Muscle loss after ACL surgery?

[kiaran95]

Hi, I had ACL reconstructive surgery on the 15th of September, my recovery is going very well as I am virtually painless, have almost full ROM back and can fully extend my leg.

But i've noticed that I've lost a lot of muscle in my right thigh (operated leg) visually, when I tense both of my thighs the difference in size between the two is very noticeable. I did expect to lose some muscle but I was not expecting a massive visual loss.

I have no trouble lifting my legs, bending or any trouble doing any of the exercises given to me, but visually my right thigh looks depleted, is this normal?

If anyone can help me out that would be appreciated.

[Snowy]

Yes - unfortunately very rapid muscle atrophy is one of the things that has to be contended with post-surgery, given the early limitations that are required to protect the graft as it heals.

Keep doing your exercises, and as you're able to do more you'll find that the muscle mass gradually returns. But this will take time. Once you're far enough on in rehab to be stressing the knee a bit more, get your physio to work with you on a specific strengthening program. That will help you rebuild the muscle ready for your return to full activity.

Sounds like everything else is going well for you - good luck with your recovery!

[mjeffrey]

Hi Kiaran95

Consider diet. Nutritional requirements go up when you are injured and recovering.

I wrote in detail here.
http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=64635.0

If you can afford to gain a weight, try overeating, this will reduce muscle wasting. Otherwise increase protein percentage and keep calorie intake the same.
If the PT allows it, I also used an electrical muscle stimulator to try to retain muscle mass. Mine was expensive but you can get reputable ones (some people bought Omron) for $100.

good luck
Mark

[mjeffrey]

(Cross-posted in Knee breaks forum)
Interesting article on supplementing with protein for older patients undergoing TKA:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3809795/

After 2 weeks patients receiving protein had 3% muscle atrophy versus 14% for the placebo group. At six weeks it was 6% versus 18%.

TKA patients receiving placebo exhibited greater quadriceps muscle atrophy, with a –14.3 ± 3.6% change from baseline to 2 weeks after surgery compared with –3.4 ± 3.1% for the EAA group and a –18.4 ± 2.3% change from baseline to 6 weeks after surgery for placebo versus –6.2 ± 2.2% for the EAA group

EAA = Essential Amino Acids (essentially protein, composition given in text)
Participants took the supplement after exercise.

Conclusion. EAA treatment attenuated muscle atrophy and accelerated the return of functional mobility in older adults following TKA.

I'd be interested to see a similar study for younger open knee surgery patients.

[DontCountMeOut]

Muscle loss is part of it. Being a college volleyball coach for many years I've seen my athletes lose muscle mass on the leg they had surgery. But they gained it back.

Now, I had ACL surgery 4 months ago. I had a total weight loss 25 lbs. My leg shrunk so much it was scary. I took pictures comparing both of my legs. But as the previous poster said, keep up your exercise and eat healthy.

[terrifickmb]

i had surgery on my right knee on the 17 th of september, had a big chunk of broken loose cartilage removed and a lateral release. i too can lift my leg no problems, rom isn't great i can get to about 80 degrees, but i have hollows where i used to have large very tight muscle along the outside of thigh, itb area and the inside left of my shin bone.