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Author Topic: Recovery Concern  (Read 603 times)

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Offline PwordsB

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Recovery Concern
« on: September 21, 2018, 06:54:47 PM »
Hey, people.

Any thoughts on the following (still two weeks before I can see my surgeon)?

I had a medial closing wedge distal femoral osteotomy and lateral tibial plateau microfracture six weeks ago. All was going well, range of motion got to about 120 with minimal pain. Non-weight bearing for six weeks, with no accidents. Unfortunately, a week ago, as I was moving around I had a horrid crack sort of sensation around the lateral tibial plateau and I couldn't move the leg for two days. I had an X ray to rule out any bone chunks in the joint, but that's all. Since then, the new tibial pain is really strong when I am trying to flex passed about 100 degrees and when I try to come back to extension from there.

The bit that I'm not sure about is... Picture me lying on my back. I can bend my leg all the way to 120 and bring it back quite easily and with minimal pain if I use my hands to support the limb, but when I try it unsupported it cracks, gets stuck and hurts like hell. I don't see why the additional weight from no supporting my leg should cause that much trouble, which is leaving me confused.

Any ideas?

Thanks :)
Snowboard injury 21/01/16
Open cartilage graft (Chondrotissue) 29/06/16
Sub-total lateral meniscectomy, LTP cartilage removal 20/01/17
11mm Closing Medial DFO and LTP Microfracture 10/08/18

Offline Vickster

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Re: Recovery Concern
« Reply #1 on: September 21, 2018, 09:00:03 PM »
Muscle weakness? What does your Physio think?
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline PwordsB

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Re: Recovery Concern
« Reply #2 on: September 21, 2018, 11:25:52 PM »
Muscle weakness? What does your Physio think?

I would have gone for muscle weakness, except that it suddenly became a problem after a single move, rather than gradually.

Physio thinks it's probably just all the weakness and tightness and the ligaments having to adjust to the osteotomy and that kind of thing.

I suppose it has to be something minor because if there was anything in the joint, it would lock with or without the support, it just doesn't feel anything like that nasty atrophy soreness. Hmm.

P.S. Thanks for reading. When I saw there was a reply I thought it would probably be you! :)
Snowboard injury 21/01/16
Open cartilage graft (Chondrotissue) 29/06/16
Sub-total lateral meniscectomy, LTP cartilage removal 20/01/17
11mm Closing Medial DFO and LTP Microfracture 10/08/18

Offline PwordsB

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Re: Recovery Concern
« Reply #3 on: October 01, 2018, 02:33:09 PM »
Muscle weakness? What does your Physio think?

Hey, Vickster. Quick question, if you don't mind. This sort of stuff doesn't matter to everybody because it's so taxing in the soul to consider, but I really did lose everything to this injury and everything that I get wrong knocks another activity off the list of things I'll ever manage again (the list already lost all of the things I want to spend my life doing).

The above issues has continued to worsen, fewer motions are tolerable. I'm seeing my surgeon on October 10th and I suspect he will say it's probably muscle weakness and tell me to wait another three months and see. From my perspective, I can feel something moving in there and the pain is far too familiar to me to be muscle wastage. So in preparation for seeing him, and trying to push for an MRI to have a look or something, does this make sense to you:

In hydrotherapy, I am able to perform single leg squats at about waist high water on the operated leg. Since this is FAR more demanding of strength than a simple seated leg extension, it can't be a lack of strength in the quads or surrounding small muscles causing the problems. I've also tested the hamstrings and hip flexors and they're doing great.

I know it's not necessarily comparable because the glutes are so involved in a normal one legged squat, but my body and I have built up a great relationship over a life filled with more exercise than anything else and I can feel plenty of strength (relative to my situation) in my leg.

I know I'm trying to get awfully technical at this point, I'm just desperate to get the best result I can, as this is very probably my last chance before a knee replacement catches me, and at 28, I don't fancy low quality injections to try to help until someone thinks I am old enough to have a knee replacement.

Any thoughts? All responses welcome :)

Thanks
« Last Edit: October 01, 2018, 02:40:16 PM by PwordsB »
Snowboard injury 21/01/16
Open cartilage graft (Chondrotissue) 29/06/16
Sub-total lateral meniscectomy, LTP cartilage removal 20/01/17
11mm Closing Medial DFO and LTP Microfracture 10/08/18

Offline Vickster

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Re: Recovery Concern
« Reply #4 on: October 01, 2018, 02:45:06 PM »
What does the Physio say?

Also, now you have a load of metal in your leg, wonít an MRI be unreliable due to artefacts?

Youíre still v soon after a major op. 6 or even 12 months would be a better time to fully assess presumably
« Last Edit: October 01, 2018, 02:48:59 PM by Vickster »
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline PwordsB

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Re: Recovery Concern
« Reply #5 on: October 01, 2018, 02:50:54 PM »
What does the Physio say?

He said that it's either fine or not fine but my focus should be to build strength. I agree with him, but I need to do it smartly. I have a very low amount of respect for physiotherapists because they have only ever worsened my condition, even when I've paid for them.

I am not sure about MRI scans. I have had a fair bit of cartilage bashing going on so they're already pretty unreliable.  I can't imagine all the metal will help!

Yeah, many more months before I have a clue what has worked really, it's just that it felt so good and then after a crack, it got a lot worse. Got me awfully worried!
« Last Edit: October 01, 2018, 02:56:58 PM by PwordsB »
Snowboard injury 21/01/16
Open cartilage graft (Chondrotissue) 29/06/16
Sub-total lateral meniscectomy, LTP cartilage removal 20/01/17
11mm Closing Medial DFO and LTP Microfracture 10/08/18

Offline Vickster

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Re: Recovery Concern
« Reply #6 on: October 01, 2018, 02:57:16 PM »
Are you seeing someone recommended by the surgeon? Thatís the way Iíd go after major surgery
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline PwordsB

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Re: Recovery Concern
« Reply #7 on: October 01, 2018, 03:05:45 PM »
Are you seeing someone recommended by the surgeon? Thatís the way Iíd go after major surgery

No. Just the one who was there at the time. I haven't had the privilege of getting to speak him yet and when I sent him a few questions he said I should speak to him in person. So still waiting on that. It's infuriating how hard it is to see the guy even after this sort of surgery. I'll add that to my list of questions. I would absolutely love a decent physio to assist me :)
Snowboard injury 21/01/16
Open cartilage graft (Chondrotissue) 29/06/16
Sub-total lateral meniscectomy, LTP cartilage removal 20/01/17
11mm Closing Medial DFO and LTP Microfracture 10/08/18

Offline Vickster

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Re: Recovery Concern
« Reply #8 on: October 01, 2018, 03:10:18 PM »
Unfortunately, thatís how it is with the NHS. Youíre young and fit, the majority of his patients are probably elderly and frail with a need for far more input. Also, once ortho surgeons have done the carpentry, itís up to the rest of the MDT and more importantly the patient to do the recovery

Recovery is going to be slow to start, never linear. Hopefully, a time will come when you are less focused on the knee but thatís probably a year or two away.

Talk to your GP about pain management if you think you need to. If something hurts, simply back off and try something else. Need to be patient, as frustrating as it is

Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline PwordsB

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Re: Recovery Concern
« Reply #9 on: October 01, 2018, 07:21:50 PM »
Patience... these bloody knee injuries act like we have an infinite supply of the stuff to pour all over them.

Thanks for your input, V.

Have a good night!
Snowboard injury 21/01/16
Open cartilage graft (Chondrotissue) 29/06/16
Sub-total lateral meniscectomy, LTP cartilage removal 20/01/17
11mm Closing Medial DFO and LTP Microfracture 10/08/18

Offline Vickster

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Re: Recovery Concern
« Reply #10 on: October 01, 2018, 07:23:31 PM »
Yep I'm 9 years in...but I've had a knackered elbow, shoulder and now my back to distract me  :o :o

Good luck for your appointment on the 10th. I'd definitely get a physio recommendation from Prof Snow
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up