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Author Topic: Emma's MPFL Reconstruction & Lateral Release surgery  (Read 23788 times)

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Offline esm87

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Emma's MPFL Reconstruction & Lateral Release surgery
« on: May 08, 2014, 01:54:56 PM »
Hi Everyone

I finally had my surgery last Wednesday, the 30th April 2014.

Some background information about how I ended up here:

I've been having recurrent dislocations in my left knee since I was about 11 years old. (I'm 26 now). My first dislocation occurred when I was playing sports at school. My knee continued to dislocate a few times a year and in the last few years its become so common place that I put the kneecap back into place myself, ice, rest for a few days and carried on as usual. However, last summer my right knee dislocated for the first time ever and it has caused me a lot of pain and discomfort, more than I've experienced before with my left knee.

I live in the UK and had been to see my GP many times regarding this and all they did was prescribe me ibuprofen . I tried to avoid taking this however as I'm well aware it's not wise to take for prolonged periods of time. I was also repeatedly told that I would "grow out of it"

However last year when my right knee dislocated for the first time I pushed for a referral and was sent for an MRI scan. The results of this showed that I have ruined my MPFL on both legs and will need an MPFL reconstruction and lateral release on both legs. I chose to have the surgeries one at the time, starting with my right leg as it's been causing me the most pain recently.

My surgery was scheduled for the 30th of April and I made sure I had done my research beforehand because I'm the type of person that likes to know exactly what they're in for! I've found this website to be invaluable for reading other people's experiences (although it's hard not to worry when you read the negative stuff) and for planning ahead for your surgery.

I decided I'd stay with my parents after the surgery and they had made up a bed for me in the study in the downstairs of their house. I'm a week after my surgery now and I'm so glad we did this as it would have been extremely difficult for me to get up and down the stairs, especially as the toilet is downstairs too!

The surgery went great and I'm really please with how my leg looks so far. I've had minimal swelling and even although I still have my dressings on (scheduled to get my stitches out tomorrow) the incision areas look super neat. I can't wait to see my scars tomorrow when the dressings are off and they're cleaned up. I'm wearing basically a full leg support stocking/bandage and I have a brace to wear too. I've also got crutches.
The first week has been really tough, I can't lie. The pain has been really hard to deal with (I had to phone and get stronger painkillers from my doctor) and I've also had this strange pulling/moving sensation at the side of my knee where the ligament was reconstructed. I spoke to the physio on the phone who confirmed this is normal and will be painful as the new ligament is very tight at first. I was pretty scared when I first felt this, I wasn't sure if I'd damaged something!
Getting up and down for the toilet the first few days was really difficult too as I was in so much pain. I've just rested and iced and elevated my knee and it's slightly easier now.

My first physio appointment as been scheduled for next Wednesday so excited but also scared for that too as I know things are about to get much, much harder.

I'd stocked up on shorts before my surgery which was great as it's all I've worn for a a week solid! As I'm able to get them over my brace. Today I managed to wash my hair for the first time in a week too!!

Baby steps (literally) I guess for now.

I'll update tomorrow after I've been to the doctors to get the stitches out (and have managed to get in and out the car which will be a real challenge).

Thanks for reading!

Emma

Offline esm87

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Re: Emma's MPFL Reconstruction & Lateral Release surgery
« Reply #1 on: May 10, 2014, 03:59:55 PM »
So yesterday I had an appointment with the nurse at my Doctor's surgery to get my stitches out.

I managed to get into the back seat of the car (even though it was a real challenge) and got to the surgery.

The nurse took off the dressings that were covering the incision sites which was okay, although one was stuck so I now have some broken skin which really stings where that was taken off.

All the scars look amazing! Much smaller and neater than I had expected. I had dissolving stitches so it was only the ends that needed trimmed.

When I got home I was completely exhausted and really sore as it was the most I'd done since I had the surgery.

Still feeling super tired and sore today so will update again soon!

Offline lucha86

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Re: Emma's MPFL Reconstruction & Lateral Release surgery
« Reply #2 on: May 11, 2014, 06:06:33 PM »
I understand what you mean Emma by the weird feeling on the inner side and it's a very tight sensation I have found before I start walking I flex the knee a little on a chair I'm sitting on and then when I start walking the sensation isn't as strong I wish I had a brace with my mpfl surgery but my surgeon had other ideas.... :-\

Offline rob2278

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Re: Emma's MPFL Reconstruction & Lateral Release surgery
« Reply #3 on: May 14, 2014, 03:52:52 AM »
Hey...

Even at 3+ months post op I still have that 'tightness' where the ligament was replaced. It almost feels like a rubber band! It definitely has gotten better over time, but expect it to take months before your knee feels 'normal' again

Emma.. keep us posted on your recovery. My advice (as I've given it before) is to really work on your ROM at this point. The quicker you get back your motion, the quicker your recovery will be. You've gotten over the worst part - it slowly gets better from here on out..
Knee History:

01/1990 - R Knee - removal of bone chips
05/1990 - L Knee - dislocation
Fall 1991- L Knee - 2 dislocations
12/1991 - L Knee - LR/MR
1992-2013 L Knee subluxations
04/2008 - R knee reconstruction (torn patellar/quad tendons)
04/2013 - L knee - dislocation
01/31/2014 -MFPL reconstruction

Offline esm87

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Re: Emma's MPFL Reconstruction & Lateral Release surgery
« Reply #4 on: May 14, 2014, 10:22:03 PM »
Hi Rob
Thanks for your advice.

I had my first Physio appointment today. I was pretty worried about this and had visions of this angry physiotherapist bending my knee despite the pain!

Thankfully it was nothing like that. I'm 2 weeks post-op today and hadn't been given any exercises to do. The physio told me that I was to stop using my brace today (and my stocking bandage) she gave me two exercises to work on for the next week. One where I sit with my knee on a flat surface and try and push the back of my knee down as hard as I can.

The second is trying to bend my leg. I find this incredibly difficult. My knee feels so tight (exactly like the rubber band that's been mentioned) and at the moment I've got a pretty measly bend. I'm determined to work on this but at the moment it feels like an impossible task. Is this how everyone feels?

I also feel really apprehensive and nervous when walking or doing anything really as i've had the brace and bandage as support up until now. I've still got my crutches but i'm finding it really difficult to get used to. Hopefully this will change soon?

I don't feel that positive today but i'm hoping that will change in the next couple of days. I've been trying really hard to remain upbeat so hopefully I can improve this bend and trust my knee. At the moment I just feel a bit scared!




Offline esm87

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Re: Emma's MPFL Reconstruction & Lateral Release surgery
« Reply #5 on: May 17, 2014, 04:50:21 PM »
Since my last post I've been working hard on the exercises given to me by my physiotherapist.

She told me to have my leg flat (on a bed etc) and to use a towel round my heel to help me pull and in turn, bend my knee. I've to do sets of ten, holding for ten seconds.

I've also to work my quads by pushing the back of my knee down into the bed, sets of ten, again hold for 10 seconds.

I've also to go outside for a short walk each day and also to go up and down the stairs in my house twice a day.

My physio appointment was on Tuesday so I've been working on these since Tuesday evening. I've found going upstairs to be okay actually, not too much of a struggle as I have the handrail (bannister) and my crutch however coming down is a different story. I'm finding coming downstairs extremely difficult.

On Tuesday I was only able to bend my knee ever so slightly doing the heel slide with the towel. However now I'm finding after doing a few I can see a considerable difference, which is great. It is extremely painful and uncomfortable though as the new ligament is so tight. Does this eventually get easier? and how long does it take? My first heel slide is always pathetic and its only after a few that I can see a considerable bend.

Walking with my crutches is going okay although I still cant bend my knee when walking. I'm hoping keeping up the heel slides will loosen the ligament and allow me to have more of a bend when I'm walking?

It's such a slow process and it's hard not to get frustrated with how slow things are progressing. If anyone has any words of encouragement they'd be most appreciated!!

Offline esm87

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Re: Emma's MPFL Reconstruction & Lateral Release surgery
« Reply #6 on: May 23, 2014, 09:28:54 PM »
I had another physiotherapy appointment on Tuesday. When I attended last week the bend of my knee was measured at 10 degrees as it was the first time I'd even tried to bend my knee. This week it was measured at 60 degrees. My physiotherapist was really happy with the improvement. She also got me to sit on a chair properly (instead of me sitting with my leg straight) which was incredibly sore and also got me to sit on the edge of the bed and move my leg up and back. This was also incredibly sore. I was also told I wasn't allowed to use my two crutches and was reduced to just one.

The last few days I've been carrying out the old exercises and the new ones however the new ones have created a whole new world of pain! The site on my knee where the new ligament was constructed is incredibly sore and right and my knee and foot have swollen to twice the size. So much so that I phoned physio this morning to check that was to be expected and nothing to worry about.

She told me to elevate my leg and lay off sitting "properly"
For the rest of the day so that the swelling settles.

It was three weeks since my surgery on Wednesday and things are still difficult and painful. Hopefully it'll settle down in the next few days.

Offline rob2278

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Re: Emma's MPFL Reconstruction & Lateral Release surgery
« Reply #7 on: May 24, 2014, 03:17:52 AM »
Emma..

Congrats on the advancements with your ROM.. 60 degrees in week 2 is great progress.

Patience is key. Think about it- even if you're able to increase your ROM 30 degrees a week, that's still on average only 4+ degrees a day. And I definitely know the feeling about making progress, only to start again all over again the next day from worse than where you left off! It took me about two months before my knee stopped stiffening back up at night.

I'd advocate to continue working on ROM as much as possible. You wont injure your knee from non weight baring bending. Go on amazon and buy the resistance bands and get to work!

As far as PT goes - the pain is 100% normal with new activities. I was popping a pain pill post-PT for about a month after my surgery. Listen to your Dr and elevate/ice the knee a few times per day- that will definitely help with the swelling..

Most importantly, keep your chin up. I know it's easy to hit those lows during recovery - but you're doing it, and are on your way.. keep up the good work!
« Last Edit: May 28, 2014, 06:18:14 PM by rob2278 »
Knee History:

01/1990 - R Knee - removal of bone chips
05/1990 - L Knee - dislocation
Fall 1991- L Knee - 2 dislocations
12/1991 - L Knee - LR/MR
1992-2013 L Knee subluxations
04/2008 - R knee reconstruction (torn patellar/quad tendons)
04/2013 - L knee - dislocation
01/31/2014 -MFPL reconstruction

Offline esm87

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Re: Emma's MPFL Reconstruction & Lateral Release surgery
« Reply #8 on: May 28, 2014, 04:39:26 PM »
Hi rob.

Thanks so much for your advice. It's great to hear from someone who is further along with the recovery than I am.

I had another physiotherapy appointment today. I feel it went really well. My rom is now 95 degrees (up from 50 last week) so I'm pretty pleased to see that all my hard work is starting to pay off. I was convinced it would
Only have increased by about 10 degrees so that was a nice surprise.

I still can't do a straight leg raise but can lift my leg independently from a sitting position, albeit with intense pain round my kneecap. Apparently this is all normal.

The swelling in my knee and foot has got much worse in the last week due to me being able to sit down on a chair like a "normal" person now, without me having to sit with my leg straight out in front of me. When doing this I have intense tightness after about a half hour and only getting up and walking can remedy this. Determined to keep on with what I've been doing as I can put my own socks and shoes on now (I never realised how much I took that for granted!!)

I've been given some new exercises, one being lying on my stomach and bending my knee up (which I was convinced I wouldn't be able to do - I think this really shows that mental strength is huge part of this recovery) and I was able to do it.

Hopefully I can continue to make improvements this week and hopefully I'll be closer to losing my
Crutch shortly.

I also had to get my pain medication changed as the physio has meant I'm in a lot more pain but hopefully the new medication will keep that at a manageable level.

Emma

Offline esm87

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Re: Emma's MPFL Reconstruction & Lateral Release surgery
« Reply #9 on: June 02, 2014, 08:01:22 PM »
Been continuing with my exercises given to me by my physiotherapist and I've been trying to go a walk each day. I still have one crutch but I'm finding walking is still difficult. I can bend my knee to work on my rom
Exercises but it's really hard to bend my knee when I'm walking. It's also really tiring me out.

My other exercises have been going okay. I've also found the exercise where I lie on my stomach to stretch out my hamstring and the back of my leg is hard to do and it feels horrible. I'm
Hoping this will get easier too.

Starting to feel really restricted and as I'm almost 5 weeks post op I can feel people beginning to tire of me not being able to do what I'm used too! I'm still not back at work as I know I couldn't sit at a desk/concentrate on work. It's really hard to explain to people who haven't had this surgery what it feels like (even after nearly 5 weeks!)

I have another physiotherapy appointment on Wednesday so I will wait and see what that brings

Emma

Offline Mpflcheerleader

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Re: Emma's MPFL Reconstruction & Lateral Release surgery
« Reply #10 on: June 05, 2014, 06:51:48 AM »
Emma,
     Did you lose much muscle in your leg after surgery? I'm really surprised that they took your brace and crutch away so soon but that's great! After my first surgery, for about five months I would have times where my knee would give out from losing so much muscle in it so you really have to be careful when you walk on it with your knee bent but it really helped to practice with your crutches.
     Your ROM is AMAZING though it gets me excited to get to therapy and work on mine.
Keep up the progress,
Cristee
Sep 2012- deep bone contusion in knee
Sep 2013- dislocated patella
Oct 2013- mpfl medial reefing/cartilage cleanup
May 2014- mpfl reconstruction/cartilage cleanup

Offline esm87

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Re: Emma's MPFL Reconstruction & Lateral Release surgery
« Reply #11 on: June 05, 2014, 09:55:02 AM »
Hi cristee,

Yeah, I can actually see a difference between my legs now. My
Right leg is definitely weaker. I still can't do a straight leg raise. I got my ROM measured again yesterday at 120 degrees so I'm pretty pleased with that! My other leg has a ROM of 135
Degrees so I think doing my exercises non stop has really paid off.

I also got to use an exercise bike at my physiotherapy appointment yesterday which was exciting! I managed to cycle on it really well actually much to my surprise (and I think to my physio's surprise too as she had told me just to push as far as I could and it didn't matter if I couldn't go full circle. I was 5 weeks post-op yesterday.

I know what you mean about walking. That's what I'm really trying to work on now. Bending properly when walking is really difficult! I still have one crutch but there's talk of that being taken off me next week which makes me nervous! How long did you have your crutches for?

Emma


Offline Mpflcheerleader

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Re: Emma's MPFL Reconstruction & Lateral Release surgery
« Reply #12 on: June 06, 2014, 04:45:07 AM »
I'm so jealous of your ROM they're keeping me restricted at 90 for the next month.

 I only really used my crutches for the first three days after my surgery and I only use them now for long walks so my foot doesn't swell but I guess its a little different because they're keeping me in my brace for the first 7 weeks. After about 3 weeks I was able to take it off and walk around the house without anything but I don't try to bend it when I walk because my ligament is still so tight and I don't have great ROM yet.

It takes a while for your muscle to come back and honestly its half of the battle in your recovery. The best thing I found after my last surgery was to eat a lot of protein to help that muscle to grow. I would usually drink a protein shake right after I finished my PT to restore the muscle.

cristee
Sep 2012- deep bone contusion in knee
Sep 2013- dislocated patella
Oct 2013- mpfl medial reefing/cartilage cleanup
May 2014- mpfl reconstruction/cartilage cleanup

Offline lucha86

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Re: Emma's MPFL Reconstruction & Lateral Release surgery
« Reply #13 on: June 06, 2014, 11:27:03 PM »
I must say mpfl surgery unless you have been through it people will not understand my surgeon asked me would you have this again I replied I would rather wrestle 100'men in a ring than do this again......
Some doctors I feel due to lack to research on mpfl surgeries I have checked medical journals with my sister who is in medicine and we could only find 45 articles/ journals of research compared to acl surgery with had over 5000 ......some doctors say oh your not at this degrees why not?? Your not at this point why not? And sometimes i agree with you Emma sometimes doctors make you feel your best isn't good enough or get tired because you have slow progress... But what we must remember us everyone is different and heals at different paces......and with mpfl surgery it can be hard and there can be complications  keep up the great work Emma that's great news about your  rom range don't worry or fear coming off the one crutch just think how far you have come to get to that stage and it will only make you more determined :)))
« Last Edit: June 07, 2014, 12:47:32 PM by lucha86 »

Offline 2cutekiddos

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Re: Emma's MPFL Reconstruction & Lateral Release surgery
« Reply #14 on: June 07, 2014, 03:00:24 AM »
Wow! Great progress on the ROM! I remember trying to learn to walk properly was interesting. I thought I was doing good but the PT kept telling me I was leaning! Keep up the great work!

Yes, I agree lucha86 there is a small number of doctors who are specialized to perform the MPFL. In my research I found articles that describe several different techniques and methods to the procedure. One ortho I went to I asked how he performed it and he explained the typical approach: tunnel through patella and anchor on the femur. I asked him would that restrict my ROM and he said that 120 would be functional...I left knowing that I wouldn't use him! I wanted full ROM...I mean heel to butt!

I was happy when I found my doctor who said that his approach would allow for me to regain full ROM by weaving the graft through my muscles and then anchor to the femur. I am happy to say I regained full heel to butt ROM.

Unfortunately some people aren't so lucky and the doctor over tightens the graft which leads to less ROM and grinding. Look into how your doctor performed the procedure. I am soooo sorry you have had it so rough lucha86!

Andrea
1981 First Subluxation/Dislocation Rt knee - 7yrs old
1981 to the Present: Countless Subluxation/Dislocations of Rt & Lt knees
1993- Rt Knee LR & Medial Reefing (failed)
1996- Lt Knee LR & Medial Reefing (failed)
2012- Lt Knee Fulkerson TTT & MPFLr
2014 -RT Knee Fulkerson TTT & MPFLr: scheduled 6/18