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Author Topic: My MPFL Reconstruction (12/31/2012)  (Read 21151 times)

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Offline emzobe

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My MPFL Reconstruction (12/31/2012)
« on: December 27, 2012, 08:45:25 PM »
I have been reading and posting on Knee Geeks off and on since my first knee surgery. I am scheduled to have an MPFL reconstruction on Monday and a tendon from my hamstring will be used to help stabilize the patella. I thought I would provide a brief history of my knee and keep a diary during the recovery and rehabilitation.

I began having knee problems almost 4 years ago when my knee subluxed while playing soccer in March 2009 and again in July 2009. I never had any torn ligaments or damage that appeared on an MRI to warrant surgery, so I did a round of physical therapy for each subluxation and thought my knee problems would be resolved. In November 2009, the pain returned and my knee felt as if it had subluxed despite no incident having occurred to warrant the pain. From November 2009-July 2009, I did physical therapy, had two cortisone injections, and had additional MRIs and x-rays to try to pinpoint the source of the pain. I was told that I would outgrow the pain by an orthopedic doctor at the time, so I consulted with another orthopedic doctor for another opinion, who thought the pain stemmed from an inflamed plica. After 6 weeks of therapy/modalities that did not improve the pain, I had my first knee arthroscopy in October 2010. The pain disappeared for 3 weeks and then returned. From November-February, I did additional physical therapy, took Vitamin D supplements, and took a prednisone pack at one point, but the pain still continued. I was referred to pain management and had two procedures done on my knee (an injection and an ablation) to treat what the pain management doctor thought was a neuroma. The pain continued over the following months, but on October 31, 2011, my kneecap popped out of place. I saw an orthopedic doctor who had recommended a lateral release initially, but when an arthroscopy was performed in January 2012, the OS did not perform a lateral release and instead did a scar tissue debridement and arthroscopy. Again, after surgery, my knee was pain and dislocation-free for 3 weeks before my kneecap began to sublux on a pretty frequent basis. I continued to do PT (without improvement) and in June, I was told that an MPFL reconstruction would be the best option to address instability (since at this point, the pain in my knee only stemmed from it popping out of place, rather than being isolated pain). Since June, my kneecap has popped out of place multiple times, sometimes up to 3 or 4 times in one day, 7 times a week, etc., so I will be having an MPFL reconstruction Monday, December 31st,

I don't quite know how nervous I am. I know that it is a lot greater undertaking in terms of how I will be feeling the first few weeks after surgery compared to a traditional arthroscopy. I am trying to stay positive and be optimistic. I will be weight bearing as tolerated after the surgery with a brace and I start classes 2 weeks after the surgery. I have an iPad, so I am pretty confident that I will be able to not be too incredibly bored after the surgery when I am not sleeping. If anyone has any other things that they found useful throughout the recovery from surgery, I would love to hear any advice or feedback from people who have had an MPFL reconstruction or surgery with a similar recovery time and protocol.

Thanks in advance!

Offline Summer007

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Re: My MPFL Reconstruction (12/31/2012)
« Reply #1 on: December 27, 2012, 10:03:28 PM »
Hiya Emzobe,

Sorry to hear of all the trouble you are having with your knee!

I had an MPFL Reconstruction in August. Before the surgery I was very much in the same situation as you, I was having many subluxtions/dislocations every week and no amount of physio was working. I had a lateral release in Ocotber 2011 but after a couple of months my knee was popping out again. It got to the point that I had to have my leg splinted for months in an effort to try and stop the knee coming out! I too like you was told that I should out grow the pain.
I am now four and a half months out of surgery and I am in pain everyday and things are heading towards the way they were before. My knee still 'slips' out of place too, but I am having a hard time to get anyone to listen to me! However, most of the other people I have heard and read about on here have had success and been much better off after the surgery- so please dont let me dishearten you!

As for things to do after the surgery, I did a lot of reading, watched films and I had my laptop to hand. Anything that takes your mind off of it is good really!
If you can get hold of a shower chair/bench, that would also be great for you. I found that standing in the shower was agony and it will also help make you feel more stable and you can have a wash without worrying too much about slipping.

I wish you the best of luck with your surgery on Monday. Please let us know how you get on when you feel up to it!

Best wishes, Summer  :)
October 2011-L LR
August 2012-L MPFL Recon
July 2013-L TTO & MPFL revision
March 2014-L Arthroscopy surgery

Offline Ouchy

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Re: My MPFL Reconstruction (12/31/2012)
« Reply #2 on: December 28, 2012, 02:14:05 PM »

Hi Emzobe,

I also had a MPFL recon at the end of August this year, luckily mine has been more successful than Summers sounds to have been (you poor thing Summer  :( ).

The iPad is a good idea, though it might be an idea to put a few audiobooks on it and take some headphones, I was so out of it on Morphine for about 3 days after my surgery that I couldn't focus my eyes on anything! If you're going to be in hospital for a couple of days also take some slippers that are very grippy and easy to get on as you'll need them when the physio's want to get you back on your feet and slippers that are difficult to get on and off are a nightmare!!

I agree with Summer that a shower stool/chair is an absolute must, I used mine for a month or so post surgery and it helped so much, I'm back to standing in the shower now but a bath mat is still really useful for grip as I'm still a bit unstable at times!

After surgery I borrowed an aircast cryo cuff and cooler from someone and it was absolutely fantastic, it meant I could ice my knee for 6-8 hours every day and meant that I cut down on pain killers much faster than was expected. I've now actually bought my own and even 4 months post surgery I still use it at least every other night and it keeps the swelling down wonderfully.

With your painkillers, especially in the first few weeks, make sure you really keep on top of them, make sure you don't run out too! I kept a note books with my dosages, when I'd taken them and when I could take them next for the first few weeks, I was on quite a bit of codeine once I was home and keeping track of them seemed a bit OTT but I regularly forgot when I had last taken them as the codeine made me rather confused, so having it written down made sure I didn't take too much.

Are you in the UK on the NHS? I was and I decided to pay to see a private physio with a good reputation for rehab after knee ops. It was quite expensive but really really really worth it! The NHS physio's didn't even recognise the operation and kept trying to get me to do exercises that my surgeon had told me explicitly I am not allowed to do! The private physio has been fantastic. Definitely go and see the NHS ones as well, but if they don't seem to be doing a lot it might be worth thinking about spending a bit now to see a private one to get a lot of benefit in the future.

Please feel free to ask me anything you would like to know about the surgery/recovery, I might be able to shed some light.

Good luck for Monday!!!

Claire



2001-2010 - Multiple dislocations of both patellas
October 2010 - R patella dislocation during first aid training!
June 2011 - R arthroscopy with lateral release & debridement
August 2012 - R MPFLr

Offline emzobe

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Re: My MPFL Reconstruction (12/31/2012)
« Reply #3 on: December 28, 2012, 09:45:46 PM »
Claire and Summer,

Thank you so much for your replies. My surgery is scheduled for early afternoon on Monday and it appears like I will be prescribed OxyContin and Percocet for the pain after the surgery, which makes me a little nervous. I have a feeling I have been under estimating the post op pain a little bit.

I will be at home for the first week and a half after surgery and then I am headed back to school to start another semester of college classes that begin 2 weeks after my surgery date.

I will try to post again on Monday after the surgery if I can muster some coherence for putting words and sentences together. Until then, thank you again for your well wishes!

Emily

Offline Summer007

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Re: My MPFL Reconstruction (12/31/2012)
« Reply #4 on: December 29, 2012, 08:28:57 PM »
Emily,

I hope that your surgery all goes well on Monday afternoon! I too very underestimated the pain that I was going to experience after the surgery, but dont worry, Im sure you'll be fine!

I hope that when you go back to college that you won't find it too hard. I was scheduled to go back to college after three weeks as I had my surgery in the Summer break- however, I didnt manage to actually get back for quite a bit longer than that.

If you need any more advice or information then feel free to give me a shout :) Hoping to hear from you very soon! Good luck again!
October 2011-L LR
August 2012-L MPFL Recon
July 2013-L TTO & MPFL revision
March 2014-L Arthroscopy surgery

Offline emzobe

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Re: My MPFL Reconstruction (12/31/2012)
« Reply #5 on: December 31, 2012, 11:57:12 PM »
December 31st

I just got home from surgery. I arrived at the Surgery Center at 12:15 and my surgery started around 2:30 and was a little over 2 hours. I have this ice machine that hooks up to underneath the brace and it is a lifesaver! After the surgery, the cold was not reaching the part of the knee where most of the work had been done and the recovery room nurses' solution to the problem involved bumping the tender part of the knee from surgery, bringing me to the brink of tears. Now that it is working, I am much happier!

Before I left the surgery center, I was walking and with the support of a nurse on my right side, I was able to walk around the recovery room and put weight on my leg which was a very pleasant surprise. I don't know if it is the drugs and anesthesia, but at least for now, the pain is manageable and I am at least putting some weight on my leg and I am just listening to my body for what is too much.

I see the doctor in a week. Until then. I am using crutches weight bearing as tolerated, have a brace to wear, and am hoping this is the start of a patella subluxation free future.

Offline emzobe

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Re: My MPFL Reconstruction (12/31/2012)
« Reply #6 on: January 01, 2013, 12:09:33 PM »
January 1st

Happy New Year! I am doing a lot better than I expected! I stayed up to watch the ball drop at Times Square on TV and slept through almost the entire night.

I have a little bit of a sore throat from what the anesthesiologist put in for the duration of the surgery behind my voice box, bt nothing that water can't fix. Hopefully, that's gone in the course of today or early tomorrow.

I can feel where the incisions are, but I am still able to put quite a bit of weight on the leg when I get up and use crutches. I don't have any ROM exercises to be doing right now since the brace is locked pretty straight and I am just supposed to be working on getting around and putting more weight on my leg until I see my doctor again a week from now.

I am keeping ahead of the pain (I've made the mistake in a past surgery falling behind) with the pain medication, so the pain is pretty manageable. Apart from a pulling sensation behind the knee when I get up, there is little discomfort.

Thanks for reading and have a happy New Year!

Offline Summer007

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Re: My MPFL Reconstruction (12/31/2012)
« Reply #7 on: January 01, 2013, 12:56:33 PM »
Hiya Emily,

Happy New Year to you too- hopefully this year will be subluxtion free and there will be better times ahead! 

I am glad to hear that the surgery went well and at the moment the pain is manageable! Well done with being able to put a lot of weight on your leg and being able to walk about, thats a phenomenal achievement so soon after surgery!

Please continue to keep us updated on your progress, and good luck with your appointment next week if I dont hear from you before then!

Summer

October 2011-L LR
August 2012-L MPFL Recon
July 2013-L TTO & MPFL revision
March 2014-L Arthroscopy surgery

Offline emzobe

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Re: My MPFL Reconstruction (12/31/2012)
« Reply #8 on: January 02, 2013, 04:12:02 PM »
January 2

There have been quite a few changes from when I posted yesterday morning. First, the good news. Yesterday, I was able to take a shower, which felt wonderful. After using an entire package of Saran Wrap and two garbage bags, the brace and dressing sustained no dampness. Since it was quite a production to actually wrap the brace and leg to be able to take a shower, I am planning on doing so every two days ( not tonight, but I would shower tomorrow night again). My leg was not that bad from standing in the shower (surprisingly), so I took that as a good sign. I am also able to still bear weight as if I am walking with the support of crutches, so I am getting around pretty well.

Now, the not so fun news. Last evening, I began to feel the anesthesia or what remained of the anesthesia wear off, surprising me with some pain and discomfort on the inside and outside of my knee. I don't think I was too pleasant to be around, but my parents have been wonderful, so they put up with me (haha). I also began to experience some discomfort with the brace and compression sleeve. My ankle has swelling from where the brace wraps around and the top wrap around strap of the brace was constricting my thigh pretty uncomfortably, but loosening both straps seems to have alleviated that discomfort. The compression stocking was constricting my big toe earlier this morning and my pinky toe just a little bit ago, but I adjusted that and hope that discomfort does not return.

I have taken some time off from the ice machine, but will probably be returning to it with the next dose of pain meds. At this point, the pain is pretty manageable. I just so look forward to getting to take the brace off while I am lounging around this weekend and having the compression stocking and dressing taken off at my follow up appointment!

Thanks again for reading and all the warm wishes!

Emily

Offline katiey86

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Re: My MPFL Reconstruction (12/31/2012)
« Reply #9 on: January 02, 2013, 08:15:19 PM »
It seems that you're doing really well so far by the sounds of what you've said :)

I remember really well the feeling slowly returning after the anaesthetic and after that the numbness around the wounds slowly disappearing too, luckily it seems to continue to be manageable as long as you stick to the pain meds and the ice, mine was always fine until the day I woke up a little later than usual and hadn't taken the meds.

Good luck with the rest of your recovery & keep us updated! :)

Offline emzobe

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Re: My MPFL Reconstruction (12/31/2012)
« Reply #10 on: January 03, 2013, 12:30:49 AM »
January 2nd (Part 2)

Once I woke up this morning and got the compression sleeve all figured out, I thought I was doing pretty well. My dad brought me lunch home and I had been up and around and feeling pretty good. Around 3:15, I took a pain pill and was going to go lie down and rest.

I had gotten settled, my leg was elevated, and I was about to go to sleep, but for a brief moment, I felt dizzy (like the room was spinning), so I decided to sit up for a second to make sure that I was okay. A few minutes later, my leg I had surgery on completely went numb and I lost all feeling from where the brace starts down through my ankle.

I found the number for my doctor's office and the nurse called back. After what seemed like an eternity, we slit the compression stocking and tried re-elevating my leg. The numbness was gone, but. Then my leg was throbbing. The nurse had said if I still was not better, to get rid of the compression stocking, so that is gone and my leg is no longer throbbing or numb!

My ankle was incredibly swollen and so was the top of my thigh, so hopefully that will begin to subside. I finally was able to start my nap at 5:45 that I had planned to take at 3:15. Hopefully, that is the last surprise for today and I can rest peacefully for the remainder of the evening!

Emily

Offline emzobe

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Re: My MPFL Reconstruction (12/31/2012)
« Reply #11 on: January 04, 2013, 12:05:53 AM »
January 3rd:

I woke up today and immediately felt that there is no longer any anesthesia or numbness from the surgery left in my knee; I am pretty much feeling all surgical pain from where they did most of the work.

I woke up this morning and redid my ice machine since I was home alone for the day. I took a pain pill and went back to sleep since t was pretty painful getting around. Then, I woke up 2 hours later and decided I would get up, get changed, brush my teeth, etc. this was quite a lengthy process and I felt so exhausted by the time I was finished. I had even taken frequent breaks as I was making my way around a pretty confined area, but was exhausted enough that when I went back to sit down, I went back to sleep for a while.

I got up for lunch and to take more pain meds and then was sitting up for a little while when a friend came to visit. I was feeling fine until dinner. My stomach has not been sensitive this entire time, but after taking the third bite of a slice of pizza, that was it. I rushed to a trash can and did not have any pizza for the remainder of dinner. After dinner, I felt the same wave of feeling nauseated, so now I am just lying down with my leg elevated and an ice pack on my really swollen ankle, hoping I feel better for the remainder of the evening.

Thanks for reading! I see the doctor on Tuesday, so between now and then, I am trying to get up and walk around a little bit more, now that I know I can go a full day getting around by myself.

Emily

Offline emzobe

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Re: My MPFL Reconstruction (12/31/2012)
« Reply #12 on: January 05, 2013, 01:34:57 AM »
January 4th:

I got up at 7 this morning and discovered that the mornings are the roughest. I am able to sleep through the entire night (which I am grateful for), but my knee is usually quite stiff when I get up to first walk around. After I took pain meds, I resettled and went back to sleep for a couple hours. I woke up again and my knee I'd not feel as bad when I went to get up and walk around a little bit.

I sat around and slept for a good portion of the day. Everyone keeps telling me that I look tired and I feel exhausted anytime after I get up and walk around, so my couch has been a really good friend. I could actually eat more today (which was exciting) and by this evening, I felt better and was in better spirits.

I made a milestone (kind of) by only taking Percocet once every 8-9 hours instead of taking it every 4 hours. I will see if I can continue this trend over the weekend.

While the recovery has definitely had its downs and frustrating moments thus far, I am pretty happy with where I am on the fourth day after surgery, I am walking with crutches and hope I can be up and around more this weekend.

Thanks for reading! Tuesday is my post op appointment so hopefully I can start moving my leg more and see what my knee looks like and get a better picture of goals for my upcoming rehab.

Emily

Offline emzobe

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Re: My MPFL Reconstruction (12/31/2012)
« Reply #13 on: January 06, 2013, 12:39:03 AM »
January 5th:

I woke up early this morning to take a pain pill since I only took my second to last OxyContin before going to bed last night. It is always hard to get up since my leg is usually stiff from lying down all night. I went back to bed and woke up a couple hours later. I was doing pretty well until around lunchtime. With the dressing, bandages, and ice sleeve for the machine I have been using, and the brace, my leg still felt really heavy any time I would try to get up and walk. The pain and frustration from the past couple days all caught up to me and I was pretty upset.

Two hours and one nap later, I went out of my house and rode with my mother to the mall. While it was nice to get out, the plan backfired. I stayed in the car while my mom went to pick something up (which was supposed to last around 5 minutes), it ended up taking much longer (closer to around 20 minutes) and despite repositioning myself to make sure my knee would not get too stiff, the 15 minute ride home just about had me in tears and I hit the couch and Percocet once I got home.

I rested a little while and managed to muster up the energy to wrap my leg to take a shower. Despite the minor struggle and temporary pain from my leg hanging down, my mood has completely turned around, I have been up more since then, and I am in good spirits watching football on the couch.

I have taken the brace off while I am just sitting so I can move my leg a little more and to take some pressure off of my leg. I can see some bruising starting to settle in around the thigh, calf, and ankle, so I am hoping my leg does not look too black and blue when the dressing comes off on Tuesday.

I am hoping everything starts to take a turn for the better in terms of pain and just overall feeling better. 2 more days until I see my ortho doc and 4.5 more days until I head back to school!

Thanks for reading!

Em

Offline Summer007

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Re: My MPFL Reconstruction (12/31/2012)
« Reply #14 on: January 06, 2013, 01:40:15 PM »
Hiya Emily,

I have just read through your posts and apart from your down moments, you seem to be doing pretty well at the moment. It is really good that you can sleep through the nights and then also sleep during the day as this is something that a lot of people find hard after surgery and with no sleep you eventually turn off. Im sure that the pain will get better for you, keep thinking positively :)

I wish you the best of luck at your appointment, hopefully everything will be the way your OS wants it to be! Also  good luck with going back to school, I think that it is a very big step this soon after the operation, just dont over do it!

Please continue to keep us updated on your progress. Summer
October 2011-L LR
August 2012-L MPFL Recon
July 2013-L TTO & MPFL revision
March 2014-L Arthroscopy surgery