3 1/2 months after OATS, grinding and popping coming from knee

[brobb129]

Hello,
I had an allograft done after a failed microfacture to repair torn cartilage under my left knee cap.  This was done almost 3 1/2 months ago in early December '14. 
For an idea of how my PT went: For about 2 weeks my knee was locked straight in a brace and then afterwards in another brace where I was only allowed to bend to a max of 60 degrees.  The pain was pretty bad the first few weeks, mostly when lifting my leg.  PT started the Monday after my surgery and mostly involved straight leg lifts in all directions and bends to the point I could tolerate.  For weeks, bent leg extensions were extremely painful.  I remember the first exercise they had me do was to stick a basketball under my knee and had me do a couple quad extensions.  I told them it was so painful that it wasn't happening, LOL.  They backed off of that and didn't try again for another month.  After the second brace came off at about 6 weeks I walked with one crutch.  At that point I was allowed to bend past 60 degrees and progressed at about 10 degrees every weeks until I hit 95 degrees.  I hit a wall.  It was extremely painful when they tried to push me past 90.  The doc told me to take 2 weeks off of therapy and take 2 aleve twice a day with tylenol.  After 2 weeks, I came back to therapy.. made it to 112 degrees easily with no pain.  That was a couple weeks ago and now I can't get past 115.  It's still very painful when they try and push me past that limit.

For about 6 weeks (minus the 2 weeks I was told to refrain from PT) they had me do light squats and step ups.  2 weeks ago after doing some squats in PT, I noticed I can feel some grinding and hear some popping when my knee moves into full extension.  It's noticeable in both directions and there is no pain when I move it.

My question is:  at this time, almost 4 months in, is this normal?  My doc does not seem to be concerned but did not give me specifics as to why I should not be concerned.  Is this part of the healing process?  At no point, before the microfracture or after.. have I ever had any sound or feeling like this in my knee and it's kind of scary.  My previous symptoms and some pain and swelling which impeded my range of motion after using my knee for any period of time.  Could this be scar tissue that still needs to break up?  I would appreciate any advice from any one who has had a similar surgery. 

[hiitsali]

Hi!  I've been told that clicking and stuff like that is normal because the cartilage needs to "resurface" itself while in motion.  My surgery was on the MFC so maybe it's different but I'd bet it still applies

[WeenietheWarriorPrinces]

I think we are pretty much in the same boat! I had an OATS( except autograft) performed Nov '14. Mine is on my MFC. I had a previous microfracture June '14 and March '13(also had patella microfracture and lateral release this time). i can only go short distances inside without a crutch or cane and still need it outside and on uneven surfaces. My knee also makes a LOT of noise. It is SLOWLY improving. My dr said that as long as it doesn't hurt when it pops and grinds than it is ok. It needs to resurface. He also said it can take up to 2 years to fully heal! Everybody heals a little differently. So yes you are in the "normal" range in my opinion. Keep strengthing the quads and hang in there!!!

[hiitsali]

Hey WeenietheWarriorPrinces!  We're in really similar situations, I had a 2.8 cm diameter allograft to the MFC (7.84 cm2) on March 18th 2015. You're still sorta kinda on crutches (if I did math correctly) ~6 months after surgery?  I'm 12.5 weeks post op and just had to change physical therapists (I'm a college student, term ended and I went home), and my new PT was very surprised that I'm still reliant on crutches.  How long was it until you could walk short distances without pain?  I didn't think I was that far form the norm, but my physical therapist was really concerned.  It's still pretty painful to put more than 50% of my body weight on it right now, but I have almost a full range of motion (132 degrees).  I don't see my surgeon again for another 2.5 weeks, but I'm considering calling to clarify the difference in opinion between PTs.  Also, did your leg ever turn blue/purple/grey/look like a dead leg after surgery?  When I stand for more than five minutes or so it starts turning purple and splotchy and progresses to look what I call dead haha.  Sorry for all the questions!  I just want to ditch the crutches so badly!  Thanks!

[WeenietheWarriorPrinces]

Sorry for taking so long to reply. It took me almost 7 months to get off crutches. It has been 8 months and at times IO still use a cane on long trips and uneven surfaces. I am nowhere near walking over 2 miles I was before the car accident. However most people do not have 2 microfractures and an OATS in a little over a year and a half on the same spot. Also I was on still on crutches from a failed microfracture at the time of the OATS. Because of all of this I have disuse osteopenia and some ankle issues that delayed me coming off the crutches. Everyone is different and we heal at different rates. I still have popping and clicking and as I increase my bend with weight bearing exercises it gets more noticeable. I think this is because of the resurfacing it has to do. My OS has said as long as it isn't painful it is okay.
   Yes, my leg has turned colors and will also get really cold to touch compared to the rest of my body. This is "normal" when you don't use your leg like it is designed to be used. My OS said it is the blood vessels getting confused and out of whack. This has gotten better as I have increased activity and weight bearing. However this past week it has acted up more than usual and I am not sure why. I am just figuring that it is like all other healing and a step back every now and then. The best I can tell you is take it slow and be patient. That is best for long term out come. If staying on crutches an extra few weeks means no new procedures for several years it is worth it to me! It sounds like you are right on tract with healing. hang in there! (When I had the first microfracture I was on crutches for 4 months)
Hopefully you are reading this crutch free and with less discoloration and knee noises!
Weenie

[Jakedasnake91]

Hey just had the same procedure and I having the same issues, wondering how it all turned out for you? Sorry I know this was posted years ago but figured I would give it a shot lol