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Author Topic: Soccer player- ACI & Meniscal transplant diary and the road to recovery  (Read 15738 times)

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Offline cfranc

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Re: Soccer player- ACI & Meniscal transplant diary and the road to recovery
« Reply #45 on: April 09, 2010, 01:34:35 AM »
Non weight bearing ball rollouts...I am not familiar with them...can you elaborate so I can try them ...thx!
Jan 1991 Lateral release
Nov 1997 VMO/Lateral release
April 1998 scope to remove bone chips
Feb 2002 VMO/TTO
Oct 2009 Biopsy for ACI
Feb 3, 2010 ACI/TTO

Offline Rennschnecke

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Re: Soccer player- ACI & Meniscal transplant diary and the road to recovery
« Reply #46 on: April 11, 2010, 02:49:43 PM »
Ball rollouts: just lie on your back, place your heels on a gym ball and roll it in to your bottom then out.  To make it passive, drive the movement with your good leg.  If bringing it into your bottom is difficult, go to as far as it's comfortable then hold to stretch it gently.

If you have the right size ball, you can use this instead of a CPM.
1/05 Ski accident: 5/05 ACLr LK; 10/06 Scope – debridement, trochlear cartilage lesion (Gr4); 12/08 Scope – chondroplasty, hematoma; 5 & 6/09 MACI patella & trochlea 'kissing lesions', ROM 0 to 80; 9/09 Scope – LOA, IPCS & patella infera; 9/10 Scope – AIR & LR.

Offline ajschnelk

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Re: Soccer player- ACI & Meniscal transplant diary and the road to recovery
« Reply #47 on: April 12, 2010, 03:55:15 PM »
I've been doing these since about 4wks post  before starting all of my excercises and have to say it really does help with ROM.  I use an excercise/yoga ball which helps due to the larger size.   

Offline tremy1977

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Re: Soccer player- ACI & Meniscal transplant diary and the road to recovery
« Reply #48 on: April 12, 2010, 10:20:34 PM »
thanks for the advice you guy's..I did manage to see the surgeon 3 days later who was satisfied i hadn't damaged the ACI. The swelling in my knee just isnt going down at all with the anti-flam or the ice packs !!

how's your rehab going rennschencke ?

Offline Rennschnecke

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Re: Soccer player- ACI & Meniscal transplant diary and the road to recovery
« Reply #49 on: April 14, 2010, 08:46:53 AM »
Paul:

I think it's fantastic the OS has been so reassuring to you.  Hopefully you'll be able to put this behind you now (easier said than done, I know!).

With the swelling, I found it helped to ice and elevate through doing heel slides down the wall.  Meant I would feel like I was doing some rehab as opposed to lying there and snoozing! ;)

As for rehab [AHEM! :-[] ...  As my gym was closed I had intentions of doing pool therapy (RIGHT!), but I got an infection over Easter coupled with a migraine-like headache which had me asleep for 5 days, horizontal for a further one and then very delicate.  Finished a course of antibiotics only to then (6 h later) get a phone call from the hospital asking me if I could get in the next day for an op.  Back from hospital with instructions of no pool work for 4–5 days.  My gym opens again on Monday so after fretting about not getting there the time's all gone. ::)

However, not all is lost!  Didn't have an op in the end but got a steroid injection.  My AF has been thoroughly checked (c. 1h clinical checks) and apparently it isn't bad.  Patella infera is quite subtle (has improved a bit) and no different from what might be expected after MACI (this was news I hadn't been able to find out any other way).  After checking my function post-injection when I was still enjoying the benefits of the anaesthetic by my OS marching me faster and faster in the corridors of the hospital, I was discharged with instructions to use whatever pain meds necessary to stop the pain and get back to PT with lots of stretching.

My pain meds kit is looking quite interesting now.  There's the usual paracetamol, ibuprofen and tramadol to which I also have gabapentin, oramorph and Fentanyl patches.  When I looked up the Fentanyl I had a bit of a laugh as it seems some people in the US get addicted to smoking my skin patches (more addictive than heroin)!  Looks like I have the blessings of the medical fraternity to get a little bit high!  ;)

Now it's straight back to the same old, same old quad sets, SLRs, patella mobes, ball rolls, wall slides etc. [YAWN!!!]  :o :o

Hope everyone else had a good Easter.  I got some Hotel Chocolat eggs [YUM!] :-*
1/05 Ski accident: 5/05 ACLr LK; 10/06 Scope – debridement, trochlear cartilage lesion (Gr4); 12/08 Scope – chondroplasty, hematoma; 5 & 6/09 MACI patella & trochlea 'kissing lesions', ROM 0 to 80; 9/09 Scope – LOA, IPCS & patella infera; 9/10 Scope – AIR & LR.

Offline Dennis BadKnee

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Re: Soccer player- ACI & Meniscal transplant diary and the road to recovery
« Reply #50 on: April 18, 2010, 11:45:42 PM »
Paul,
I am glad to hear your ACI is ok.  I hated to read of your fall.  I bought an Aircast Cryocuff autochill online before my surgery and had been icing 20 hours per day.  I also have ice packs in the freezer for use when I am not using the Cryocuff.  I asked Dr. Minas if I could possibly be harming the ACI by icing too much.  He said no, that the cold cannot reach the ACI (but I wonder because I get the knee rather very cold).  He reiterated that the cold is good for swelling, but not to damage my skin by freezing.  So, I feel the ice works wonders and continue to use it.

BTW - The leg muscles will come back.  Slowly keep working, but not into pain or swelling.  The ACI needs nourishment through movement.  So movement is good.

Hope you are continuing to improve.

Regards,
Dennis

Offline JuhaH

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Re: Soccer player- ACI & Meniscal transplant diary and the road to recovery
« Reply #51 on: November 13, 2010, 09:57:53 AM »
Hi there,

This is really interesting topic. I have also articural cartilage damage and almost total meniscectomy. Only 20% medial meniscus left.

I'm thinking that what happens to articular cartilage after Actifit implant has melted away? Actifit is supposed to recess in patient΄s body, and in theory it is going to eliminate from the knee in couply of years.

Good luck to rehab  :)
Skiing accident in january 2010. Left knee, medial joint space narrowing and constant pain following partial meniscectomy (30% medial meniscus left). Trying to prolong the knee replacement as long as I can.

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Re: Soccer player- ACI & Meniscal transplant diary and the road to recovery
« Reply #52 on: November 13, 2010, 05:59:55 PM »
Hi everyone, I'm popping in this thread a little late, but perfect timing for me being 10 days out patella ACI/AMZ.  Reading through some of the pt stuff was very interesting, as I begin formal PT on Monday and a bit apprehensive about what I can and can't do to and am terrified that I may do something to damage the graft. My PT is very knowledgable, but he hasn't done many (if any) ACI's, but my docs PA told me that it can be difficult to find someone with experience, as it is somewhat of a less common procedure, especially a patella ACI with the AMZ. 

I've been in my cpm at 40 for the first day and then I've been at 45 since, which is what my OS told me to do, but I also am still not to move up from 45 at all.  For only being 10 days out, I've been able to dangle to 90 since about day 7 post op, which was the 2nd day I even attempted. My Dr.'s PA said I was way ahead of the game for where I was at yesterday at my post op.  Although because I have no issues getting to 90 when I dangle, I wory that maybe I may damage my graft. 

And I may have missed it, but is it okay to do straight leg raises with the AMZ and the patella ACI? I was told I could try by my docs PA, but if it changed my facial expression at all due to pain then back off and not do it.  Essentially, at 10 days I am only doing quad sets and ankle pumps., but feel I should be doign more??  Maybe once I start formal PT, I'll have some guidance...but then it gets back to potentially being instructed to do something that is overly aggressive.  Who knows...maybe I'm just being overly worrisome.


Is there anything specific I should NOT do?

Offline Rennschnecke

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Re: Soccer player- ACI & Meniscal transplant diary and the road to recovery
« Reply #53 on: November 13, 2010, 10:44:55 PM »
Hi cdubb

Avoid anything that introduces shear forces at the patella.  So nothing open chain for now and no active flexion or with any loading.

I was doing SLRs from the early days.  Had no problems with the brace on.  I'd probably advise keeping the brace on because if there is a lag you may potentially introduce shear forces at the graft.  If this causes you any pain whatsoever, back off.

You need to focus on pain management, reducing swelling and keeping the tissues mobile at the stage.  You have fantastic ROM, so there is no need to worry and push.  I think you must be doing really well, and it's tempting to try more but you can't hurry the process.

Be good!  ;)
1/05 Ski accident: 5/05 ACLr LK; 10/06 Scope – debridement, trochlear cartilage lesion (Gr4); 12/08 Scope – chondroplasty, hematoma; 5 & 6/09 MACI patella & trochlea 'kissing lesions', ROM 0 to 80; 9/09 Scope – LOA, IPCS & patella infera; 9/10 Scope – AIR & LR.

cdubb

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Re: Soccer player- ACI & Meniscal transplant diary and the road to recovery
« Reply #54 on: November 14, 2010, 12:20:00 AM »
Thanks Renn,
I'm sure everyone worries about damaging the graft and that is a normal concern. I'm managing pain quite well and have since my discharge about an hour and a half after surgery.  Had lots of good meds to get me through.   My docs PA did tell me that my leg looked much better swelling wise than almost all ACI/AMZ patients that he sees and many are not seen back until 14 days post op.  He was very happy.  Tons of bruising from thigh to foot, but was also told entirely from the AMZ (not ACI) and completely normal.  I actually feel like I have a sprained foot and ankle, but told normal.  I have a post op diary thread going and I have some pics posted from 2 days post op and then one from 1 week post op mostly showing the bruising on the leg, so you go check out my legs if you want!   :-[   It's in the post op diary section and titled my Nov. 3 patella ACI/AMZ

Gotta remember...no loading and no shear forces at the patella!  Thanks!















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