Post ACL surgery

[S_Man99]

Snow... I'm now recovering from my surgery, which I had last Friday. I was diagnosed with a completely torn ACL and a medial meniscus tear. When they got in there for the surgery, they found that the meniscus tear wasn't repairable, and therefore just snipped the torn piece off. That came as good news cause I can WALK around at my will, as long as I can take the pain. My whole leg from about half way up the shin to about 1/5 of the way up into my quad is swollen and very badly bruised in random spots. I'm using a cold therapy machine, (pumps ice water from a cooler through a tube into an ice pack around the gauze on my knee) and a passive motion therapy machine. ( machine that constantly moves the leg) The cold therapy machine is to be used whenever inactive for about a week to help with the swelling, and the motion machine to be used for 3 hours a day increasing the degrees of tension 10 degrees each day. I'm also ordered to start basic physical therapy with ankle pumps and circles whenever inactive, and some other light things on the side. I can walk around the house fine (with a slight limp) but getting up stairs is tricky. Don't really need the crutches for assistance. Anyway, just thought i'd fill you in on how everything went. Let me know what you think. Thanks.
S

[snow85]

the acl/meniscus combo is common. i had that too, but mine healed and i didn't need the snip. what i tore was the anterior medial horn, i think. coulda been posterior... i'd have to pull my record.

but, that 'snip' is normal. that's what i had done for my 2nd surgery.

i'm surprised that they're letting you walk right out of surgery. of course, you know the bruising is normal. sounds like you've got a cryo-cuff. those things are awesome. i still use mine, and it's been 12 years since my surgery. your passive therapy, while it may help with swelling, is really to get your range of motion back. extension is always harder than flexion, and i'm sure they'll try to get you to at least 180 degrees, or wherever your other leg goes.

you need to be really, really careful-- especially if you're not using crutches. are you in a brace of any kind? (this is especially true if you have a dog that tends to get under foot.)

how are you feeling this week?

[vladnedelea]

Snow , since you are already reading this post I have a question for you. Recently I had torn my acl/mcl ligaments in my left knee but the doctor said there was no meniscus tear (he said all this based on the MRI scan). I went to physical therapy and managed to get full range of motion or my limb in a very short time and then i went back to the doctor..He checked my knee out and then he told me i'm free to go and i'm allowed to do pretty much whatever i want so i listened to his advice and i started squatting , playing racquetball , and messing around in the water. After the first time i started pushing it , my knee became a little puffy and sore so i just iced it but my biggest concern is the pop i hear sometimes. Usually if i flex my leg and then try it to extend it it pops (sometimes it doesn't , sometimes it barely pops and sometimes it pops really hard). My dilemma is : Can this be from the meniscus ? Do i have a small piece of broken meniscus floating around in my knee or is it just the side effects of my injury and will not harm me at all ?
PS. It doesn't hurt , hope you'll notice this post and reply back to it..thanks

[S_Man99]

It's been about 2 and a half weeks since my sugery, and most of the pain has gone away. I finished up with my passive motion therapy and am starting physical therapy this week. They said they needed my knee to extend another 7 degrees or so to get to where my other one is at, and about another 20 degrees of flexion. (when I pull my heel to my butt) I have been giving a series of home exersizes like the ankle pumps and ankle circles to do and now am starting quad flexes and leg lifts. They also have an exersize for me to do where I take some sort of towel, or band and place it under my foot while i'm sitting down and slowly pull my heel to my butt. (trying to get that range of motion back)

I am walking around with no pain in my leg whatsoever. (except when I walk up stairs) The knee as a whole is feeling a lot better and I can definately feel the difference in stability from before to after surgery. Although it's only been a few weeks, I'm a little worried about my knee cap. When I try and flex my quad, there is a sharp, but mild pain right above it. Do you believe this is still just the after effects of the surgery and the fact that there may still be some swelling? Also, when i'm sitting in a chair, and lift my leg off the ground a little bit and do a leg extension out slowly and back slowly I feel a sharp but mild pain as well. Overall I feel pretty good and am surprised at the progress i'm making. I have definately heard enough from many people stressing not to over do it right out of surgery so I'm being cautious not to do anything physical other than what my surgeon and PTs have told me to do. The incisions have healed up nicely as well.

What is a cryo-cuff by the way?
And no I don't have a dog that can get under the leg, so that's not a problem either.

S_man

[snow85]

haha. your pain has gone away because you haven't started PT yet. have you been on a bike? your program is the strangest i've heard. everyone i know, myself included, has started PT the very next morning following surgery day. that you've waited for so long, and have been left to your own devices at such a critical stage in the healing process is weird.

make sure you're getting a full contraction on your quad sets. very, very important. it translates to successful running and jumping later on. leg lifts-- make sure your foot is flexed, leg as straight as possible.... unless they told you to slightly bend your knee-- but only if they told you to do that. (there would be a reason for it.)

funny thing about the stabiity huh? i'll bet it's nice to have that 'end feel' again when you straighten your leg.

"knee cap:"


When I try and flex my quad, there is a sharp, but mild pain right above it.


above it? meaning directly on top of your patella or above it-- an inch or so above it on your quad?


do a leg extension out slowly and back slowly I feel a sharp but mild pain as well.


where? same place?
and when? when you're extending your knee or flexing it?

physical progress and physical healing are two different things. sure, you can run at 10 weeks, but that doesn't mean that you should go running down the street on a 3 mile cruise. your leg will feel fine long before the graft has healed and is ready to be subjected to stress. you need to be very, very aware of this for several months. are you going to be in a brace for activity, and if so, for how long?

didn't i tell you--?

cryo-cuff = best thing EVER.

2 kinds. i have an original, so i have the cooler. i like it b/c i can control the level of compression and how cold it gets while it's on my body.

http://aircast.com/products/product.htm?pid=24&pgid=67335325-A0DF-4201-A43D-4AD9D173BE42&rnd=229441049

[S_Man99]

haha. your pain has gone away because you haven't started PT yet. have you been on a bike?


I started my actual physical therapy at a proffessional place with a physical therapist last thursday. The morning after surgery, I was told to start my home therapy routine consisting of the ankle pumps, ankle circles, quad flexes, and leg lifts. There was no way I was going to be on a bike or doing anything other than those exersizes for that first week. Last thursday when I was with my physical therapist, I did about 10 minutes on the bike and then some other medicine ball exersizes, and a few strength band workouts.


make sure you're getting a full contraction on your quad sets. very, very important. it translates to successful running and jumping later on


I contract my quad as much as I can until that pain starts and then I hold it for about 10 seconds and release for 10 seconds, and continue that for about 10 minutes.

The knee cap pain is above it near the quad. Comparing my knees, I still have a lot of swelling so could that be what is causing this pain? The leg extension pain feels like it's physically under the knee cap. Not below it above the patellar tendon, and not above it near the quad but actually under the knee cap. It's actually not as bad today, but it's a slight pain. This pain occurs when am slowly bringing the leg back toward my body.

I'm not currently in a brace, but when I start up more physical activity (running, basketball, lifting) I will have it in a brace. I haven't dicussed that part of my rehab with my PT yet.

Is ice the best way to get the swelling down? How long until the swelling should be mostly subsided?

[snow85]

what kind of graft did you have again?

you need to be icing and elevating for about 20min after your pt.

How long until the swelling should be mostly subsided?


tell me the particulars abt the surgery. did you say cadaver?

[S_Man99]

Yes, it was an allograft. (cadaver)

Snow... you seem to be very knowledgable about most medical issues on this site. What exactly do you do? Would you mind if I looked at your credentials? Not that I don't believe that you are a certified doctor, or something of that nature, i'm just curious about the information I get from people that I don't know. No disrespect. sean.humphreys@colorado.edu is my e-mail addy if you could send some stuff. Thanks and again, no disrespect whatsoever, I'm just curious.

[snow85]

haha. i'm not a doctor, although if i was, i'd be living up in your mountains, getting richer of knee surgeries every winter. good times.

email inbound.

(btw, are you from there/ do you know anyone who appraises land in CO?)