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Offline CJ808

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extremely unusual?!
« on: December 08, 2008, 09:33:34 AM »
Hi Guys.

5 days in from my ACL Reconstruction and Meniscus repair. Now i apreciate that i am bound to be swollen around my anke and in my foot etc, but i also have a squidgy shin bone?

Just in the few inches beneath my brace and only on my shin bone ( Not either side) i can litteraly push down and a dint will appear and gradualy return to normal.

Obviously very worries about this (As with every single side effect of surgery i encounter). Not panic too much as i understand there could be a simple explanation. Possibly fluid from the op? Maybe even put there to protect my shin?

Please somebody ease my mind.

Thank you

Offline eaglemom

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Re: extremely unusual?!
« Reply #1 on: December 08, 2008, 10:02:59 AM »
I don't know, but I'd say you need to ice and elevate.  Make a call to the os if you feel its needed.

Offline Kaputt_Knee

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Re: extremely unusual?!
« Reply #2 on: December 08, 2008, 11:07:57 AM »
It is a normal part of the post operative swelling and the wearing of the brace restricts the flow of fluids around your knee. You need to elevate your leg as much as possible and make ice your best friend ever. If you can get lymph drainage massage this helps dissipate the fluids much more quickly than passive RICE. I have had both LD massage and ice massage to reduce the swelling.

Your body has produced a large amount of lymphatic fluid to protect the damaged tissue. By elevating and massage (this is a VERY VERY gentle stimulation of the lymphatic system not a sports massage!) the lymphatic system can be stimulated to re-absorb the excess fluid.

I also used the elevation to help with obtaining extension passively - I rested my foot and ankle on a raised cushion on a stool and left the knee unsupported except for the brace. Gravity acts on the knee passively and helps with early post-op extension. I learnt this trick the hard way as after my first ACL recon I supported the knee and had major problems getting full extension. Eventually I had to have an MUA, not painful as I was knocked out by a GA but still another anaesthetic.

It's early days yet but the sooner you can reduce the swelling in and around the knee the quicker you can get on with passive exercises for extension and flexion.

Sue

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 CJ808

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Re: extremely unusual?!
« Reply #3 on: December 08, 2008, 12:34:54 PM »
Hi Sue,

Thank you so much for your reply. I honestly do not know what i would do without this site and people like you!

I`ll take your advise onboard and as we speak i am resting m foot on a raised cushion and stoll and leaving my knee unsupported!

Thank you

Offline Kaputt_Knee

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Re: extremely unusual?!
« Reply #4 on: December 08, 2008, 12:43:40 PM »
No probs glad to be of help in any way!  ;)

If you are in the UK or Europe you should be able to get lymph drainage massage - in the UK you may have to pay for it. I didn't have it after my ops in the UK but have always had it almost from Day 1 post op here in Germany. It really does reduce the swelling so quickly. Here we also have our drains left in for at least 3 days (I always seem to get three which makes balancing them on the crutches a pain in the a). Then they start on the intensive LD massage which certainly shifts loads of the fluids back into the lymph system.

Sue  ;)
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 CJ808

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Re: extremely unusual?!
« Reply #5 on: December 08, 2008, 01:19:08 PM »
Thanks Sue,

I can see you have been through an awfull lot with your knees! I hope you are keeping well.

I am a private health member (Which i am extremely grateful of) So if i contact my hospital, do you think they may be able to sort a massage for me? If i do not have one, will the fluid sort itself out over time? its an awful feeling, and also seeing the skin push in so much is quite disturbing!

Have you ever experienced cold feet? the foot of my operated leg seems to get cold quite a bit, and last night in bed i completely lost all feeling in it due to Pins and needles ( I somehow managed to lay on my side and probably blocked the circulation).

On a positive note, im 5 days post op and can walk without crutches (still keep my crutches on my arms, somehow if they are not attached to me my brain will not let me walk) I can lift my leg in the air when lying flat and i can bend 30 degrees (Acording to my brace).

Thank you for your help.

Kind regards

Chris

Offline Kaputt_Knee

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Re: extremely unusual?!
« Reply #6 on: December 08, 2008, 03:15:26 PM »
Hi Chris

You can ask at your Physio Centre but I don't think it is offered at most UK hospitals - I was never offered it and I had most of my surgery there albeit under the good ol' NHS!

Check with your health Insurance provider - it may be covered as it is therapeutic. I really notice the difference in recovery times as well as helping reduce the pains - especially with the night time pins and needles, restless leg and cold extremities syndrome!

The fluid is reabsorbed - it's like any bruising/swelling but this just helps it a long a wee bit faster. My therapist does currently 20 minutes LD and 10 minutes ice massage (not as bad as it sounds). As you start moving the lymph is pumped up your leg along with the blood - hence the ankle pumps. There is no automatic return system in our legs or arms, hence they swell when in an inactive downward position for extended periods.

You do need to follow your surgeons instructions with regards to weight bearing and crutch use - the meniscus repair/trim makes it difficult for anyone else to advise as every patient has their own personal protocol depending on what was done. But congrats on being able to spread your wings a wee bit!  ;)

What kind of brace are you in and is the flex stopped at 30 or is that just as far as you can go so far? It is also helpful for others to help if you say what kind of ACL graft you had - hamstring, patella tendon, allograft or what ever.

Have you looked around the Cruciates Board yet? There are some sticky threads there (at the top of the board and don't move away) with lots of advice on exercises to relieve the boredom.

Keep up the good work

Sue  ;)



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 CJ808

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Re: extremely unusual?!
« Reply #7 on: December 08, 2008, 03:42:32 PM »
Hi Sue,

Thank you for your support. You have really helped me today as it is my first day on my own and now i am completely relaxed!

My surgeon said from day one i should weight bear, however, up untill today that has been impossible. I had the hamstring graft and the lateral meniscus was repaired using staples i think.

Before my op i was unable to straighten my leg. I think that was due to the meniscus which was torn in two places. My surgeon said that if my knee was not locked it would have given way, which from what i have heard is a common result of a torn ACL?

I and the people i live with are completely amazed at just how much this operation has and will effect my day to day life. To be honest, before the op i had no idea it was as serious as i am experiencing. I completely played it down, telling workmates i would be back after the weekend (surgery was on a wednsday) and gym freinds i would be training again in a week.

I have decided not to go out for my girlfreinds birthday night in town this saturday as i do not feel confident being around drunk people. However, for a christmas present i am taking my girlfreind to Amstrerdam on the 18th of december. From experience and your knowledge, do you think that that is impossible? or stupid?

As for my knee bending ability, i am able to bend it 30 degrees and i think the brace is set at 70. so still along way to go, but im hoping that when i see my surgeon in a weeks time i will be almost there. Very scared about what he will say, and also what is hiding underneath this bandage i have under my brace.

Thanks again Sue, your a star!





Offline Kaputt_Knee

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Re: extremely unusual?!
« Reply #8 on: December 08, 2008, 05:25:39 PM »
Hi Chris

you obviously did not get much in the way of help prior to the op on what to expect! Don't you just love these surgeons sometimes  ::) ::)

You chose wisely about the girlfriend's birthday even with crutches it would probably have been too much. With regard to the trip to Amsterdam you need to get the all clear from your surgeon first, then tell the airline that you are on crutches and have limited mobility. Depending on which airline it is you may get better seating and priority boarding. Lean heavily on the crutches, cos if it's a normal flight you may even get bumped up a class! You never know.

The 18th is just on the two week mark so you may want to arrange the appointment for removing the stitches now for either before or after (depending on how long you'll be away for. You might find it hard work walking around Amsterdam but it is flat and the people on the whole are pretty polite and considerate - it's not like fighting your way down Oxford Street in the Sales for example. Make sure you have enough pain killers in case you need them and take some ice packs to ice your knee if it swells up. I sometimes used towels soaked in cold water and wrung out a bit to wrap around the knee when I was able to get the wounds wet. This cools and compresses the swelling which helps reduce pain associated with swelling.

Any way talk to your surgeon or one of his staff or your GP as the airline may ask for a medical clearance but Amsterdam is only an hour from the UK so I don't think it's a big deal.

Have fun

Sue
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 CJ808

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Re: extremely unusual?!
« Reply #9 on: December 09, 2008, 04:08:43 PM »
Hi Sue,

Your right, it hapened pretty fast and i didnt really get any post-op advice. But i do have the upmost confidence in my surgeon, knees and hips are all he does.

Back to the gel like solution which appears to be hiding between my skin and shin bone. How long will it take for this to go away, and should i contact my hospital to inform them? Just slightly worried about it. is it something to worry about?

Thanks

Offline Kaputt_Knee

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Re: extremely unusual?!
« Reply #10 on: December 09, 2008, 04:16:44 PM »
Hi Chris

It's just the lymph fluids and basically water for want of a better description! No big deal unless it is extremely red and very hot and not going away at all. The more the foot is down the more it will swell as the fluid is going to the lowest point. If it gets very hot and red - get to the doctor PDQ as it indicates and infection! But you also have to have a fever for that to be even halfway true!

So foot up on that stool - ice packs around the knee and ankle pumping like there is not tomorrow!  ;D ;D ;D My knee is still swollen in places after 4 months and after I have been on my feet all day the calf swells too.

If you look at your compression marks from the brace all the straps cause indentations in the skin/flesh but the lower ones are the worst because of the flowing "downhill" effect

Sue  ;)
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 CJ808

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Re: extremely unusual?!
« Reply #11 on: December 09, 2008, 04:55:46 PM »
Hi Sue,

once again, to the rescue!

I had a moment of panic when i wrote that last post. My aunty rang me and asked how i was. When i told her of the fluid she went into panic and said go to hospital, which automatically made me panic.

Its not red, or hot :)

I actually just undid my very bottom strap on my brace last night as it was digging in my leg and your absoloutly right, their is a compression mark and all of the yellow stuff the surgeon must have put around my leg has rubbed of in that particular area.

I think its very strange how i go up and down throughout the day. One moment im positive and exercising, the next im almost in tears thinking my life is ruined!

Im now at almost 50 degrees flexion! Slept almost all night long with the exeption of one toilet trip at 5.30 and im able to walk a good distance without crutches!

One other thing that has bothered me since waking up from my op is a pain in my groin. Now, my surgeon and anethatist both came to visit me once i woke up, and when i told them my surgeon shrugged it off saying its because thats near where they took my hamstring and as the anethatist came to investigate, my surgeon (Whom by the way has a strict No-Nonsense attitude and a DO NOT PAMPER mentaility) pulled him away.

I did mis an entire season when i was 16 due to a groin strain in the same groin, anything to worry about?

Chris