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Author Topic: ACL replacement leading to CS, AF and possible ankle reconstruction or fusion  (Read 37091 times)

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Offline kcknee

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Re: ACL replacement leading to CS, AF and possible ankle reconstruction or fusion
« Reply #135 on: December 31, 2015, 05:18:27 AM »
When I saw my surgeon one week out of surgery, he told me that if my xray at 4 weeks showed my bones were almost healed, I could start weight bearing then. Unfortunately, when I saw him today at 3 weeks, he decided I can't put any weight on my foot until after X-rays at 6 weeks. Ugh, I'm only half way to walking.

He removed over 20 staples from the outside of my foot and ankle, more from the medial side and then cut sutures from my heel, top of foot and arch. I was bleeding a bunch from so many holes so I can't unwrap until Saturday when I can get foot wet and start to move it outside of boot, I noticed and he confirmed that tendons to my 2nd and 3rd toes are tight. Wouldn't discuss stretching or other treatment at this point. One staple radiated pain down to toes when removed and he said something about nerve in surgery. I have had pain on outside of heel for weeks which I blamed on staples, but now think is nerve that was hurt in surgery. Not constant or severe, just annoying.

Of interest is the different way that he, a podiatrist, treats scar tissue compared to orthopedic surgeon. When I had arthrofibrosis in knee, I had typical surgery where sheets of scar tissue were removed from my knee, I have also had scar tissue cut from around muscle compartments and nerves by orthopedic surgeons. Scar tissue didn't belong and needed to be cut out. This podiatric surgeon approached the massive amount of scarring in my foot a different way. He left it alone. His focus was to get my foot bones and muscles to work despite the scar tissue. Tendons were relocated and lengthened, bones were shifted and reshaped. It will be interesting in a few weeks to see how this approach works.
12/31/08 - Skiing injury L knee
6/1/09 - ACL stump removed from joint
8/31/09 - ACLr - Hamstring Graft
12/21/09 - Ant Fasciotomy 
8/26/10 - Anterior Interval Release
12/6/10, 5/5/11, 12/22/11 - Fasciotomy
12/7/12 - Nerve Decompression
6/3/13(m), 7/29/13(l), 12/13/13(m & foot) 2/3/14(l) Fasciotomy

Offline Scubagrl4

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Hang in there' you have been through so much, I'm sure you have completely had it with crutches and other assistive devices. Your continued efforts and strength in finding a solution for your problems has truly been inspiring. I wish improved health and comfort for 2016.
Scubagrl
4/14/14 L ACL rupture, grade 2+ MCL tear
6/6/14 ACLr allograft
9/4/14 MUA
10/6/14 LOA/AIR, synovectomy, lateral/medial retinacular release, partial lateral menisectomy, chondroplasty, deep tissue
biopsies.
11/20/14 insufflation, MUA
10/19/15: LOA/air, PLM, chondro, synovectomy, med/lat releases

Offline kcknee

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Thanks Scubagrl14. I wish my ACL  surgery had been successful without complications and that I could gave found surgeons along the way that would have listened and believed me so that I didn't have to be the one always trying to figure out what was happening in my knee/leg/foot and what should then be done to fix it. I never wanted to read a zillion medical journals and research studies, and have to educate my own surgeons in what I learned and argue for treatment. Unfortunately as a friend pointed out this situation of dismissing a woman's complaints is way to common in medicine. She sent me this article, which although the disease the woman in article has is way scarier and different, the way she is treated is the same. Too many times I read posts here of male surgeons dismissing women by offering antidepressants, telling them pain doesn't exist and in one case I believe a woman was told to take up gardening instead of being offered treatment.

Here is article: http://www.msn.com/en-us/health/medical/i-confronted-the-doctor-who-missed-my-cancer/ar-AAgrkzL?li=BBnba9O

I was 4 weeks post-op yesterday. Nerve pain on side of ankle, a pinching sharp pain, is not as frequent. Foot has finally started moving a bit more side to side but still very stiff. I did feel something painlessly pop or jump several times in side of ankle where the peroneal retinaculum was put back in place with bone anchors. I am hoping so much that tendons are not still subluxing. The whole point of having my foot reconstructed was to stop the tendons from jumping. X-rays at 6 weeks to see if bones have healed enough to walk.
12/31/08 - Skiing injury L knee
6/1/09 - ACL stump removed from joint
8/31/09 - ACLr - Hamstring Graft
12/21/09 - Ant Fasciotomy 
8/26/10 - Anterior Interval Release
12/6/10, 5/5/11, 12/22/11 - Fasciotomy
12/7/12 - Nerve Decompression
6/3/13(m), 7/29/13(l), 12/13/13(m & foot) 2/3/14(l) Fasciotomy

Offline Scubagrl4

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I went through the same problem with my first doctor. To make things worse is that I worked for him for four years in the past before I became a patient. I really expected him to trust that I knew what I was talking about because of my medical knowledge and with him knowing my personality but no such luck. He just looked at me like I was crazy when I told him about how bad my pain was. Now I'm afraid that if I run into him around town I will end up in jail because I'm still so angry at the way he treated me. He even laughed at me when I asked him some very valid questions. I'm just so thankful that my new doc is completely different.
I am so glad to hear that your pain is improving and that you are gaining some movement. I also hope that the popping is normal post op stuff and that it isn't your tendons going crazy again. I'm sure at this point it is hard to even tell what you are feeling with everything relocated like it was. Hopefully the lack of pain with the popping is a good sign. I'm looking forward to seeing a post soon announcing that you can come off of those dang crutches. Wow do they suck!
4/14/14 L ACL rupture, grade 2+ MCL tear
6/6/14 ACLr allograft
9/4/14 MUA
10/6/14 LOA/AIR, synovectomy, lateral/medial retinacular release, partial lateral menisectomy, chondroplasty, deep tissue
biopsies.
11/20/14 insufflation, MUA
10/19/15: LOA/air, PLM, chondro, synovectomy, med/lat releases

Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
Hi Kristin,

I hope you continue to see further improvements in your post-op recovery and hope that the x-rays show that the bone is healing well enough that you are able to fully weight bear again. It is nice to find a understanding OS that believes and knows you are in pain and how to go about treating it properly.

Hoping that 2016 is going to be a more positive year for you and your on-going foot/ankle problems. Thanks for supporting and advising me throughout 2015. Scuba and I understand the frustrations while going through a medical problem that is hard to get right again.

nickwclarke2016DroitwichSpaUK
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline kcknee

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My appointment with surgeon did not go great. My heel has still not healed enough. Still NWB until weekend and then can tap boot on ground without weight using crutches for a week. After that weight bearing as tolerated. See him in 3 weeks. Might be walking in boot then.

Did not believe me I felt possible tendon snapping on side of foot. Said must be scar tissue. Unfortunately I couldn't get snapping to happen there, so he says doesn't happen or would have happened then. Also pretty much dismissed sharp pain in side of foot that I have had since week two. I think pain is related to boot putting pressure on something in foot. My guess is that there is a freestanding bone (oS Peroneum) in that area located in the peroneal longus tendon. This tendon was cut and sewn to another tendon. From the xray, the bone is now jutting out from side of foot, I think boot is pressing on that bone. Hopefully in a few weeks the pain will stop when I get out of the boot. I hope the pain doesn't happen in normal shoes.

The worst part of appointment was when he said he had thought my arch would havre dropped down a lot more than it had. Made some comments about tendons, spasms etc. I get the really bad feeling that once again a surgeon didn't listen to me and blamed the childhood stroke for the cavus and based his surgery on the 40+ year old stroke symptoms having a major influence on arch shape. He has my X-rays before the CS destroyed my foot and my arch was normal then, not sure why he thinks any after effects from a stroke would suddenly change foot shape forty years later. So he didn't make the bone cuts severe enough to drop my arch back to normal. Hopefully he did enough to help with some of the pain. So if tendons might still be snapping and foot is still cavus, what was the point of putting myself through all this?
12/31/08 - Skiing injury L knee
6/1/09 - ACL stump removed from joint
8/31/09 - ACLr - Hamstring Graft
12/21/09 - Ant Fasciotomy 
8/26/10 - Anterior Interval Release
12/6/10, 5/5/11, 12/22/11 - Fasciotomy
12/7/12 - Nerve Decompression
6/3/13(m), 7/29/13(l), 12/13/13(m & foot) 2/3/14(l) Fasciotomy

Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
Hi Kristin,

I am sorry that once again things are not going smoothly and are not being listened to again properly! Itís a never ending nightmare for you. Take one step forward then take 2 steps back again. I hope you are able still to salvage something out of your last surgery, so you do not have to suffer any longer unnecessarily.

[email protected]
« Last Edit: January 25, 2016, 04:07:35 PM by Clarkey »
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline kcknee

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Re: ACL replacement leading to CS, AF and possible ankle reconstruction or fusion
« Reply #142 on: February 14, 2016, 08:57:47 PM »
Busy week in recovery. I finally was able to put full weight on leg last weekend so now getting up stairs to shower is a lot easier. I've slowly stopped using crutches over course of week. I saw my surgeon on Wednesday and he wants me to keep using boot for at least another week and then switch to sneaker. I am to start PT to try to get more mobility. He was happy that incisions are healed and not much swelling. He is not convinced that snapping with weightbearing is the tendons subluxing but said we need to keep an eye on it. Surgeon did not check me weightbearing. Snapping feels the same now as did pre-surgery. He said he did not think during surgery that he had to cut a groove into the bone to help hold tendons in place, but maybe now I will need to have that done. I guess because my cavus was not corrected enough. I had to stand for about half an hour on Friday to get my son's passport paperwork done, and when I took boot off when we got home I had blood dripping from end of incision on outside of foot. It always hurts there.
12/31/08 - Skiing injury L knee
6/1/09 - ACL stump removed from joint
8/31/09 - ACLr - Hamstring Graft
12/21/09 - Ant Fasciotomy 
8/26/10 - Anterior Interval Release
12/6/10, 5/5/11, 12/22/11 - Fasciotomy
12/7/12 - Nerve Decompression
6/3/13(m), 7/29/13(l), 12/13/13(m & foot) 2/3/14(l) Fasciotomy

Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
Re: ACL replacement leading to CS, AF and possible ankle reconstruction or fusion
« Reply #143 on: February 24, 2016, 06:00:44 PM »
Hi Kristin,

I am glad you are now able to fully weight bear again and are able to have a proper shower once again. The crutches might come in handy still when you are having a bad knee day. The snapping sensation is never a nice feeling to be going through. Hope it does not require further surgery as you been through enough of them already. The bleeding around the incision does not sounds too good! Did you get it checked over properly afterwards.

[email protected]
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline kcknee

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Re: ACL replacement leading to CS, AF and possible ankle reconstruction or fusion
« Reply #144 on: February 28, 2016, 04:07:30 PM »
Thanks Nick. The incision has not bled since, so have not seen anyone about it. It bled from a small round hole, so wondering if internal hardware poked through. There is not much padding in skin below lateral ankle bone and I know he used bone anchors on retinaculum. Snapping has become worse since switching from boot to shoes. Foot only fits in crocs, foot to swollen for sneakers. Others in the room can hear snapping as I walk. Much stronger and more painful than before surgery. I have ordered a pillow that wraps around foot so I can hopefully sleep with less pain. I haven't been able to motivate myself to go to PT yet. I have been through it so many times and have done all the stretches etc. myself. I see surgeon in 2 weeks so have to go to PT this week. At least surgeon will hear snapping, but I don't know if I could handle 8 weeks NWB again after another surgery.
12/31/08 - Skiing injury L knee
6/1/09 - ACL stump removed from joint
8/31/09 - ACLr - Hamstring Graft
12/21/09 - Ant Fasciotomy 
8/26/10 - Anterior Interval Release
12/6/10, 5/5/11, 12/22/11 - Fasciotomy
12/7/12 - Nerve Decompression
6/3/13(m), 7/29/13(l), 12/13/13(m & foot) 2/3/14(l) Fasciotomy

Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
Re: ACL replacement leading to CS, AF and possible ankle reconstruction or fusion
« Reply #145 on: February 29, 2016, 04:14:09 PM »
Hi Kristin,

Sorry you are having yet more setbacks post-op with your ankle/foot problems with snapping sounds is not a sound one wants to hear. I hope it settles down soon so you can finally get your life back together again and several years of pain and discomfort and failed surgeries.

Cannot be easy not just for you but for your family and friends that are seeing you suffering unnecessarily with no end in sight. Hopefully your surgeon can sort it out swiftly with a minor procedure to fix it.

Good luck with your next see your surgeon, he will do all he can to sort out your ankle.

[email protected]
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline kcknee

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Thanks Nick. I also didn't have the best appointment with my surgeon today. (I just responded to your post)  Although my ankle has the telltale signs of a golf ball sized swelling behind the outside ankle bone, I couldn't get the stupid peroneal tendons to snap over the bone during the appointment (it's not a party trick, I don't control it!!), so my surgeon is still not convinced my tendons are snapping. I get it, he needs to see the problem before he can operate, but this has been going on since I was still NWB and time keeps passing. I lost movement in my little toe which he thinks is from a nerve entrapped in scar tissue. He also believes that what I think is snapping tendons is scar tissue or scar tissue forcing tendon into wrong position. He told me he was going to do an injection today into my nerve and by my tendons. No way!! Besides my complete phobia of needles, I feel the tendons snapping which could cause fraying or tears and he wants to inject a steroid in there that can weaken tendons. We agreed that I would find a PT that would only work on any possible scar tissue from the surgery. I will also try to film my ankle when I feel my tendons subluxing over the bone so he can see and hear what is happening outside of his office. He also prescribed lidocaine patches for pain which I hope insurance will pay for.  I go back in 6 weeks, unless I am able to get video proof to him sooner that tendons are still subluxing. He is insisting that the next step is he gets to inject me twice.
12/31/08 - Skiing injury L knee
6/1/09 - ACL stump removed from joint
8/31/09 - ACLr - Hamstring Graft
12/21/09 - Ant Fasciotomy 
8/26/10 - Anterior Interval Release
12/6/10, 5/5/11, 12/22/11 - Fasciotomy
12/7/12 - Nerve Decompression
6/3/13(m), 7/29/13(l), 12/13/13(m & foot) 2/3/14(l) Fasciotomy

Offline kcknee

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Still waiting for PT to start next week. Decided to wait for experienced PT so I wouldn't have to teach foot anatomy like I had to with my last PT. Peroneal tendon pain while walking has been bad. I can barely get up the stairs with horrible pain in my peroneal tendons as well as on top of foot. Top of foot pain and swelling seems to match what I found on Internet for extensor tendinitis.there has been a small bump in my tendons above my ankle bone. I still sleep with pillow wrap around foot.

Today I managed to make things worse, although I don't know what exactly happened or extent of injury. I was walking down stairs one at a time and "tested" my bad ankle on last step to see how much it resisted bending forward. Usually it resists and I go back to bad leg first down the stairs, but today it collapsed forward with a snap/crack. Intense pain and I haven't been able to put any weight on my leg since. Unfortunately, my pain meds and boot are upstairs, but I managed to find my son's old orthopedic boot from when he had sever's in his heel. Not sure if I call surgeon now or wait and see if pain settles down.
12/31/08 - Skiing injury L knee
6/1/09 - ACL stump removed from joint
8/31/09 - ACLr - Hamstring Graft
12/21/09 - Ant Fasciotomy 
8/26/10 - Anterior Interval Release
12/6/10, 5/5/11, 12/22/11 - Fasciotomy
12/7/12 - Nerve Decompression
6/3/13(m), 7/29/13(l), 12/13/13(m & foot) 2/3/14(l) Fasciotomy

Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
Hi Kristin,

I can fully understand why you are reluctant to have further steroid injections in the fear that the tendons will suddenly snap! I am also thinking in the same way with my right knee problems, I will not accept any more steroid injections. The 3 last year did not help to ease any of the pain and discomfort.

It's very hard and frustrating to find an understanding PT that knows how to go about treating less common knee and ankle problems. The PT's I have seen so far have just added to my right knee problems not eased it in any way pushing me too hard. 

Hopefully the collapsing and snap/crack will gradually improve, might be a wise decision to get your ankle checked over by your OS. 

[email protected]
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline kcknee

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Thanks Nick.

I spoke to my surgeon's office yesterday and they wanted me to  get an xray today to see if I had broken any of the screws in my foot. I have had no bone pain so didn't think that was right, but insurance requires xray before mri request, so I agreed.

I was still NWB this morning, but tried touching my heel to floor and found that although I couldn't stand flat foot, I could stand and walk on my heel (in my boot). I went to my SportsMedDoc  and asked him if he would ultrasound my peroneal tendons to make sure no tear or rupture. He said he would do xray too. So, my screws are all still intact and unbroken and I have no tendon ruptures. My peroneal tendons are enormous when compared to my good leg and are filled with fluid, but still intact. I emailed copies of all scans to my surgeon tonight for his review. I didn't think of it at time, but I hope my surgeon can make sense of the ultrasound pictures and figure out if the peroneal retinaculum is still intact and tight enough. I see my surgeon Wednesday. I start PT on Monday, although  I am not sure how much I can do there.

4/13- I saw PT yesterday. She did a full assessment of lower body and took medical history. She said in 32 yrs she had not come across another case like mine, I assured her my surgeons had not either and that is why my leg is in the bad shape it is in. The joint in ball of foot is frozen. She planned on calling my surgeon to find out what she can and can't do along with I am sure checking my crazy medical history story. The PT dept at hospital also offers Graston and I think ART too ti try to break up scar tissue.

I saw my surgeon today. He was happily surprised with my latest X-rays in that the arch of my foot has fallen down a lot and is more close to normal. That might explain why my snapping tendons stopped when the pain in tendons increased. The lowered arch, from continued weightbearing stretching out tissues, would put less stress on tendons so they wouldn't snap as much over bond while the lowered arch would put excess tension on tendons when stretching if they were stuck in scar tissue in tunnel on side of my foot. My surgeon believes when my foot collapsed forward it tore the scar tissue out of the tunnel allowing tendons to glide again. The horrible pain going upstairs has stopped since the fall on stairs, so he might be right. I go back in 8 weeks unless something goes wrong before that. Tendons did snap over bone twice yesterday, do I still am not sure that problem is solved.

« Last Edit: April 13, 2016, 07:08:04 PM by kcknee »
12/31/08 - Skiing injury L knee
6/1/09 - ACL stump removed from joint
8/31/09 - ACLr - Hamstring Graft
12/21/09 - Ant Fasciotomy 
8/26/10 - Anterior Interval Release
12/6/10, 5/5/11, 12/22/11 - Fasciotomy
12/7/12 - Nerve Decompression
6/3/13(m), 7/29/13(l), 12/13/13(m & foot) 2/3/14(l) Fasciotomy