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Offline roze87

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anyone had PLC surgery?
« on: July 05, 2010, 03:04:51 PM »
Hi

I posted a previous post a while ago but cnt find it so will give you brief history

7 years ago I fractured my femur
  patella
  tibia
  fibula
  tore acl

After being fobbed off with a sprain, i went back a week later and had emergency my knee put back together with metal work to realign my femur.

4 years later...failed acl reconstruction due to infection of the joint that was failed to have been recognised for a long time

3 months later - infection taken out via surgery

2 years later - revision acl reconstruction - was advised this would be bneficial.

To date - have just found out my acl revision has failed and i am left with posteoleteral corner damage with probable PCL aswell. I do not know the extent of the damage as I am currently waiting on an urgent 2nd opinion to a specialist surgeon as i have completely lost faith in my current surgeon. He was very vague about my MRI and i have self diagnosed my posterolateral corner with the help of my new physio ( i am 99% sure of this).

I have done alot of research in the meantime and I wish i had never had this op becuase i realise now that i was better off before and this was enevitable! I had everything stacked against me and he should never have done it. Why did he do an MRI and then say nothing about it apart from 'oh your acl graft is there but its loose!!' But that is too late now the damage is done.

I am anticipating PLC/PCL/ACL recon now, and am looking to hear from PLC success stories please!! I dont care about running, jumping, twisting,sports etc i am way past that I just want to know if i will be able to walk ever again! I am prepared to go through this op if there will be any improvement in my stability coz it cant be worse than this. But, as you probably know, there is just no information on plc outcomes and i know outcome is unpredictable but success stories are welcome please!!! thank you so much

06/04 Fell - Fractured tiibial plateau, femur, patella, torn acl
ORIF and bone graft of tibial plateau
09/08 failed acl recon due to wound infection
06/10 failed revision acl with pcl/lcl/plc damage
now facing multiligament surgery

Offline Kaputt_Knee

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Re: anyone had PLC surgery?
« Reply #1 on: July 05, 2010, 03:23:54 PM »
I had PLC repairs done in august 2008 and was back skiing and flying (paraglider) in Feb 2009. The original injuries were missed by my first surgeon and along with misplacement of my graft, led to my needing a revision.

The head of the fibula had repaired itself trapping the nerves in the resulting scar tissue and the LCL was completely avulsed. Even if the original repair had been good it would have failed sooner or later due to the instability in this area. By the time it was repaired the LCL could not be re-affixed so I had an autograft using part of the hamstring tendons.

I was told 6 weeks NWB followed by 6 weeks restricted to 90 flex and 0 extension. I was in an immobiliser brace immediately post-op and this was changed to a Don-Joy Legend after 2 or 3 weeks (I can't remember to be honest). I returned to work after 6 weeks as I'm a desk jockey these day with the Don-Joy set to 90 at first then gradually increased the flex. I was actually only NWB for 4 weeks and very quickly achieved the necessary 90 flex needed to drive again (left leg so no brake problems).

At 5.5 months I was cleared to ski but only if I wore a functional brace to protect the LCL reconstruction. I had to do this for two seasons, so I continued to wear it this year and will probably continue to use it as a prophylactic/psychological crutch. At 5.5 months the Don-Joy was swapped for a Townsend Rebel CI (combined instabilities). Since then i have returned to all my sports without any adverse effects. I now only use the brace for skiing and paragliding.

I had been through the rehab several times and I stuck religiously to my programme. I also had a team of PTs who I knew and who knew me. We worked well together and we were all amazed at the progress I made. I am a firm believer in the value of Lymphatic Drainage Massage in addition to ice and compression to reduce post operative swelling as quickly as possible to enable early passive movement.

I hope this helps. Let me know if there are any questions I may be able to answer.

Sue  ;)
1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline london_lass23

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Re: anyone had PLC surgery?
« Reply #2 on: July 05, 2010, 04:11:37 PM »
Hi, i had my plc reconstructed in April this year.

My injury history is left knee dislocation after a rugby tackle resulting in;
Fracured patella
torn acl and pcl
damaged lcl, mcl and mpfl
other damage within the joint

The dislocation happened in may last year but it took me till Christmas to see the right surgeon through the nhs. Between may and chirtsmas last year i saw 8 consultants and had two failed operations. i was originally told that it was just my acl damaged.

I went in for the operation on the tuesday and due to a couple of complications i was in till the saturday. If there had been no complications i would have only been in till the thursday. Anyway after the operation i woke up in alot more pain than i had thought i would. They used part of my hamstring from my right leg for the graft so both my legs were pretty painful. The bandages were taken off the next day and i was fitted with a brace but there was no limit to the flextion or extension. I saw the physio that day (i think) and they got me to walk a couple of steps but i wasnt told to be nwb just pwb. I never realised how weak my right leg would be so i foung walking very hard going to begin with. The next day i tried two steps and thi was even harder. Anyway after i was home i did the exercises as i was told and went to physio two weeks later. This turned out to be pointless as the physio had never even heard of the operation and he said since i was going to be getting further reconstruction i should judt work on building my muscle. I went back to see my os a month laster and he told me to keep wearing the brace and using the crutches for 4 months. To be honest i only put the brace on and use the cruthes when im going out anywhere, around the house i can walk without them. I still get quite a bit of pain if im on my feet for too long and where the screw is is pretty painfull sometimes. Im not sure if i feel my knee is any more stable since the operation but i guess thats cos i still need a lot of work done on it. The next step for me is getting my acl and possibly pcl done in august. Hope this helps

Offline roze87

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Re: anyone had PLC surgery?
« Reply #3 on: July 06, 2010, 02:07:45 PM »
Thanks for sharing your experiences!
06/04 Fell - Fractured tiibial plateau, femur, patella, torn acl
ORIF and bone graft of tibial plateau
09/08 failed acl recon due to wound infection
06/10 failed revision acl with pcl/lcl/plc damage
now facing multiligament surgery

Offline kpoppy

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Re: anyone had PLC surgery?
« Reply #4 on: July 12, 2010, 12:38:07 AM »
Hi Rose-

I appreciate your reply to my first KG post under the "cruciates" section.  I just finally replied as I've been crazy-busy working extra hours in prep. for my upcoming surgery.  I read your posts and we DO have similar stories. 

I too had a joint infection that ruined my 1st ACL reconstruction, causing it to be stretched and non-functional.  Per the MRI, the graft was "intact", so that was good enough for my doctor.  He never once explained the inevitable, severe articular cartilage damage that an infection can cause.  On top of the infection, he cracked my patella harvesting the graft.  And, as I recently found out, that graft wasn't even placed in the correct spot.  My 2nd ACL was placed incorrectly also.

I also suspected I had a PLC problem since my initial injury 3 1/2 yrs ago.  I completely understand your frustration and bitterness.  I think some doctors don't look too hard for answers because it is just beyond their scope of knowledge.  And if that is so, they should recognize their limitations, be straight with patients and refer appropriately.  Just know that once you find the right doctor for you (and you will) all the bitterness, anger, disbelief, and built-up frustration will dissolve.  Don't give up.  You are worth it and deserve it.

As far as PLC reconstruction,  it depends on what structures are torn or stretched/and associated problems for what specific repair may be needed/and the outcomes.  Did you check out the PLC course on KneeGuru by Dr. Noyes yet?

Hang in there. 

KP

R ACL,MCL,med/lat men tears- basketball 06.

ACLr w/ BPTB auto, w/intraop. patellar fx/ORIF 06

Med/lat part. meniscectomies 07, Post-op infection, I & D.

Revision ACL w/ ham auto 1/09.

Bone graft ACL tunnels, debridement AF Jan. 2010

ACL Revision #2/PLC procedure July 21, 2010

Offline roze87

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Re: anyone had PLC surgery?
« Reply #5 on: July 15, 2010, 05:49:22 PM »
Hi Kp. Thank you for your reply. I completely relate to your comment about doctors knowing their limitations and being straight with patients. They should (a long time ago!) instead of trying 'tidy things' up with more of their operations. And with regards to my gp, it has been a struggle trying to get him to refer me to a second OS. Nightmare,but after harrassing him he eventually, reluctantly did and, a month on I am still waiting on it. In the meantime my life is on just on complete hold, i am totally helpless, Have had to give up my job, move home to my parents, give up uni in trade for a life of rest and physio. I am 23 yrs old! Very depressing. I just wait for a letter or phonecall with my referral everday so that i can get the diagnosis, operation, and get on with my life! Yes i did read the PLC course on Kneeguru some time ago thanks, very very good and helpful infomation. It helped me realise alot about my symptoms. I am glad to hear the relief you got when you finally got those answers you were looking for and I really hope that day comes for me soon as Im sure it will.

No long to go for your op now, and i so pleased for you! Im sure you are so nervous, apprehensive and so so hopeful. Be strong, you have been so far and this (hopefully) will be the final heardle in a long journey. Work hard and you will reap the benefits. The very best of luck with it, I have my fingers crossed. i hope you will be coming back here to let us know how you are getting on and to be an inspiration to us as a success story!

Sue, I felt really uplifted after reading your post. Sounds like you're a real success and its had to believe what you can actually do after being so through much, well done!
06/04 Fell - Fractured tiibial plateau, femur, patella, torn acl
ORIF and bone graft of tibial plateau
09/08 failed acl recon due to wound infection
06/10 failed revision acl with pcl/lcl/plc damage
now facing multiligament surgery

Offline roze87

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Re: anyone had PLC surgery?
« Reply #6 on: July 16, 2010, 10:53:45 AM »
Also to 'lenore' who sent me a personal message - sorry I am unable to send personal msg for some reason but thank you for your message it was really really appreciated.
06/04 Fell - Fractured tiibial plateau, femur, patella, torn acl
ORIF and bone graft of tibial plateau
09/08 failed acl recon due to wound infection
06/10 failed revision acl with pcl/lcl/plc damage
now facing multiligament surgery

Offline kpoppy

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Re: anyone had PLC surgery?
« Reply #7 on: July 20, 2010, 04:07:26 AM »
Hi Rose!

Thanks for all your words of encouragement.  After 6 months of waiting, I am finally ready for the big day.  I'm done with my marathon-stretch of working 6-7 days/week for the last 4 months.  I've packed the fridge and the house is clean.  I dropped the kids and pets off at my in-laws today.  Great relief.  I kinda feel like the hard part is over.  HaHa.  We are leaving (5 hour trip) in a few hours as I have pre-op testing tomorrow.  We'll be staying in a hotel til the end of the week.  I'm not sure I will write a detailed post-op post.  I've never been much into keeping a diary.  In fact, (and I'm sure you can relate) over the last couple years I rarely bring up my knee problems to anyone as I feel everyone is sooo tired/bored of hearing about the ongoing problems.  So, I usually just try to internalize my thoughts.  So, we'll see.

Did you get your appointment yet?  I sure hope the ball gets rolling for you soon.  It sucks to be in a waiting game.  Take care and keep up the pre-hab.

KP


R ACL,MCL,med/lat men tears- basketball 06.

ACLr w/ BPTB auto, w/intraop. patellar fx/ORIF 06

Med/lat part. meniscectomies 07, Post-op infection, I & D.

Revision ACL w/ ham auto 1/09.

Bone graft ACL tunnels, debridement AF Jan. 2010

ACL Revision #2/PLC procedure July 21, 2010

Offline roze87

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Re: anyone had PLC surgery?
« Reply #8 on: July 23, 2010, 09:34:24 AM »
wow a five hour trip. That's a real journey. Will be well worth it tho. I'm in UK and only have to travel 45 mins away and thats for my 2nd opinion! Yes i can completely understand where you are coming from - to just internalise your experience and not expressing your every concern to ppl, as it is just the same one long knee 'problem' to others. I no longer go into detail about each and every bone i have broken around my knee, each ligament i have torn and the countless operations i have been though, the sacrifices i have had to make as a result, the anger and regret i have, the bore of physio and the guilt if i miss a day off my excercises; or in fact keep anyone updated of each and every new fear I acquire with every day and every concern with new symptoms and pains. Or how I actually feel nausea when i walk because i can feel my patella going back inside my knee somewhere which totally freaks me out! I dont even try to explain that I am not scaredof surgery, thats the easy part, its the rehab and result that scares me now. Not that people are not supportive or don't listen, my boyfriend, family, friends are great, i just feel that it is something only i can deal with now and there is more to me then my knee! (i think) Kneegeeks is great for venting...rant over now!

However if you ever do feel like sharing your rehab experience even just as a one off i would be interested, as this is a shared experience i would definitely appreciate.

After harrassing my OS's secretary i have an appointment (yay) in 3 weeks time for a consultation with a very well respected specilalist. Its going to be a long 3 weeks but i can see the (albeit dim) light at the beginning of the never ending tunnel now. Well done with organising yourself before going in, im sure will lessen the stress of it all.

Take care and best of luck

rose
06/04 Fell - Fractured tiibial plateau, femur, patella, torn acl
ORIF and bone graft of tibial plateau
09/08 failed acl recon due to wound infection
06/10 failed revision acl with pcl/lcl/plc damage
now facing multiligament surgery

Offline onthewave

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Re: anyone had PLC surgery?
« Reply #9 on: July 26, 2010, 03:53:32 PM »
Hi everybody,

Kapute_knee, did i understood well? you have had a first PLC surgery and after that you made a revision?
Im asking because i had a external plasty that was made in order to help the ACL work, but now I am shure i have a PLC injury and I am afraid by having already made some work in the lateral side of the knee, i dont know if it can compromise the reconstruction of the PLC.

Thank you in advance.

Good luck to everybody trying to get a better quality of life.

Hug





Offline fultonius

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Re: anyone had PLC surgery?
« Reply #10 on: August 07, 2010, 01:47:33 PM »
Hi Roze87,

I'm 13 weeks post-op for a PCL/LCL/PLC reconstruction and doing great!

I'm walking without the brace, can go up and down stairs, doing squats and back on the static bike. It feels really good. Strong, stable and doesn't hurt.

I've been keeping a record of my rehab here, the link is on my profile. Good luck and stay positive!
Climber, Snowboarder and Mountainbiker. Complete tears of PCL and Poplliteofibular Ligament Jan 2010, reconstructed May 2010.

Offline roze87

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Re: anyone had PLC surgery?
« Reply #11 on: August 12, 2010, 08:28:40 PM »
thats fantastic news well done!

thanks and the best of luck I will be catching up with your progress.
06/04 Fell - Fractured tiibial plateau, femur, patella, torn acl
ORIF and bone graft of tibial plateau
09/08 failed acl recon due to wound infection
06/10 failed revision acl with pcl/lcl/plc damage
now facing multiligament surgery

Offline kpoppy

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Re: anyone had PLC surgery?
« Reply #12 on: August 12, 2010, 09:03:12 PM »
Hi Rose!

Hope you are doing well and that your appointment (I think is any day now) goes well.  Got back into town yesterday from a follow-up appointment with my surgeon.  I'm about 3 weeks post-op ACL revision/PLC procedure now.  Everything was successful according to my doctor.  He feels he has restored the stability.  I am currently NWB in a long post-operative brace and will slowly progress to full weight-bearing over the next 4 weeks or so.  Best of all, no complications. 

Wish you the best.

KP

R ACL,MCL,med/lat men tears- basketball 06.

ACLr w/ BPTB auto, w/intraop. patellar fx/ORIF 06

Med/lat part. meniscectomies 07, Post-op infection, I & D.

Revision ACL w/ ham auto 1/09.

Bone graft ACL tunnels, debridement AF Jan. 2010

ACL Revision #2/PLC procedure July 21, 2010

Offline roze87

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Re: anyone had PLC surgery?
« Reply #13 on: August 28, 2010, 05:49:42 PM »
Hiya sorry for late reply. Thats fantastic news really well done for sticking with it and getting so far. You are my inspiration! I have been told by my new surgeon that i need to have my acl tunnel 'filled in' with a bone graft from my hip before he can proceed to reconstruct the LCL/PLC/ACL at a later date. Very gutting as the whole process is going to take about 2-3 years. ARGH! But at least he got he diagnosis right and is doing what he can to help me get the best result. In the meantime i am just stuck in what feels like an endless waiting game of xrays, results, appointments, etc. It would be really great if you have a spare minute at any point where you feel you could drop another line of your progress as your procedure is very similar to what i am looking (forward?) to! All the best and keep at it, i hope everything goes smoothly for you now

rose
06/04 Fell - Fractured tiibial plateau, femur, patella, torn acl
ORIF and bone graft of tibial plateau
09/08 failed acl recon due to wound infection
06/10 failed revision acl with pcl/lcl/plc damage
now facing multiligament surgery

Offline kpoppy

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Re: anyone had PLC surgery?
« Reply #14 on: August 30, 2010, 06:02:52 PM »
Good to hear from you Rose-

Glad you have some long-awaited answers.  Sounds like you are confident in your new surgeon.  I know what a sense of relief it is to know that there is a real solution, despite whatever lengths it will take.  My biggest fear was that all the prior damage in my knee/surgeries would prevent it from even being fixable.  But, once you get in the hands of the right knee specialist, wonderful things are possible.  It is a long process, but it will be worth it.  It has been almost a year since I first decided to take the big step travelling to a knee specialist.  My bone grafting procedure was in January (bone taken from my hip as well) and then the reconstruction 6 months later.

I currently am almost 6 weeks post-op now.  Still in the long-leg brace locked at 10 degrees, 25% wt bearing.  Wednesday I am allowed to unlocked the brace 10-90 degrees.  I have to say (and hopefully you have a similar experience), the pain has been very minimal after ~1 1/2 weeks, nowhere near unbearable as I expected for such an extensive procedure.  I actually have had more discomfort from my other knee where my patellar tendon was harvested for the new ACL. 

ROM has been fairly easy to achieve, surprisingly.  I was at about 90 degrees the day after surgery.  A lot of stiffness, but I have about 0-130 degrees right now.  I am limited in the types of exercises that are allowed at this point- mostly isometrics, SLR's, stretching, e-stim.  My quads are hanging on, barely...  Swelling has been the biggest challenge and frustration- it doesn't take much upright activity.  So even though I feel good, I have to force myself to be a "slug" on the couch with ice.

I go back to Cincinnati next week and then probably monthly to make sure all stays on course.  When is your bone graft procedure?  Do you know what type of grafts will be used for your LCL/PLC/ACL?


Kate

R ACL,MCL,med/lat men tears- basketball 06.

ACLr w/ BPTB auto, w/intraop. patellar fx/ORIF 06

Med/lat part. meniscectomies 07, Post-op infection, I & D.

Revision ACL w/ ham auto 1/09.

Bone graft ACL tunnels, debridement AF Jan. 2010

ACL Revision #2/PLC procedure July 21, 2010















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