleanout of to achieve full ROM
5/3/06 - Surgery-ACL Reconstruction-Allograft
9/12/07 - Large Loose body removed;Grade 4 Lesion on LFC
9/17/08-Microfracture, Lateral Release (all right knee)

Offline EyeSpy21

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Saw you on another thread JB and have been looking forward to reading your post-op progress.  Thanks for posting, and in such detail.  Good luck with the recovery!  Will be following with interest.
R knee symptoms 2003
Feb 06: MRI extensive complex tear/shredded R medial meniscus
Aug 06: NHS offer removal of most of meniscus
Oct 06: Partial meniscectomy, plica resection and CMI in Germany
Mar 2008: R CMI failure
L knee symptoms 2006
Mar 2008: cartilage defect patella, pes anserine bursa

Offline jb-knee-geek

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Hi CJ, I think I'm past the worst of the pain, perhaps rehab will cause a spike. I've read some study where day 2 is a common spike with pain levels going down through day 5.

Agree on the need for anti-inflamms, still taking those 3x daily. I take my bandages off tomorrow, hopefully the swelling will be ok.

For you I doubt squats in your daily life would be any problem.

For me, avoiding hoops, long distance running, and deep squats (I'm assuming with weights) is due to the meniscus that he had to slice.  If it was just an ACLr, I'm pretty sure I could return to all sports. 

I'm in my late 40's so probably best I look at a change of activities anyway. It took a while to accept this, it's a conservative approach but, I think it's worth it.

EyeSpy - I remember reading your posts, I hope you get the proper opinion for your situation.  Take time to find an OS you have confidence in. If you haven't read it check out Dr. Grelsamers book, a great read.

Day 4 pretty much lke Day 3, a little more wieght bearing, still no need for pain meds today. Week 1 rehab seems easier today, progress? Still icing every couple hours over the bandages, hope this is effective.
torn RK ACL March 2001, surgery Aug. 14 2006, after 4 knee sprains since Oct. '05.  Allograft, ~40% medial meniscus removed, some wear in the trochlear groove. Everything else looks good.

Post-op diary: http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=29749.

Offline SarahY

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Hi JB!  Glad to see you have your own diary going.  Thanks for the link in your first post.  I have actually learned something new.  Sounds like things are getting better.  I'm guessing a meniscus trim and a meniscus repair have different protocol.  You mentioned being able to put some weight on your leg, but Jennifer (in-clyde) wasn't able to do that for a while.   

For myself, I noticed a big difference from day 1 to week 3...just about every day.  Now progress is happening little by little.  Thanks for the support you gave me!  Glad your angel is taking good care of you  :)
Sarah
ACL tear, 3/06
ACL allograft 7/06

Offline jb-knee-geek

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thanks sarah, pretty amazing technique using the cross pin, I was fascinated, I was assuming 2 inteference screws. I'll check your diary for my peek into the future.

It's the same technique used for hamstring grafts.

Meniscus trim and repair are very diffferent, the repair requires NWB for a while due to the fact it needs to heal, the advantage obviously is a full meniscus. Comaparatively speaking, repairs are not used in many cases due to location of the injury and patient age. 

Day 5 starts out with removing the bandages, got a look-see at the wounds and swelling; lovely.

Shower today, yippee, got a plastic yard chair for the shower, should be fun. Yesterday I had a little more pain due mostly from being slightly more active. A friend came by and we researched some things on the net, so I was moving the leg around and more weight bearing, by the end of the day, the knee was barking.

Ice, ibuprofen quieted things down, no pain meds last night but it was close. Woke up today after a decent nights sleep, about 7 hours.

Plan for today, shower, rehab, ice, ibuprofen.
torn RK ACL March 2001, surgery Aug. 14 2006, after 4 knee sprains since Oct. '05.  Allograft, ~40% medial meniscus removed, some wear in the trochlear groove. Everything else looks good.

Post-op diary: http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=29749.

Offline jb-knee-geek

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day 5: week 1 rehab moving along slowly, plenty stiff and sore, more weight bearing daily, still crutching, could go to one if I had to. highlights: shower in a plastic chair, with plastic bag tape around knee (both ideas from posters in the cruciate ligament board), still using anti-inflamms, got to hang outside with friends, I was on the lounge chair with leg propped, swelling improving slowly.

start of day 6: I'll try the cryo cuff now that the bandages are removed, perhaps it will be more effective. 
« Last Edit: August 21, 2006, 03:37:24 PM by jb-knee-geek »
torn RK ACL March 2001, surgery Aug. 14 2006, after 4 knee sprains since Oct. '05.  Allograft, ~40% medial meniscus removed, some wear in the trochlear groove. Everything else looks good.

Post-op diary: http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=29749.

Offline SarahY

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Hey JB...I noticed the most important part of the first week or so was getting the swelling down.  Ice, ice, ice, and ibuprofen.  I'm glad you are seeing things get better.  For myself, my knee is always stiff in the morning, when I first get up.  When do you start PT?

Sarah
ACL tear, 3/06
ACL allograft 7/06

Offline jb-knee-geek

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Hi Sarah, PT starts tomorrow, swelling has improved, got my cryocuff working. I've been doing the exercises they gave me in pre-op, those have been going well.

I have phased PT work for each week, I'll try the phase 2 work today

Cryocuff is effective now that the bandages have been removed. My ice maker can't make ice quick enough.

Day 6 highlights: improved swelling, can go to one crutch, more weight bearing. Able to do more on my own. Need to run this progress by the OS. Used the cryo cuff most of the day. Still resting, leg elelvated, icing, crutching, sleeping with soft brace. Overall pain level down, no pain meds for days. Noticed calf muscle wastage. Quad muscle, hard to tell from the swelling, glad I did pre-op leg strengthening.
« Last Edit: July 04, 2007, 06:15:15 PM by jb-knee-geek »
torn RK ACL March 2001, surgery Aug. 14 2006, after 4 knee sprains since Oct. '05.  Allograft, ~40% medial meniscus removed, some wear in the trochlear groove. Everything else looks good.

Post-op diary: http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=29749.

Offline EyeSpy21

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Blimey 6 days passes quickly!  Well, when you're not recovering for surgery I suppose.  But you're sounding happy enough with how things are progressing.

So what quad strengthening did you do prior to op?  Gym?  I went for a naughty 8 mile run yesterday after 5 miles on the beach on Saturday and my thighs are screaming!  And that's only after 3-4 weeks out.  I've been doing some quad exercises I found online obviously are not enough.

Are you just doing your own PT or getting assistance?
R knee symptoms 2003
Feb 06: MRI extensive complex tear/shredded R medial meniscus
Aug 06: NHS offer removal of most of meniscus
Oct 06: Partial meniscectomy, plica resection and CMI in Germany
Mar 2008: R CMI failure
L knee symptoms 2006
Mar 2008: cartilage defect patella, pes anserine bursa

Offline jb-knee-geek

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Hi EyeSpy - Lunges of different shapes and styles seemd to work best for me. Leg press too. Squats as well.

I discovered swimming recently, when I get winded I did walking lunges then backward jog to get the hammies, it works!

Becuase of my meniscus problems I couldn't get the full ROM for leg press and squats. So, lunges seemed to work best for my situation.

I found the warrior pose (a yoga move) to be great for quads. I was at the gym for at least 2-3 nights per week for a year before my surgery.

I've got PT prescribed, and an excellent person to work with. For the first couple of months my PT is about getting back ROM, strength, reducing pain, so it's pretty standard fare.

Be patient with stregthening, it just takes time and consistency.

check this site:

http://bodybuilding.com/fun/exercises.php?MainMuscle=Quadriceps
« Last Edit: May 03, 2007, 03:19:05 PM by jb-knee-geek »
torn RK ACL March 2001, surgery Aug. 14 2006, after 4 knee sprains since Oct. '05.  Allograft, ~40% medial meniscus removed, some wear in the trochlear groove. Everything else looks good.

Post-op diary: http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=29749.

Offline EyeSpy21

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Thanks JB, my knees are hurting just looking at some of those squats!  I know to be careful about how far to bend though, but I have some dumbells and ankle weights I may incorporate into what I've been doing.  The bike will be out this week too and I know I keep mentioning... the aquajogger!  I haven't been to the pool in ages... but seems a good place to be at the moment and I shall try some of your lunges.  Wearing the aqua jogging belt I'll be getting weird looks anyway!!

Well, going to the gym 2-3 nights a week for a year... you must be pretty dedicated.  So I'm sure you'll breeze your PT and be back pretty quickly.  I have read, and I'm sure you have to, that it is likely to be the meniscectomy that limits things more than the ACL repair.  But that's a whole 'nother thread eh?
R knee symptoms 2003
Feb 06: MRI extensive complex tear/shredded R medial meniscus
Aug 06: NHS offer removal of most of meniscus
Oct 06: Partial meniscectomy, plica resection and CMI in Germany
Mar 2008: R CMI failure
L knee symptoms 2006
Mar 2008: cartilage defect patella, pes anserine bursa