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Author Topic: 22 year old just had knee operation advice and help needed  (Read 2183 times)

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Offline chelsea86

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Hi im new to this forum, i am 22 years old and have had major surgery on my right knee on the 12th june 2008, i am just really going explain my situation my grievances, pains and aches and worries and seek advice on how to get strong and have a stable knee as quickly and safely as possible.

Firstly i injured my knee playing football had it diagnosed as a torn acl two years ago had an initial operation to clean up cartiliadge arthriscopically, nhs cancelled on me and had to wait until 12th june 2008 to have the procedure done on my knee. When he went in he saw many more problems than acl tear, also had snapped lcl and damage to posterior lateral corner. The procedure to correct these problems remains somewhat of a mystery still have not had it properly explained.

 As far as i know on the 12 june 2008 i have had an anterior cruciate reconstruction surgery via a hamstring autograph, with a lateral collateral ligament reconstruction via a archilles tendon allograft and reconstruction of the posteriolateral corner. The problem is the posterio lateral corner (plc) is very complex and i am not sure which structures within this mass of ligaments and tendons in the plc he has repaired.

I am also somewhat concerned with my aftercare, as i know that the post operative rehabilitation period is paramount to the future success of the knee, i have recieved very little contact or information from a physio or consultant regarding the structure and form my rehibiliitation can take.

They have placed me in a brace, i have to wear it for 3 months, it is initially set at 20 degree extension with 60 degree flexion for the first 6 weeks, and will be changed to encorporate 20 degrees extension to 90 degrees flexion on the 23 july 2008 by the consultant who did the operation, but after this it has not been made clear what will happen does anyone out there know.

I am particularly concerned with the lack of physiotherapy and lack of new exercises i have been doing post operatively, as I am still doing the same exercises on the 10th july 2008, the hospital physio prescribed me on the 13th june 2008.

The excercises they gave me include:
pumping right ankle up and down for 30 seconds
tensing my quad muscles for ten seconds at a time ten times
moving my knee within full limits of brace, 20 degrees extension to 60 degrees flexion, 10 times
wiggling my knee cap with my fingers ( can someone explain why they have made me do this  ????)
all exercises need to be done every hour i am awake

I am just worried as i am 4 weeks post op and still cannot walk properly even with crutches, cannot support any weight on the right knee, and am still experiencing a lot of pain in the knee. I was prescribed co-codamol post op but stopped taking them after 2 weeks due to side effects. I have really strong aching and sharp stabbing pains on the inside of my knee this comes on really strong sometimes and sometimes i wake at 5am with the pain.I am just wandering is this a normal level of pain as it sometimes is unbearable, the only drugs i am taking is 400mg ibuprofen 3 times a day.

I am just wandering can anyone give an indication of when i will be able to walk and whether i have done inadequate amounts of exericise on the operated leg post operatively, what exercises are safe to do, what should i be doing, am i doing enough as i know a lack of affirmative post operative care and rehibilitative exercises can directly effect the future of my knee stability and range of motion. As i will only see my physio for the first time on the 11th july 2008 and have had no prior contact with them regarding my operation. I am quite dissappointed with my post op care under the nhs as i have had to do all the running around arranging appointments myself for the physios who have been most unhelpful when i have gotten through. I have not been really given any indication on my condition, my rehibilitation time scale specific for the procedure done on me, as the recovery period is much more difficult with multiple ligament reconstructions rather than just acl reconstruction as they can walk 2 weeks after the operation.

I am just hoping that someone can explain the recovery process for the operation i have had done on my right knee, for example a possible timeline of progression, what to expect when. When will i walk again, what exercises should i be doing 4 weeks from the operation, what am allowed to do in terms of walking and weight bearing and when. I am also intrigued about physical activity on other parts of the body, as i am active, i actively weight trained before, having many weights at home, when will i be able to bench press squat, deadlift and do these core exercises. What role will squats and lunges play in my rehibilitation as they are a good closed chain exercise, can they damage the ligament grafts or are they safe to do if done right as they are the best exercise to do to build up all the muscles in the leg evenly which is really important.
« Last Edit: July 11, 2008, 06:04:52 PM by chelsea86 »

Offline cwalukevich

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Re: 22 year old just had knee operation advice and help needed
« Reply #1 on: July 11, 2008, 04:16:42 AM »
I can't believe your surgeon did not answer all of these questions for you!
They usually give you reams of paperwork and refer you to a physical therapist immediately.
Try contacting your internist/family doctor, too, for answers. Sometimes surgeons
don't communicate as well as family doctors do.

One thing-you are only about 1 month out, after a complicated surgery, I
don't think they would want you to be too agressive right off. You sound like
you are doing a good range of exercises and often for the first month. Remember,
just because it is not weight lifting level, what you are doing is contributing to
recovery. At your age,you may want to go full bore but have patience.

As for timelines, you may get them at your next visit, but don't be too set
on them--every body has its own built in recovery schedule-mine is slow lol.

I have not had knee surgery but have had back surgery with nerve damage to my foot.
My back surgery recovery was 3-4 months. My foot never recovered and I recently had
another surgery for that. My recovery is now @ 3 mos. (4 weeks later than originally quoted.)

You have so many questions, I would make a consult appt. with the surgeon, go
in with a list and read through it. I did that and although he looked pained and rushed
(healthcare in the US stinks) he did answer them finally.

Good luck!

Offline Kaputt_Knee

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Re: 22 year old just had knee operation advice and help needed
« Reply #2 on: July 11, 2008, 08:52:27 AM »
The excercises they gave me include:
pumping right ankle up and down for 30 seconds
tensing my quad muscles for ten seconds at a time ten times
moving my knee within full limits of brace, 20 degrees extension to 60 degrees flexion, 10 times
wiggling my knee cap with my fingers ( can someone explain why they have made me do this  Huh?)
all exercises need to be done every hour i am awake


Your injury rehab is complicated by the PLC repair - there is a board for this type of injury so you might find some useful help down there.

The patella mobilisations you are doing are standard ACL post op as this stop the knee cap from sticking to any scar tissue that might build up under the kneecap The ankle pumps, best done when your leg is elevated by the way to be most effective, are to help reduce the swelling by pumping the fluids back up the leg. It is very important to do these as much as you can in the early stages.
In the Cruciate Ligament Board you will find lots of explanation of a whole variety of post op protocols. There is also an excellent section in the Community Hub (information pages) about ACL post op rehab. However, it is apparent that most surgeons have their own protocols for post op rehab and you need to stick to what your surgeon wants you to do. He is after all the only one who really knows what he did inside your knee.

Sorry to see you here but you have found an invaluable resource here, not only in the factual content but the people who really understand your frustrations because they too have all been there!

Sue  ;) in Germany
1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline chelsea86

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Re: 22 year old just had knee operation advice and help needed
« Reply #3 on: July 11, 2008, 12:17:53 PM »
thanks i just needed some reassurance as i dont know what to do and when is the best time to do it, i really just am worried about mobility post op and what safe exercises i can do that cannot damage the knee that will help knee and build up leg strength. Are squats inherantly bad in rcovering knees or do they take a proactive role in the recovery of the knee, as i really like squats and want to build up my quads hamstrings equally which squats do perfectly.

Offline fuzzybob

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Re: 22 year old just had knee operation advice and help needed
« Reply #4 on: July 11, 2008, 05:41:11 PM »
I am on the NHS too, but have nothing but full prasie for my surgeon and physio etc. I was scheduled to have an HTO and PLC reconstruction March 2008. My OS told me for the first 6 weeks I would be in a locked knee brace at 0 degrees, NWB, followed by unlocked brace for next 6 weeks PWB building up to FWB. After 12 weeks to start more agressive rehab and PT. Told to expect to take at least 12 possibly 18 months to fully rehab / recover. PLC injuries are complex and unlike ACL reconstrucrtions there is less certainty and guarentees of success rates. But I was willing to take my chances.

Not sure how the ACL recon would change this early post op rehab programme but as you will see with PLC reconstructions, the rehab it is much more conservative and its is important not to stress the grafts too early. I hope this give you some reassurances and what you are currently doing seems about right.

But I agree it is inexcuseable they have not talked you through your op and rehab, or given you any information at all. It is important you ask you physio and surgeon questions and express your concerns about the lack of information.

hope this helps and best of luck with the rehab
09/06 bad hamstring tear/undiagnosed knee injury
03/07 >6 months PT.OS referral
05/07 OS#1 diag. old age
07/07 OS#2 scope/EUA. Diag.LCL/PLC/ACL laxity, Grade3 medial femoral condyle damage, medial meniscus displaced
12/03/08 HTO,TPFx in surgery!
04/09 hardware out scope/EUA.PLCr not needed
ACI?

Offline cwalukevich

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Re: 22 year old just had knee operation advice and help needed
« Reply #5 on: July 11, 2008, 07:58:01 PM »
SQUATS- 4 weeks post op! NO NO NO!
I hated squats even when I was healthy. I would NOT do anything
but what they gave you till they ok it. You could do some serious
damage. You could send yourself back to surgery.

Also, if you do not follow the protocol and go off on your own
and cause damage, you could have insurance coverage problems,
too.

Your knee (and whole body) has had a bit of a shock with surgery
remember. I would be cautious at first. Before you know it, your
young self will bounce back. Before you ADD anything to your
exercises--ask you doctor and therapist if it is appropriate.   

As soon as they see your enthusiasm for therapy and exercise,
they won't hesitate to recommend more for you to do. They like
patients who actively participate in therapy as so many people
are afraid to do it for the pain it may cause.

Hang in there!!

Offline FormerlyActive

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Re: 22 year old just had knee operation advice and help needed
« Reply #6 on: July 11, 2008, 11:33:04 PM »
Maybe if you can sit and not involve your leg in any way you could do very light bicep curls slowly. I wouldn't do any overhead pressing because thats bad for your shoulder. Maybe light side lateral raises, light front DB raises. Light kickbacks. Wrist curls. Concentration curls. Of course you don't want to look like a lopsided person , i.e. all upper body, but just to retain some tone.

I would consider a new hobby during this time not to go crazy. I have picked up classical piano again and am taking lessons twice a week to try to help with sanity. Its very hard and I can't think about my knee when I am working on it.

Do all else to help your body and consider it part of your rehab. Eat right, take vitamins. Get regular sleep if you can. Think positive healing thoughts. Use affirmations. Best wishes and keep us posted.
3/82 - Medial Synovial Plica removal both knees
9/89 - Lateral Release both knees
3/08 - Reinjury left knee hiking Asia Pac
5/08 - Miserable Malalignment diagnosis
4/08 - 9/08 Five doctors diff. opinions
7/08 - 02/09 - In PT, no chg.
4/09 - Dr. 6 opinion femur & tibia derotation together

Offline chelsea86

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Re: 22 year old just had knee operation advice and help needed
« Reply #7 on: July 12, 2008, 11:49:48 AM »
thanks for the advice, its good to have the shared experience of so many people who have gone through it before so i dont make too many mistakes in my rehabilitation as this is the most crucial time.

do people think that the real rehibilitation will take place only after i get my brace off as i have to have it set within 20 degrees extension, 60 degrees flexion for the first 6 weeks, then changed to 20 degrees extension, 90 degrees flexion. Will I be able to cycle with the brace at 20 degrees extension, 90 degrees flexion, what do you think i will be able to do when the brace is set at these limits.Physio who was poor with no communication from consultant, no rehabilitation protacol from consultant, said i would not be able to cycle while brace is on at all, she said that my operation was a custom operation and that she siad she had not seen an acl, lcl, plc reconstruction is this operation that rare how many people have this done in the uk per year doe sanyone know.

Offline cwalukevich

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Re: 22 year old just had knee operation advice and help needed
« Reply #8 on: July 12, 2008, 07:54:28 PM »
When you say "the real rehabilitation" it sounds like you think you are doing nothing right now. Everything counts however small a movement. You are doing rehab right now :)

It helps if you look at rehab in stages-post op/1-3 mos/6 months/1 year/2 years/ever after.
I really feel your doctor/consultant should have this info ready for you or the therapist he refers you to should have it for you. I would contact his office again and insist on it. I'm in the U.S. so I don't know what the protocol is where you are. Maybe they don't give you anything in advance?

What they do give you  will be average/normal expectations and you need to know you may not be able to do them exactly on schedule. Listen to your body and stop when needed. Extreme pain signals a need to stop and re-evaluate. Don't skip phases of the rehab because you are in a hurry to get to the later ones.

The brace will dictate/restrict how many things you can do I am sure. Just remember,
it also serves to protect you from getting over zealous.

Have you tried looking online for info on physical therapy for cases like yours?

Best of luck!

Offline FormerlyActive

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Re: 22 year old just had knee operation advice and help needed
« Reply #9 on: July 12, 2008, 08:08:07 PM »
Since it sounds like you are very motivated perhaps you should keep a journal of each day, your meds, your exercises, how the knee is feeling, any symptoms etc. That can help motivate you especially if you feel you are going to slow you will see slowly slowly you can do more things. Its also helpful when you go to the doctor and PT you can tell them exactly where you are.

Maybe set some non-knee related goals also to help raise your spirits. I put together all the photo albums during my last post-op, got caught up on letters, cleaned out some boxes of papers etc. All the stuff you don't get to do when you are busy being active. But put some fun things in there also. Maybe purchase or rent all the episodes of a show you never got to see.

Best wishes and keep us posted.
3/82 - Medial Synovial Plica removal both knees
9/89 - Lateral Release both knees
3/08 - Reinjury left knee hiking Asia Pac
5/08 - Miserable Malalignment diagnosis
4/08 - 9/08 Five doctors diff. opinions
7/08 - 02/09 - In PT, no chg.
4/09 - Dr. 6 opinion femur & tibia derotation together

Offline chelsea86

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Re: 22 year old just had knee operation advice and help needed
« Reply #10 on: July 13, 2008, 12:51:46 AM »
my surgeon was N.A.K. Flynn does anyone know of his reputation whether he is good or bad, im in the united kingdom on the nhs is it possible to arrange a meeting with the surgeon without them arranging it on your own demand or would you need to pay for his consultancy privately on your operation outside nhs hours.

just went to physio on the 11th july, not positive news im afraid physical therapist knew literally nothing of my injury just told me to do the same things i was prescribed to do just two days after my operation. No notes from my consultant surgeon N.A.K. FLynn no rehabilitation protacol had been recieved by physio from the surgeon, so there is no template being recieved for my rehabilitation, as my surgery was more than the run of the mill acl reconstruction having a reconstructed anterior cruciate ligament, reconstructed lateral collateral ligament, reconstructed posteriolateral corner there is no standard protocal for my rehabilitation for me to discover on the net. I was wandering has anyone out there had my surgery and know of a rehab protacol that is safe for me to follow as i don't know what is safe for me to do and at what times.

Also does anyone have any advice regarding sorting out my current situation with the nhs, why should i be running around trying to find out a rehabilitation protocal, it should be provided for me in a structured safe manner by a proffessional explained exactly by the surgeon and carried out smoothly by a trained physiotherapist.

Offline FormerlyActive

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Re: 22 year old just had knee operation advice and help needed
« Reply #11 on: July 13, 2008, 10:00:41 PM »
I don't know anything about NHS but formal documentation in some type of letter of inquiry - is that a possibility to get wheels moving? Either to your doctor or GP or whomever is directing your care?
3/82 - Medial Synovial Plica removal both knees
9/89 - Lateral Release both knees
3/08 - Reinjury left knee hiking Asia Pac
5/08 - Miserable Malalignment diagnosis
4/08 - 9/08 Five doctors diff. opinions
7/08 - 02/09 - In PT, no chg.
4/09 - Dr. 6 opinion femur & tibia derotation together

Offline Nettan

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Re: 22 year old just had knee operation advice and help needed
« Reply #12 on: July 13, 2008, 10:06:09 PM »
Call your OS and get the answers that you need and also make him send you to a therapist that have worked with damages like yours.
Surgery 6 times left knee torn meniscus, RSDS,chondromalacia, nervdamage cause constant nervpain,chronic inflamm.
Spinaldamage wheeler 100%.
Right knee damaged aug-06, use brace surgery 4/9-07.LCL tear.