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Author Topic: Continuous knee trouble after knee surgery  (Read 1027 times)

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Offline alexa33

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Continuous knee trouble after knee surgery
« on: September 05, 2013, 01:15:12 AM »
Hello All!

I'm completely new to this webpage and a little lost on which bulletin to post in but here I am. My frustration has reached its max and so has the pain. On November 17th 2012, I went on a long (3-4 hr) hike, made it through the whole hike without a problem but when I arrived home I got in the shower (tub) and slipped. My legs were so worked and tired that once I slipped my left leg completely went out on me causing my knee to snap as I fell sideways down into the tub and then I landed sitting on the leg. At first, I thought I for sure broke my leg because the pain was ridiculous and I couldn't move my leg at all. Keep in mind that I'm only a 22 year old female and quite fit/athletic. After a couple of minutes, I was able to pull myself up out of the tub using my arms and sat down. Within i'd say 10 minutes, my knee has swollen and the back of my knee had developed a huge sack of liquid and I still couldn't stand on it or put any pressure on it. Well, that quickly led me to the emergency room where they were able to rule out no broken bones or patella damage with a few x-rays. The doctor referred me to an orthopedic surgeon that quickly got me into an MRI. I hit the jackpot! I had a completely torn ACL and PCL tear, as well as meniscus damage and had large amounts of liquid between the joints. A month after the accident, I had surgery using allograft ligaments from a donor since my doctor and his PA suggested that was the best choice for me. Well, I made it through surgery and suffered more pain than I imagined I would throughout the first weeks of recovery. It's been eight months now and instead of being completely cleared, I'm still attending therapy once a week and see my surgeon every 3 weeks. I am not able to get my leg to full extension, when I try getting it straight it just feels STUCK and gives me great pain. However, bending the knee is not much of a problem. Whenever I try to do any physical activity even it's just walking on a track for example, I have lots of pain and wake up sore the next day with a stiffened knee. My therapist has tried so many different techniques and practices/exercises to try and straighten the knee and nothing works! I've completely lost all my quad muscle and calf muscle on my left leg and when I try contracting the quad muscle to move the knee cap, I can't. It's that same feeling or having something stuck and it just feels like my knee will explode into pieces if I try. My doctor has no idea what the issue is because he had me go in for another MRI and everything came back normal except a little joint liquid. So, he suggested the cortisone shot and I did that and it didn't work. Every time I go in to see him he tells me the same thing, "Keep going to therapy, do your exercises and we'll see your improvement in 3 weeks." Yet, there's never any improvement. A little over a month ago, he finally recommended I get the Dynasplint. I haven't noticed any change since I've been using it. I see him this Friday and I'm about ready to give up on this doctor and go get another opinion because I'm so frustrated and tired. I feel like I'm going to be stuck like this forever! I cannot run, jump, dance, bend (squat), twist, etc without horrible pain and aches. I'm only 22 and I can't believe i'm already having such bad knee issues. My therapist suggests I get another arthroscopic surgery to see what's really going on in there since you can't view everything through an MRI. However, surgery is surgery and I'm afraid to go under the "knife" again especially with the same doctor since he has "no idea what's going on with my knee." So here I am on kneeguru trying to get some insight on what could possibly be wrong and/or what I should do.

Offline greatfulgann

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Re: Continuous knee trouble after knee surgery
« Reply #1 on: September 05, 2013, 02:52:58 AM »
Were you moving your knee after your injury but prior to the surgery?  If not, you might have developed excessive scar tissue or arthrofibrosis. 

I would re-post this in the rehab section under "soft tissue problems-arthrofibrosis". 

I agree I would be looking at a second opinion at this point.

Offline allyd

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Re: Continuous knee trouble after knee surgery
« Reply #2 on: September 05, 2013, 04:13:55 PM »
What is your ROM in degrees? How far are you off from full extension? You say you have no problems bending/flexing? 

I always get a little worried when the first piece of advice thrown out is arthofibrosis. Be aware of it, but, not to minimize those that do suffer, this is semi-rare complication. Scar tissue can/will form without it turning into arthrofibrosis. And extension is one of those things that if you donít get it back right away Ė they always say, itís the hardest part to regain. Not to say that you wonít, but just keep chipping away at it.

Overall, Iíd say be patient. Not everyone heals at the same rate. It can take up to and over a year to fully recover and regain strength from major ligament reconstructions. The quad strength can be a mysterious case from one person to the next in terms of when they want to Ďwake upí and regain strength. I guess my point is that Iím not sure that running/jumping/cleared for all activity at 8 months post ACL/PCL recon is completely realistic in general. Thatís one thing my OS/PT always drove home to me be realistic. Not compared to others or the Ďrehab protocalí but based on your progress. And perhaps a scope/LOA would help clean up some of the scar tissue that is preventing full extension. Just something to think about.

Perhaps some ACL or PCL recon people can post some of their struggles/experience to help you out.
04/09 RK - Dislocated Patella & Grade III MCL Tear
06/10 RK - Re-Dislocation Patella
09/11 RK - MPFLr + Lateral Lengthening

jtcarlto

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Re: Continuous knee trouble after knee surgery
« Reply #3 on: September 19, 2013, 06:55:29 AM »
Alexa, sorry your having knee troubles! :( 

Anyways, you might want to get a second opinion, especially on diagnosing/examining the MRI.  Make sure you bring a CD if the MRI if you do opt for a 2nd OP.

You could have scar tissue, a cyclops lesion (common after ACL surgeries), Your new ACL could be wound too tight (hence why you can't extend fully).   You could have an irritated plica or synovium from the surgery.  It's hard to know without actually going in there.  You may have to opt for an exploratory arthroscopy.  If you don't trust your current doc, then research one who has good reviews/ positive friends experiences in your area.  Or you could opt for a "doc to the stars", like Steadman or something. 

Your doctor should have some idea of the possibilities although I guess he's not saying that.  Standard after this experience would be a) too tight of ACL b) scar tissue c) possible rejection of allografts (?)

Do you have any visible puffiness below your knee-cap?  That might be scar tissue/ or your fat pad being enlarged from the surgery.

Anyways, I hope it works out for you.  To gain some strength back you might want to try biking, maybe it would help break up scar tissue if that's the problem.  If that's too painful or doesn't feel right, then the exploratory arthroscopy might be the way to go.  There's only so many options.

Best of luck!!!! :)
Jeff

Offline alexa33

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Re: Continuous knee trouble after knee surgery
« Reply #4 on: October 09, 2013, 06:26:50 AM »
Thank you guys for the replies and helpful information. After thinking and talking it over with my doctor, we decided to go through with the arthroscope since he's the one that performed the prior surgery and knows the issues I'm having. I'm currently two weeks out of surgery and I feel OKAY so far. Turns out I did have a huge amount of scar tissue underneath the knee cap and surrounding the new ACL that somehow didn't show up on the MRI, which was causing inability to straighten my leg, etc.. I was able to walk and bear weight on my leg after the surgery and I will start physical therapy tomorrow. I'm hoping this it and the problem's solved. However, my knee will never be the same. I still feel stiffness and "stuck" when i try straightening it but I'm hoping it's just too soon to tell if i'll be back to normal range yet. The pain post-up wasn't too bad but I have to constantly move my leg and bend it or else it gets super tense and sore. I'm also going to continue using my Dyna splint and hope for the best!! After almost a year since my accident, I'm ready to have a pain free, normal-looking, and feeling knee. Once again, thank you for your concerns and words, I greatly appreciate it. :)

Offline IHMK

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Re: Continuous knee trouble after knee surgery
« Reply #5 on: October 09, 2013, 05:05:14 PM »
I'm so glad to hear that you did the arthroscopy and that a probable cause was found for your suffering.  It is not at all surprising that you "still" feel stiff and sore 2 weeks after that exploration - it was surgery after all, and you have to heal from it.  I know very well the frustration of working so hard on those exercises and feeling pain every time you start to do them - I'm hoping that at least by the end of a set of repetitions your knee feels better (and of course, it hurts again when you start them all over again in an hour - been there!!!).

Please do post about your progress - I will be very interested to hear how you're doing.  Keep your spirits up - it is a long road and hard work and there are no short cuts but all kilometers are made of millimeters, and repetition will be your greatest friend.

Best of luck to you!
My knee story: http://www.ihurtmyknee.org

28 March 2013: tore right ACL (also meniscus tear, MCL tear ["Unhappy Triad"!!], tibial plateau fracture & condylar bruise)
28 June 2013: surgery to reconstruct ACL (allograft)















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