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Author Topic: 1 week post ACL and Lateral Meniscus Repair  (Read 1065 times)

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Offline mancunianjob

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1 week post ACL and Lateral Meniscus Repair
« on: February 10, 2012, 01:21:39 PM »
I'm new to the board and thought I'd post some thoughts following my ACL reconstruction with meniscus repair on Friday 3rd Feb at the Spire Hospital Manchester. I'm 31 years old, a casual footballer and casual gym visitor. Naturally I was nervous leading up to the op, largely not knowing how it would feel being put to sleep and how severe the pain would be when I awoke.
Well the anaesthetic part was so fast, it caught me off guard. One minute I was told I was being given a relaxant, the next I woke up 2 hours later in a lot of pain. When I tore my ACL in October 2011 I was playing football (soccer) and my planted right leg stayed put whilst my body twisted the other way following a shot I took. There was no pop but the pain was enough for me to know I'd done some damage. I managed to drive home and iced it. It was diagnosed in December following an MRI scan. The pain upon waking from the op was much worse however and I was on a morphine drip for two hours to control it. The main issue I had for the 3 days following surgery was the havoc the painkillers (Diclonefac and Codeine) had on my stomach. Cramps, wind, sickness you name it. I stopped them and used paracetamol and Ibuprofen instead. Much better! I'm now 7 days post op, struggling with the swelling even with a cryo cuff machine, my extension isn't bad but knee bending is really really painful, I manage 90 degrees at a push! I'm down to one crutch with a bad limp, but every day is different and every hour of every day throws up different emotions. Sometimes I worry if I'll ever recover, then an hour later I'm really optimistic. I'm generally a busy person, always finding things to do restlessly so sitting around not doing much is a mental battle especially with two young toddlers around me!  I'm hoping in another week the swellings gone down and this will allow me to bend my knee past 90 degrees. It's going to be a long hard journey but I'm determined to get there!

Offline 2020

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Re: 1 week post ACL and Lateral Meniscus Repair
« Reply #1 on: February 10, 2012, 03:58:43 PM »
It's tough.  ACL revision is common & maybe the recovery is minimized by the uninformed for that reason.  Unlike the injury itself and the anesthesia, everything now will happen gradually.  Speaking from experience (ACL recon with medial meniscus suture repair 4 months ago), it's helpful to be persistent and patient & don't try to overdo it.  Just follow your physician's rehab schedule, and ice, ice, ice!  The swelling will wax and wane until you have regained your quad strength which takes months.  The pain gets better after the 2nd week but that also resolves on a continuum ie not suddenly.  You will recover, but you can't rush biology.  The graft takes about a year to "ligamentize".  Take care, and enjoy meeting the small goals.  Every day will be better than the day before.

Offline Kaputt_Knee

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Re: 1 week post ACL and Lateral Meniscus Repair
« Reply #2 on: February 10, 2012, 06:33:59 PM »
2020 not sure if your comments are a) helpful to mancunianjob and b) correct! Where did you get the statement about taking a year to "ligamentize" for example?

Mancunianjob has had a reconstruction NOT a revision. True, the uninformed do think that recovery is swift. It is not and most people here know that.  We who have undergone these operations know differently that's for sure.

Mancunianjob, welcome to the ACL reconstruction club! We are a fairly widely scattered elite  ;D Unlike top-flight sportsmen and women, we mere mortals have to take what we can get in terms of rehab treatment. Look at this recovery as being the start of a very long hard marathon, then you will be pleasantly surprised by the improvements that take place. The first week is always a killer, you have the general anaesthetic still in your body, you have undergone a massive trauma to your knee and it hurts like he!!

Stick rigidly to the protocol you have been given by your surgeon. Do your exercises regularly and make sure you alternate the icing with the exercises. The cryocuff provides cooling and compression, but not icing, so ice after each batch of exercises. In order to reduce the swelling, which will inhibit your flex for a while, make sure you rest your leg with the heel/ankle supported not under the knee itself. If you can elevate the leg as well this helps as does doing as many ankle pumps as you can to pump the fluids back up your leg so they can be reabsorbed by the lymph nodes in your groin. By supporting under the heel/ankle and leaving the knee unsupported you can actually help to improve your extension passively as well.

As for the emotional roller-coaster, don't worry that particular ride will be over soon. I think we all suffer that one in the first week to 10 days after an operation of this type. Your body has taken some heavy "abuse" and your lifestyle has had to suddenly change to accommodate this.

The critical period for your graft is between approximately week 6 and week 12 post-op. This is when it is at its weakest while it revasculizes, i.e. the graft itself begins to die off and the living tissue developing on it begins to take on the nature of the original ACL. This period also corresponds with the time most people feel more mobile and start to do too much, hence it is a period where you have to be particularly cautious despite feeling you feel that you can actually do a lot more.

What type of graft did you receive? I have had both patella tendon grafts and hamstring grafts. I found the latter more painful to begin with.

If you are a desk jockey, you may be able to return to work at about 6 weeks. If the job is more physical the recommendation is to wait until 12 weeks before going back to light duties. Whenever you return to work, be prepared for some set backs as your rehab routine will have to fit in with your work hours.

Don't worry you do actually have the worst behind you know, it will get better!

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

Offline mancunianjob

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Re: 1 week post ACL and Lateral Meniscus Repair
« Reply #3 on: February 10, 2012, 09:45:34 PM »
Thanks for the advice and guidance. New bruising appeared today on the underside of my knee... Every new symptom creates doubt and concern at the moment. It's really down to focusing on every little detail too much! I had the hamstring graft by the way, quadruple bundled I'm told.

Offline Kaputt_Knee

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Re: 1 week post ACL and Lateral Meniscus Repair
« Reply #4 on: February 11, 2012, 08:51:30 AM »
Good morning Mancunianjob,

Be careful to ice the graft harvest site as well as your knee! This is sometimes overlooked, but your hammies will feel a wee bit punished as well. I found the harvest site very painful for a while and as I progressed it was easy to upset it as well.

While the knee is so swollen, you cannot get much in the way of flex, so concentrate of getting extension. With full extension you can use a normal walking gait (even if you are still on crutches). Once off the crutches it is important to maintain that gait and avoid limping. Flex will come as you move more normally and start to use the calf muscles to pump up the fluids from the lower leg. This in turn reduces the swelling so you have more flexibility.

Start giving yourself small milestones to aim at that are easily achievable. If you focus on the big ones, you tend to obsess about them (believe me I've been there, done that and thrown out the T-shirt in frustration). Do not compare your rehab with anyone else's. We are all unique in terms of the way our bodies react to trauma, the amount of pain we can bear and the speed of the healing process. There are some commonalities, but no two ACL reconstructions are ever the same.

I notice you have had a meniscus repair as well. That will slow things down a bit, particularly with the flex and weight-bearing. What have you got in the way of advice about weight-bearing and activity levels? Are you getting physiotherapy already or do you have to wait a wee while yet?

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

Offline mancunianjob

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Re: 1 week post ACL and Lateral Meniscus Repair
« Reply #5 on: February 13, 2012, 01:57:27 PM »
The surgeons advice was not to slow down the physio as the meniscal repair was small, so I'm doing all the ususual start up exercises. I can just about bend to 90 degrees and flexion is almost straight. I feel the swelling is holding me back somewhat. The hamstring area has not troubled me too much. I just use ibuprofen now for pain and arnica for bruising. Don't like the surgical stockings much tho! Physio told me I'll be on a stat bike this Friday.. sounds scary!