Advertisement - Hide this advert





Author Topic: I'm losing my knee extension and need help.  (Read 1591 times)

0 Members and 1 Guest are viewing this topic.

Offline kcknee

  • Forum Faithful
  • ****
  • *
  • Posts: 375
  • Liked: 54
I'm losing my knee extension and need help.
« on: March 11, 2010, 08:07:49 PM »
I'm sorry if this is a long post, but I really need help figuring out what to do next.

Here is a brief history of my past year. I tore my ACL on New Years Eve 2008, but was not correctly diagnosed until late Spring when I got a second opinion from a new OS. I had surgery in June to remove the torn ACL that was stuck in my joint, and a ACLr surgery at the end of August, after ROM and strength were back to normal. I regained all my strength and ROM following the ACLr and my knee has felt solid and strong since the ACLr surgery and I have not had any experiences of instability. I did get swelling and some inflammation in my leg that did not fully go away and was prescribed NSAIDs. When I started attempting to run and jump during November, I started showing signs of a variant of compartment syndrome and had fasciotomy surgery in late December. My OS said there was a lot of scar tissue on the muscle fascia most likely from the initial skiing accident. I stopped the NSAIDs before the fasciotomy surgery and the inflammation leg pain did not return after the surgery, although my leg is still slightly swollen.

After this surgery I initially was able to regain full ROM and strength, but since a few weeks ago I've had trouble keeping my leg extension. My PT would stretch out my leg and have the back of my leg flat on the table and then during either the treadmill or strength exercises, my knee will start to feel tighter or thicker inside and my knee will start to contract and be hard to keep straight. My PT was the first to notice this contraction. He would make me get back on the table and push my knee back to flat, usually with a clunk sound. If I went back to the treadmill or strengthening, the contraction would happen again and my PT would repeat extending my knee for me. I have not been allowed to try to run or jump yet since my knee contracted a lot after the only 30 second jog that I was allowed to do. During my last few appointments my PT did not let me use the leg press or the treadmill at all. I have also started to get a pain in the front of my knee below the knee cap and a few times at night my knee will ache inside, towards that same front area, and wake me up. The ache hurts but is more painfully annoying. I have not taken any medication for it. Stairs at times are painful and I walk with a noticeable limp. I do the extension exercises every morning and night, but then I lose the extension again as the day goes on or my activities increase. 

I guess my question is: has any "normal" person had a successful knee/leg surgery and an initial good recovery and then a month or two later lost their full extension? If so, what was the diagnosis? My OS is leaning towards a neurological cause since I had a stroke when I was young, but I'm not so sure since I have not noticed any muscle weakness or loss of strength in doing the strenghth exercises and was doing them without any problems at all before and immediately after this last surgery up until a few weeks ago. I believe also that the post-polio syndrome occurs on the overworked damaged neurons of former polio patients while my entire left side remapped itself to a different area of my brain following the stroke when I was 4. My PT thinks my leg has just been through too much. I am now released from PT and told to go to my local gym and don't see my OS for three months. I'm not sure whether I should try to locate a rehab doctor in case it is neurological or just start pushing myself hard at the gym to rehab my knee and leg and hope I can keep the extension without assistance. I know my symptoms are odd, but I'm hoping that someone might have had a similar experience or that one of the doctors that frequent the board might be able to give me an opinion. I just want to be able to run and play with my son again. I was so close to being better last Fall before the compartment syndrome started, my knee was doing great then.

Thanks,

Kristin
« Last Edit: March 22, 2010, 11:34:46 PM by kcknee »
12/31/08 - Skiing injury L knee
6/1/09 - ACL stump removed from joint
8/31/09 - ACLr - Hamstring Graft
12/21/09 - Ant Fasciotomy 
8/26/10 - Anterior Interval Release
12/6/10, 5/5/11, 12/22/11 - Fasciotomy
12/7/12 - Nerve Decompression
6/3/13(m), 7/29/13(l), 12/13/13(m & foot) 2/3/14(l) Fasciotomy

Offline kcknee

  • Forum Faithful
  • ****
  • *
  • Posts: 375
  • Liked: 54
Re: Losing knee extension at almost two months after surgery
« Reply #1 on: March 13, 2010, 02:14:37 AM »
I haven't had PT since Monday night (I had been going for 3 one hour sessions a week) and my knee is feeling tenser. I have to actively keep pushing it back into hyper-extension when I'm standing in order to keep it straight. It feels like pushing against something spring-loaded. If I relax, it goes back to slightly bent. When I'm sitting with my legs at 90 degree angle, I can straighten my leg in the air front of me, but then there is a loud snapping sound when I bend it out of hyper-extension. If I sit on the floor with my legs out in front of me, my left leg stays bent and does not lie flat on the floor. It is not as pronounced as it used to get at PT after exercise, but this is at rest.

I'm pretty scared/clueless on what to do next. I don't think things are going great and now I don't have a PT anymore to turn to for help and my OS scheduled me to not come back until June. I'm going to start going to the gym this weekend and working out by myself like he told me to, but if anyone has any ideas on what I should do next or what might be happening, please let me know. I really need some help.

Kristin
12/31/08 - Skiing injury L knee
6/1/09 - ACL stump removed from joint
8/31/09 - ACLr - Hamstring Graft
12/21/09 - Ant Fasciotomy 
8/26/10 - Anterior Interval Release
12/6/10, 5/5/11, 12/22/11 - Fasciotomy
12/7/12 - Nerve Decompression
6/3/13(m), 7/29/13(l), 12/13/13(m & foot) 2/3/14(l) Fasciotomy

Offline Janet

  • SuperKNEEgeek
  • *****
  • Posts: 3679
  • Liked: 2
Re: Please read. I'm losing my knee extension and need help.
« Reply #2 on: March 17, 2010, 08:26:23 PM »
Kristin:

I will reply to you here instead of on the personal message. I'm sorry you're feeling so confused and not getting the answers you need from your doctor. Fortunately for me, I never dealt with extension issues, so I'm not sure what to tell you. Keep doing all the extension exercises. I'm not sure why they want you to go to the gym when that just seems to make it worse.

It is possible to do well initially after surgery and then have scar tissue become a problem. But I have no way of knowing if that's what happening with you. Any time you have concerns and aren't getting answers from your medical team, it's time to get a second opinion, preferably with one of the doctors that treat patients with scar tissue problems. Search in the section on Arthrofibrosis to find a list of the doctors Knee Geekers have found to be helpful.

Good luck to you.
Janet
Torn quad tendon repair & VMO advancement 4/99, MUA with LOA 10/99, Patella baja and arthrofibrosis, LR & medial release & LOA 5/01, LOA & chondroplasty 6/03,TKR on 11/06, MUA 12/06. From perfect knees to a TKR in 7 years, all from a fall on a wet floor...and early undiagnosed scar tissue.

Offline kcknee

  • Forum Faithful
  • ****
  • *
  • Posts: 375
  • Liked: 54
Re: Please read. I'm losing my knee extension and need help.
« Reply #3 on: March 19, 2010, 06:24:26 PM »
Thanks Janet.

I have an appointment next week with an OS trained at the Steadman-Hawkins clinic that lists arthrofibrosis of the knee as a specialty. He should be able to make an accurate diagnosis and let me know if this is the problem I am dealing with now.

Kristin

12/31/08 - Skiing injury L knee
6/1/09 - ACL stump removed from joint
8/31/09 - ACLr - Hamstring Graft
12/21/09 - Ant Fasciotomy 
8/26/10 - Anterior Interval Release
12/6/10, 5/5/11, 12/22/11 - Fasciotomy
12/7/12 - Nerve Decompression
6/3/13(m), 7/29/13(l), 12/13/13(m & foot) 2/3/14(l) Fasciotomy

Offline Janet

  • SuperKNEEgeek
  • *****
  • Posts: 3679
  • Liked: 2
Re: Please read. I'm losing my knee extension and need help.
« Reply #4 on: March 19, 2010, 08:44:00 PM »
That sounds like a good plan. I'm glad you're moving forward with an appointment instead of just taking a wait-and-see approach.

Janet
Torn quad tendon repair & VMO advancement 4/99, MUA with LOA 10/99, Patella baja and arthrofibrosis, LR & medial release & LOA 5/01, LOA & chondroplasty 6/03,TKR on 11/06, MUA 12/06. From perfect knees to a TKR in 7 years, all from a fall on a wet floor...and early undiagnosed scar tissue.