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Author Topic: Dennis gets a new ACL & MPFL  (Read 7276 times)

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Offline DennisKnee

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Dennis gets a new ACL & MPFL
« on: February 08, 2012, 11:30:58 AM »
Hi All,

After consultations with 3 different orthopedic surgeons, each with his own ideas on the type of surgery I require, I now have a way ahead that I’m comfortable with and am confident will offer the best solution to my knee problems. So, the journey begins…..

I look forward to keeping you updated with the progress of Dennis (my knee, so aptly named after “Dennis The Menace”).

The story….I’ll make it short for now (let me know if you’d like the “Tale of Two Cities” version): I have a full-thickness ACL tear, torn MPFL, medial meniscus tear and torn medial retinaculum. Winner!

The most recent injury to my knee was a dislocation of my left patella sustained 29 DEC 11 since which time I have only been able to regain 90 degree flexion.

Operation 1 – scheduled for 23 FEB 12 is an arthroscopy to clean up in the knee and address the medial meniscus issue, manipulate under anesthetic, tidy ACL stumps in preparation for the impending reco and get me in a CPM machine post surgery to get the bend happening.

Operation 2 – should be no sooner than 4 weeks after the first surgery is to reconstruct my ACL and MPFL. Still no decisions as to what ligaments to use. If I go with my own hamstring tendons for both reco's, then it’ll mean going into both legs – even my “good” right leg  :( That makes me nervous.

I’d be super interested to read people’s thoughts about my surgery, offer advice for rehab and just share their own experiences.

Operation 1 in two weeks……the countdown begins!
Sep 10 - confirmed ACL & medial meniscus tear
Dec 11 - chronic patellar dislocation - MPFL tear
23 Feb 12 - scope, MUA & 50% medial meniscectomy
17 Apr 12 - ACLr and MPFLr

Offline DennisKnee

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Re: Dennis gets a new ACL & MPFL
« Reply #1 on: February 11, 2012, 11:38:52 AM »
As the countdown continues to surgery number 1, I am wondering if there's anyone out there who's had an ACL & MPFL reconstruction done at the same time in the same knee? I'd love to have  a link to a post op diary for someone who has had this procedure so I have more of an idea about what to expect.

Cheers  :)
Sep 10 - confirmed ACL & medial meniscus tear
Dec 11 - chronic patellar dislocation - MPFL tear
23 Feb 12 - scope, MUA & 50% medial meniscectomy
17 Apr 12 - ACLr and MPFLr

Offline DennisKnee

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Re: Dennis gets a new ACL & MPFL
« Reply #2 on: February 20, 2012, 07:55:03 AM »
It's like counting down to Christmas but less fun.....only 3 sleeps to go until my first surgery and I'm getting nervous. The only other operation I've had was when I had my tonsils removed and that was almost 20 years ago - oh gosh, I am getting old(er)!

I've spent quite a bit of time wading through post op diaries but haven't had any luck finding anyone who has had an ACL & MPFL reco done at the same time.

So, here I am just 3 sleeps away from my arthroscopy, MUA and steroid injection. I haven't been able to improve beyond 90 degrees flexion so it's time to bust up some scar tissue and enjoy the company of a CPM for a couple of weeks. Then.....the big op (big for me at least)! The reco's  :-[

Please let me know if you can recommend any good websites or post op diaries for me and my knee, Dennis  :)
Sep 10 - confirmed ACL & medial meniscus tear
Dec 11 - chronic patellar dislocation - MPFL tear
23 Feb 12 - scope, MUA & 50% medial meniscectomy
17 Apr 12 - ACLr and MPFLr

Offline oohheykate

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Re: Dennis gets a new ACL & MPFL
« Reply #3 on: February 21, 2012, 01:48:21 AM »
Good luck with your surgery!!

I had a scope and MUA after my MPFLr and it was easy peasy! I was stuck at 85 degrees flexion at nine weeks. I was up and walking around the next day. The only reason I needed crutches was because my knee was giving out. I didn't even take pain meds until Saturday (my MUA was on Tuesday). For some reason, the pain kicked in then. It still wasn't bad though.

You'll do great.
-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 DennisKnee

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Re: Dennis gets a new ACL & MPFL
« Reply #4 on: February 21, 2012, 06:13:02 AM »
Thanks @oohheykate that's really encouraging! I'm still reading through your post op diary - it's certainly an interesting read.
Sep 10 - confirmed ACL & medial meniscus tear
Dec 11 - chronic patellar dislocation - MPFL tear
23 Feb 12 - scope, MUA & 50% medial meniscectomy
17 Apr 12 - ACLr and MPFLr

Offline oohheykate

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Re: Dennis gets a new ACL & MPFL
« Reply #5 on: February 22, 2012, 01:10:37 AM »
I hope my post-op diary isn't scaring you too much. I tend to write a lot. Haha.
-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 DennisKnee

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Re: Dennis gets a new ACL & MPFL
« Reply #6 on: February 24, 2012, 02:48:43 AM »
Home less than 24 hours after my arthroscopy and feeling surprisingly good. A great time to start my post op diary leading up to surgery number 2!
Sep 10 - confirmed ACL & medial meniscus tear
Dec 11 - chronic patellar dislocation - MPFL tear
23 Feb 12 - scope, MUA & 50% medial meniscectomy
17 Apr 12 - ACLr and MPFLr

Offline oohheykate

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Re: Dennis gets a new ACL & MPFL
« Reply #7 on: February 25, 2012, 02:50:08 AM »
Glad you're doing well! I hope you stay that way until your next surgery. Do you have to do PT?
-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 DennisKnee

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Re: Dennis gets a new ACL & MPFL
« Reply #8 on: February 25, 2012, 09:46:15 AM »
Hey Kate!

Got home yesterday just before lunch which was perfect timing as I was expecting delivery of my CPM between 1200-1300! What a god send! I'm already at 117 degrees flexion after my MUA so if I can maintain that until my next op, my surgeon should be pleased. I'm convinced I can do better though!

I saw a physiotherapist before discharging from the hospital. He gave me a crutch, compression wraps (doubled over for during the day and single for sleeping) and some shower bags to keep my bandages dry until tomorrow morning. He suggested a couple of exercises too.

Turns out the CPM and rehab exercises I've been doing loosened my bandages and they slipped down - oops. They have been removed revealing 2 little dressings and there's no bruising or swelling. Cryo cuff is almost always on between exercising and CPM sessions.

I'm due to see my regular physiotherapist on Monday. I see her twice a week in her rooms where I generally get soft tissue therapy to loosen my quads, focus on VMO strengthening and sometimes have dry needling. She also runs clinical pilates that I attend twice each week. It's a great way to focus on alignment of my hips etc. 4 sessions a week is great and I look forward to getting back in a pool soon. I am also fortunate enough to have a spin bike at home so I'll get on that tomorrow to see if I can actually do a full revolution.

Pain wise I'm just so surprised! I've already reduced my tablets from Panadine Forte down to Panadine and am taking 1000mg SR Naproxen once a day.

I see my surgeon 07 Mar and we'll set a date for the big one!

I tried to head up to the shopping centre today and found it really exhausting. I think it's because I concentrate so hard on each and every step so I don't revert back to limping - can't let that scar tissue come back!

So far, so good  ;D
Sep 10 - confirmed ACL & medial meniscus tear
Dec 11 - chronic patellar dislocation - MPFL tear
23 Feb 12 - scope, MUA & 50% medial meniscectomy
17 Apr 12 - ACLr and MPFLr

Offline oohheykate

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Re: Dennis gets a new ACL & MPFL
« Reply #9 on: February 26, 2012, 01:51:53 AM »
Wow! It sounds like you are doing awesome. Keep up the good work and keep your knee moving. Before you know it, you'll be having your big surgery.

And it looks like we're seeing our Orthos the same day!
-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 DennisKnee

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Re: Dennis gets a new ACL & MPFL
« Reply #10 on: February 26, 2012, 10:00:51 AM »
Still haven't started a proper post op diary and my excuse is that I'm saving it for after the next op. I woke up a little stiff this morning and started my first CPM session at 97 degrees flexion, ending that 1 hour session at 114. I'm more focused on flexion at this time as I've been told by my surgeon that I need to maintain good ROM since my MUA just 3 days ago. I've just finished my third session for the day at 121!

Biggest achievement for the day was my 3 minutes on my spin bike - full revolutions for the first time since my dislocation 29 Dec - such a great feeling even if it will be short-lived  :-\

A few new exercises today have me a little worried about how little hamstring strength I have left and my thigh is so thin compared to the other side where the muscles are so well defined. I don't really want to drag out the time between surgeries but wonder if I'm rushing things by not taking the time to rebuild the muscle I've lost??

A great tip from this forum has been to use frozen water bottles to keep the water cool in my cryo cuff - so much easier than chewing through a ton of ice and trying to find space in my freezer.

My day was spent researching again as I'm trying to get a clear picture of my MPFL injury. Whilst the ACLr is extremely common and straightforward to fix, I still have so many questions regarding all the medial structural damage and the relationship between all the bits and pieces. The second surgeon I saw had me scheduled for a TTT and LR without even getting measurements etc and wasn't the least bit concerned that I only had about 80 degrees flexion at that time - twit! It has certainly encouraged me to ask a million questions. Thank goodness my current surgeon has plenty of patience.

I just want things to go well.

Kate, what are you heading back to your OS for?

The surgeon I have now
Sep 10 - confirmed ACL & medial meniscus tear
Dec 11 - chronic patellar dislocation - MPFL tear
23 Feb 12 - scope, MUA & 50% medial meniscectomy
17 Apr 12 - ACLr and MPFLr

Offline DennisKnee

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Re: Dennis gets a new ACL & MPFL
« Reply #11 on: February 26, 2012, 10:10:31 AM »
......is a great guy so I hope yours is just as good. Judging by the progress you've been making, seems like you got yourself a winner! Keep me posted with how your appointment goes and thanks again for the link to your post op diary  :)
Sep 10 - confirmed ACL & medial meniscus tear
Dec 11 - chronic patellar dislocation - MPFL tear
23 Feb 12 - scope, MUA & 50% medial meniscectomy
17 Apr 12 - ACLr and MPFLr

Offline DennisKnee

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Re: Dennis gets a new ACL & MPFL
« Reply #12 on: February 26, 2012, 10:21:16 AM »
Kate,

If I hurry up and get to the end of your diary, then I guess I'll know more about your upcoming appointment. That can be part of my mission for tomorrow...and it'll save you having to explain  :D
Sep 10 - confirmed ACL & medial meniscus tear
Dec 11 - chronic patellar dislocation - MPFL tear
23 Feb 12 - scope, MUA & 50% medial meniscectomy
17 Apr 12 - ACLr and MPFLr

Offline oohheykate

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Re: Dennis gets a new ACL & MPFL
« Reply #13 on: February 27, 2012, 12:58:46 AM »
You really are doing phenomenal with ROM! It took me about a week to get where I was pre-MUA with ROM. Then it took me about a month (maybe, I can't remember) to get almost normal ROM. I'm actually still gaining ROM and I can finally touch my foot to my butt which I couldn't do before my MPFLr. And yes! The water bottles in the cooler is a life saver. They stay frozen longer and it's cheaper.

My knee OS is awesome! I adore him ;D I wish I would've found him sooner. I'm aiming to see him again in the beginning of April to see what the plan is for my other knee. But my appointment for March 7th is with my hip OS...as you get towards the end of my diary, you'll read about that saga.
« Last Edit: February 27, 2012, 01:01:22 AM by oohheykate »
-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 DennisKnee

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Re: Dennis gets a new ACL & MPFL
« Reply #14 on: February 27, 2012, 11:32:11 PM »
It's Tuesday morning - 5th day post op - and I'm on my CPM for the first session of the day. Once again I was a little stiff this morning but Dennis is coming along nicely now. I haven't been on my spin bike for a couple of days - thought I might have been overdoing things but I'll have another go later today.

I'm really looking forward to having a swim after I've seen my OS next week. My walking has improved but I'm experiencing a little pain, almost like a pinch, when my injured leg is almost at full extension (behind me) and I push through on my toes to step forward. It almost feels like I've lost some muscle control and my knee wants to lock back too far if that makes sense.

For those out there who have had an MPFLr without LR or TTT/TTO procedures, has it been successful and what reasons did your OS give for not addressing a possible anatomical predisposition to patellar dislocation (if any)?? As my reading and research on the topic continues, I am increasingly concerned that my upcoming MPFLr will address the damage but not any underlying reasons for the dislocation in the first instance.

I am happy that a LR has not been recommended by my OS and satisfied with that decision however, my kneecap dislocated while I was at the gym doing a simple static lunge - nothing crazy, just a lunge, so I can't help but wonder whether or not this procedure alone will be successful. More reading!

Also, I've been reading up on a far bit of rehab protocol info to do with post arthroscopy & meniscectomy stuff, all of which mentions electrical stimulation of quads. My PT (saw her yesterday) has never used this on Dennis & Co. and I'd like to read about others' experiences. Does anyone have info on issues to do with timing of quad muscle firing or a link?

Thanks....sorry for all the questions but I'm trying to prepare for my OS appointment next week.
Sep 10 - confirmed ACL & medial meniscus tear
Dec 11 - chronic patellar dislocation - MPFL tear
23 Feb 12 - scope, MUA & 50% medial meniscectomy
17 Apr 12 - ACLr and MPFLr















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