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Author Topic: acl tear and arthrofibrosis  (Read 2260 times)

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Offline skigirlny

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acl tear and arthrofibrosis
« on: April 14, 2009, 02:34:19 PM »
I tore my acl skiing at the end of February, and went through 4 weeks of pt to prepare for acl surgery.  When I went in last week, my knee didn't have full flexion, but the surgeon thought perhaps it was due to an impingement from the acl stump.  However, when I was under, he had to forcibly flex the knee to break up the adhesions that had formed, which caused bleeding in my knee.  He scoped the knee, cleaning up tissue and said we should wait for another few months to get my knee fully flexible and pain free before repairing the acl.  I already have stiffness again in the knee, and have started working it.  I am beginning pt again this week, but I am wondering if anyone has had any good experiences with surgeons who specialize in arthrofibrosis in either the NY or southern CT area.  My surgeon seemed to do the right thing in not operating, but I am concerned since he does not have experience with my condition. 
I also wondered if anyone else has had an acl repair with this condition, and if they opted to use the patellar tendon or to use a cadaver.  I had originally planned to use my own patella, but with this condition I am concerned that it may be a bad decision since my body forms these adhesions so quickly.  Anyone have experiences to share?

Offline nariswan

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Re: acl tear and arthrofibrosis
« Reply #1 on: April 14, 2009, 03:26:59 PM »
I, too, had acl tear (among other damage) from skiing accident in Feb, and had blockage removed about 3 weeks ago. My ACL reconstruction is now scheduled for 5/22 and I have been instructed to get full ROM by then.

The way my doc explained it to me - scar tissue forms on anything damaged. He said stiffness is basically scar tissue and to 'push past it' and break it up gently and steadily to get my full ROM back.

Being that I am no expert, I don't know the difference or similarity btw your 'regular old' scar tissue and arthrofibrosis. Although, now hearing about it, and being as obssessed with my knee and care as I am, I am certain I will be doing some research and asking some questions!!! I will probably start on this site - I found this right off (http://www.kneeguru.co.uk/KNEEnotes/node/632)

However, he did also say he would not operate to reconstruct the ACL (in my case,I chose hamstring allograft) until I had full ROM. He explained that it would be stiff and restricted like that forever if he did.

So, I have started pouring over the exercises, and hope to be able to set my sights on steady improvements until I go under the knife in May.

If you learn anything, or if I do, let's share! It seems we are in similar situations & in similar stages along our recovery :)
« Last Edit: April 14, 2009, 03:35:05 PM by nariswan »
1985 - patellar realignment (L)
2009 - torn ACL (R)

Offline skigirlny

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Re: acl tear and arthrofibrosis
« Reply #2 on: April 14, 2009, 03:52:38 PM »
Thanks, I appreciate the information! I am currently doing a fast course to try to learn all I can about arthrofibrosis and acl repair! 

My surgeon won't even give me a date for surgery until I have regained full ROM and can bike without pain.  I am working on it, and will start pt again this week.  Are you doing any specific exercises to help prevent the scar tissue build up?  I am doing regualar straight leg raises with my back against a wall, and wall slides, bringing my foot slowly down the wall to try to bring it to bent position, and am riding the stationary bike.  At first I can only cycle forward and back and can't get all the way around, but as I keep at it, I can gradually bring it fully around, and I am riding for 20 minutes.  It seems that the key is to work gradually through the pain. 

Let's keep each other posted.  We seem to be in the same predicament!! :)

vinnic

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Re: acl tear and arthrofibrosis
« Reply #3 on: April 14, 2009, 07:00:19 PM »
Working through it is the right thing to do, and I've found the bike and heel slides (wall slides) to be excellent in helping with flexion.  For my heel slides, I put a plastic bag on my foot and pull it toward me making it easier to slide.  I also have a towel around the heel that I can gently pull on to increase the bend very carefully though.  I've also lying on my back with feet propped up on a stability ball, gently rolling the ball toward me bending my knees and then rolling it away straightening them again.  It's still stiff every day but I find that with every set it loosens up quiet nicely.  Another thing to do is to lie on your back and bring your knees to your chest and let gravity bend the knee - I do this too carefully and start out by supporting the bad leg with the good leg (by the foot).  I've also sat in a chair where my legs can dangle, and gently pull back on the bad leg with the good leg forcing it into flexion as well, holding it for a few moments.  At therapy, my therapist has me on my stomach, legs extended, and bends the bad leg up gently for assisted flexion, and massages the knee and leg like crazy to work through the scar tissue.  Ask your therapist to do this massaging too - (my first PT did not do this after my scope this summer and just told me to do it at home and I really didn't know what she was talking about).  Be sure to post and read on the cruciate ligament board too - do a search on this board for arthofibrosis or scar tissue and you'll get lots of posts there that are well worth the read - one is called "How Much Bend" but I don't have the link at the moment.  Good luck to you!

Offline skigirlny

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Re: acl tear and arthrofibrosis
« Reply #4 on: April 15, 2009, 08:14:00 PM »
Thanks for your help!  I hadn't thought of using a bag on the foot to help it slide.  Today I saw my new pt, and she did exactly the moves you described, including the massage through the bend.  It was much more productive.  Have you already had the acl surgery?  I will look on the board for  that post you recommended for more info.  This site is incredibly helpful for becoming your own advocate.  I appreciate all of the ideas.   :D

vinnic

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Re: acl tear and arthrofibrosis
« Reply #5 on: April 15, 2009, 08:24:23 PM »
Glad to hear your therapist did the massaging and bending.  That should help greatly with increasing your flexion in a careful way.  Yes, I'll be three weeks post-op tomorrow and have a diary started in the post-op section too.  However, please check out other post-op diaries first as well as the cruciate board.  There are much more experienced posters on both who could help you loads just by reading their threads and answering any future questions, from pre-hab through the end of rehab.  Good luck to you!

Offline skigirlny

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Re: acl tear and arthrofibrosis
« Reply #6 on: April 17, 2009, 12:05:50 AM »
Great advice, I will check out those posts.  Glad to hear that you are on the road to recovery!! 















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