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Author Topic: LCL Rehab Post Op Advice  (Read 4953 times)

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scratchyknee

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LCL Rehab Post Op Advice
« on: August 24, 2011, 10:30:06 PM »
Hi,

Sorry for the length of this post but I feel it is best to start from the beginning.  Kinda wish I had made a post 6 months ago, then it would be shorter.   You lives and learns.

I feel skiing in Switzerland in January, pretty much immediately new something bad had happened but stubbornly decided to ski down.  Swiss GP looked at my knee and sent me for an MRI as he suspected ligament damage.   The MRI results came back with completely broken LCL, possible damage to the ACL and bruised bone in the joint.   Swiss GP said I should see surgeon as soon as I got back to UK and that he though 50/50 whether surgery was necessary.   He said if surgery was necessary then it should be done in 6 weeks.   I left Switzerland and went back to the UK with a CD of my MRI still in a straight leg brace.

Unfortunately I have travel medical cover but not UK cover, so everything is through the NHS.   The NHS are great but overworked which is where things started to go a little wrong.

Got back to the UK saw my GP and got a referral.   Two weeks later saw a surgeon unfortunately he turned out to be a bone joint specialist, not a soft and connective tissue specialist.   I was therefore refereed to see the soft and connective tissue specialist the next week.   I was also told to take my CD to be put on the system.   I had backed up the CD before I went to hospital, so I dropped it off with the appropriate people.   Next week I went back to see the soft and connective tissue specialist who looked at the leg and agreed the LCL was broken.  He couldn't pull up the MRI but said he wanted his own done.   He felt there was a good chance that the ligament would heal, if treated conservatively.   I was put in a ROM brace and told to go for am MRI in two weeks, then come back in 6 weeks.

Much Physio went on, the leg seemed to get a little better but I didn't feel it was progressing as it should.   I'll spare you the details as they are largely irrelevant.  I did have problems finding a ROM brace which worked for me but eventually found one which worked.

6 weeks later I returned to see the specialist.   He said he had my MRI results and the only option was surgery.   I asked if he had found my original MRI but he said they where irrelevant as the damage to the LCL was so bad.   I was kinda floored at this point as I felt had he looked at the first MRI we wouldn't have wasted six months.  Surgery couldn't be scheduled for another 3 months and until then I had to remain in a ROM brace.   I asked if I could get a sports brace as I wanted to swim.  Surgeon said that was fine.  I got myself a ossur CTI and tried to build up my leg as bit.   Got to admit the motivation is hard when you are only building a leg up too loose all the muscles again.  I managed to get the the gym a couple of times a week on average but could have done better (some weeks better some worse).

Surgery day came and the op went well.  Well I think it went well.  I was last in surgery on Friday and the specialist had gone home by time I woke up.   I was checked out of hospital by his registrar the next day.  He seemed happy with op but said they had found some early arthritis in my knee when they arthroscoped it.  The ACL was defiantly fine though.   I was to go to physio and come back in 2 months to see specialist.   A physio came round and gave me an ACL booklet, I pointed out that it was the LCL, he said exercises pretty much the same.    I knew most of the exercises from pre op physio so was happy doing them.   I later discovered that heal slides and knee bends were bad for LCL in early stages when it started getting sore.  Returned to see physio a week and 1/2 later who put me on the correct track.

Things went well again and I progressed through the stages of the ROM brace until after 2 months the brace could come off.  I kept a physio log to ensure I progress better.    My physio looked at my leg and said she could feel a bit of movement in it.   I decided to hire a private physio as I wasn't sure I was getting on great with the NHS one, many due to time restrictions placed on her.  He looked at the knee and said he felt it had some slack in it but might tighten up. 


When I went back the the specialist he said he was reasonably happy.   He was very nervous though and said I was to put knee in brace if I was worried about it or on uneven ground.   I was told to start getting fit though so was happy.  NHS physio was keen I pushed myself forward and lived my life.  Slight logistical problem with the brace.  I can't wear the CTI since the op as it doesn't fit over my knee, the only brace I have is a large ROM brace which only fits if I wear shorts.   Not something that is easy to cart around with you.   I should have mentioned this but in the 15 minute slot you have it is difficult to cover everything.  I have another appointment in 2 months now.

1 week later somebody knocked me over and I felt my knee go.   I haven't been able to see my NHS physio for the last week and 1/2 but fortunately have seen my private physio.  He says he thinks the ligament is slightly worse as the joint is now gaping.  Haven't heard from specialist.  Physio advised me to start wearing brace again.

I'm not trying to knock anybody the system is what it is.   Most of the problems are due to shortages of resources.   However I can't keep on like this and have come to the conclusion that I have to spend my savings if necessary.   The other problem is that I have a unusual injury,  they are used to fixing ACLs but LCL on own is very rare.

I have a wedding this weekend and still need wear brace.   I am weather to get CTI adjusted or try and get something lighter weight.

I am also considering seeing a private specialist.   I know this will cost me a lot but I can't continue like this. 




Offline Kaputt_Knee

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Re: LCL Rehab Post Op Advice
« Reply #1 on: August 25, 2011, 07:54:26 PM »
Hi,

Sorry you are in this situation. I had an LCL reconstruction using part of my hamstring tendons in the Sumer of 2008 and was back skiing in Jan/Feb 2009.

I have a Townsend Design Rebel CI ( combined instabilities) brace which I promised my surgeon I would wear for a minimum of 2 seasons post-op. I also had an ACL revision and a wee bit of meniscus tidying up. My rehab was fairly involved and was in part controlled by the LCL reconstruction and partly by the. Revision.

You need to find some who really knows about postereo- lateral corner injuries. It helps to say where you are, so that people with experience can give you recommendations.

I'm based in Bavaria, so my surgeon would be of little use to you.But there are others who have undergone multiple-ligament surgery who may be able to recommend someone in your neck of the woods.

Good luck - in the mean time try reading about PLC injuries in the Information Hub, there is a lot of information there that could prove useful to you.


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

scratchyknee

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Re: LCL Rehab Post Op Advice
« Reply #2 on: August 25, 2011, 10:46:47 PM »
Hi,

Sorry, I'm in London.   I have decided two get a second surgical consult.   Nearly 2 Weeks and no word from Hospital Physio or surgeon. 

I know I am very unusual due to the fact that I have little damage other than to LCL, none of my physios have seen a similar case.

One thing which would be useful to know is regarding bracing.   I have been provided with a range of motion brace.   It isn't exactly something you can carry around easily as it is full leg length.  My knee is still fairly swollen so I haven't wanted to get CTI brace adjusted (am planning on wearing for high impact sports once recovered).  Physio had told me to avoid wear brace, so I hadn't had it adjusted.   I am think that getting CTI adjusted is now a good idea.  As having a small brace I can carry around might be a good idea.

Giles