Arthroscopic knee surgery (04/19/10)

[TOMMAX2]

Hey everyone, just had my knee surgery 9 days ago. Im bored laying in bed w/ pain so I decided Id make a post and record my progress in a thread.

Background-

-laterally dislocated knee cap 5 yrs ago (plant and twist)
-intermitent pain/ aching for the past 5 yrs so decided to get surgery since all conservative approaches had been exhausted
-mri's/ x-rays were all normall so doctors did not take it seriously for years
-clinical evalutations were hit and miss
-visible deformity/ indentation at medial aspect of patellar tendon (medial retinaculum area which indicated a torn medial retinaculum).



Arthroscopic findings-
-lateral patellar misalignment (surgeon performed a lateral release to try and correct the problem)
-lateral meniscus tear (posterio-lateral: was cleaned up)
-scar tissue @ MPFL (debrided?)
-scar tissue @ medial patella-femoral jointline (medical synovial plica damage, debrided the damaged tissue)


Post-op-

Lots of quad and knee swelling. My knee is the size of a grape fruit and the area where the lateral release was performed has a large kiwi sized bump on it which is extremely painful. ROM is about 45 degrees with great difficulty and some days up to 80. Lots of quadricep tendon pain as well. Dr. prescribed 60 T3's and Ive only got 7 left, lol. Have been taking T1's OTC as well.

So from my understanding it will take about 4-6 weeks for the swelling to go away and start to achieve more rom and for everything to completly heal it takes about 3-5 months.

Anyway, ill keep this thread updated as things progress and if anyone has any questions feel free to ask.

[TOMMAX2]

Well, today has been 2 weeks and things are slowly progressing.

Knee is still significantly swollen but has been slowly reducing. Pain levels are a little bit better everyday. Im relying less and less on pain killers. Im pretty much down to taking pain killers twice a day (once in the am and once before bed). On bad days ill prolly have to take a mid day dose. My dose of pain killer typically consists of 1T3 and 1T1 in one sitting.

Im still using crutches to get around but it seems my knee can handle a little bit more each day and it is feeling considerably more stable especially in the last few days. I think I will probably have to rely on crutches for another few weeks, the sooner I dont have to rely on these things the better but at the same time I dont want to over stress the knee and get carried away so Im just trying to keep that fine balance.

ROM is at about 30 degrees because there is still a considerable amount of swelling around the knee and the anterior aspect of the quadriceps tendon and alot of tightness and pain around the lateral retinaculum and quad tendon. It seems once the quad tendon starts to relax and stretch out the rom will come back so I expect that to happen once swelling reduces more.

Other than that have a dr's appt tomorrow with my gp so hes gonna give me all the technical details of my surgery from the surgeons report.

[TOMMAX2]

Today is 21 days since the surgery.

Some of the progress that has been made in the last week is:

-can bend knee to 45 degrees
-improved strength/ stability/ only using one crutch to get around
-pain levels minimal/ discomfort and tightness mostly (pain only when trying to bend near/ past 45 degrees)
-taking otc advil, 2 tablets per dose for swelling 2 to 3 times per day (using ice also 3 times/ day)
-much more mobile and walking alot around the house during the day
-sitting in chairs some of the time but its pretty uncomfortable so I still sit in bed most of the time when Im resting. (Sitting in a chair should be alot more comfortable once the knee will be able to hit 90 degrees flexion I believe).


The knee is still considerably swollen around the area of the quadricep tendon, vmo, and lateral retinaculum. It has gone down maybe 1/8 of an inch so its very little of an improvment and this swelling is what is holding me back from getting more rom imo. I have some hypodermic needles and have been tempted to drain my knee but I am going to hold off on that for now since I have an appt. with my OS next week and dont want to do anything without his approval first. Also he said the swelling would take 4-6 weeks to subside so its probably a bit premature to start panicking just yet.

Other than that Im just trying to pre occupy myself by watching alot of tv and stuff and doing physiotherapy type exercises and stretches to keep things as conditioned as possible.

[Bnice76]

has the Dr. prescribed physical therapy yet or at least mentioned physical therapy in your near future?

[TOMMAX2]

Havent updated in the last couple weeks cause things are progressing pretty slowly.

So far I have the passive knee flexion up to about 100 degrees. I dont have full extension yet either and am about 10 degrees away from that. I feel sharp medial jointline pain when I try full extension and my MPFL really hurts so Ill have to wait for that stuff to settle down before any more progress is made with the extension.
I still have swelling on the superior part of the knee cap as well and medial patella-femoral jointline. Also have a significant swelling/ cyst type bump on the lateral superior part of the knee where the lateral retinaculum was cut.

Im also getting this sharp catching sensation @ the lateral meniscus area when bending my knee from full lock out so hopefully that will go away as time passes. It is really noticable and painful when im lying on my stomach and doing a leg curl motion.

Other than that Ive been completely off of crutches for the past week and the knee feels pretty stable but I dont have a normal gait yet and I walk like an ostrich.

I do stretches and strengthening for the knee about 3 or 4 times/ day.

has the Dr. prescribed physical therapy yet or at least mentioned physical therapy in your near future?

Yes, I went to see the OS on May 19th and he gave me a prescription for physiotherapy which is aggressive ROM and quad strengthening. I am starting formal physiotherapy tomorrow.

Other than that he told me to do therapy at home 4- 6 times / day so I have been doing that.

My goals for the next couple weeks are to achieve full active flexion (135- 140 degrees), full active extension, eliminate swelling, pain free articulation, improve muscle strength, and achieve a normal gait pattern.

[TOMMAX2]

Just to update, progress has still been slow but there have been improvements.

-Passive knee flexion is @ about 130 degrees, Im about 10 degrees away from full ROM.
-Active extension is still 10 degrees short of full extension and swelling is preventing that.
-Swelling has improved. I measure the knee girth on a daily basis and its about 3/4" from being completley gone.
-There is still swelling on the lateral-superior part of the knee and the medial jointline. They have diminshed in size quite abit but are still holding me back from achieveing certain goals.



My biggest concern right now is the tenderness and catching/ locking sensation I am expriencing in the area of my lateral meniscus from hyperextension to about 15-20 degrees flexion. This area was asymptomatic prior to surgery but the surgeon cleaned up this area a bit because he said it was damaged. I am frustrated that he chose to do that even though I never complained of pain in that area and that was not part of the agreement before we went in for the surgery. I am still hoping that once the sweling completley goes away, full extension and flexion return, and full strength returns that this issue will resolve and not cause me any problems.

As far as the medial jointline where the scar tissue was cleaned goes, im happy with the articulation I am feeling in this area. Im also happy with the lateral release so far and I feel my patella is tracking well and there is good patella femoral stability. My only quam is the lateral meniscus issue, I really hope its not fuked up but it will still take a bit more time to figure out how significant of a problem it is or isnt.

Other than that I called my surgeon today and he will call me back tomorrow to discuss the locking and pain in the lateral meniscus.

Ill update more in the future.

[TOMMAX2]

So Im 10 weeks (70 days) post op today. There have been some more improvements since I last posted.

Some of the improvements are:

-swelling is about 80-85% reduced. There are some small pockets of swelling in certain places (lateral superior, quad tendon, medial jointline). The swelling is mild and I expect it to be completley gone in about 2 weeks.
-ROM flexion is pretty much full. Im about 2 inches from touching my heel to my glute so once the swelling is completely gone I should be able to accomplish this.
-extension is about 0 degrees. I am still waiting to gain the 5 degrees of hyper extension but the remaining swelling is holding me back from accomplishing this IMO.
-strength has been improving alot but i still need to gain an inch or 2 in curcumfrenece on my leg muscles. Still needs a good amount of work until its satisfactory.


For exercises, Im mainly doing stationary bike, treadmill walking, b/w squats, wall chairs, leg extensions, and standing hamstring curls.

Other than that I still have some quirks and twinges Im trying to iron out.

In regards to the lateral meniscus comlaints from my last post, they have seemed to settle down for now but Im keeping it out of that range of motion and not testing to see if it bothers me or not. Im just kind of working around it and will test it some time later in my rehab when my strength and flexibility become normal.

A problem that I have noticed in the past couple weeks is when I go up stairs, or do leg extensions, and somtimes during b/w squats that there is pinching and grinding during the medial jointline articulation. It feels like there is a bone spur at the superior medial part ot the patellar articular cartilage, i can feel it when I touch it with my fingers in that area as well. I have had this bone spur since before the surgery and Im confused as to why the surgeon would not remove this, it was basically my main problem b4 the surgery. My plan for the mean time is to try not to aggrivate it and work around it. Im hoping that once the swelling is 100% gone and the full flexibility, strength, and tracking has returned then it wont be a big problem and I wont notice it. Otherwise if that dosent work ill probably consider having an arthroscopic revision to touch up that area but hopefully I wont have to waste anymore time and things will work out for the best naturally.


Anyway, thats all I can think of for now so ill update again soon.

[beerbellyUK]

Looking forward to an Update!
Hope you are recovering OK

[TOMMAX2]

Okay, so its finally the 3 month mark today. Things have been pretty challenging over the past 3 months but seem to be getting easier everyday.

So the particualr details of my knee as of now are as follows:

-swelling is about 90% reduced. There is still some minor puffiness and lack of definition around the medial and lateral side of the knee cap. In all reality I think this is probably gonna take another month or 2 to get down to 95-100% just cause its slowed down so drastically. Well, as long as it completely goes away eventually ill be happy.

-passive Rom flexion is FULL. Last week while doing my streches I finally touched the heel of my foot to my glute. I was pretty psyched when I accomplished this. It takes me a good 10-15 min streching session to get it to that point of flexion but that just means it can only get easier nas time progresses.

-active extension is still a few degrees short of full hyper extension, about an inch and a half. I can still feel that there is excess fluid in the joint so its still holding me back from the full extension. When I walk, I still have a slight limp due to the extensor lag as well. My physiotherapist describes the fluid as a glue like substance that is between the joints and tendons so that is blocking the joint surfaces from fully articulating into position currently. Once this "glue" leaves the joint space I should be able to fully hyper extend it. Hope it happens soon!

-exercises Im currently sticking to are: stationary bike, multi-directional SLR's, heel slides, non-weighted leg extensions while sitting at the edge of my bed (high reps), standing hamstring curls (sometimes), wall chairs, walking outside, and balancing on 1 leg.

-I have been avoiding body weight squats for now because there is just too much discomfort and soreness with them right now and my medial patella femoral jointline grinds a bit while doing this so Ive put it on hiatus for the time being til I get stronger with the more basic exercises.

-I can ascend and descend stairs now but there is still some discomfort behind the knee cap and I am getting the medial patella femoral jointline grinding/ pain so Im just being slow and careful with it right now and hopefully things will get stronger and the articualtion will smooth out.

-morning stiffness/ soreness has become more minimal in the mornings. Some mornings its barely even there after ive rested for a couple days. It gets pretty painful though on the mornings after ive done a hard therapy sessions the day before or over used it.

-I take 1 or 2 5-325 ******** every couple days when pain flares. I also have a bad shoulder/ scapula problem so I use it for all of my pains. Its a great drug and I find alot of relief from it.

-I have been utilizing a neoprene knee sleeve that I bought from the dollar store which I use when I go for walks outside and stuff like that. It really helps support the joint and makes things feel more stable while im outside.

-Physiotherapy is still twice a week. The types of therapy that is used is: moist heat pad heat treatments, electronic stimulation massage around the knee cap and menisci, ultrasound (not as much anymore), deep tissue massage, and sometimes passive rom flexion and extension.

-Im still getting some medial jointline problems where the plica was debrided. I still have my suspicions that there is a bone spur protruding from the medial articulating cartilage surface which is gouging my medial femoral condyle cartiallge during the extension articualtion of the knee from about 45-15 degrees rom. Im gonna give it another month of rehab til I make another appt. with my surgeon so ill see how things progress in the mean time.

-Also, still getting a bit of catching where the lateral meniscus was repaired but it seems to be getting less problematic as time progresses so Im still thinking it may iron itself out and not be a problem as more time progresses.


So bascially my knee is probably 50-60% healed right now. I think its gonna take another 3 months to really get it to 90-95%. Its pretty much the same as when I dislocated my patella, it takes a good 6 months to get pretty comfortable and then another 6 months to get to near 100%. It is definetly a solid 6 month to one year project from my experiences and also reading other peoples blogs who have went through knee surgery it just seems 6-12 months is a common time frame so Im just trying to keep calm, stay positive and let time do its thing.









@ beerbellyuk: hey, how is your recovery going? what exactly did you have done besides the lateral release? Hope everything is going well with you my friend. Just remember that the surgery is pretty challenging both physically and mentally and you will probably experience somewhat of an emotional rollercoaster going through this rehab but things will get better and just be patient. Patients and positive thinking is the key to this and not getting frustrated. That is your best ally in your recovery. (oh and strong ass pain killers

[TOMMAX2]

Its been 3 1/2 months today. Not much has changed in the past couple weeks. I can do stairs easier and walk around for most of the day. Pain still flairs up if I over use it or do the wrong exercises that irritate it. Still mild swelling/ puffiness left around the knee cap (medial jointline is the puffiest). Wondering when and if it will go away completely.

I worked out for the past 6 days straight doing alot of stationary bike (2-3 times/ day) and walking (8 hours/ day) and for the past couple days my medial patella femoral jointline has been on fire so Im just taking it easy. Taking pain killers and just zoning out. My lateral meniscus is still acting up as well during the extreme points of hyper extension so just tryin to continue to work around it.

Went to see my GP last week and he said that hes a bit concerned about my healing and thinks its slow. He wants me to call my surgeon for another appointment to have him assess the current situation. OS is back in the office tomorrow so I will call to schedule appointment then.

Otherwise just playing the waiting game, managing pain for the time being, and hoping things turn out for the best in the long run.

Stay tuned for further updates.

[beachguy498]

Nothing like knee surgery! You had a lot going on for a 'scope job. Mine required the scope plus a large incision on the inside of the knee cap. Mine was mostly a clean out and tendon graft. I was out of work (had a physical job) for 10 weeks.

Pretty much the same deal as yours for total recovery. I did crutches for 3 weeks solid and went to a cane for the next 8 weeks or so. I didn't bend it past 90 degrees for maybe 12 weeks. The swelling did go down but still had swelling if I abused it for as long as 2 years post-surgery.

BG

[TOMMAX2]

Wow, I cant believe its already a little over the 4 month mark. I thought things would have been alot further along by now but its still pretty slow going. Im pretty frustrated and depressed right now and Ive slept for most of the weekend and didnt really do anything.

I went to see my surgeon last thursday and told him all of my complaints which are: extensor lag, sharp pains/ burning in the area of the lateral release area, LPFJL pain, lateral meniscus sharp pains, and MPFJL pain. All in all he was satisfied with my progress, how the knee looks, and the amount of ROM I have. He said that as the strength returns, the quad muscle bulk returns, and the knee cap aligns it self better, the extensor lag will resolve and my knee will function normally. He also said he expects that I will be able to return to the sports and activites I enjoy eventually. He also said all the pain issue will resolve and it will take "months". (he didnt specify how many months, just "months"). Im not sure if he is really confident that things will work out for the best or if hes just trying to cheer me up but either way Im just gonna have to keep working at it for now and hope that things turn out satisfactory.

So basically the extensor lag is one of my biggest problems right now, its not as bad if Im sitting on the edge of the bed and doing a leg extension, I can get it about 1/2" to 1" from full lock out in this position. For some reason when I walk the extensor lag is more pronounced, probably about 3" of lag or about 5-10 degrees. The knee just hates to articulate into the hyper extension position and there are sharp pains/ popping @ the lateral meniscus, MPFJL, and lateral retinacular area.

Otherwise the swelling is about 95% gone. There is quite a bit of definition but still very slight areas that are filled in around the knee cap and quadricep tendon. THinking another couple months til it looks normal? I have no clue, just hope it goes away eventually.

Still going to physiotherapy, Im down to once a week now. I still do exercises at home on pretty much a daily basis. Im gonna attempt a new routine this week.

sun.- stationary bike (15min)
mon.- strengthening exercises, stat. bike, outdoor walk
tues.- stat. bike x 2, outdoor walk
wed.- stat. bike x 2, outdoor walk
thurs- strengthening exercises, stat. bike, out door walk, physio
fri.- stat. bike x 2, outdoor walk
sat.- stat. bike x 1


For strengthening exercises Im gonna pick 3-5 variations from my physiotherapy list and do 3 sets of exercises for each and about 10-20 reps/ set.

My exercise list consists of:

-45' wall slides
-45' wall chair
-45'back stepping lunges
-45' b/w squats
-standing tke w/ theraband
-leg extensions
-stat. bike
-walking
-SLR's
-step ups/ downs onto a 6" platform
-standing hamstring curls
-light SLDL's
-balancing on 1 leg
-lateral movement walking

I did my first day of the program today which was: 25 min out door walk, wall chairs 3 sets, standing tke's 2 sets/ 10 reps, step-ups 3 sets 20 reps, balancing 1 leg 2 sets. Ill see how bad my knee feels tomorrow after this but it was okay during the exercises cause I took 2 T1's when I got up this morning.

Nothing like knee surgery! You had a lot going on for a 'scope job. Mine required the scope plus a large incision on the inside of the knee cap. Mine was mostly a clean out and tendon graft. I was out of work (had a physical job) for 10 weeks.

Pretty much the same deal as yours for total recovery. I did crutches for 3 weeks solid and went to a cane for the next 8 weeks or so. I didn't bend it past 90 degrees for maybe 12 weeks. The swelling did go down but still had swelling if I abused it for as long as 2 years post-surgery.

BG

Thanks for the post beach guy. So was your tendon graft for an acl repair or patellar tendon or something else? Sounds pretty grueling either way and 2 years is quite a bish of a time for a surgery recovery. How is your knee now adays, are you back to lifting and doing the activites you enjoy? Do you think it was worth getting the surgery or do you regert it? Any limiations with your knee?

[beerbellyUK]

Ok, so I had my knee surgery done on 6th july, and it is now the 28th august. Until these last few days it has all been good, barely any swelling, good movement the day I took my bandages off etc - I have a lateral release done to each side and that was it. Anyway, I went out clubbing on night after my exam results and the knees have been stiff and achey since. I can barely put any power down on the bike and have remained the same for a few weeks - to be honest the knees now feel how they did before the op - starting to get really down about it all. Just a case of plodding on with it and fighting hard I guess.

TOMMAX....if your knees hurt, do you still do the exercises? Hope it is all going well now

[TOMMAX2]

Ok, so I had my knee surgery done on 6th july, and it is now the 28th august. Until these last few days it has all been good, barely any swelling, good movement the day I took my bandages off etc - I have a lateral release done to each side and that was it. Anyway, I went out clubbing on night after my exam results and the knees have been stiff and achey since. I can barely put any power down on the bike and have remained the same for a few weeks - to be honest the knees now feel how they did before the op - starting to get really down about it all. Just a case of plodding on with it and fighting hard I guess.

TOMMAX....if your knees hurt, do you still do the exercises? Hope it is all going well now

Hey, good to hear from you. Wow, clubbing 4-6 weeks after surgery, thats crazy. I still cant even walk properly let alone go to a club. I get my dad or my g/f to buy my groceries and help me out with everything outside of the house, thats how bad my knee still is. Walking around the block is still challenging and feels messed up.

Before the surgery, my only problem was the medial plica pain and I conveyed this information to each specialist I spoke to. I was fully functional and had near full strength, it was just the plica pain that was bothering me. I was extremly specific and detailed in regards to where my pain was and what I thought the problem was. My surgeon agreed as well that he believed the crux of the problem was a band of scar tissue between the patella and medial femoral condyle (plica) so thats why I signed up for the surgery because we seemed to be on the same page and I was certain he understood how to treat the problem correctly and would do that right thing.

I am beyond irate right now that he chose to cut 3 inches of lateral retinaculum to correct the patellar alignment (which I think is bs because the alignment felt fine before the procedure but now it feels to far medialy and unstable). Why would he take such a huge risk of cutting this tissue and messing with the extensor mechanism when all he had to do was clean up some scar tissue (plica) on the medial femoral condyle and call it a day. I just dont understand the logic what so ever.

Also, Ive decided to rest now since friday, no working out, minimal walking, im back to babying it for this week. Ive done 12 weeks straight of physio already which seems to be doing more harm than good. All its good for is flaring up the pain and swelling, it dosent seem to be doing much else really.

Anyway, what are you doing for you physio right now? And in regards to your knee flaring up and stiffining, you should rest it for now and let it settle down, maybe just do some gentle movements to keep it mobile and dont punish it/ aggrivate it. Keep me posted and let me know how your doing.

[JDkeystone]

TOMMAX2, question- when you first dislocated your knee 5 years ago, was it a full dislocation, or just a sublux? Did you have to go to the hospital to get it put back in, or did it go back in on its own?

Also, do you know if it's normal a for knee that only subluxed (but supposedly "didn't" tear anything) to still be aching sporadically, as well as still have residual swelling 6 weeks after the subluxation happened? What would be the standard recovery time for this, assuming there really was no major internal damage?

[TOMMAX2]

TOMMAX2, question- when you first dislocated your knee 5 years ago, was it a full dislocation, or just a sublux? Did you have to go to the hospital to get it put back in, or did it go back in on its own?

Also, do you know if it's normal a for knee that only subluxed (but supposedly "didn't" tear anything) to still be aching sporadically, as well as still have residual swelling 6 weeks after the subluxation happened? What would be the standard recovery time for this, assuming there really was no major internal damage?

Yes, I did fully laterally dislocate the knee in spring of 2005 after a major plant and twist injury and I was rushed to the hospital to have the patella reduced (popped back into place).

Also in junior high, I had about 3 or 4 incidences of lateral subluxation from trivial things like reaching for a bar of soap in the shower, just very small twisting movments that partially popped the knee cap out of place. At this age I remember healing to be quite speedy. Took me around 2-3 weeks for them to heal back to normal and there wasnt any swelling that I recall. I think kids heal much faster than adults though so I attribute that reason to my quick recoveries at those ages. At our ages, in our late twenties, I think it takes substantially longer of a time to heal and 6 weeks does seem to be early days still in regards to recovering from the subluxation.

The exercise that helped me best in junior high to reslove the instances of patellar subluxations were the straight legged raises lying on my back. Lie on your back with the knee contracted in the full extension position and then raise your leg off the ground til its at a 45 degree angle and hold that position for 5 to 10 seconds. Then slowly and controlled bring the heel down back to the starting position. I used to to 20- 40 reps of these/ day, 10-20 reps/ set (youll be able to do more as you progress obviously). You can also use ankles weights to add resistance as you progress (around 5 to 10 lbs).

Heres a pic of the SLR:


With the subluxations, the structres that are most vulnerable to injury are the medial retinaculum and medial patella femoral ligament. Also a weak vmo is typically part of the problem and needs to be strengthened. You might have streched out the med. retinaculum and/ or MPFL a bit but I think over time and with light strengthening and progression you will eventually tighten up the medial structures and have proper patella-feomral tracking within your trochelear groove.













Just an update for my sitiuation, I have completly rested since friday and my knee is feeling very bareable right now as long as I take it slow and easy and dont push it. The alignment still feels strange and I get some twinges of pain through out the day, the quadricep tendon feels weak and still feels traumatized from the lateral release. Im waiting for it to settle down more and mature and hopefully it will function better over time but its much better than the torture I was putting it through with constant exercise for the past 12 weeks. I think I was really over doing it and even when I get back to strengthening I need to really tone things down and take the slow and steady route. After this friday I will probably take 1 more week of complete rest and then get back into light strength and conditioning 2 or 3 days a week so Ill update then.

[JDkeystone]

Yes, I did fully laterally dislocate the knee in spring of 2005 after a major plant and twist injury and I was rushed to the hospital to have the patella reduced (popped back into place).

Also in junior high, I had about 3 or 4 incidences of lateral subluxation from trivial things like reaching for a bar of soap in the shower, just very small twisting movments that partially popped the knee cap out of place. At this age I remember healing to be quite speedy. Took me around 2-3 weeks for them to heal back to normal and there wasnt any swelling that I recall. I think kids heal much faster than adults though so I attribute that reason to my quick recoveries at those ages. At our ages, in our late twenties, I think it takes substantially longer of a time to heal and 6 weeks does seem to be early days still in regards to recovering from the subluxation.

The exercise that helped me best in junior high to reslove the instances of patellar subluxations were the straight legged raises lying on my back. Lie on your back with the knee contracted in the full extension position and then raise your leg off the ground til its at a 45 degree angle and hold that position for 5 to 10 seconds. Then slowly and controlled bring the heel down back to the starting position. I used to to 20- 40 reps of these/ day, 10-20 reps/ set (youll be able to do more as you progress obviously). You can also use ankles weights to add resistance as you progress (around 5 to 10 lbs).

Heres a pic of the SLR:


With the subluxations, the structres that are most vulnerable to injury are the medial retinaculum and medial patella femoral ligament. Also a weak vmo is typically part of the problem and needs to be strengthened. You might have streched out the med. retinaculum and/ or MPFL a bit but I think over time and with light strengthening and progression you will eventually tighten up the medial structures and have proper patella-feomral tracking within your trochelear groove.

Yeah, I'm also doing the straight-legged raises as well (with 3-5lb weights wrapped around my ankle). Also doing wall-sits (both long and short for time), and balancing on my bad leg on a pillow for 75-100 sec increments. It does feel like it's helping to a degree (knee feels a lot more stable and secure than it did a month ago); it's just the continuous, on-and-off pain I'm still getting when walking for long periods, as well as the last bit of residual swelling that I can't seem to get rid of.

But I saw my surgeon again yesterday (for my final post-op for my shoulder), and he examined my knee while I was there, and assured me the ligaments were fine; he said, at worst, I might have some slight cartilage damage, but he didn't think it was any worse than that. He also said if I'm still experiencing pain in another 6-8 weeks, I could come back to him for a cortisone shot. But what was the real kicker is he said even if it was only a tear-free subluxation with no major or lasting damage, it could still take anywhere from 6 months to a full year to heal.

Speaking of cortisone shots, did you ever get one prior to surgery? What are your thoughts on them?

[maynardjames]

Before the surgery, my only problem was the medial plica pain and I conveyed this information to each specialist I spoke to. I was fully functional and had near full strength, it was just the plica pain that was bothering me. I was extremly specific and detailed in regards to where my pain was and what I thought the problem was. My surgeon agreed as well that he believed the crux of the problem was a band of scar tissue between the patella and medial femoral condyle (plica) so thats why I signed up for the surgery because we seemed to be on the same page and I was certain he understood how to treat the problem correctly and would do that right thing.

I am beyond irate right now that he chose to cut 3 inches of lateral retinaculum to correct the patellar alignment (which I think is bs because the alignment felt fine before the procedure but now it feels to far medialy and unstable). Why would he take such a huge risk of cutting this tissue and messing with the extensor mechanism when all he had to do was clean up some scar tissue (plica) on the medial femoral condyle and call it a day. I just dont understand the logic what so ever.

.

Wow that sucks.... He seems to have gone overboard with it,,,,
did you talk to him about it later on....???
Repped and good luck......Great posts btw,

[maynardjames]

TOMMAX2, question- when you first dislocated your knee 5 years ago, was it a full dislocation, or just a sublux? Did you have to go to the hospital to get it put back in, or did it go back in on its own?

Also, do you know if it's normal a for knee that only subluxed (but supposedly "didn't" tear anything) to still be aching sporadically, as well as still have residual swelling 6 weeks after the subluxation happened? What would be the standard recovery time for this, assuming there really was no major internal damage?

i seem to have the same problem....
Right knee cap seems to have kinda popped out and there's swelling on the underside of knee.....running caused it....also its painful

[TOMMAX2]

Yeah, I'm also doing the straight-legged raises as well (with 3-5lb weights wrapped around my ankle). Also doing wall-sits (both long and short for time), and balancing on my bad leg on a pillow for 75-100 sec increments. It does feel like it's helping to a degree (knee feels a lot more stable and secure than it did a month ago); it's just the continuous, on-and-off pain I'm still getting when walking for long periods, as well as the last bit of residual swelling that I can't seem to get rid of.

But I saw my surgeon again yesterday (for my final post-op for my shoulder), and he examined my knee while I was there, and assured me the ligaments were fine; he said, at worst, I might have some slight cartilage damage, but he didn't think it was any worse than that. He also said if I'm still experiencing pain in another 6-8 weeks, I could come back to him for a cortisone shot. But what was the real kicker is he said even if it was only a tear-free subluxation with no major or lasting damage, it could still take anywhere from 6 months to a full year to heal.

Speaking of cortisone shots, did you ever get one prior to surgery? What are your thoughts on them?

Ya, that on off pain can linger for quite awhile. Soft tissue structures take along time to heal because of the poor blood supply compared to other areas of the body so 6 months doesnt seem too far fetched of a time frame to heal.
I see it as a positive thing that you only had a subluxation (not a more serious injury) and your doctor does not think you tore anything or have any significant damage. Subluxation is one of the more minor knee injuries so Im pretty sure it should be able to heal up nicely if you give it enough time and put in a decent amount of work into strength and conditioning (watch out not to over do things as well).

In regards to cortisone shot, no I have never had one administered to my knee, Ive had an injection into the bursa of my shoulder a few years ago after an injury and it didnt help at all. I was going to try one before my knee surgery but decided against it since it would just mask the pain. If I were you, I would probably try to stay away from the shot for as long as possible and really give your knee alot of time to heal before making that decision. If anything, just use oral anelgesics to curb your pain flares for the time being and give it at least 6 months before deciding if you want to try a cortisone shot.

Wow that sucks.... He seems to have gone overboard with it,,,,
did you talk to him about it later on....???
Repped and good luck......Great posts btw,

Hey, thanks for checking out my thread and Im glad you found it helpful.

Yes, I did express my concerns to my surgeon at my last appt. 2.5 weeks ago but he re assured me that everything will work out for the best and it will take "months" for everything to heal. I guess ill have to give it more time to see if he is bs'ing me or not, haha.

i seem to have the same problem....
Right knee cap seems to have kinda popped out and there's swelling on the underside of knee.....running caused it....also its painful

Hows your knee doing now? Did you get a dr. appt. to get it checked out yet? Sounds like you might have subluxated it as well and will need to work on the patella femoral stability and emphasis strengthening of the medial structures. Let me know how things are progressing.















Update for my knee, Im just over 20 weeks post-op and for the past 6 weeks things have kind of plateaued with the swelling, pain, and functioning of my knee. The quadricep tendon still feels fried/ dysfunctional, I have about 5 degrees extensor lag when I walk and there is still moderate pain on the medial patella femoral joinline and some sharp twinges at times @ the lateral meniscus.

Im going to make an appt. with my general physician this week and get him to refer me to hospital physiotherapy because my therapist right now is charging me $30./ appt. and I really feel Id be getting a better quality of therapy at the hospital and it would be covered by healthcare. Im also going to get another ******** prescription. Im taking one tablet about 4 times/ week right now and I usually stack it with a T1 as well.

[JDkeystone]

Hey TOMMAX, any updates?

[TOMMAX2]

Hey everyone, havent updated this in awhile cause things havent been going too well.

I am now certain that the lateral release was completley unnecassary in my case and it has caused alot more problems than I had before. I am positive now that I only needed the band of scar tissue (medila plica) cleaned up and nothing else. The mechanics and articulation of me knee cap feel really messed up now and it was articulating properly before. I had the same alignment as my good knee before surgery, now with the lateral release my knee cap is pointing inward and when I walk it feels like my leg is crooked and knock kneed. My knee cap grinds alot now and when the leg is in full extension it feels like the articulating cartilage of the knee cap is getting crushed within the groove, I never had this problem and this much pain before and I had proper functioning which I have now lost due to the incompetence of my surgeon.

I blame my surgeon for poor communication and poor judgement of this situation. It really pisses me off because I know that my knee would be 100% right now had he just done what we agreed on in the first place and cleaned the band of scar tissue but he ended up going full retarded and realigning my knee cap. Fuk I hate him.

I ended up mailing 4 letters yesterday complaining of my situation and this doctor. 1 to federal minister of health, 1 to provincial health minister, 1 to Regional health authority, and 1 to college of physicians and surgeons. Im hoping to get some answers from the higher ups as to why this realigment procedure was done, is the surgeon who did my procedure competent, and what Im supposed to do now and how Im supposed to live my life like this? I dont know what else to do. In the mean time I continue to do my physio exercises and try and eat properly and hope that I will adapt to all fo this some time in the future.