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Offline telemarkerSteve

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swelling during OATS recovery
« on: April 09, 2010, 04:50:27 AM »
Hey everyone,

I was wondering what kind of inflammation issues people experienced during their OATS recovery?

I am 6 months out (Oct 7 surgery for the focal defect in lateral, posterior femoral condyle with something like 1 1.5cmx1.5cm allograft plug)

I think things have been going well.  I have very little pain and about a month ago my OS cleared me to try "anything in moderation and working into it gradually" - including offpiste skiing and martial arts - so I have been happy.  But as I work into things I always get some inflammation and I am trying to figure out how much is too much.  At about 3 months, I got to where my right heel will just touch my left butt cheek with some patient, steady tugging so my ROM is pretty good.  Since then, my general rule about inflammation has been that if I lose heel-to-butt, then I take that as a sign that I have done to much and back off a little.  I came up with the rule after my last meeting with the OS, so I haven't really had a chance to bounce that off him.

 -Is everyone else still getting swelling at 6 months post op? 
 -If you are, how much do you/your PT/your OS think is too much? 
 -Do you get pain more frequently than swelling or swelling even when you don't have pain?

I am going to try to get an appt to drill down on this stuff with my OS but he's a busy guy and I never seem to get specific, understandable answers to these kinds of questions...

 -Are other people getting cleared to ski at less than 6 months or is that aggressive? 

I am a little worried because last Wed I got a lot more swelling than usual and lost 15 degrees from my heel-to-butt steady state and haven't dared to ski since...



Offline Dad3

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Re: swelling during OATS recovery
« Reply #1 on: April 09, 2010, 12:28:49 PM »
I had OATs and ACL in Nov 09 - I now have a little swelling in the Lateral Femoral Condyle area - and by a little, i do mean a little. Its about the size of a small rounded walnut. My swelling is still there from surgery, and doesn't come or go.
I'm seeing my OS, for the first time in 6 weeks and I've been released by my PT to "do what I need to do".

Running is still painful, but this is due to the CMP in my patella, ascending/descending stairs is OK'ish. Sorry don't ski, so can't help there.

Might be time you pestered your OS or PT for some direct answers to rather pertinent questions.

Good luck
RT Knee collapsed 08/2009
MRI 10/2009 - torn ACL
Arthroscopy and MFX - 10/2009
ACL and OATS 11/2009
RT knee lateral release, mosaicplasty and medial reefing - 22nd September 2010.
Still not 100% OK :(

Offline telemarkerSteve

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Re: swelling during OATS recovery
« Reply #2 on: April 09, 2010, 04:36:33 PM »

I have the walnut too - which I always assumed was scar tissue.  If I go a week or so of nothing (except maybe some biking) I get down to where the walnut is pretty much my only swelling but pushing boundaries always brings more swelling than that.  Of course, it also did back during PT so I am sure some amount is OK but how much is what I am struggling with...

So you still have some stair discomfort which you think is not pattelar?  I feel great going up, but generally feel a little something going down which seems to be about 1/2 pattellar and 1/2 from the OATS site.

Going to try to see the OS Monday, I guess.

Thanks again

Offline blometti

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Re: swelling during OATS recovery
« Reply #3 on: April 10, 2010, 03:41:03 AM »
hey guys,
Im very jealous of you two, but at the same time at least I know I have something to look forward too! I am 2 months post op. Im not sure of the size of my plugs but I do know they are huge, and there are 3 of them. I am nowhere near being able to get heel to butt! Then again I am still on crutches...  one more month to go.
My knee is still rather swollen, every time my doc sees it he wants to drain it.

How long does the pain around the scar last? granted my scar is about 10 inches long, I still get shooting pain along and near it.
Have you ever experienced pain at the plug site? There have been several times when I will get a pain that I can only describe as a someone turing a screwdriver inside my bone. I told my doc this and he thinks its not actually in the bone, but at the scar.

Anyway, its good to know that in a few months things should be better and I will be at the very least walking again! Skiing or running... I can only hope!

Offline telemarkerSteve

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Re: swelling during OATS recovery
« Reply #4 on: April 11, 2010, 02:24:50 AM »
ah those difficult early weeks...

I definitely don't miss the crutches

anyhow, I didn't have much pain with my scar (about 6" long) except for one spot where some kind of painful scar tissue formed around one particular suture - that stayed painful until my OS actually took it out as part of a follow up scope to check on the plug and clean up scar tissue at about the two month mark

I don't remember how long the general pain around the scar lasted but I think it was there for 2 weeks, mild for another 2 or so and nearly gone by 6 weeks - except for the first few days it wasn't bad enough to bother me compared to inflammation issues

I never had significant pain that felt like it was coming from inside the knee but would get aches that felt like they came from the plug location when doing step downs at PT

relative to other people I seem to have less problems with pain and more problems with swelling (I didn't have significant pain prior to the surgery despite the gaping hole in my cartilage and bone) so that may not be typical

these days I can definitely feel normal walking level ground or up hill and skiing actually doesn't hurt at all during - it's the swelling after...

Offline telemarkerSteve

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Re: swelling during OATS recovery
« Reply #5 on: April 13, 2010, 01:44:15 AM »
saw OS today

he  took X-rays

said the X-rays indicated "the plug was still encorporating normally" and that most likely I was either prone to inflammation or had overdone as I did in fact have much more inflammation than he would like to see then he drained 50cc from the knee and told me to take it easy for a while and try to feature biking over skiing

Offline thehammah

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Re: swelling during OATS recovery
« Reply #6 on: April 18, 2010, 04:51:49 AM »
OMG... I thought I was the only one!!  I had my surgery in late January and am just now hobbling around without crutches or a cane.  and boy oh boy do I have swelling.  My doctor almost put me under the knife again last week due to a portion of the incision that hasnt healed yet.  yup its been more than 13 weeks and part of the cut hasnt healed completely. 

The big issue is my dependence on my cold therapy machine.  keeps me tied down at home or close enough that if my gel packs get thawed out its time to go home.  Thank god I work out of the house because I would still have to be on disability.  My guestion to you fine folks is does your knee feel like a red hot poker if you dont keep it cold? 

I am now trying to cycle through the cold therapy so that the final portion of the incision can better get some air.  So I keep the cold therapy on for an hour or two then take it off for 30-40 mins.  I cant go too much longer because if I pass an inflection point then my knee really gets hots and hurts and it will take all night to calm it down. 

My total range of motion is around 130 degrees but had to stop pushing it since it was pulling my incision open so no more than about 100 until I see the wound specialist next week.  I am also on antibiotics just in case but the infection dr didnt really think I had an infection as I dont feel sick. 

I am really bummed since I had the surgery to help me get back to my more active life.  Before the surgery I could weight life a bit but couldnt do any cardio as my knee would get swollen for days and thats after all the meds and icing i could do.

I have two plugs in the lateral throchlea/condyle main weight bearing area.  This was all caused by a van hitting me in 1984 and over the years it just wore down.  5 surgeries later and this was really my only option short of a knee replacement and I am still too young..

It doesnt look too swollen no walnut..  just feels like a hot poker if I let it go too long and gets so stiff its very hard to move..Anyone with the same experience..  So hard to find any information