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Author Topic: New here-- w/ ugly knee situation  (Read 1647 times)

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Offline tkdmama

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New here-- w/ ugly knee situation
« on: March 09, 2011, 06:00:04 AM »
Hi all,

I'm new to the forum, so am posting my intro and summary of my route here. I'm an active 38 yo (F)-- former high level athlete and until injury was still running 3-5 miles/day and teaching/coaching/training in my sport. I'm a very physical person in general-- never sit still, do a lot of home projects, landscaping, hard work and love outdoors and being on the go with my family. My injury makes for a really lousy story. With everything I do, I managed to destroy my knee just falling and landing badly while doing some work around the house. When I fell I landed on a wooden crate, and most of the impact was  my bent knee against its hard edge. I knew it hurt worse than I'd expected it to-- but I iced it and a bit later kept on going with life. I'd cut it, too, so was focused mostly on the surface wound at the time. I returned to normal life after the wound was healed and the pain was better. But I was still having some soreness/pain-- mostly on stairs. Then it worsened-- one day my knee got very very swollen and I knew it was more than just some tightness where I'd banged it up. An ortho got me in quickly (this was 9/10), but after draining and injecting (fluids were tested and fine), misdiagnosed it. I tried following what he recommended, and it blew back up again. So, knowing something was obviously still wrong, and with all of the swelling, etc., I called my gp, he got me in and ordered an mri so he could get the ball rolling and get me in with some orthos he trusts. I saw the new ortho, with my MRI in hand. I had ruptured my patellar tendon-- (not totally-- there was some in tact and the tear was longitudinal). I'd also torn my meniscus-- had some lesions and debris in the joint. Think there was a small cyst or some debris or something around my acl, too (I'll have to order my notes). So, on 10/6/10 I had open knee and arthroscopy. The RPT wasn't total and there was a good chunk of healthy tendon, so he was able to repair without screws. And he did a chondroplasty, cleaned up the debris, etc. Afterward he said it was even messier in there than what showed on the MRI. My rehab was going pretty well for a while-- though my swelling was more than average, though apparently not enough so to be worrisome. I think I was able to do a bit more/earlier in PT than some with the rpt, b/c it wasn't a total tear. I hit 130 ROM and things seemed to be looking good. Then wham-- one day after PT it hurt more than usual and got very swollen again. We tried stepping back a bit, and I did lots of RICE to try to help it. But no luck-- kept swelling back up-- and was feeling "stuck" at a certain point, and between that and the swelling, my ROM began to backslide. Back to my OS, who wanted to treat conservatively first-- put me back in the immobilizer, locked, and kept me off PT and locked in for a couple of weeks. By time that was over my ROM was back to 75 or so, I got it back to 95 and then the knee was pretty stuck. I think I broke 100 once or twice, but not easily (and would swell more afterward).  OS at that point tried an injection and when it didn't work, a few weeks later, I ended up having arthroscopy to clean up scarring and adhesions, and he did "MUA" (and apparently got my heel to meet the back of my leg-- I'm very flexible-- my ROM on my good leg exceeds 150).This was on 3/2. He confirmed it was arthrofibrosis when I asked him about it in post-op. He had me go straight from post-op to PT-- where we started some passive motion. I've been going to PT appointments once a day, and doing several sessions at home. Passive motion, mostly-- heel/wall slides, piggybacks, bike with no resistance, longer duration stretch, some designed to stretch my quads-- which were killing me after the MUA-- they haven't bent that far since Sept!

My passive ROM is now at 122. But it takes some doing-- not functional/active ROM. Mostly my pain/what stops me is the strained quad, which is really sore. I've got a little bit of discomfort in the knee itself now, but not much. Swelling has been decent but today is worse-- and the knee more sore, too. And tonight around/beneath the incision on one side there is a swollen lump-- not hard like a cyst or node,  just like there's a pocket of squishy swelling beneath it or something. No redness, heat, pus or worrisome stuff... I  freaked out at first b/c when my tendon ruptured I had a squishy hunk of tendon in that same spot, but to my untrained fingers things feel the same as they did-- and like the other knee except for the swelling.

One of the thing's I'd heard about the scarring I had was that it could have happened b/c of the immobilization the tendon required, which didn't allow the  the typical rehab one should do for the cartilage-- and that the trauma to the join, and the complicated surgery increase chances of scarring issues. Does this sound right? I'm still getting up to speed-- but from what I've seen here arthrofibrosis seems like its usually a recurrent issue. I don't have any underlying health conditions-- I'm a health nut. I do tend to get thicker, or hypertrophic scars on my skin-- if that makes a difference to internal scarring tendencies, as well; it seems to be familial. I'm usually pretty tough and stubborn, but this thing has been dragging on so long now and is really starting to wear me down, and I'm terribly concerned about the implications of the arthrofibrosis. I just can't imagine not getting my life back to the way it was.

So, that's where I am now.

Cheers.


open knee, arthroscopy, chrondoplasty 10/11
for RPT, meniscal tears, etc.
developed arthrofibrosis
arhtroscopic clean up, MUA
3/2/11

Offline Stasha83

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Re: New here-- w/ ugly knee situation
« Reply #1 on: March 09, 2011, 10:01:09 AM »
Hi

I too have arthrofibrosis so can understand how you are feeling. If you post this in the arthrofibrosis section of this board I think you may get more responses. Also the regulars in that section have a wealth of knowledge and experience with AF and will be able to give you good advice.

I was only diagnosed in December and had my LOA and MUA a week and a half ago and have learnt so much from this board, it literally was a knee saver for me! Being immobilised for 6 weeks and having my fat pad removed were the causes of my AF.

There are also some great documents in the information hub on AF, the document by Dr Noyes is brilliant. There is also a document with rehab info too.
June 2010 - R knee TPF & Hoffa removal
Dec 2010 - R knee- Arthrofibrosis
Dec 2010 - L knee Myxoid degeneration of meniscus
Jan 2011 - R Knee 11 steroid injections & Synvisc1
Feb 11 - MUA & LOA
June 11- Steroid inj, EMG & nerve tests
Aug 11 - MUA & LOA
Feb 12 - R Knee denervation

Offline Kimberly 77

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Re: New here-- w/ ugly knee situation
« Reply #2 on: March 10, 2011, 04:50:14 PM »
Your surgery wasn't very long ago and your at 122 flexion, sounds like it will eventually get there, just gonna take some work. How is your extention? I am having trouble with both my flexion is 95 with force and my extenxion is -15 with force. I don't know if I have af or not but my pt is thinking that way, I see my os in April so won't have any answers until then.  I am 8 weeks out from my 2nd scope so you are doing better than me if that gives you any hope at all.
Right leg amputee.
Osteoarthritis in left knee.
Medial femoral condyle defect, arthoscopy 8-2-10
Grade 3 defects, patella, medial femoral condyle, tibia scoped1-12-2011
Physical theraphy and awaiting microfrature 2-1-12

Offline tkdmama

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Re: New here-- w/ ugly knee situation
« Reply #3 on: March 11, 2011, 02:43:34 AM »
Thanks to you both for replying!

Well, my ROM is already backsliding and my swelling increased, so things are a bit more worrisome now. I measured 115ish yesterday, but I had a lot more swelling in the joint holding it back and we also didn't push it or try to get it to its absolute limits. Still would have been less than the day before, though-- more swollen and my quads hurt and I felt all around stiff.  My PT thinks too much too soon and has had me step back from trying to get too far too fast with the ROM for the past couple of days. He has had me keep up with the knee motion and the slide/stretch type exercises, but with those step back a bit and not shoot for getting it as far as it can go, just getting a gentle stretch out of it-- especially through my quads since the quad pain has been a killer since the MUA. He had me take a day off of working with him at the clinic today, too, and had me do just what I mentioned above at home. And lots of RICE.

But, I'm freaking out. I had a lot of swelling last time, too-- then the complications...

Kimberly, my extension is normal/fine-- has been all along since the first surgery-- I've only had trouble with the flexion. Sorry to hear you've got it going on both ends-- that's tough! 

Also, don't know if any of you have experienced this-- but I've been waking up at night the past few nights with bad quad pain-- like it's getting tight/knotted up while I sleep or something.

Officially a basket case now and up for any/all suggestions to help with the swelling, quad pain/tightness, rehab, mental state, etc, etc.

TIA!

open knee, arthroscopy, chrondoplasty 10/11
for RPT, meniscal tears, etc.
developed arthrofibrosis
arhtroscopic clean up, MUA
3/2/11

Offline Kimberly 77

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Re: New here-- w/ ugly knee situation
« Reply #4 on: March 11, 2011, 03:46:49 PM »
I do understand your frustration, I am a bit discouraged too.  Its so hard to try and change your life around to accomadate for the things you can no longer do. I have lots of life experience with that, I lost my leg when I was 6 years old, so have always had to struggle somewhat but I have never let anything stop me from living my life, but this knee thing is so hard. I am like you feeling down most of the time, can't seem to get use to the idea of not being able to walk. The one thing I have always said my whole life is that I would never let myself ever be in a wheelchair and now here I am 33 years old and stuck in this stinking chair most of the time. Its hard for anyone who has to deal with something so life changing. I think I could use a bit of cheering up too.  I hope your knee gets better soon and we can all go on with our lives and not have t put so much on hold anymore!! I guess I get through each day by looking at the positives in my life.
My 3 wonderful kids, my loving husband, and the fact that I'm still here in this world. I find it really helps to try and see a brighter side of life and try not to dwell on the struggle life has to offer us.

On the quad thing, is it like a charlie horse cramp? If so it is probably because your quads need strecthed and worked out. My therapist told me to massage my quads whenever I get a chance to help loosen things up. Mine stays really sore and stiffened up too, I don't get cramps at night but for some strange reason I wake up kicking my leg straight in the middle of the night, which is so painful bcause I can't fully straighten yet. Good Luck with everything and Cheer up! ;D
« Last Edit: March 11, 2011, 03:49:23 PM by Kimberly 77 »
Right leg amputee.
Osteoarthritis in left knee.
Medial femoral condyle defect, arthoscopy 8-2-10
Grade 3 defects, patella, medial femoral condyle, tibia scoped1-12-2011
Physical theraphy and awaiting microfrature 2-1-12

Offline smillie

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Re: New here-- w/ ugly knee situation
« Reply #5 on: March 11, 2011, 04:35:32 PM »
Have you read the course on arthrofibrosis in the information hub? That will be helpful for understanding and also reading and posting in the arthrofibrosis forum. The trick to rehabbing after AF seems to be finding the delicate balance between working hard enough to get results but not getting the inflammation fired up. Swelling and heat are the enemy and if you are seeing an increase, then you are at risk and need to back off. The tendency is to want to push it hard and get it over with, but in doing so, you can end up starting the scar tissue process back up and making more. There is a wealth of information here. Read through as much of it as you can and get some tips for handling this. It is a balancing act. When you are swelling, be sure to do lots of elevating and ice ice ice! You want to keep the knee cool and get the swelling down. And if you deal with the swelling, then you will probably get some of that ROM back. You may also have to back off on normal activity to get it back under control. Do anything you can do to take care of it now and it will pay off in the end.  Good luck!
patella pain began early teens
'94 TTT/LR/VMO adv.
'94 MUA
'10 tried PT again
1/11 scope/hardware removal
4/11 (Finally!) dx medial instability due to LR
5/9/11 LPFL reconstruction scheduled

Offline tkdmama

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Re: New here-- w/ ugly knee situation
« Reply #6 on: March 12, 2011, 02:04:29 AM »
Yes-- I've read the course on Arthrofibrosis, and lots of posts, etc. on here. My OS never told me it was arthrofibrosis prior to the arhtro/mua-- he just explained the scarring, etc and what he was going to do. I came here and started researching when I entered panic mode the night prior to the procedure--knew the site b/c I'd browsed the forums back before my surgery for the RPT. I figured out it was likely arthrofibrosis thanks to everything I learned here, so I knew to ask my OS about it at the procedure-- and he confirmed it. He seems good about answering questions/providing more info if you ask-- but he's not very forthcoming on his own. My PT is great, though. I know he's read the articles here and these boards, too, b/c we've talked about them.

Anyway, I am going to move myself over to the arthrofibrosis area now. Just posted here b/c I thought newbies were supposed to start off in the general area.

Thanks again for your replies!

See you over there :)
open knee, arthroscopy, chrondoplasty 10/11
for RPT, meniscal tears, etc.
developed arthrofibrosis
arhtroscopic clean up, MUA
3/2/11