Post ACL reconstruction problems

[Nicolas_]

Hello,

my name is Nicolas I'm 23 years old and I've tore my acl in June 2020. In July I had ACL reconstruction surgery. After that I've been training my ROM and muscle strength daily for about 2-3 hours + physical therapy. Unfortanetuly I was only able to achieve flexion of 100 degrees and there was lack of extension. Because of that in November I had a scar tissue removal surgery. Right now - over 1 month post op my flexion is still the same but extension is a little bit better, still not full and no hyperextension (despite all the training and rehabiliation which I did a lot).

I'm gonna see my doctor soon but I wanted to ask you if anyone had been in a similar situation or might have any idea what is wrong with my knee and would like to share their knowledge.

[RenatoSN]

Hello,

I am 27 years old and had ACL reconstruction on my left knee in 2008 and on my right knee in 2013.
My left knee is perfect, never felt much pain, even when I injured actually and have full mobility.
The other knee was different. felt a lot of pain and lost ROM since i hurt it.  Recovery was very painful and really hard to restablish movement. The doctor just said that each recovery is different (was the same doctor both operations). After a some months phisiotherapy and a lot of pain forcing the leg to bend I`ve reached an ok ROM (I could walk, sit and do almost anything with no pain) I used to weight lift before injury and continued after, as the doctor recommended also and reached to a point where I could do bar squats normally with no pain. Although my knee still felt stiff like a mechanism without oil I could forced it to bend until my anckle almost touch my butt.

In all those years I've noticed that if I stay without moving my leg for some hours it hurts to extend it back and to flex it too.
If i force too much it hurts the next day also. I was living with it until some days ago after I spent some days mostly sitted working, didnt stretch or made any exercise exept walking and woke up with pain on my knee and loss of ROM (less of what i could do before) and decided to go cycling ( i used to cycle once or twice a week with no pain). This time i went further than ever and when i started to go back my quad started to hurt and my knee also a little. When i got home i got so frustrated seeing the how it is so hard to gain mobility back and how easy it is to lose again. So I decided that i wanted to go to the doctor to see my knee again if there is something that can be done and started researching. I finally discovered a condition that explains exactly what i feel. The name is arthrofibrosis. It is scartissue in excess created after surgery. It causes loss of ROM and pain to move the knee in some cases.

I am reading about it and I am anxious to go to a doctor, make exams and know if surgery would treat it.

As you asked, i recommend you to keep stretching and exercising many times a day. If it is swollen and hurts puts a lot of ice on it. You should avoid inflamation at all costs since it triggers creation of scar tissue. I think you can still gain movement since your surgery was just a month ago. So keep your head up and keep treating.

Please update afterter you went to your doctor.
I am very interested to know about the recovery and success of scar tissue surgery since i may have to do it also.

[RenatoSN]

This video explains the condition very well:

https://www.kneeguru.co.uk/KNEEnotes/videos/what-arthrofibrosis

I've found in the arthrofibrosis section of this forum.
You could get more information there too.

[Holly23]

I also have problems many years after an ACL reconstruction.  Could Arthrofibrosis be the cause?

I have an obvious lump of scar tissue under my knee, where the hamstring was attached, I have reduced range of movement- -it's uncomfortable to sit cross legged for example.  But my main issue is pain throughout the muscles and fascia on that side of my body - ITB, Psoas, hip, lower back, all the way up into my shoulder and neck, even into my head and face, and going down the side of my leg to my foot and into my ankle.

I feel like, over the years (had my ACL in 2012) everything has just tightened up.  Could all these issues be caused by my kneecap being pulled too tight, by arthrofibrosis? 

[vickster]

Have you followed up with a knee specialist? Physio?
Had a scan?
Nerve tests?

[Holly23]

Hi Vickster,

No one seems very interested in my theories!  I have mentioned it to physios and similar. I get the feeling they think some pain is to be expected after a knee op.

I'd love to have a scan but there's zero chance of getting a referral from my doctor.

Any ideas how I could see a knee specialist or get a scan privately?  Anyone that would actually listen?

[vickster]

Are you in the U.K.?
If you identify a knee surgeon you would like to see privately, contact their secretary to make an appointment, you may need a referral from your GP but that should really be a formality.
The first appt might be virtual but now with Covid most Consultants are seeing new patients and face to face. If s/he thinks a scan if required, they’ll provide a referral. The cost of scans does vary depending on where you are based, what facilities are around. In my experience, independent scanning sites tend to be cheaper than getting at a full service private hospital.
Presumably you don’t have private insurance through work and will pay out of pocket?

If not in U.K., things may of course be different!

Your knee op was 9 years ago, any post of pain should be long gone unless there were complications. You maybe have other damage in there, either from the op, further injury or the passage of time.

If in U.K., the Bupa Consultant finder is a good resource with names, specialism and secretary details (it’s not just for Bupa members).
If self paying, I would personally find a surgeon who also has a sizeable NHS practice in case surgery is needed. Many will be prepared to refer you to their NHS list although you could have a very long wait for non urgent treatment due to Covid backlogs (big backlog in orthopaedics).

https://finder.bupa.co.uk/Consultant/search/?qn=&giottoFormFlag_consultant=1&hospitalSwiftId=170677&first=1

There aren’t many knee surgeons with an arthrofibrosis interest in the U.K., maybe find a ligament specialist in the first instance. There’s a global list here, by no means comprehensive though

https://www.kneeguru.co.uk/KNEEnotes/primers/whos-who-knee-surgery/whos-who-anterior-cruciate-ligament-acl-surgery

The forum has a database too
https://www.kneeguru.co.uk/KNEEnotes/knee-surgeons/knee-surgeons-europe/knee-surgeons-uk

[riley2388]

hi i’m a professional football who is 7 months post acl and lateral cartillage repair surgery, 7 weeks ago i underwent am arthroscopy to remove a cyclops lesion and remove all other scar tissue also a small lateral tear of my meniscus, i was told i would be back running by now and my knee does not feel good i get a lot of stiffness and aching of the knee after a leg weights session, do you think my knee is able to resume everyday professional sport

[vickster]

That’s really something to discuss with your healthcare team, presumably as a professional sportsman you’re working daily with physios and conditioning coaches, plus of course your surgeon who will be experienced in treating elite athletes.
There’s no such thing as a normal or typical recovery after surgery, everyone is different in terms of how and how quickly you can recover. Just follow your physio and surgeons instructions.

[LimpingLuis]

Hello,

my name is Nicolas I'm 23 years old and I've tore my acl in June 2020. In July I had ACL reconstruction surgery. After that I've been training my ROM and muscle strength daily for about 2-3 hours + physical therapy. Unfortanetuly I was only able to achieve flexion of 100 degrees and there was lack of extension. Because of that in November I had a scar tissue removal surgery. Right now - over 1 month post op my flexion is still the same but extension is a little bit better, still not full and no hyperextension (despite all the training and rehabiliation which I did a lot).

I'm gonna see my doctor soon but I wanted to ask you if anyone had been in a similar situation or might have any idea what is wrong with my knee and would like to share their knowledge.

The same thing happened to me. Had an OATS, then a lysis of adhesions 4 years later which didn't work (have full flexion but a lack of extension). No amount of exercise or streching fixed my extension issue.

Hopefully you get your extension back. But if you don't, you have a serious problem that you need to address right away. Don't wait like I did.
 
Go to the "Soft Tissue Healing Problems - Arthrofibrosis" board and post there. Unfortunately arthrofibrosis is poorly treated by the medical community, and many have had the same experience as you and I. Most recommend to travel to an arthrofibrosis specialist if you have recurring arthrofibrosis.