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Author Topic: Need advice: scar tissue after PLC-r  (Read 643 times)

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Need advice: scar tissue after PLC-r
« on: January 29, 2014, 12:16:38 PM »
Hi, I was wondering if anyone could give me some advice. Itís been almost 1,5 years since my last surgery. They did an anatomical reconstruction of the posterolateral corner (LaPrade technique) using achilles tendon allograft, restoring LCL, PFL and popliteus tendon.  My knee is now stable, so you could say the surgery was succesfull.

My problem is that I canít bend my knee over 100 degrees. Every time I get near 100 degrees, I get incredibly sharp pains on the lateral side of my knee cap (in the region between knee cap and fibula) and you can see a sort of Ďbumpí bulging out. When I put weight on my leg, itís even worse, then my maximal flexion is only 70 degrees. I canít properly descend stairs or ride a bike. When I walk longer than 30 minutes, my knee gets really stiff  and swollen.

We have tried everthing, absolutely everything  in PT and Iíve had three cortisone injections, but they only helped briefly. OS now suggests a MUA, but Iím a bit hesitant about that. Iím afraid it might make things worse, and have the feeling it might be better to remove the scar  tissue, instead of breaking it up aggressively.

I have had four surgeries up to now, and my knee reacted quite heavily after every surgery. So my OS is afraid to do another surgery. But then: my surgeon is an expert in (complex) ligament reconstruction, and not in arthofibrosis.

Anyone have any ideas or advice what to do? I would love to hear from you.

FYI: my surgeries up to now:
5/2011 ACL-r hamstring
11/2011 Scope to clean out scar tissue and part of retorn ACL
9/2012  PLC-r (LaPrade, achilles tendon allograft)
10/2012 Surgery tot put back  tendon that slipped out of upper femoral bone tunnel

Offline Chester57

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Re: Need advice: scar tissue after PLC-r
« Reply #1 on: January 29, 2014, 01:57:42 PM »
Hi, go under the section entitiled "Soft Tissue Healing Problems.....Arthrofibrosis".  You will find a lot of information on what you are dealing with.  You also will find a list of OS's who some posters on this board have had success with treating their arthrofibrosis (AF for short).  You will see that there are only a handful of surgeons who have experience in dealing with this condition.  I have been dealing with it for decades and although every one of my OS's were well respected, well rated surgeons who operate on famous athletes, none of them knew how to treat (and never even saw) a case of arthrofibrosis.  And I can tell you from personal experience it is a disaster.  I will also tell you that an MUA is NOT what you want to do.

Please take some time and read through the information on this site.  Also read Dr. Noyes 12 chapter tutorial on AF.
1980 LK open total synovectomy to remove AVM--Undiag AF Begins--MUA-AF & Instability--Debridement-AF--LOA, Synovectomy, Menisectomy, Chondroplasty, M/L Ret Release-AF, Instability & Sublux--MCL, POL, MPFL Allo Recons-AF--LOA, LR, Synovectomy-AF--LOA, M/L Ret Release, Synovectomy-AF