05/25/2008 10:37 AM
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rks
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Although this thread is old, I found it informative and wanted to add my experience for others who, in the future, may also be looking for the same. First a little background, I'm a 43 year old male who enjoys running, bicycling, and motorcycling.
After getting 'tapped' off my Ducati while doing about 50mph by a drunk driver the good news is that the only 'serious' injury was to my knee (broken rib, concussion, slight pneumothorax all minor IMHO) as I was wearing my vanson leather jacket (unfortunately only jean pants). The not so good news was that after 5 days in the hospital and the orthopedist was available to operate, my ACL and PCL had to be replaced with donor (cadaver) tendon and my medial meniscus needed repair as well. I am very lucky as any further trauma to leg, I am told, would have resulted in vascular damage, or worse, possible amputation.
Surgery took over 4 hours. The Orthopedist/Surgeon said after he put me out he could freely bend my knee in both directions - yikes. Another 4 days recovering in hospital with a rigid (0 degree flex) brace from thigh to ankle brace and then I was discharged. Self administered Lovinox for 2 weeks (blood thinner). Dr ok'd a CPM machine (rented for home use) after another week or so at home.
Happy to begin some kind of therapy; stared CPM at 20 deg flex with goal of 45. Suppoed to use it 4-6 hrs a day. It helped, but each time, it felt like the previous gains disappeared. In other words, I could not simply pick up at the degree that I left off during the previous session, but would have to lower the flex and work up again. As discouraging as this was, I was glad to see improvement in flex. This 'starting from scratch' behavior would continue with the CPM as well as daily ability to flex in general.
Another week or so and I was ready to start *real* physical therapy. I had graduated to about 40 deg of flex and had swapped out the stiff leg brace for one that articulates at the knee and can be adjusted for the amount of flex. It has four padded double-velcro bands to keep it on your leg. Pro: I'm not locked at zero deg flex any longer! Con: it is somewhat heavy and causing what appears blood to pool in between the 2 bands on the thigh leaving what looks/feels like a knotty bruise on my thigh.
CPM 4+ hrs a day and phys therapy 2-3 times a week has helped. Almost up to 45 deg flex and leg muscles noticeably stronger. Phys therpy has helped strength (via leg lifts on back, stomach, and right and left side) but also the fact that I am fairly fit (jogging and bicycling) must have played a part as well. Only now, 6 weeks after surgery, flex progress has plateaued at 45 degrees. PT tech, while bending my knee accuses (playfully) me of tightening muscles and preventing manipulation. But I was completely (well almost) relaxed. It feels like something in my knee has reached its limits of flex. Pain is not of the strenuous exercise variety, but rather, the something is amiss variety. Orthopedist agrees and cites scar tissue buildup as cause for stymied progress. Outpatient arthroscopic surgery in a week is recommended. I have the procedure. I feel like one step forward, two steps back after the 2nd surgery, but remain optimistic. Apparetnly dr manipulated the %^$# out of knee while I was under as following surgery, my quadracep felt like I had just run a marathon!
One week later phys therapy started again - this time with 'no limitations' on what I can do. Up to this point dr said no weight bearing on leg. Also, now I switched phys therapy facilities. Prev place had PT assistants doing most of work. They would give instructions and then disappear; i don't blame them for poor results . . . entirely. Anyhow, new facility along with agressive instructions from dr seem to be helping but i'm concerned about plateau-ing again.
Two weeks now after 2nd surgery and i'm off the walker - using crutches and placing weight on leg/foot. PT tech's at new facility are great - better technique and great attitude! (Don't SETTLE for what your insurance sets you up with if results are poor - fight the SOB's) I'm flexing about 60 degrees. Hopefully that trend will continue. DON'T FORGET TO ICE. I've had moderate and persistent swelling but the instructions to ice 3 or 4 times a day seem to have fell between the cracks untill after 2nd surgery. Applying ice packs for 20 min, 4 times a day has noticeably reduced swelling, which apparently improves ability to recover.
I'm icing knee as recommended and it *is* reducing swelling. Putting pressure while walking, albeit with only moderate pressure on leg, with crutches has had the most impact towards reducing swelling in knee and foot.
So thats my story at about 11 weeks since accident. Will update later if able to ... Hope someone finds this rant useful. Cheers!
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10/30/2006 12:19 PM
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Johanne1
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My goodness, I am so so sorry to hear of your plight Megan... my heart goes out to you.
I have a similar injury and am awaiting surgery. I too dislocated my knee, whilst on holiday in Italy in June of this year, getting home was a nightmare. I was then in plaster for 4.5 weeks and then underwent an MRI scan which confirmed that my ACL had been torn. My knee was inoperable so I was in physio for 2 months to get strong. My surgeon, then, because my recovery had been hard and the way the knee was still so lax decided that arthoscopy was the best way forward, together with performing patella lateral release to make incisions in the tendons as he feared that dislocation could be a further problem for me as my VMO muscle is weak and I still have muscle wastage. Anyhow I had the surgery last month, also suffered a blood problem (hematoma) after surgery and have a huge lump on my knee which I am told the body will eventually absorb, I hope so. I am now recovering not too badly though have pain and can't even contemplate stairs, but at least am now only walking on one crutch and flexion is good at 125+. The have had very good physio and hydrotherapy treatment and am now able to get to the gym (on my crutches!) to aid my rehab. The very bad news is that the arthroscopy has shown up that not only have I torn my ACL, but also my PCL and MCL and I have postero lateral instability. My surgeon is now referring me to another surgeon who I am seeing next week, as he believes that this new surgeon (Mr Beacon) will be able to help me better, this new surgeon though uses artificial ligaments and I have read a great deal that these don't do the job as well as patient's own or donor. I too am at a loss, my life is on hold, I have been practically housebound since June and have not worked, fortunately my job is still safe but I shouldn't think for too much longer if I don't get back soon, so then.... do I lose my house....., I live alone and am responsible for all the bills. I totally understand your dilemma Megan, truly from a simple fall, how can so much damage happen, that can totally change life and then you have surgery and it still doesn't go away and life doesn't seem to get better.... it is all such a worry, and to know the best thing to do. Megan... how are you doing, and Kate, how about you too? I'd be very interested to know, who was the surgeon that operated on you both and how you are doing now.
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06/08/2006 10:28 PM
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megan2162
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Yes, and add to that a torn LCL ligament as well. I'm 33 years old. I fell three months ago, slipped on a stupid piece of paper, dislocating my knee and severing all four ligaments. When they were repairing the dislocation in the ER, they inadvertently cause a blockage in my femeral artery, necessitating emergency surgery which delayed the surgery for the ligaments by three weeks, because by the time the staples came out of the incision for the vascular surgery, my doctor had left for a conference. Was in the hospital then for 11 days, then home for 10 days.
The ligaments could not be repaired and were all replaced on March 31st. My doctor told me it was the worst knee he'd ever seen. Oh, and at the same time, they nudged the artery they'd repaired, and it collapsed, causing a blood transfusion of 7 pints, and they had to rebuild the whole thing. The surgery to repair the ligaments was long: I went under at about 11AM, woke up briefly at 6:30pm after that surgery, while they were moving me to another OR for the vascular surgery. I was in the hospital for 2 weeks. It was painful, but eventually it improved. I was supposed to beging physical therapy mid-May, but delays and errors on their part have me still waiting for PT to start--I'm first on the waiting list, they tell me. Great. In the mean time I can now put some weight on the knee; wear my brace most of the time, have to use the walker if I don't use the brace, and basically am housebound, which makes life difficult, especially since I have a 2.5 year old at home. I have to say that this has been the most trying experience of my life--being basically cut out of my life for months, and god knows when things will improve. I can bend my knee a bit, but it's extremely stiff. I just want the PT to start, that's all. The doctor says I'll be walking pain free by September or October, but I just don't see how that can be possible.
Anyway, I feel your pain, literally. Sorry so long, I just haven;t written all this out before, and it's been a really hard time for me.
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