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Author Topic: Dennis gets a new ACL & MPFL  (Read 9071 times)

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Offline oohheykate

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Re: Dennis gets a new ACL & MPFL
« Reply #15 on: February 28, 2012, 12:54:31 AM »
As you know, my MPFLr has been successful. My OS didn't do a TTT because my TG-TT offset is 20mm...borderline for fixing--it really depends on the OS you see. Mine, obviously, doesn't do the TTT unless it's more the 20mm offset, some do it at 20mm. My TG-TT offset on my right is 15mm so that one will only need an MPFLr when the time comes. My OS got all of this information from my patellar tracking study.

Has your OS measured your TG-TT offset? I don't know if you can get it off of an MRI...mine was from a CT.

I understand your concern though! I was worried that the MPFLr wasn't going to be enough either and that it wasn't addressing everything since my offset is really on the cusp of needing to be addressed. However, I trusted my OS and I'm really happy with the results.

I haven't done e-stim since my third surgery (December 2009). My PTs wanted to try it and it was part of my OS protocol but I had something going on with my skin and they didn't want to irritate it. E-stim isn't that fun...so you aren't missing out! 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 #16 on: February 28, 2012, 10:10:26 AM »
Oh, good one Kate - I'll be sure to ask my OS what the measurement came back as (TG-TT offset)! I know he contacted the radiologist to get that information.

It's great to finish the day at........124 and I have definitely improved by around 5 degrees on extension too so that should have me at around -5 - 124!!! 

Nothing for pain since 0930 this morning and I'm feeling pretty positive. Isn't it sad that I was reluctant to type that just in case I jinxed myself. On the other hand though, I can't afford to have any negativity floating around! I think the next one is going to be tough so I'm just trying to be as positive as I can, while I can  ;D

Between icing and CPM sessions today, my second exercise rehab session included a few new exercises that I found here on "KNEEgeeks" that I can attribute that extra 5 degrees extension to. This place has been such a valuable resource.....and outlet.

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 #17 on: March 03, 2012, 10:47:35 AM »
Just checking in at 9 days post op. I've been super busy with a minimum of 5 hours rehab each day just to keep my knee flexion >90 degrees. It seemed so easy at the outset but my experience over the past few days has been a little rough. The better I seem to bend at night, the worse things are the next morning, sometimes starting all the way back at 85!

I just persevere until it's back at 124 (my best effort yet) then start from scratch the next day -it's exhausting and I'm really not looking forward to the next op.
 :-\
Karen

« Last Edit: March 03, 2012, 10:50:14 AM by DennisKnee »
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 #18 on: March 04, 2012, 03:12:49 AM »
Keep your head up, Karen! It'll get better. Recovery is up and down. Sometimes you'll feel like you're doing amazingly well, then next day you'll be wondering why you even had surgery in the first place. It's worth it in the end, trust me.
-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 #19 on: March 07, 2012, 11:20:28 AM »
The date is set!

ACL & MPFL reconstruction for my knee Dennis, Tuesday 17 April. I'll see my surgeon a week before to make a final decision regarding the choice of graft but for now, I think it'll be my hamstring for the ACL and allograft for the MPFL, saving my "good leg". Initially it was looking like hamstring would be taken from both legs so I'm happier with this way ahead.

Another countdown begins!

Anyone have any opinions re autograft vs allograft?

 :)
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 #20 on: March 08, 2012, 01:05:23 AM »
Woohoo on having a date!

I had an allograft only because I'm hypermobile and if my own tissue was used, it would stretch out again.
-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: Dennis gets a new ACL & MPFL
« Reply #21 on: March 08, 2012, 01:48:48 AM »
My Surgeon recommended the allograft for the MPFL as well(which is what I used). Said the only time she uses autograft is if/when a patient has personal/religious reasons for not wanting the allograft. My OS has had plenty of success w/ the allograft, doesn't feel it is inferior for the MPFLr, and you won't have a harvest site to heal. 
04/09 RK - Dislocated Patella & Grade III MCL Tear
06/10 RK - Re-Dislocation Patella
09/11 RK - MPFLr + Lateral Lengthening

Offline DennisKnee

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Re: Dennis gets a new ACL & MPFL
« Reply #22 on: March 08, 2012, 11:21:39 AM »
Well, I'll have one less harvest site to heal. Still need to decide on what to use for my ACL. It's really comforting to know that both your allograft reco's went well. It's not a popular choice down here in Oz but my surgeon, after training in Europe, thinks it's the way to go for at least the MPFL part of my surgery.

I'm still trying to find some info on rehab protocols for these two procedures done at the same time but no luck as yet.

Back to work on Monday which is really going to cut into my rehab time. Still having trouble walking properly despite fantastic ROM. I'm still getting the occasional pinch and snap feeling when I bring my injured leg through from behind to ground it. It's really frustrating as I thought I'd be walking perfectly by now  >:(

Did you guys have two holes drilled in the patella and the one screw in the femur?
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 allyd

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Re: Dennis gets a new ACL & MPFL
« Reply #23 on: March 08, 2012, 02:47:58 PM »
Hey Karen… MPFL technique – There are few different ones out there. I had a small tunnel drilled all the way through my patella, then a short overdrill on the medial side for the graft insertion. Sutures were pulled all the way through, and fixed on both sides. As for the Femur attachment, I have no holes/screws. My OS simply wrapped it around a tendon in the area, and then brought back up to the patella, and stitched in place.   

I think the technique I had is a little less common, and have seen lots of stories with the two hole/1 screw approach.

I think you’ll be fine with the Allograft for the MPFLr – Your OS seems to be approaching from the same standpoint I had it explained to me.

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: Dennis gets a new ACL & MPFL
« Reply #24 on: March 08, 2012, 11:56:09 PM »
Like Allyd said, there are different techniques out there. My OS drilled a hole all the way through my patella for the graft and sutured it then screwed the other end into my femur with a biocomposite screw. Another OS I saw for my hip (he used to see me for my knee) said his technique was completely different from my OS who did the surgery.
-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 #25 on: March 10, 2012, 10:31:58 AM »
Saw my physio 2 days ago and was told that the "pinch and snap feeling" I've been experiencing could be attributed to extremely tight quads and something to do with my ITB. Solution - stretch, massage and foam roller!

Back in the pool tomorrow for the first time in a while and the spin bike continues to go well. I've been able to add some resistance to get that muscle back!

allyd - that's quite an unusual MPFLr technique. Did you keep a post op diary? Link?

Kate - I think mine will be similar to yours but no sutures as far as I know.

Booooooo to going back to work in 2 sleeps!
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 joval

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Re: Dennis gets a new ACL & MPFL
« Reply #26 on: March 10, 2012, 12:30:40 PM »
Hi Karen,

Your posts are so positive.  For us that are sifting through posts in preparation they are a great confidence builder.  I know there are good and really bad days, but you make even the bad days seem not so bad.
Keep up the great work.

Love the "two sleeps."  I first heard that first from my Canadian family and adopted in when talking with my grandsons about upcoming visits.  They love it and now use it.  Makes me smile.

Best of luck on Monday.
Take care.
Jo
01/12  Fell
02/12  MRI ACL tear
04/12  RK ACL recon Allograft, meniscus trim

Offline allyd

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Re: Dennis gets a new ACL & MPFL
« Reply #27 on: March 10, 2012, 02:24:11 PM »
yes, I have a post-op diary going. Things have gone very well for me... http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=57539.0

It's a different technique, but My OS thinks it's more forgiving and avoids some pain/discomfort by not drilling into the femur.

Keep up the good work - the more you can do now, the more you'll thank yourself when you have the reconstructions. And I agree with Joval - stay positive! A good attitude really helped me get through everything with ease.
04/09 RK - Dislocated Patella & Grade III MCL Tear
06/10 RK - Re-Dislocation Patella
09/11 RK - MPFLr + Lateral Lengthening

Offline joval

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Re: Dennis gets a new ACL & MPFL
« Reply #28 on: March 11, 2012, 12:54:00 PM »
Hi Karen,
Hope all is well.  Reading your posts I see you have a CPM.  I'm to have one delivered this week for Wednesday surgery. Trying to get the house in order the next few days so I'm as ready as I can be.  Does this CPM sit on your bed, in front of a chair?
Big day for you tomorrow!  Have a good first day back at work.
Jo
01/12  Fell
02/12  MRI ACL tear
04/12  RK ACL recon Allograft, meniscus trim

Offline DennisKnee

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Re: Dennis gets a new ACL & MPFL
« Reply #29 on: March 12, 2012, 07:13:05 AM »
Hi Jo!

I have my CPM up on the couch/sofa. I made sure it was pushed up against the arm of the sofa so it couldn't creep away. I could potentially move it to the floor now that I'm more mobile but it's just easy to have it on the sofa where I can nap and watch tv etc.

I hope I'm not luring you into a false sense of security with my posts. I've certainty had my moments but overall, I've got so much to be thankful for. Besides, I know that if I answer the door when frustration and disappointment knock, it'll just come rushing in and I refuse to let this beat me. It's tough when I've spent my life playing competitive sport - there's even a chance that my job will be affected if this doesn't go well. I'm confident that it will though  ;)

My first day back at work was tough. I spend most of my day sitting down and it makes for a stiff and cranky knee come home time. The heavy boots I'm required to wear don't really help either! Tomorrow will be better.

Ally - I read your post op diary. Thanks for the link. It was nice to read something that wasn't predominately doom and gloom.

Off to ice and rehab exercises after a long day. Ice......weeeeeeee!

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