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Author Topic: MPFL surgery and possible MUA  (Read 2138 times)

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Offline ca0394

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MPFL surgery and possible MUA
« on: September 07, 2017, 05:34:10 PM »
Hi everyone,

I'll start at the beginning. My left knee has been dislocating for the past 7 years (I'm now 22) so at the end of June 2017 I had MPFL reconstruction. I was discharged the next day and was told that my operation had went well. note: I was discharged in a full leg cast and this was kept on for 2 weeks.

One week post op I was rushed back into hospital due to severe pain in my side and difficulty breathing,  and they discovered that I had blood clots in my lungs and a chest infection. This was a really scary time, as you never think it will be yourself that will experience these side effects of an operation.

I was kept in hospital for 1 week and discharged after having my cast taken off, I was now in a leg brace that was locked. I was told not to push my knee, and that I would receive physio 6 weeks post op. I'd be on medication for the clots for the next 6 months. When I arrived home I was still really unwell and feeling the effects of the clots (chest pains, breathlessness), so my knee wasn't really my main concern. In hindsight I should have concentrated more on my MPFL recovery, but there's nothing I can do to change that now.

I saw a consultant at the hospital 7 weeks post op (later than anticipated). He told me I had to get my leg moving asap and refered me to physio.

It's now 10 weeks post op. I've had 3 weeks of physio and I am getting about 45 degree ROM. I know I am far behind with my recovery,  but I am making progress slowly but surely. I saw my surgeon today and he has given me a few weeks to get as much ROM as possible or I will need a manipulation under anaesthetic.

I'm really anxious about this due to the complications I had after my op. I feel like everything that could go wrong has went wrong, I'm really struggling to cope, and struggling with the mental side of recovery.. Reading the posts of this website has made me realise that I'm not alone, but it would be great to hear from anyone who has had a similar experience or has any advice.

X
« Last Edit: September 09, 2017, 08:44:58 PM by ca0394 »

Offline Susan17

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Re: MPFL surgery and possible MUA
« Reply #1 on: September 07, 2017, 09:48:06 PM »
Hi X....I am so sorry to hear this. You are definitely not alone. I am behind "the norm" too but magically dodged the manipulation surgery. Before I went to the doctor I sort of prepared for him telling me I had have the knee manipulation. My husband just told me that if I did it would end up helping and I thought that if it had to happen at least it would move me along - though it would suck.

This PT thing is so up and down it's ridiculous. Sometimes I feel like I am on the path to some real results and then I hit a set back and I feel like I am back to square one.

I guess it's just not linear healing. I just want to let you know that I can sympathize with you and am hoping things get better. Let us know.

Susan
6/20/17 - ACL Tear
7/25/17 - ACL Patella Autograft Reconstruction
8/11/17 - Started PT

Offline Brandon123

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Re: MPFL surgery and possible MUA
« Reply #2 on: September 08, 2017, 09:50:07 AM »
Sorry to hear about your experiences, you have had some bad luck indeed. The mental side of recovery (and long term knee issues in general) can be really tough. I haven't gone through as much problems as you have, but can still relate to this. In my experience, it helps to take one day at a time, trying not to focus on all possible negative future scenarios. Just try to get trough the day and do the best you can (with PT, activities etc.), and try to forget about the future. If a manipulation is needed in the future, you cross that bridge when you come to it. And please vent here in the forum and keep us updated, I think it can help you to cope with the situation + sharing your experience is also valuable for others in similar situations. 
RK sharp pain while running, diagnosis chondromalacia patellae 6/09
RK arthroscopic chondroplasty 9/09
RK rehab, recovery, 90% normal, started running again -> back to square one 5/15
RK diagnosis patellofemoral arthritis + LK diagnosis chondromalacia patellae 8/15 -> conservative treatment

Offline ca0394

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Re: MPFL surgery and possible MUA
« Reply #3 on: September 09, 2017, 08:43:52 PM »
Thank you both for replying. I'm sorry you've both been through something similar.

The past couple of days have been really difficult mentally. I'm in a really bad place and I can't seem to stay out of it for very long. I'm just so frustrated by the way everything has been handled. I'm angry that I had to wait over 7 weeks before receiving physio, when everyone else seems to have started it within the first couple of weeks post op. I'm at the point now where I'm ready to just have the manipulation because I need to get my life back.

Aside from the recurrent dislocations, before I had my surgery I had a really good quality of life. I was encouraged to have the surgery to prevent more dislocations and hence prevent problems when I get older (arthritis etc). But I was able to do pretty much anything I wanted. I had complete independence.

I feel like I was completely mislead. I had no idea how hard the recovery would be. And with being so far behind, along with the other complications I've had I really feel like having this surgery was the worst decision I've ever made and it has ruined my life. I've lost all of my independence. My mum and my boyfriend have been there for me 100%, but this whole experience has definitely taken a toll on these relationships.

I'm really trying with my exercises but I feel like I'm getting no where. I'm now 10 and a half weeks post op and I'm worried it's going to be left too late to fix.
« Last Edit: September 09, 2017, 08:55:42 PM by ca0394 »

Offline patriciapatella

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Re: MPFL surgery and possible MUA
« Reply #4 on: September 10, 2017, 07:43:30 AM »
Hi! I'm sorry to hear about your difficulties with the recover. I had my own share of difficulties as well and I'd like to give you hope that you will get better. I had an MUA and I believe it helped with my progress. You can find more details about my experience in my blog: http://www.kristinecamins.com/mpfl-reconstruction-week-5-to-7/

I hope my experiences help with your recovery! And just keep pushing through :) It will get better!
MPFL Diary <-- my MPFL blog

1998 - first experienced bilateral patellar subluxations
1999-2014 - multiple dislocations every year
12/01/2014: MPFL recon of right patella
1/18/2016: MPFL recon of left patella

Offline ca0394

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Re: MPFL surgery and possible MUA
« Reply #5 on: September 11, 2017, 12:29:58 PM »
Thanks for replying and sending the link to your blog. It's reassuring to hear about others who've gone through a similar struggle and came out the other side.

I spoke to my doctor today about having the MUA asap, but as the anesthetic carries risks, and with the complications I've already had they'd rather not put me under again unless absolutely necessary.

I have been really pushing myself with my exercises over the weekend. I've also been sitting with my legs dangling over the bed for as long as I can stand, and trying to walk with one crutch. My leg raises are getting better and I can see my muscle starting to build up again.

I had physio this morning and got to 52 degrees flexion. I'm happy with that as it's a 7 degree improvement in 4 days. I'm going back on Thursday and I'm really hoping to reach 60 degrees.

I should add that I've never used a CPM machine that I've seen a lot of you have used. I'm unsure why I've not been given this option, but my flexion is just from unaided heel slides. At home I've started using a belt around my heel to try and pull past the point I can get to with my leg alone.

The past weekend has been one of the worst of my life, but seeing an improvement has made me feel slightly better. The whole experience is such a rollercoaster of emotions. I just hope that things keep going in the right direction and start looking up again.

Thanks again for your support.
« Last Edit: September 11, 2017, 12:38:10 PM by ca0394 »

Offline ca0394

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Re: MPFL surgery and possible MUA
« Reply #6 on: September 14, 2017, 01:43:21 PM »
UPDATE

Today I had physio again, and I managed to get to 60 degree flexion unaided. I'm really happy as this is what I was aiming for. That's an 8 degree increase in 3 days. I hope it continues to improve at this pace.

I've been doing my exercises around 5 times a day. These are:

heel slides unaided x10
heel slides aided (usually a belt around my heel to pull) x10
pushing my knee down trying to straighten it as much as possible x10
as above, only with my leg turned out to the side x10
with a pillow or rolled towel under my knee, bringing my lower leg up to straighten it x10

I've also been sitting with my legs dangling off the bed for as long as I can stand several times a day. I sometimes use my good leg to push my left one back even further.

It's not been easy, I've been putting myself through a lot of pain to get here but it's definitely worth it. As long as I keep on top of my pain medication it's bearable. .

It's been a week since I saw my surgeon, and although I'm still anxious about the future I can see that I have made a lot of progress this week. I've made a 15 degree improvement in 7 days, I'm letting my legs dangle freely off the bed which I hadn't done before, I'm able to get my leg up onto the bed unaided which I couldn't do before and I'm now walking steadily with one crutch.

I have physio again on Monday and I'm really hoping to reach 70 degrees.
« Last Edit: September 14, 2017, 01:45:19 PM by ca0394 »

Offline ca0394

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Re: MPFL surgery and possible MUA
« Reply #7 on: September 21, 2017, 08:47:29 PM »
Another Update

After a week of feeling more positive and seeing improvements I've had a set back.

On Monday I reached 65 degree flexion, but today I was measured back at 60. I'm feeling really disheartened as I've been continuously working hard. I know it's only a 5 degree set back but it feels like so much more.

After seeing continuous improvement it's hard to see a week with none. Although I'm really trying not to stay down about it, I just feel like I have such a long way to go and even 90 degrees is so far away never mind full range of movement. The thought of more weeks or months passing feeling like this is just horrendous.
« Last Edit: September 25, 2017, 10:20:54 AM by ca0394 »

Offline Susan17

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Re: MPFL surgery and possible MUA
« Reply #8 on: September 24, 2017, 10:04:02 PM »
Sorry to hear this friend. It is like that though. A few steps forward and then some back. My ROM is still only slightly over 90 degrees but when I start my exercises it's like 60 at first. You will get there slowly but surely. I tweak this thing at least twice a week and have a setback even though I am going at a controlled rate of PT.

Best of luck. Keep posting.
6/20/17 - ACL Tear
7/25/17 - ACL Patella Autograft Reconstruction
8/11/17 - Started PT

Offline ca0394

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Re: MPFL surgery and possible MUA
« Reply #9 on: September 25, 2017, 10:20:22 AM »
Thanks Susan. I found out on Friday that I'll be having the manipulation sometime this week. I'm just waiting on the phonecall. I'm feeling okay about it though, I think it's the best thing at this point.

I've not had the best weekend. I decided to try to come off my pain medication (dihydrocodeine) after speaking to my doctor about how these tablets can become addictive. I thought since I'd only been on it for 12 weeks it would be okay. I had been taking 4-8 tablets a day. I didn't expect to have any withdrawals.

Friday-Sunday were really bad. I had cold sweats, a headache, difficulty sleeping,  pains all over my body, nausea and no appetite. I didn't feel any need to take any of the tablets, so it was more just my body reacting physically to not having the medication.

I had researched and a lot of people were saying that the crash is just as hard even if you wean yourself off them. I thought since I hadn't been taking too many anyway, it would be better just to grit my teeth and deal with the withdrawals to get it over with. (note: I'm actually finding that there is no difference pain wise doing my exercises now than it was when I was taking dihydrocodeine, I didn't even need them anymore)

The first day was the worst. I woke up feeling really sick (about 12 hours after taking my last tablet) and the other symptoms came throughout the day. They persisted throughout Saturday. Sunday I was feeling a little better but still not great. And today I'd say I'm feeling pretty much back to normal.


Offline Susan17

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Re: MPFL surgery and possible MUA
« Reply #10 on: September 25, 2017, 05:32:22 PM »
Sorry to hear you had a bad past few days. Glad you got off the meds though. I think the manipulation surgery will be a lot of help. It will sting a bit for a few days after but it will get that scar tissue out for sure. Let us know how it goes.
6/20/17 - ACL Tear
7/25/17 - ACL Patella Autograft Reconstruction
8/11/17 - Started PT

Offline ca0394

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Re: MPFL surgery and possible MUA
« Reply #11 on: October 07, 2017, 12:45:36 AM »
Hey guys just wanted to update you.

I had the MUA and I can honestly say itís been the best thing thatís happened in the past 3 months. I was so scared to have it when the time came, but itís been the best decision Iíve made.

They managed to bend my leg quite easily despite me being 14 weeks post op when it took place. I had read lots of horror stories about ruptures and tears but if anyone is in the same position as me I want to let you know it can be successful.

I was put to sleep and woke up in the recovery room about 40 minutes later. Once the medication had wore off I tried doing a heel slide and could already see I was getting much further than I had been an hour ago.

Surprisingly I had very little pain. I was expecting to be in agony due to what Iíd read about othersí experiences, but it was really quite easy. The first time I stood up I had a bit of pain, but it got much easier the more I did it. I took some stronger pain meds the night of my MUA, but since then Iíve only been taking paracetamol.

I was put on the CPM set at 110 degrees continuously for 24 hours. I didnít sleep at all that night but I thought I could sleep when I got home, as this was more important. It was more uncomfortable than painful, and only really started to get uncomfortable at about 95-100 degrees.

My first physio session went really well and I was easily achieving 100 degrees doing an unassisted heel slide. With help from the physio/a belt to pull my foot I was getting 110.

Iím so pleased with the outcome and I feel like a massive weight has been lifted. I feel like myself again, which I havenít for 3 months. My physio said it was like seeing a completely different person.

I was in a really dark place and genuinely thought I wouldnít ever have a functional knee again. But this has completely changed things for the better. :)

Offline Susan17

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Re: MPFL surgery and possible MUA
« Reply #12 on: October 07, 2017, 03:07:22 AM »
This is amazing to read. I am so happy for you. I can't wait to get there too. This just goes to show that all the reading we do about these things before they happen is just not a predictor of our individual cases.  You worked really hard to get here and you deserve this! Best of luck!
6/20/17 - ACL Tear
7/25/17 - ACL Patella Autograft Reconstruction
8/11/17 - Started PT

Offline ca0394

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Re: MPFL surgery and possible MUA
« Reply #13 on: October 08, 2017, 02:17:39 PM »
Thank you so much Susan. Itís the little things that make all the difference like being able to sit properly on a chair again. I hope itís not long before you get some normality back too. Thank you for your support and the best of luck for your recovery too :)















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