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Author Topic: Paule's right knee PCL and MCL allograft repair  (Read 2234 times)

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Offline paule23

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Paule's right knee PCL and MCL allograft repair
« on: April 30, 2010, 07:37:33 PM »
Hello All

Quick introductions.  I have a rather long history of problems with my right knee going back 18 years and 8 operations.  Originally hurt playing football (that's Association not American!) then injured again playing rugby (yes I know, I never learn, my wife said something similar).

I had a revision ACL repair to replace a failed Kennedy LAD repair 6 months ago, but due to continued instability, pain, crunching and a complete stall in my rehabilitation program I had a PCL and MCL allograft x repair 3 days ago. So some poor sole has kindly contributed a used Achilles which is now supporting my knee.

So, how are things going I hear you ask?

Well, actually not too bad, although I think that's mainly because the main bit of physio has not started yet.  I had the op late Tuesday evening (3 1/2 hour surgery) so most of Wednesday was spent sleeping fitfully due to the long anaesthetic.  Pain was fine throughout the day with operative analgeasia topped up by co-codamol.  Main problem was a really sore eye, felt like I had a large bit of grit in there (very defensive medical staff 'don't know how that happened, your eyes were taped shut') but that's healing up nicely now with some anti-biotic drops.

My knee is in a fixed brace (similar to a Donjoy 3 panel knee splint) which I don't really like as it's very bulky and far too much velcro, but it does the job of keeping the knee immobilised for now whilst I negotiate an upgrade to a hinged brace.

I was very surprised to be told I can weight bear with the support of crutches as I thought I would be relying completely on crutches for the first 2 weeks before partial weight bearing, but I am allowed to hobble around with crutch support.  Not much home physio yet, just lots of quad tightening and a few supported bends (I am very nervous about the bending due to the risk of stretching the graft, after 8 operations I think I've had enough!).  First proper physio on Tuesday, let the pain commence!

Pain has got a little worse as I've moved about more and done some more exercises so now upgraded to dihydrocodeine but honestly, they don't do much for me.  My GP always looks at me as if I'm a junkie if I ask for stronger pain relief (as happened today) so I'll have to see how it goes before I go back to ask for more.  Any advice on how to broach this would be much appreciated.

I believe I have 9 months of hard physio ahead so here's to a long, painful but hopefully successful recovery.

Paul
1992 - Tore MCL, partial tear ACL. 
Op 1 - MCL repair
1993 - Tore MCL and ACL,
Op 2 - MCL repair
Op 3 - ACL repair
1996
Surgery 4 - Arthroscopy
2005
Op 5 - Partial menisectomy
2009
Op 6 - Partial menisectomy
Op 7 - Revision ACL repair
2010
Op 8 - PCL repair (allograft), MCL repair

Offline kneetmare

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Re: Paule's right knee PCL and MCL allograft repair
« Reply #1 on: May 01, 2010, 02:41:22 AM »
jeez paule good luck mate!

could i ask a question or two if you don't mind? first off, why did they repair the MCL, did it snap in half? was it the re-occurrence of the knee giving away that led to the PCL being damaged? do you think the order inwhich you have had your operations has effected the long term of problems?

good luck paule hope you recover well!

Offline paule23

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Re: Paule's right knee PCL and MCL allograft repair
« Reply #2 on: May 03, 2010, 09:07:25 AM »
Hi Kneetmare

I can only really answer for the most recent op as the others are so long ago.  The MCL has been repaired this time dur to ongoing laxity.  I know MCL's are normally left to their own devices, but mine remained unstable and quite loose (although not actually torn in half) so an allograft has been placed alongside to support and tighten it.

I'm not sure about the PCL as I was originally told 18 years ago I had tore it, but it was never repaired and no-one mentioned anything more about it until post my second ACL repair when I still had instability and suddenly the PCL became the focus (grasping at straws perhaps, both me and the surgeons!).  A couple of surgeons had noted some PCL laxity in this knee (tibial drop on bending) but never proposed any surgery.

I'm not sure if the order of ops impacted on anything.  My main frustration was when I had my second meniscectomy last year, I was still suffering with pain, instability and a collapsing knee but the surgeon insisted there was no problem, a referral onwards and I'm told the original ACL repair has failed, why did the first guy not spot this?  Took 6 months to get that diagnosis, but at least it was found eventually.

This should be the last op as there's not a lot left to repair/tighten in my knee anymore so here's to hoping it all works out well.

Thanks for the good wishes.

Paul
1992 - Tore MCL, partial tear ACL. 
Op 1 - MCL repair
1993 - Tore MCL and ACL,
Op 2 - MCL repair
Op 3 - ACL repair
1996
Surgery 4 - Arthroscopy
2005
Op 5 - Partial menisectomy
2009
Op 6 - Partial menisectomy
Op 7 - Revision ACL repair
2010
Op 8 - PCL repair (allograft), MCL repair

Offline kneetmare

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Re: Paule's right knee PCL and MCL allograft repair
« Reply #3 on: May 03, 2010, 06:59:04 PM »
thanks for the answers paule! hope it goes well for you. i have noticed you also have a blog.. i will keep up to date with it and hope the last roll of the dice does the trick!

Offline paule23

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Re: Paule's right knee PCL and MCL allograft repair
« Reply #4 on: May 06, 2010, 07:21:27 PM »
ust under 7 days after the op and had my first 'formal' session of physio on Tuesday.  I say 'formal in inverted commas as I've been doing a load of quad tightening and straightening of the leg over the pas t few days, but this was the first session with a physio at the hospital.

And I must say, it was quite a pleasant surprise as the pain wasn't excrutiating.  Now don't get me wrong, it definitely smarted a bit, but I wasn't nearly in tears for most of the time, and after my ACL recovery, that's progress I can tell you!

I think the main reason for this is the lack of exercises I can do at the moment.  Those of you who have had  a PCL repair will know it is so important not to over-bend the knee in the first few weeks to avoid stretching the graft and ending up back at square one.  So I'm only allowed to do stiff leg tightening and raises (to activate and try and minimise quad mnuscle reduction) and some limited extensions from about 15' of bend.  The only potential pitfall was the passive straightening done by the physio.  I was apprehensive about this for two reasons, firstly not wanting to over-stretch that damned graft, and secondly 'cos it hurts.  But luckily I already have a significant bend in my knee, measured at over 80' (I'm not allowed to go beyond 90' in the first 6 weeks so to reach 80' already is great).  As I've got a good range of motion already I think the physio let me off lightly.  And as there is not much for them to do right now, I don't got back for a couple of weeks.

So all good so far, although I know I'm storing up for some hard graft ahead.  Gotta make this op stick so the re-hab is so important.  Despite work pressures I've been keeping up my home physio for once, you can always do more but I least I'm doing regular exercises.  In case no-one reads this I'll tell myself, Well Done Paul, keep it up!

Take care out there.

Paul
1992 - Tore MCL, partial tear ACL. 
Op 1 - MCL repair
1993 - Tore MCL and ACL,
Op 2 - MCL repair
Op 3 - ACL repair
1996
Surgery 4 - Arthroscopy
2005
Op 5 - Partial menisectomy
2009
Op 6 - Partial menisectomy
Op 7 - Revision ACL repair
2010
Op 8 - PCL repair (allograft), MCL repair















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