Banner - Hide this banner





Author Topic: Arthroscopy with Fat Pad Impingement Trimming Surgery & Recovery  (Read 924 times)

0 Members and 1 Guest are viewing this topic.

Offline RyanC

  • MINIgeek (20-50 posts)
  • **
  • Posts: 42
  • Liked: 2
  • On a mission to run again
Re: Arthroscopy with Fat Pad Impingement Trimming Surgery & Recovery
« Reply #30 on: March 28, 2021, 08:33:57 AM »
Week Sixteen & Seventeen

During the past 2 weeks I have seen some improvements in my knee. I don't feel like it is quite as good as what it was about a month ago before it flared up but it certainly isn't as bad as the week after it flared up. I really haven't been doing much rehab and am noticing that my legs are getting really quite weak which is a bit concerning.

I got a sports massage a couple of weeks back. I was feeling like the muscles down the side of my leg, both above and below the knee were quite tight and getting sore. I paid AUD $60 for the 30 minute massage. It wasn't too bad, probably won't get another one for a while but this guy was also a physio and was giving me some exercises I could try. I told him it was hard for me to do any kind of quad exercise but he said that I should be trying to focus on any muscle in the legs/glutes that I could work out without it putting pressure on the knee. He got me to do some 'hip thrusts' with about 20kg on my stomach and it felt good. Since then, I have been going to my gym and just trying to work out most if not all my leg muscles. At the moment I can do:

  • Calf raises on the machine with quite a bit of weight
  • Hamstring curls with quite a bit of weight - this one feels a little iffy on the knee
  • That adductor one where you pull in with the groin and can switch it to push out with the hips
  • Quad leg extensions with low weight, but I essentially go from a straight position, bend my knees only about 15 degrees then back up again, any lower and I know ill flare my knee up
  • Pelvic thrusts with about 40kg on my lower stomach for my glutes
  • There is this squat machine thats on a bit of an angle that I seem to be able to do. I do no weight on them but squat down, hold for 10 seconds and then come back up

There seems to be quite a few exercises I can do without flaring the knee up so hopefully a month or two of this and my legs will start to get a lot stronger and help with the injury. Thats all for these two weeks!

TL;DR:
Knee feeling a bit better. Got a sports massage and was pretty good. Guy was also a physio and gave me some exercises to do. I have been in the gym working out every leg muscle I can without flaring up my knee.
Ryan from Adelaide, South Australia
23/11/2020 - Right knee arthroscopy: Fat pad impingement trimmed and minor chondral breakdown tidied up

Offline RyanC

  • MINIgeek (20-50 posts)
  • **
  • Posts: 42
  • Liked: 2
  • On a mission to run again
Re: Arthroscopy with Fat Pad Impingement Trimming Surgery & Recovery
« Reply #31 on: April 19, 2021, 02:25:36 PM »
Week Eighteen, Nineteen and Twenty

I haven't posted in a while so I'll give an update for the last 3 weeks. The last three weeks have been up and down. My knee is just so irritable. One day it feels quite good, I am walking around the office with little to no pain; sometimes it stays like this for a few days, and then it just seems to flare up a bit and is sore/achy, the muscles around it are sore etc. I haven't really been able to figure out a pattern or what exactly flares it up, but I just seem to go in these cycles. It is about 5 months post operation now, which seems to be a long time. I don't know at what point I can say, 'the surgery didn't work' and now I have a really irritable knee, or whether its still recovering.

A few weeks ago, my left knee (my good knee) was starting to hurt in the exact same spot as my right knee. Obviously this made me pretty concerned as this was my good knee. I had been neglecting my left knee as all rehab etc was done on my right. I haven't been running obviously so my left has gotten quite weak. I have been continuing my rehab at the gym and have been making sure I work out my left knee as well. At the time of writing this, the pain in my left knee has gone away. This has got me thinking though, maybe a lot of my knee pain is caused by very weak muscles rather than irritation of the fat pad, or the weak muscles make it easier for my knee to flare up. So I have been getting into the gym quite a bit over the last three weeks and been doing rehab on both legs, doing the exercises I listed in my previous post. I am definitely getting stronger and am able to left more and more weight. I am still trying to take it easy though. Any sign of knee pain, especially on the leg extension machine or the squat machine I will stop.

So I guess the plan for the next couple of months is to try and build as much strength in my legs as possible without flaring it up too much. I am not convinced that my knee is completely settled since the surgery and I am reluctant to even consider a second surgery any time soon. I think even if I flare up my knee a little bit doing rehab, the benefits from the strengthening might be worth it!

TL;DR:
Knee up and down still. Left knee (good knee) starting to hurt in the same spot. Getting back into rehab and working out might left at the same time. Left knee not hurting anymore. Still taking it easy with the gym leg exercises and plan to continue over the next couple of months
Ryan from Adelaide, South Australia
23/11/2020 - Right knee arthroscopy: Fat pad impingement trimmed and minor chondral breakdown tidied up

Offline silver_maple

  • MINIgeek (20-50 posts)
  • **
  • Posts: 37
  • Liked: 4
  • Protect your knees
Re: Arthroscopy with Fat Pad Impingement Trimming Surgery & Recovery
« Reply #32 on: May 02, 2021, 07:05:31 PM »
Ryan, there is one California-based knee doc who has quite a following on this board. His name is Scott Dye. On the question of post surgery recovery he states the following:

[...] it can often take up to 18 months or more to achieve full joint homeostasis/healing following even minimal surgery. All concerned need to respect this principle.

As previously stated, healing is a “rate-limited” biological phenomenon analogous to the maturation of a fine French Bordeaux such as a Château Lafite Rothschild. Eight to ten years are required to create a drinkable vintage from the initial grape juice. The vintners understand the chemistry (to a degree) but they don’t control it. They cannot make a palatable wine in a week, month, or a year. Similarly, we cannot “accelerate” restoration of joint homeostasis/healing.
Each knee must take its own unique time. Therefore, patience is a virtue in this clinical setting.


Ref: Dye SF, Dye CC. An overview of patellofemoral pain—from a tissue homeostasis perspective. Ann Joint 2018;3:61.

Please keep updating us. I for one read each installment of your progress with great interest.
2019 - Chondromalacia patella gr 1-2, both knees; early bilateral tibio-femoral arthritis; another 5mm focal lesion; partial meniscus tear (right knee)
2020 - PRP x3 in right knee
2021 - PRP x2 in right knee

Offline RyanC

  • MINIgeek (20-50 posts)
  • **
  • Posts: 42
  • Liked: 2
  • On a mission to run again
Re: Arthroscopy with Fat Pad Impingement Trimming Surgery & Recovery
« Reply #33 on: May 05, 2021, 08:59:51 AM »
Twenty-one & Twenty-two

Hi All,

I went to the surgeon about a week ago for my five month post op check up. I explained to him that I am still getting a lot of pain in my knee and that I don't really feel like it is getting better and that it is worse than pre-operation. He basically explained to me that if it is not better now, then this is how my knee will be... which was obviously pretty hard to hear. I do tend to read different things online i.e. many people say 6-9 months to heal, others say 18 months so I am trying to stay optimistic. He has gotten my to do another MRI and we are going to go from there. I am very very reluctant to have another surgery. He said he can basically do the same surgery but give cortisone injections at 2 and 4 weeks to change the healing process. This is something to consider, but as I said, I am very reluctant to do this and will most likely be looking to wait at least 12 months after surgery to consider another.

In terms of symptoms/how the knee is going, these past two weeks have not been too bad and I have seen some very slight improvements in my knee. Long story short but I was at a friends birthday party and got chatting to a girl who is a physio. We immediately had plenty to talk about and she was keen to listen and give me some advice. I briefly explained all of my symptoms (including a new one - both of my knees seem to get sore, below the kneecap, when I sit for too long) to her. She told me that I should stretch out my quads and also really focus on trying to strengthen my glutes. So that is what I have been pretty much doing. I have noticed that when I stretch my quads, its quite tight in my knee when I get my foot very close to my glute muscles. I get a bit of a sharpish pain above my kneecap on the right side when I do it. I have also been doing that stretch, on the ground on my side and pushing down on my right leg that I am stretching to really stretch out my ITB. That sharpish pain about my kneecap is more pronounced when I do that. It is a bit painful, and is sore after I come out of the stretch, but it seems to free up my knee a bit. I have also been doing the glute 'hip thrusts' at the gym which have been pretty good.

As I mentioned my knee has felt slightly better. I even went down to the beach on sunday morning, after knee rehab and went for a bit of a walk (on the concrete) and it was the first time in a very long time that I was just walking a long completely pain free. I also feel like I have slightly more stability in my legs and have put on about 2-3kg in the past month or so. This weight definitely has to be leg muscles as my diet has not changed and I have not been doing any upper-body weights. As I am writing this though, which is about 3 days after this week has finished, I feel like my knee has gotten a bit worse but I will update that in the next post.

On another more positive note, I have been absolutely desperate to play sport for the past year but just haven't been able to. I have started to get back into indoor bouldering and have been doing yoga and my usual bike riding, but I also enquired about a local wheelchair basketball league. There are casual games on Tuesday nights at 6:30 and 7:20pm with a skills session beforehand. I ended up giving it a go two weeks ago and absolutely loved it!! I had no idea what I was doing but kind of got the hang of it after a bit. I have now played 3 games for my team 'The Demons'. It's a great feeling walking into a sports centre on a chilly autumn night and playing some sport. It has really helped with my overall mental health around the situation as I can sometimes get quite sad about my knee issues.

Finally, I plan on continuing with rehab. At the moment, I am getting down to the gym about twice, sometimes three times a week and doing a pretty intense leg workout. I am starting to be able to lift heavier and heavier weights. In saying that, my legs are still pretty weak, and over a year of minimal activity/injury cannot be made up in a month or so, so I have to stick at it. I am very curious to see how my knee is after 2-3 more months of rehab.


TL;DR:
Saw the surgeon, told me that my knee probably wont get any better as it has been 5 months. Having another MRI to see if he can see anything. Very reluctant to get another surgery. Knee going OK, some improvements. Been stretching quads/ITB and focusing on glutes at the gym which I think is helping a bit. Have put on 2-3kg from doing rehab in the last month or so. Started playing wheelchair basketball and absolutely loving it, great feeling to be playing some sport again. Will continue with rehab as usual
« Last Edit: May 08, 2021, 06:13:21 AM by RyanC »
Ryan from Adelaide, South Australia
23/11/2020 - Right knee arthroscopy: Fat pad impingement trimmed and minor chondral breakdown tidied up

Offline RyanC

  • MINIgeek (20-50 posts)
  • **
  • Posts: 42
  • Liked: 2
  • On a mission to run again
Re: Arthroscopy with Fat Pad Impingement Trimming Surgery & Recovery
« Reply #34 on: May 07, 2021, 09:06:08 AM »
Hey silver_maple,

Thanks for checking in and thank you for that information. That paper is reassuring to my situation! I feel like I have always been a slow healer. It's almost like it is quite hard for me to get injured i.e. I played years and years of sports without even a pulled muscle (well up until I was 28), but when I do get injured, it takes me a while to get better. I think back to when I rolled my ankle, it took me a good 6 or so months to stop feeling any pain where I rolled it, which I think is longer than usual.

I'll try and keep posting here, I myself like to look back when I feel like I am making no progress and see where I was. If anyone else is reading in say hi as well!

Regards
Ryan
Ryan from Adelaide, South Australia
23/11/2020 - Right knee arthroscopy: Fat pad impingement trimmed and minor chondral breakdown tidied up

Offline RyanC

  • MINIgeek (20-50 posts)
  • **
  • Posts: 42
  • Liked: 2
  • On a mission to run again
Re: Arthroscopy with Fat Pad Impingement Trimming Surgery & Recovery
« Reply #35 on: May 09, 2021, 08:08:28 AM »
Week twenty-three

Hi everyone,

This week has been up and down but overall positive. I had quite a good week the week before this one, but at the start of this week, my knee was feeling quite achy and sore, which was disappointing. Then it seemed to turn and it was feeling OK for the rest of the week. I have been continuing with rehab, I think I have got down to the gym about 3 times this week and I am definitely getting stronger. I will put up a picture of my right leg compared to it about 3-4 months ago, my quads are certainly getting bigger! Realistically, my legs are still quite small to what they were back in my mid 20's. I've always had really quite chunky strong legs so I think there is still a long way to go. Also, I am sitting at about 80kg at the moment. My baseline weight when I don't work out is about 82-83kg. I think this means that there is still a lot more muscle for my legs to gain.

I also saw my surgeon on Thursday regarding my MRI results. There hasn't been any new injuries/damage since the surgery. He said that it looked like there was still a level of inflammation inside of my knee from the surgery. I will add some images from the MRI. The first one is what my surgeon showed me when he said there was still some inflammation. He also mentioned that I had a bit of an abnormality with the the protective coating (cant remember the technical name) on the under side of my patella. He said that the coating is missing on the bottom part of my patella which might be causing some of the pain in my knee, especially when my knee is at 30% flexion and under load. He was saying that there is a surgery that he can do that can shorten the patella tendon so that the part of the patella. He wasn't really suggesting doing that surgery, I think he more meant if in a year or so things aren't getting better or have gotten worse then that could be something to look into. As I mentioned in previous posts, I am very reluctant to have another surgery and am certainly looking to wait at least 6 months if not 12 to rethink what I can do. It is a bit promising that there is still some inflammation in my knee as my knee is yet to recover fully from the surgery. I am still remaining optimistic that with more time and rehab, I can get my knee back to a point where I can live pain free throughout the day and get back into running. I am not too concerned if I can never play sports again that involve running, but being able to go for a jog would be awesome!

Not much else for this week, I will try and check back in about a week.

Ryan


TL;DR:
Up and down. Little achy and sore at the start of the week but got better. Continuing with normal rehab. Have put muscle on my right leg but still a way to go. I am still about 3 kgs of my baseline weight. Saw the surgeon for my MRI results. Showed nothing major, just that there is still inflammation in the knee and is yet to recover fully from surgery.
Ryan from Adelaide, South Australia
23/11/2020 - Right knee arthroscopy: Fat pad impingement trimmed and minor chondral breakdown tidied up

Offline RyanC

  • MINIgeek (20-50 posts)
  • **
  • Posts: 42
  • Liked: 2
  • On a mission to run again
Re: Arthroscopy with Fat Pad Impingement Trimming Surgery & Recovery
« Reply #36 on: May 09, 2021, 08:15:54 AM »
MRI photo 1
Ryan from Adelaide, South Australia
23/11/2020 - Right knee arthroscopy: Fat pad impingement trimmed and minor chondral breakdown tidied up

Offline RyanC

  • MINIgeek (20-50 posts)
  • **
  • Posts: 42
  • Liked: 2
  • On a mission to run again
Re: Arthroscopy with Fat Pad Impingement Trimming Surgery & Recovery
« Reply #37 on: May 09, 2021, 08:16:34 AM »
MRI photo 2
Ryan from Adelaide, South Australia
23/11/2020 - Right knee arthroscopy: Fat pad impingement trimmed and minor chondral breakdown tidied up

Offline RyanC

  • MINIgeek (20-50 posts)
  • **
  • Posts: 42
  • Liked: 2
  • On a mission to run again
Re: Arthroscopy with Fat Pad Impingement Trimming Surgery & Recovery
« Reply #38 on: May 15, 2021, 03:39:49 PM »
Week twenty-four

Hi All,

I am writing this week's update a day early because I feel pretty frustrated and feel like I need to get some thoughts/feelings off my chest. Essentially, I feel like over the last 3 weeks, my knee has been improving. I  was just starting to do more with my knee and I was having less and less pain. I was also starting to lift heavier and heavier weight at the gym and my legs are definitely getting stronger. On Wednesday last week, I had my first day completely pain free. I just got up in the morning, went to work etc and even went for a walk in the afternoon. Its starting to get cold where I am and I like the nighttime walks in the dark in winter listening to some music. I have started going to the gym with a friend where we work out for a bit but then I go onto the leg machines to do rehab. On Thursday night, we decided to work out shoulders and legs. We did a couple of exercises on shoulders but did lots of exercises on legs. Long story short I flared up my knee quite badly again.. I am not sure what exercise did it as there was not a point where I got a sharp pain in my knee, but it has certainly flared up. I normally leave the gym feeling quite good on my legs but this time I felt really bad. I am so disappointed, I felt like I was making so much progress and it was taking so long to actually make progress and I have just stuffed it up. I feel like I was at the exact same point as I was at the 3 month mark when my knee was feeling better and I flared it up.

Gah, so I guess I am back to resting, icing and just sitting around at home doing nothing.

Somehow I am staying optimistic. I feel like I am still in the window where it could get better. I am very much taking the information from Claire Patella (Claire Robinson) who seems to be an actual knee guru, focusing on infra-patella knee pain. She says that it takes 6-9 months generally for fat pads to settle and they are particularly irritable in the first 2-3 months. I guess my knee was pretty irritable in the first 3 months, then started to settle and then I flared it up. Also, I guess it took a big leg workout for my knee to flare up this time. Three weeks after surgery, it took just walking around the block to flare it up, three months it took very low weight simple gym exercises to do it and this time it was heavy weight full leg workouts that did it. I hope this doesnt take another 2.5 months to settle like the last flare up did but I guess I just have to go through it. The sad part is that I was starting to plan what sports I was going to get back into and I what I was going to do with my knee that was better. I guess that is just on hold now...

TL;DR:
Knee was starting to feel a lot better, but have completely flared it up again. Really disappointed with the set back
Ryan from Adelaide, South Australia
23/11/2020 - Right knee arthroscopy: Fat pad impingement trimmed and minor chondral breakdown tidied up