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Author Topic: right knee Arthroscopy+ lateral menisectory 3 weeks problems ,rom stiffness help  (Read 2162 times)

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Offline SILENTMOUNTAIN

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Hello everyone,
I had keyhole surgery on my right knee to repair a tear on the meniscus and a bit shaved off the lateral, please excuse im not sure all he details but could get the report if needed ,im 26  a keen basketball and football player.

this was 2 weeks ago,  I had severe pain and I needed crutched for 10 days im only just starting to walk without them, I have been using ice to get the swelling down and keeping the leg raised.  ,

I have a very limited range of motion , if I bend my knee it feels like there is a clamp on thefron of the knee cap at the top of the bone that connects to the knee, the more I try and bend the tighter it gets, I had get it half bent that’s by forcing it with all my strength to try and stretch it out , 


Is this normal for 2 weeks after recovery , should I not try force it so much?


the 2nd problem is getting the knee straight , if I force it as much as I can it feels like the knee is folding in, its not painful but a very strange feeling makes me feel a little sick., I  have been doing the leg raises, and other exercises , but I still cant get it straight ,im starting to get really worried the longer these issues go on
in the right  side of my knee it feels a little rough and sore i guess thats where they shaved it away,

the knee feels very boney ,if you understand what I mean, due to he muscles going down .
any advise would be much appreciated , or any of your stories of recovery.

thank you
« Last Edit: June 24, 2012, 12:13:28 AM by SILENTMOUNTAIN »

Offline kneepaincure

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It sounds like you have the beginnings of scar tissue forming inside your knee. Were you allowed to bend your knee after the scope? Or was it kept locked in a brace?

I would suggest talking to your doctor and if he doesn't have an answer, find another one who knows how to help you.
Have had tilted kneecaps for many years, and occasional patellar tendinitis.

Offline Kaputt_Knee

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For goodness sakes, it is way too early to be talking about arthrofibrosis (excessive scar tissue).

You need to work carefully with a physiotherapist who is familiar with your surgeon's post-operative rehab protocol. If you have had a repair and a trim, then the protecting of the repair takes priority. Some surgeons want you non-weight bearing for a while, others have a more aggressive active protocol. What you really need to do is to get in touch with your surgeon again and find out what they want you to be doing. Also ask for a physiotherapist recommendation so that you get things going. You do not necessarily need to talk to your surgeon, members of his team will know the procedures post-operatively and his secretarial staff should be able to recommend a PT that works with patients treated by the surgical team.

As for the bending and straingthening, do this as passively as possible for the time being until you have better actual hands-on guidance. Sitting or lying with your foot elevated and your knee unsupported helps to gently stretch and straighten the leg. Doing it in a standing position is very uncomfortable and can be counter-productive. Flex can be similarly helped by letting you leg hang down from a higher seat or the edge of a table or bed. Another way to increase extension is to lie on your stomach and let your lower leg hang unsupported off the edge of a sofa or bed. You can support the knee, but let the foot and shin simply hang down.

If you have not used your leg properly for two or more weeks, then yes you will feel that it is being "held" when you try to use it. By gently working through this block, you should be able to push the boundary a little more each day. but the best people to advise you on what you should be doing are your surgical team and physios who actually see you working the knee.

Good luck, it does get easier as things go along. If you have never undergone such a procedure before, it is alarming and fear of "doing damage" as much as unfamiliarity with what is good pain and what is bad pain can lead you into doing nothing out of fear of doing the wrong thing.

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 lorilove

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NO!  You should not be trying to force anything!

Here are the general rules you should be following:

Whether you are rehabilitating your knee form after surgery or after an injury, progression of exercises should be slow and pain free.

Stretching exercises should be pushed into slowly and held at the first point of discomfort. Strengthening exercises should be done with a light enough resistance or weight to complete 3 sets of 20 repetitions. Exercises should never increase pain or swelling, even the next day.

Please work with your Doctor or Physical Therapist on exactly what you should and should not be doing and don't try to second guess them.   They likely have experience with thousands of patients vs. you have no previous experience.

Offline SILENTMOUNTAIN

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Thanks for taking the time to reply and help everyone today is the 18th day  , i have not been offerd any physio, all i have been given is an exercise sheet.

I really do fear doing them incase i bugger it up even more, but i have been doing them about 4 times a day and i have been trying to walk about a bit without crutches whish is difficult with limited bend.


if i push the bounderies and get my leg as straight as possible i feel there is trapped air in the joint,

you know that feeling when you click your figers or other joints.  but im unable to do so as i cant bend my knee far enough so it stays a bit locked.


how long does it usually take to get full felxation back after an op ?

I am seriously wishing i never went through with the op, i could have lived with the injury as it was before i could play sports up to a decent enough level with a bit of pain, i just want to be normal ish again, im only 26, Feeling really negative about it all now as apart from the swelling going down i have not seen much improvement, just want to  find out as i feel im in the dark its my first every op, and im getting more worried and angry each day, just want to know im making even a tiny bit of progress each day would be something  so i can be positive.

i will get the post op form which details the extact procedure maybe that will be of more help to you experts. I reall do appriciate you taking the time to reply, i hope i dont seem like im moaning im just really worried

« Last Edit: June 18, 2012, 01:55:23 PM by SILENTMOUNTAIN »

Offline lorilove

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What country are you from?  PT is fairly common here in the states unless your insurance is not going to cover it.  I had far less surgery than you and have 4-6 weeks of PT (2-3x per week).  My mother has OA and is on Medicare and the PT indicated they will likely approve her PT as long as she needs it (she is 92 so surgery is not a viable option).

Definitely ask your doctor about PT! 

Offline The KNEEguru

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If you have had a meniscal repair, then your surgeon is likely to have a 'protocol' of exercises that he has agreed with the physiotherapist - like this one http://www.drwaltlowe.com/attachments/wysiwyg/File/MeniscusRepairProtocol.pdf

Because of the stitches through the meniscus the rehab is designed to protect the meniscal repair in the early stages, and is usually therefore slower than if it had just been a trimming of the meniscus.
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Offline SILENTMOUNTAIN

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Hi,  thanks for the reply, i live in the uk so its on the NHS,

i have spoken to my gp about physio  she will try and book me some ut that would  take a couple of weeks.

I had a repair on the medial and lateral,

whats bothering me most is that i cant bend my knee fully probly half way, when i do i get pressure like a clap at the lower part of the knee cap, is this normal, at the moment  i cant get it fully straight either,

is this normal 19 days into recovery ?  when i do try and bend it more it feels like a clamp on the lower front of the kneecap.

should i still be using ice , i try to keep it elevated , 80% of the swellings gone
« Last Edit: June 20, 2012, 04:02:40 AM by SILENTMOUNTAIN »

Offline Kaputt_Knee

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  • [Ed: Sue sadly passed away in 2016]
I think you have entered panic-mode simply because all of this is so strange. Calm down and take a really deep breath! Things are not as bad as some people may imply. If you have never had an operation like this before, the unknown aspects of what you should be doing are really frightening, but don't worry too much that you may never get your sports back!  ;)

You have had repairs made to the lateral and medial meniscii, so take it easy. The main aim currently, as the Knee Guru has already said (and KG is a doctor working in the field of knee surgery so they do know what they are talking about), is to protect the repairs.

If you are so worried, call your surgeon's offices at the NHS hospital or even their private practice office and speak directly with their secretary. They can recommend a physiotherapist who can look at your knee privately (it may cost you a few quid but it will help). The secretary knows all the physios used by the surgeon in private practice and probably makes appointments for private patients.

Icing and elevation will help reduce the swelling as will sitting watching TV doing ankle pumps like your life depended on it. In the Information Hub there are some videos of early rehab exercises anyone can do to help reduce the swelling while protecting the work that has been done.

As for bending your knee, when the swelling goes down it becomes easier, so concentrate on getting the sweilling down. A simple and relatively passive exercise you can try is to sit on a chair with a plastic bag under the foot on your operated leg. Apply minimal pressure to the bag and simply move it forwards slightly and backwards again. Do it slowly at first and when you get used to it/better at it, go faster and further. As this exercise is non-weight bearing, the chances of you doing any damage to the repairs is minimal to non-existant.

I've gone through both repairs and trims, the repairs were way more frustrating than the trims but in the end I was able to return to my sports and normal activities without any problems whatsoever. It just took a wee bit longer that's all.
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 SILENTMOUNTAIN

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Hi thanks for the reply

The feeling of pressure is  at the bottom of the kneecap and where the top of the leg bone is, when I bend it to a certain point just past 90 degrees, i feel pressure not awful pain just pressure that it wont go any further,

it was in a bandage for 48 hours i could not bend it much in this time, this scar tissue thing has scared the hell out of me i have been trying to be positive up to this point  but feel really down about it all now.  its been 19 days since the op should i have more motiuon than 90 degrees by now

I tried talking to the sugeon but because he was busy i felt i kind of got fobbed off a bit.
How would i know if i have scar tissue stopping me from bending my knee ? shall i just try and force bend it.


i think its those information leaflets they give you that gave me false hope, they say you can be walking driving ect in a matter of days which you have to take with a pinch of salt ,now i knowits different for eveyrone, im suprised im sucha  slow healer even my gp said :(

I was really fit and healthy before the op ,cycle a few miles a day, i was an active rower, i played basketball every day amoung other activities , im also quite a well built person  about 17 stone. maybe because im heavy thats a factor to my slow recovery.


I have obv lost muscle but ive also put on a bit of weight, so thats not good :(
will have to go on a strict under 1000 calories a day diet, what exercises would you reccommend apart from weights sitting down. I suppose it would be ok too do sit ups ?  gentle walking.


I thank you all for taking the time to reply, it offers some hope, this site is a huge help to me . nd as long as you dont mind i will post some of muy progress  or problems ( hopefully  not) in the coming weeks

Offline Vickster

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I had a lateral meniscus trim - I was off work for 3 weeks, no driving for 3 weeks and used crutches on and off for 4 weeks.   This was not a repaire - as others have said, these are more surgery and need to be looked after.  It was a good 4 or 5 months before I felt over the surgery

As Sue has said, can you afford to pay to see a private physio if getting no joy from the NHS?  Probably around £40-55 a session - first should be an hour and then 30 mins thereafter.  The physio should be able to give you exercises, maybe get you on the bike etc.  Find the money, if just for the reassurance :)

The best exercises are heel slides, put a sock on and slide the foot up and down the bed, ankle pumps, sit on a chair and slide foot back and forth etc. If you have been doing this sort of exercises since the op, I can't imagine much scar tissue will be building up.
Where are you in the UK, maybe someone can even recommend a physio :)

And ice - no more than 15 minutes at a time, and never without a cloth or simular between the ice and skin - a £1 bag of petit pois will work well (little peas) :)

I don't think your weight will have anything to do with it.  I doubt in 3 weeks you will have lost that much muscle.
Less than  3 weeks is nothing - don't panic - we all heal differently
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline SILENTMOUNTAIN

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I hope i dont seem lke a big baby or moaning, as im sure there are people on here with much more serious injuries, just getting to that frustraited stage i expected and hoped for more of an improvement by now it will be 3 weeks from the op tomorrow.

i  havent used ice much the last week as it seems most of the swellings gone and i havent needed more than 1 painkiller a day,

 i think i have 90 degrees of motion, anything past that its too stiff like it goes into a clamp


Can i ask a favour please ?
apart from not being able to bend it i cant get it 100% straight when i stand  and walk it seems its slighty bent always , maybe a photo of the  knee or a short video showing the range of motion  would be any use until i get to see the physio, if anyone would be prepared to have a quick look.

i will try and do more heel slides like my life depends on it , and use ice again  i will report back in a few days and see if theres any improvement .
« Last Edit: June 20, 2012, 02:09:54 PM by SILENTMOUNTAIN »

Offline Vickster

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I expect the swelling and just the trauma of the surgery are causing the ROM issues. At less than 3 weeks, normality is a lot to expect - the skin has been cut and tissue trimmed, stictched etc - don't be fooled by the two little holes :)  Are you using crutches to protect the repair?

What were the symptoms before the surgery?  Was the knee locked (i.e. not able to straighten), swollen, were you limping etc?  What was the reason for the op - mine was for locking, buckling, grinding

I don't know what ROM I had at that stage but certainly nowhere near full

Check the infomration hub for videos etc, there's a meniscus and anatomy section
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline Snowy

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If you're this concerned about your knee, you need to see a physiotherapist or make a followup appointment with your surgeon. As Vickster and Sue have suggested, it's well worth paying for a private physiotherapy session if you've been told to expect a wait on the NHS. You really need advice and specific recommendations from someone who can get their hands on your knee and do a proper assessment, not from an Internet forum. Keep in mind that no surgery is a walk in the park; you've had the knee cut open, instruments jammed into it, and work done on the structures inside the knee. It takes time (always more than you expect) for the inflammation and swelling to settle down after an invasive procedure. Three weeks post-op is pretty early days.

You should still be able to do upper body exercises if you're concerned about weight gain. Watching what you eat is fine, but I would absolutely not recommend going on what's essentially a near starvation diet (below 1,000 calories a day) when you're still healing. Your body needs to be properly fueled and rested to recover.
Mar 11: R Biceps femoris tear (skiing)
Jul 10: ACLr (hamstring autograft)
Mar 10: L ACL rupture (skiing)
Feb 06: L partial ACL tear (kickboxing)
Dec 03: R bone edema (motorbike)
Jan 01: R patellar chip (motorbike)
May 93: R ACL sprain (hockey)
Ongoing: bilateral PFS and OA

Offline Kaputt_Knee

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  • [Ed: Sue sadly passed away in 2016]
Until someone has looked at your knee and reassured you that everything is OK you really should not be too active, either in leg exercises or any other activity. The heel slides I described are better than using just a sock as there is no friction. If you foot slides of the plastic bag, put your foot into the bag and gently do the same.

As Snowy and the others have said, your knee has experienced quite a big trauma. It looks like the leaflet you were given was more to do with meniscus trims, which can heal quite quickly. The best I have ever done on a trim is three weeks between operation and being back on my skis. I was driving 48 hours after the op as well, i.e. after all the general anaesthetic had left my system, even though the trim was in my right knee!

You are not being wimpy by any means, but you do need to see someone in real life who can help you. The surgeon's secretary should be able to recommend a good reliable physio that the surgical team know and have sent patients to. Even if you only have one appointment, it is likely to be an hour and by the end of it, you will feel more reassured.

We all react differently to surgery, anaesthetics, pain control, pain itself. We all heal at different rates and have different tolerance to pain. Currently, as you have said, you do not know the difference between "good" pain and "bad" pain. Someone needs to show you that in real life. We can explain until we are blue in the face, but what is good and what is bad when it comes to pain is so individual as to make any explanations we offer useless.

The longer you wait to actually see someone who can help you, the longer the process will be. You will lose more muscle because you are not using your leg properly. You will get stiffer the longer your knee does not flex properly, etc.
As for straightening it, do it passively and no harm can come to the repairs. Support your foot under the heel and ankle and just let the knee hang unsupported. It is uncomfortable at first, but the more you do it, the longer you can tolerate it. When watching TV, put the foot of your bad leg on a footstool or the coffee-table and simply let the knee hang down under gravity. You can ice it as well while you are at it.

All the exercises we have suggested are easy to do and are not a danger to your repairs as they rely mostly on passive movement and non-weight bearing. But you will not have complete peace of mind until someone knowledgeable actually sees you and examines the knee and then guides you on what to do. Until that time, I would avoid doing any weight-bearing active work just to be on the safe side. You can quickly catch up if you need to believe me.  ;)

Sue  8)
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