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Author Topic: 15 month post-op, when to worry?  (Read 678 times)

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Offline waldstein

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15 month post-op, when to worry?
« on: November 01, 2013, 03:18:39 PM »
I'm 32yo make, and 15 months ago, I had a ACLr using a hamstring graft. The surgery was 1 month after injury because my torn ACL flipped forward into the joint and created a mechanical blocking of the knee which prevented full extension so it was decided pre-hap and waiting to strengthen the knee would not help.

My first 6-7 months of rehab went great, swelling went down quickly, and straight extension was regained with no problem.

At 12 months I started to play rugby again even though my knee wasn't perfect it was "good enough" and when I pushed it, it would always do better then expected. I work out about 3 times a week, running, sprinting, cutting.

I am now 15 months post-op. My knee has full straight extension with no hyperextension, even though my other knee has about 5 degrees of hyperextension. My surgeon and PT said at about 11 months (the last time I saw them) that this was normal, and that it was just stiffness in my joint capsule caused by excess fluid.

My knee still swells up for at least a day after a workout, and during this swelling I cant fully extend my knee. If I stop working out for only a half a week or so, I see significant atrophy set in. Even when the swelling has gone down as far as I can tell by feeling the back of my knee, I still have problems. My patella tendon feels very stiff below the knee cap, and when pushed on it feel like there is hard tissue behind it. I feel like there is a mass of hard tissue behind my kneecap which is preventing me from getting that extra hyperextension, which in turn is causing my quad to not full engage and then atrophy unless I'm constantly working on it.

I'm still feeling a moderate amount of pain when going down stairs, and cannot seem to do very deep dips on stairs. Jogging still seems to hurt, and I can feel pressure behind my kneecap, even though oddly enough sprinting feels fine.

I feel like because I did so well in early rehab my surgeon and PT stopped worrying about me and just chalked any latter problems up to swelling, But I feel like I may have scar tissue behind my patella.

My first reaction is to think "Adam, stop being a wimp and push through this, its normal." But at what point isn't it normal? and at what point should my knee "feel" more or less "normal" and stop swelling to point it immobilized for days? When should I go back and find a new surgeon who will take a legitimate look and see if I have built up scar tissue with an MRI?

I'm working out regularly and intensely, and I feel like I've hit a wall. And I just thought at 15 months post-op this would not be the case.

Your thoughts welcome. Should I get an MRI? Should I get arthroscopic surgery to see if I have scar tissue behind my petella? Am I just being a wimp?

Adam Waldstein

(attached a pick of me playing rugby just to show I am pushing my knee, and hey, it feels good to be out there again)

Offline Hiker girl

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Re: 15 month post-op, when to worry?
« Reply #1 on: November 05, 2013, 08:21:36 PM »
No one is a wimp when it comes to knee surgery and knee pain.  If there is one thing I have learned about this process is listen to your body.  If you feel something is wrong go back to the Dr. and advocate for yourself.

I love the picture of you getting back your life,  hopefully I will as well. 

Rt. knee pain while hiking 08/10
Saw GP 04/11
PT 05/11  failed
MRI  clean 06/11
1st OS, nothing wrong, fired him.
2nd OS, cortisone shot 12/11 
Scope 05/12, fat pad impingement, cleaned and reshaped.
3rd and 4th OS think nerve problem
Nerve study June 2012, Femoral nerve damage