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Author Topic: Allyd's MPFL + Lateral Lengtheing - 9/23/11  (Read 21030 times)

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Offline allyd

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Allyd's MPFL + Lateral Lengtheing - 9/23/11
« on: September 20, 2011, 11:21:08 PM »
Hey all… Just thought I’d get a Post Op Journal going. My MPFL & LRR on my right knee is only a few days away. Friday 9/23/11… I’m hoping everything will go great, and I’ll be able to post my successes. We don’t see enough of that around here. OR… everything will go badly and they’ll chop my leg off. Ha. Stay tuned, we’ll see what happens!  ;)

Overall, can’t really wrap my head around what to expect as it is my first surgery EVER! Yikes. I’ve stocked my apartment up with the typical “knee needs” as well as my guilty pleasure movies, books, food, etc.

Short term goals:
Week 1 - Don’t kill my mother when she keeps “stopping by” to check on me
Week 2 – Awake from the "haze" and regain some normalcy and independence
Week 3 – Back to work & driving, albeit minimal driving. (And before a bunch of you jump on the  driving to soon – this was my OS’s take on the situation, not mine – YES, I’m stubborn enough to make it work, find a way and will not ask this question again, simply because I got the answer I wanted the first time. Sigh, I know, I know, we’ll see how it goes... This is about the time where I wish I lived in the less populated area of my childhood)
04/09 RK - Dislocated Patella & Grade III MCL Tear
06/10 RK - Re-Dislocation Patella
09/11 RK - MPFLr + Lateral Lengthening

Offline oohheykate

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Re: Allyd's MPFL + Lateral Lengtheing - 9/23/11
« Reply #1 on: September 21, 2011, 02:38:55 AM »
Good luck allyd! I'm sure it'll all go as planned and you'll be on your way to having a normal knee soon enough :)
-18 years old-
Left knee;
11.07.08- Scope
07.02.09- Lateral Release/Meniscus Repair
11.11.09- diagnosis of Patellar Instability/Patellar Tracking Disorder
12.10.09- Medial Reefing/Lateral Release
01.11- Synvisc
04.14.11- MPFL Reconstruction
06.21.11- LOA & MUA

Offline allyd

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Re: Allyd's MPFL + Lateral Lengtheing - 9/23/11
« Reply #2 on: September 25, 2011, 02:46:13 PM »
Post Op Day 3

Surgery Day went well. Everything seremed to flow smoothly. Everything went as planned, if not better. I'll post more on the op later. Overall, Pain control has been a breeze so far. There was one small incident when the nerve block wore off. So, the last couple of days have really just consisted of a lot of couch time and tv. I'm learning how to get around on my own and function. - which is good because my sister leaves today! We are gonna change the dressings and attempt a shower before she leaves. BIG DAY... haha.

will try to post more details later.
Ally

04/09 RK - Dislocated Patella & Grade III MCL Tear
06/10 RK - Re-Dislocation Patella
09/11 RK - MPFLr + Lateral Lengthening

Offline Runner1993

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Re: Allyd's MPFL + Lateral Lengtheing - 9/23/11
« Reply #3 on: September 26, 2011, 12:46:50 AM »
Glad to everything went better than planned! With both of my surgeries, I always had to have more work done than we originally planned! I'm interested to read more about how the surgery went and about how recovery is predicted to play out for you. Best of luck!
July 21, 2009 - First Patella Dislocation
December 7, 2009 - Lateral release, medial reefing, and plica excision
January 14, 2011- TTT, MPFL Reconstruction, and Lateral Release

Offline Brambledog

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Re: Allyd's MPFL + Lateral Lengtheing - 9/23/11
« Reply #4 on: September 26, 2011, 05:51:11 PM »
Hi allyd,

I'm also following your progress with interest. Sounds like you're doing well so far. Keep going and good luck with it all!

Brams  ;)
2009 - diagnosed coeliac
Aug 2011 - L knee arthroscopy
Aug 2011 - diagnosed PF arthritis L knee
Nov 2011 - diagnosed CRPS L knee
Dec 2011 - MRI R knee, PFOA is worse than L!
June 2012 - no surgery 'til TKR's
Nov 2012 - CRPS spread to L foot/thigh, increasing pain
- Worsening pain/symptoms R knee
;-)

Offline allyd

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Re: Allyd's MPFL + Lateral Lengtheing - 9/23/11
« Reply #5 on: September 26, 2011, 06:48:04 PM »
Hey all - thanks for your support. Now that I can focus a little clearer, I'll try to recount my first few days in more detail.

Day 1 - Surgery day
Surgery was scheduled at 2pm and needed to be to the surgery center at noon. Lucky me, My OS was running ahead of schedule, so I got a call at about 8am asking me to come in around 11am. We went through al the normal pre-op stuff, forms, etc. Anesthesiology came in, we decided on a general and a nerve block. The doc came by, signed off on the knee, asked a few questions and then they wheeled me back to the OR. They knocked me out and I woke up as if no time had passed in recovery. No bad side effects to the anesthesia or anything. Was happy about that.

As for the surgery itself, per my Mom and Sister - my OS said everything went really well. When they scoped the knee, they looked at the suspected damage on the backside of my kneecap and decided it was fairly mild and could be left as is. She had originally planned to shave it down. So that turned out better than thought. Everything else on the scope was clear. She then proceeded to do the lateral lengthening. They lenghtenined the lateral retinaculem and let the patella "settle naturally" into the normal groove. She ended up lengthening it by 22mm. In contrast to a simple release, I believe they actually repair it at the "proper" length. She then finished with doing the the MPFL recon, It all went fine I guess. I'm sure I'll get a clearer understanding of all this when I see/talk to myself during followup.

So, we got home about 7pm. I settled in with my drugs, pillows and a little food. My sister was laughing at me, because I was so chatty and alert... Just like when I drink! haha, good to know drugs have the same effect.

Day 2

The Nerve block wore off early in the morning about 5 am. So, I woke up to my quads randomly spasming, and that caused a lot of pain, I had cold chills/sweats, and wasn’t a good situation. I got up to use the bathroom and thought I was gonna pass out. We got me back to the couch, something to eat and another round of pain meds. After that we were very religious about keeping up with the meds at about every 3 hours. I was out of it most of the day, but mostly pain free.

Day 3
Really turned a corner today. When I woke up, pain levels had gone down a lot. We cut back dramatically on the pain meds. I didn’t feel like I needed it, and just wanted to be alert. With the Nerve block worn off, I was able to also start PWB, which helped my confidence a lot in terms of mobility. Seemed to feel better about it every time I get up. Was able to take a shower! Also changed the dressings – cant say the knee looked all that pretty… quite mutilated actually, but it is what it is.

Day 4

With my help gone, I’ve transitioned to hobbling around on one crutch around the apartment. Pain levels are still low, and I am managing with ice and a pill here and there. I think the ice almost helps more than the Percocet. Seems to be at about the 8 hour mark where I start to get to a pain level I don’t like and I’ll take one, only to pass out within an hour of taking. Hard to complain about that.

So…. That’s my basic story to date. I expect everything to be manageable the next few days. I start PT on Thursday 9/29. Guessing, pain levels and my general attitude of “I’m doing great” may change then
04/09 RK - Dislocated Patella & Grade III MCL Tear
06/10 RK - Re-Dislocation Patella
09/11 RK - MPFLr + Lateral Lengthening

Offline allyd

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Re: Allyd's MPFL + Lateral Lengthening - 9/23/11
« Reply #6 on: September 28, 2011, 03:38:35 AM »
Post Op Day 5

Okay, I'm officially bored out of my mind. Pain levels are non-existent, and I have pretty much stopped taking the Percocet. I feel lucky to not have a lot of pain. I know there are some long days with PT ahead of me. But having read a lot of other MPFL stories - I was expecting more pain early on. But I also think my OS's technique avoids a lot of the pain often associated. I have no screws in my knee, and she did not drill into the femur to attach, but instead wrapped it around another tendon in the area. Or maybe I'm just tough. ha. Whatever the reason, count me lucky.

I also noticed today that all the blood, bruising and fluid has started to settle on the outside of my knee, underneath by my hamstring. That should be fun to work out. I tested my ROM a little today in the brace and only got to about 35 degrees. Its amazing to me how tight it is. Anxious to start PT and really start working on. I can already do a SLR in my brace with no probs and have been working the quad sets. I've lost some extension. I'm probably at 0 degrees right now - but normal for me is -10 degrees. Overall, it just feels like a rock has replaced my kneecap, whether I try to extend or flex it. Patience is not my virtue.

In the meantime any ideas on how to pass the time? Even though I feel ok, I know its important to let my body heal and lay low. I just feel so shut in and I'm thinking by the end of two weeks I'll be going stir crazy.

Ally
04/09 RK - Dislocated Patella & Grade III MCL Tear
06/10 RK - Re-Dislocation Patella
09/11 RK - MPFLr + Lateral Lengthening

Offline lisa424

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Re: Allyd's MPFL + Lateral Lengtheing - 9/23/11
« Reply #7 on: September 28, 2011, 04:17:12 AM »
Glad to hear that the surgery went well and that you're not in too much pain. I'm sure your ROM will improve once you start PT.
When I had  my surgeries and was stuck inside I watched a lot of Netflix! Everytime I tried to read I'd fall asleep. The time does go by quickly though after the first few days.

Offline allyd

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Re: Allyd's MPFL + Lateral Lengtheing - 9/23/11
« Reply #8 on: September 28, 2011, 03:29:56 PM »
Thanks for the support Lisa. Netflix has been a life saver! I have a couple of books I think i'm going to start in on today as well. Since I stopped taking the pain killers, I can actually stay awake while reading. Otherwise, yup... I was out within a minute. :)
04/09 RK - Dislocated Patella & Grade III MCL Tear
06/10 RK - Re-Dislocation Patella
09/11 RK - MPFLr + Lateral Lengthening

Offline allyd

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Re: Allyd's MPFL + Lateral Lengtheing - 9/23/11
« Reply #9 on: September 30, 2011, 03:13:12 AM »
Post op - 1 week

Had my first PT appointment today. Went great really. My PT was really impressed with my strength, quad control. Said she's maybe had one other person in the last year come in a week after surgery with that good of control. I am already able to do a SLR with my brace on. My PT exclaimed as she was taking notes about the session "Your OS is gonna be so excited I wrote that!" We both agreed that my fitness, strength, and activity pre-surgery had a lot to do with this.

Main focus of the appointment though. Motion... not a pleasent feeling. I was able to passively get my self to an uncomfortable 40 degrees with heel slides, but then she also got me to 60 degrees. (got another pat on the back here, "yay, you already met your two week goal!") I think its always easier for someone else to push you than for you to do it yourself - the mental block is hard to get past.

She's not that worried about the strength yet... partially because I can already do everything they work on early on. My main goals are motion and get a better control on the swelling. I thought the swelling was fairly under control, it hasnt pooled in my lower leg or ankle... but she wasnt to impressed with that. I think I learned my lesson today that I need to be better about elevation, etc before I go into PT. I was so anxious to get out of the house today, I had my mom pick me up a couple hours early and we went out for lunch. Then after PT after a brief icing session on the couch - my sis-in-law ended up stopping by and ended up going out for supper tonight too... Tonight, I swear my knee is twice the size it was this morning? Too much for one day i think. But it was great to get out...

Tomorrow I go in for my post op visit with my OS's nurse...
04/09 RK - Dislocated Patella & Grade III MCL Tear
06/10 RK - Re-Dislocation Patella
09/11 RK - MPFLr + Lateral Lengthening

Offline Runner1993

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Re: Allyd's MPFL + Lateral Lengtheing - 9/23/11
« Reply #10 on: September 30, 2011, 04:57:53 PM »
Congrats Allyd, sounds like you are doing really well! I can't believe you have non-existent pain already!

Do you have a hinged brace? Is it locked straight at 0 degrees?

It took me about 2 weeks to do a SLR after my TTT/MPFL/LR and I was in pt 2 days after surgery. My PT was very proud of me so doing it at your first appt. is amazing!

60 degrees is great, too, doesn't seem like much, but it is. Took me at least a 1.5-2 months to get there. In addition, make sure you work on extension (my main problem).

I had a ton of blood pooling/bruising and it hurt :/ Elevate and ice! Do you have a special ice machine or are you just using bags?

Are you putting any weight on your leg with the crutches or are you NWB?

Hope your appt went well : )
July 21, 2009 - First Patella Dislocation
December 7, 2009 - Lateral release, medial reefing, and plica excision
January 14, 2011- TTT, MPFL Reconstruction, and Lateral Release

Offline oohheykate

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Re: Allyd's MPFL + Lateral Lengtheing - 9/23/11
« Reply #11 on: October 01, 2011, 01:35:28 AM »
Sounds like you are doing well!

You're very lucky (blessed with great genetics maybe?) that you don't have pain! I think the no screw thing definitely is playing a role in that. I'm almost six months post-op my MPFLr and I get pain where my screw was placed sometimes and it's supposed to dissolve.

Congrats on the 60 degrees! I didn't get there until maybe a month after? Keep working it and you'll have full ROM in no time.

How'd your post-op visit go?
-18 years old-
Left knee;
11.07.08- Scope
07.02.09- Lateral Release/Meniscus Repair
11.11.09- diagnosis of Patellar Instability/Patellar Tracking Disorder
12.10.09- Medial Reefing/Lateral Release
01.11- Synvisc
04.14.11- MPFL Reconstruction
06.21.11- LOA & MUA

Offline allyd

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Re: Allyd's MPFL + Lateral Lengtheing - 9/23/11
« Reply #12 on: October 02, 2011, 06:26:32 PM »
Runner, Kate - thanks for the reinorcement. I definitely feel great with where my recovery is at, I truthfully expected it to be worse thus far. In some ways, I almost feel bad that I made so much progress in one week and you guys struggled to get there finally after weeks of work. ;) I just hope the progress keeps up. I have high hopes for being my OS & PT's star patient. lol.

I am PWB, have been since the nerve block wore off. I am down to one crutch around the house. It doesnt hurt to even put full weight on it, I can just definitely tell my muscles arent strong enough to support it... Little wobbly. So the crutch is more for balance than anything I suppose. I just have the gel type ice packs. Which is fine, I've always like them - I just keep rotatiing them out of the freezer. I've been more conscious about getting my knee elevated since my PT appt. - I've started using 2 pillows instead of 1 type of a thing.

Post Op appointment went fine. It was just with my OS's Nurse, to check out the incisions, etc. She cut off the suture ends, asked a few questions about my pain, filled out some paperwork for my work and I was on my way. I go back to see my OS in a few weeks.

My only concern of late is I've noticed a lot more bruising suddenly around the incision for the MPFL attachment to the femur. Seemed to start after I've started working my ROM the last few days... Its definitely a lot more tender on the medial side too, but that seems normal to me... I guess just when I see new bruising in the area, I get concerned I may have started to pull apart sutures at the attachment or something. Its probably completely normal and just from the trauma of the surgeon digging around in there, plus the increased blood flow I'm creating with bending my knee.

Ally

04/09 RK - Dislocated Patella & Grade III MCL Tear
06/10 RK - Re-Dislocation Patella
09/11 RK - MPFLr + Lateral Lengthening

Offline allyd

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Re: Allyd's MPFL + Lateral Lengthening - 9/23/11
« Reply #13 on: October 06, 2011, 08:49:43 PM »
2 weeks Post Op

Quick update on how my last week has been. To start with, I was able to start driving around the neighborhood a few days ago... I didnt really ask for permission, I just tried it out. :) I was suprised at how easy it was, I had better leg control and strength than I thought and was easily able to lift my leg from the accelerator to the brake. This was a sigh of relief as I didnt have to line up rides to PT and I know I can get myself to work this coming week.

PT is still going great. Making steady progress on ROM. On tuesday I made it to 73, and today I got 77 degrees. Nothing else new was really added for PT, just the same basic SLR's, quad sets, etc. My PT said even though I was doing so well, she needed to hold me back this week and we'll be able to do more next week. (I get bored and impatient easily) I really like my PT and she has a great repoir with my OS and my surgery, which gives me all the confidence in her steps. I've had some really crappy PT's in the past, so I often have mixed feelings about these long drawn out structured PT programs.

I was also given permission to start unlocking my brace to 40 degrees this weekend. Which will be great, the locked brace was starting to annoy me. Subconsciously, I go to take a step, wanting to take a somewhat "normal" stride and you cant, at which point I almost trip over my own feet. Dumb.

I'm starting to realize even though I'm doing so great, Its still a long road ahead. Somewhat discouraging, but I guess we all have to "just keep swimming" - At the same time, I feel a little excited that if I stick it out and follow thier rules, I may finally have this crap all behind me once and for all. Time will tell.
04/09 RK - Dislocated Patella & Grade III MCL Tear
06/10 RK - Re-Dislocation Patella
09/11 RK - MPFLr + Lateral Lengthening

Offline allyd

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Re: Allyd's MPFL + Lateral Lengtheing - 9/23/11
« Reply #14 on: October 09, 2011, 01:36:12 AM »
Had a small setback after my last post. Later that night (Thursday), my knee decided to "give out" on me a couple times while walking around my apartment. I hated the feeling, was all to familiar of my knee cap sliding. yuck. The first time, I wrote it off as a fluke. The second time, I simply thought "ok somethings not right." Went to bed hoping it would be ok in the a.m. But it just felt weak and 'loose' and I needed to use two crutches around the apt, which I havent done since 3-4 days post op.

Anyways, since I was concerned, I emailed my PT. She basically said that she had stretched me more aggressively at PT that day and its common for the quad to shut down some, (causing it to give out). She didnt think I damaged anything and it was just a little flared up, but took away my liberty to start unlocking my brace until I see her this next week (Which isnt until Thursday as my appt on Monday is with one of her colleagues).   :-\ She told me to take it easy and rest over the weekend. It is feeling better and I'm not worried about it. I'm just stiff and sore. But the good kind of sore that reminds me I still have (barely) muscles.

Just really hope we start some more strengthening exercises this week as I'm tired of watching my leg waste away. Patience I suppose, Formal PT moves to slowely for me at times. But I'd hate to be the one to screw up my OS's success rate.  ;) I'm actually slightly afraid of her and would hate for my PT to report my non-compliance for my followup in 2 weeks. haha.
04/09 RK - Dislocated Patella & Grade III MCL Tear
06/10 RK - Re-Dislocation Patella
09/11 RK - MPFLr + Lateral Lengthening