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Author Topic: please help me get my range of motion back...  (Read 1136 times)

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Offline kb7

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please help me get my range of motion back...
« on: August 12, 2009, 11:20:35 PM »
I tore my ACL and lateral meniscus in February of this year, and had surgery on 3/10 in which a bone-patellar-tendon-bone graft was used and the meniscus was repaired.  By July I had only +8 degrees extension (opposite knee 5 degrees hyperextension normal) and 115 degress flexion (opposite knee 140 degrees flexion normal).  It was decided I had severe arthrofibrosis and underwent arthroscopic surgery to release the scar tissue.  A different surgeon than the original surgeon performed the scope and he said it was the most scar tissue he had ever seen in a knee.  Under anesthesia they were able to get my knee to +3 degrees flexion and 135 degrees flexion. 

I am now 4 weeks post surgery and after working very hard at extension was able to maintain the 3 degrees extension.  However, due to severe pain and extreme swelling, my ability to work on flexion was limited the first 3 weeks.  My knee was drained 3 different times, each yielding 100 cc's of fluid.  Now, my knee feels like it did before the surgery, tight and unable to flex correctly, although I can now get it uncomfortably to 130 degrees flexion (very painful and I can only hold it for a couple minutes).  I've tried long, progressive stretches but it just seems as if though my knee is progressing back to the way it was before the scope and I am losing flexion degrees.

Anybody else ever experienced this or have any words of wisdom?  It is very frustrating as I am 5 months past the original surgery but feel as if I haven't gotten anyway.

Thanks!

Offline dm

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Re: please help me get my range of motion back...
« Reply #1 on: August 16, 2009, 06:49:03 PM »
there are a lot of posts regarding arthrofirbrosis and maniplation under anesthesia which may give you some more answers and advice. If you have an arthrofibrosis issue, they might have needed to have you in a cpm machine after the adhesion removal to prevent readhesions from forming to get max ROM back. Functional ROM is flexion greater than 120, so if you're past that, they may say that you just won't get more with the adhesions.

There is things you can do to work on passive extension and flexion, to stretch out the tissues, look into those with a therapist.
multiple arthroscopies 2/00,3/01,6/01,1/03, 12/07,10/10. chondromalacia, severe medial joint space narrowing following 3 partial menisectomies, chronic pain problems, kneecap problems, OCD lesion, failed mfx.

Offline kb7

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Re: please help me get my range of motion back...
« Reply #2 on: August 26, 2009, 04:39:10 PM »
I was finally seen by a surgeon who has some experience with this problem and he was extremely helpful, I wish I would have seen him before the last surgery.  He found I have arthrofibrosis going on again, and also patella Infera/patella baja when we viewed an x-ray, just one more problem to add to the list.  He said my problem may be due to pushing the knee to gain flexion and extension, which is causing more tissue damage and in turn more inflammation and more scarring, and loss of motion, which causes me to work even harder the next day, just one big cycle.  So for now I'm back to using one crutch, no weight exercises, and plenty of rest.  He figures I will need a minimum of one surgery, possibly 2 to fix the patella infera.

It definitely makes sense, I could always tell my knee was warmer and more swollen after I performed stretches for extension and flexion.  It's really hard to accept the fact that less may be better more me as I always have the mentality that the harder you work, the better the result.  However, I'm not really sure at what point my knee is going to let me be aggressive and make gains in motion.  I can already tell I'm going to require at least one surgery as I have lost around 10 degrees of flexion since the last surgery.

Very frustrating.