Banner - Hide this banner

Author Topic: Debridement and Manipulation!  (Read 1055 times)

0 Members and 1 Guest are viewing this topic.

Offline Lynette

  • Forum Faithful
  • ****
  • Posts: 157
  • Liked: 0
  • User's Text
Debridement and Manipulation!
« on: June 20, 2004, 12:06:11 AM »
I had surgery on Monday 14 June.  I had a nerve block on my leg for two and a half days so couldn't feel my leg at all.  I was also on the CPM machine in hospital for three days, starting off at 90 degrees and working up to 120 degrees. I came home Thursday evening.  Unfortunately in England it is impossible to hire a CPM machine so i am stuck with trying to improve my ROM myself.  The surgeon rEMoved some scar tissue and manipulated my knee and said he easily got it to 90 degrees and then eventually to 120 degrees.  He said I should have no problem bending my knee.  [I still have patella baja which means my knee cap has dropped and is lower than it should be]. But my knee is similar to before the operation.  Obviously I have more ROM.  With work I can get it to 60 degrees pushing it and just about hold it there for a few seconds before it slips down.  Yet as soon as I rest with it straight for a few minutes and then start again trying to bend it it's like going back to square one and I can only get it to 30 degrees at first then eventually to 60 again.  It stiffens up almost immediately and is so tight.  Behind the knee hurts a lot when trying to bend it and also the outside of my thigh.  On the CPM machine although at first it was awful it eventually bent quite well.  I realise this is passive but I don't know why I didn't have much pain on the machine but lots of unbearable pain trying to bend it myself.  

This afternoon and tonight I have noticed a tearing sensation by my knee cap and my knee cap keeps popping also.  This happends when I try to bend it.  It's horrible because it puts me off bending it but I know I have tp persevere.

I was told by the physio I should not be using any walking aids but I've been using walking aids of some sort for over a year now as this is my fourth operation so it's not so easy just to start walking properly again.  My knee is too painful to put full weight on and it is not that stable.  I also find it hard to put my knee back when standing ias t dips forward.

I'm on tremadol tablets and paracetamol at the moment.

I'd just like to hear from anyone who is going through a similar experience to me at the moment or has been through one in the past.  Are the tearing and popping sensations normal? etc etc

My surgeon is not very nice he and the physio seem to think because he got it to 120 degrees in theatre I won't have any problem getting it there myself.  The physio in the hospital kept telling to bend my leg and spoke to me as if I was a naughty school girl doing it on purpose.  You can tell the surgeon has washed his hands of me and there is no-one else to change to and I've been told I won't be getting any physio because I can do it all at home myself.

Any advice would be appreciated!
Left -  total lateral meninsectomy '93 partial meninsectomy 99.  Right -  partial lateral meninsectomies Jan/July 03  total lateral meninsectomy, lateral release Nov 03 scar tissue removal  MUA Jun 04 Arthroscopy Aug 2005 synovitis, oesteoarthritis, articular cartilage arthritis. Mal-tracking right

Offline Leentje

  • SuperKNEEgeek
  • *****
  • Posts: 2114
  • Liked: 2
  • ER nursing rules !!!
Re: Debridement and Manipulation!
« Reply #1 on: June 20, 2004, 01:55:45 PM »
Try heel slides, put a towel under your foot and slowely pull it so you flex your knee. Get it to the point you can't go any further, hold it there for 10 seconds and then easily extend your leg. Do this 20'. And have you tried wall slides? Again use a towel and help your bad leg with your good leg.

Haven't got any experience with scar tissue myself, have seen many people with MUA's and adhesions, who's leg can be bent all the way through MUA and after that stiffens up again. CPM is only passive, a big help, but the active motion is more important (and also more painfull :-/). You'll have to do it yourself, but it's easier said then done I know!

Read some posts by heatherM, think she's in a similiar position or has been.

Bilat patellar malalignment/PFdysplasia
00/06/83 L wrist #
11/12/00 L knee LR + chondroplasty
21/08/02 L knee TTT
02/03/04 L knee stretched PCL
11/09/07 L ankle dislocation/medial avulsion #
25/05/09 L ankle medial avulsion # AGAIN!
05/06/13 R ankle dislocation

Offline Holly

  • SuperKNEEgeek
  • *****
  • Posts: 658
  • Liked: 0
  • Runs with scissors
Re: Debridement and Manipulation!
« Reply #2 on: June 20, 2004, 05:32:53 PM »
Hey Lynette:

I'm pretty much EXACTLY where you are (my MUA surgery was on 6/15) and my post-op posts are here under "8th operation - post-op progress" and you'll see how frustrated and disappointed I was with my surgery too...UNTIL I got information from others on this site and my physical therapist, Kim.  I even had the "popping" thing you have, and since that was one of the reasons I even had the surgery, I was VERY concerned and upset.  However, what I'm told is that a great deal of these post-op ROM and other problems are simply caused by the swelling  - - - and, of course, that WILL GO AWAY with time and lots of ICE AND ELEVATION.  

I do my at-home physical therapy (as opposed to when I go to my PT, Kim 3xweek) for about an hour 3 times a day.  I find if I ice thoroughly BEFORE I begin my exercises I can get pretty decent ROM.  Yes, of course, those first couple of bends are painful.  But if you stick it out and keep going, the rewards are worth it! ;D  I'm to do lots of ROM work (as mentioned by Helena above), as well as lots of quad work.  The quad work really hurts, since that thigh muscle is screaming at me still, but you get through it.  If you need some at-home quad exercises, you could try looking at the posts under STRUGGLING WITH REHAB, "Help Please" by Kathyw.  There are a whole lot of detailed exercises there.  Then BE SURE TO ICE AFTER YOU EXERCISE! ;D

Once I understood what was happening, I stopped being disappointed and angry and upset.  There's only so much room in your poor knee right now, so things don't feel right.  But hang in WILL get better!


« Last Edit: June 20, 2004, 05:37:22 PM by Holly »
1998 run over by car;Rt knee lat menisc/med menisc tear, ACL/MCL tear, patella frx, tib frx, femur frx, 4 scopes repr menisc/repr lig/debride pat, open MCL rpr, dbl osteot3/04;MUA,lysis6/04;scope10/04