Tuesday, March 22, 2016

Angus Had Surgery and Needs Our Help!


Written to me from Angus.
Let's see if we can give him some good advice in the comments section.
Hi , I emailed you earlier this year asking for some help on your 
blog about my pcl, and last week I finally had surgery which went better
 than I expected. It's been a week since and I can just about put all of
 my weight on it with crutches for reassurance. However it is still 
swollen and I can't bend it past about 30 degrees ( even with a small 
towel). I am doing all the prescribed exercises as well as ice and 
compression. I am keen to get the swelling down, is there anything else 
anyone thinks I should be doing or should it start to decrease within 
the next few weeks? Thanks 


Monday, January 11, 2016

Angus From South Wales needs advice

Hi it's Angus here from South Wales (UK). I've just seen your 
blog on pcl surgeries online and I am looking for some advice. 
Around two years ago I got tackled playing rugby and twisted my 
knee , it swelled up and I had difficulty walking on it the 
physio I had at the time examined it and said that it was only 
a minor sprain and to rest and ice it etc. A month or so later
 I noticed that I could move my shin bone back and forth by just
tensing my leg muscles , there was also instability when I tried 
to squat or bend my knee. The next physio I saw examined me and 
told me that I may have torn my ACL ligament and to book an 
appointment with a knee specialist who eventually ordered an 
MRI. Surprisingly the scan showed that I have a full grade 3 
tear of my pcl and the doctor suggested surgery was needed. I am 
due to have surgery in the next two months but I am back to playing 
rugby with some mild pain and instability (needing a knee brace ) ,
should I continue playing or stop ? 
Please don't hesitate to post this on your blog or to contact me back 
Many thanks 
Angus

Thursday, February 12, 2015

M.S. and Her Journey

 I'm a 53 year old mother of 5 children, always been active but not sporty, just walking the dog several miles, body boarding with the kids etc. Four and a half years ago (23rd February 2010 to be precise) I was walking our dog on an extending lead when she ran off behind me, I didn't have time to think about letting go of the lead and basically I was twisted and pulled over causing a tear to my knee. I couldn't move at all, just remember seeing blades of grass very close to my face! My husband dragged me onto a sledge (it was still a bit icy) and got me to a&e where they said I hadn't done anything and would be walking fine in a couple of days. Fortunately we had a pair of crutches in the shed so I just about managed at home for 5 days but as the leg had swollen hugely and I still couldn't walk I decided a second opinion was in order. The GP sent me to an orthopedic consultant and after several appointments and an MRI they discovered I had grade 3 tears to my PCL and MCL.

  I was told surgery wasn't an option, presumably because of my age, and after 8 months of physio I was able to walk without the brace and only used the crutches occasionally. Obviously a very long and painful process but at least I was managing. Recently though as I've started walking further - 2 to 3 miles max - I'm having pain in both the damaged left leg and right knee. I've been seeing orthopedic surgeons and physios privately for the last few years but I've now been referred to another surgeon in Derby who wants to reconstruct the ligaments. In addition he has identified PLC damage and says to prevent further damage and arthritis to my left knee and limit the wear in my right knee surgery is the best option. I'm in total agreement with him as the discomfort is getting worse but the thought of going through all the pain and physio again isn't something I'm looking forward too. Reading all the stories on your blog makes it all very real again but at the same time it's encouraging as so many people have seen the benefits of surgery.

  I'm on the waiting list for surgery, the surgeon will take hamstrings from both legs as it seems there won't be enough from just one leg for all the repair work. It's a strange thought, going from little pain to extreme pain but I'm trying to concentrate on the end result and not get too scared. I'm trying to find loads to do for those long and boring months after surgery and am setting goals to measure my progress by. For anyone having this injury I'd say surgery at the time of the accident or pretty soon after is a much better way of dealing with it, I wish I'd found out about it sooner. I'll let you know how it goes if anyone is interested.

  Someone on here mentioned creaking and cracking when they bent their knee? I have it too, it's crepitus and is wear of the knee joint.
 
  Thanks for setting up this blog. This seems to be an unusual and difficult to repair injury, I've had to go miles to find a surgeon capable of and willing to do the surgery, so it's really good to be in contact with others in a similar situation.
UPDATE:
Well, 10 days post op and I've just had stitches out so it doesn't look as bad as the photo. I'm relieved to be on this side of the operation, I had all the usual doubts before - could I go through all the pain and physio, what if it didn't work etc but that's all behind me now. Still haven't got an answer from the surgeon as to whether he minds me posting my experiences, I'm seeing him on Thursday and if he doesn't give an answer then I think we'll just go ahead and use a different name, don't you?

I had a spinal anesthetic for the operation so was able to watch, really fascinating and very clever. It lasted two hours, I can give details if anyone is interested. First few days were pretty uncomfortable but morphine is a great help, down to codeine now so things are improving. Lots of numbness in my lower leg and loads of bruising to my foot, made worse because I'm on heparin injections to prevent blood clots but hopefully this will pass soon. Physio starts next week, static quads and straight leg raises I believe to begin with although I've been told to remove the brace once a day and get someone else to bend my leg to 90 degrees ( they've got to be joking!) as it stops the knee stiffening. This was meant to be done daily from 3rd day after surgery, I haven't managed to pluck up the courage to have it done daily though, every other day more like.

Wednesday, April 9, 2014

Deigo's PCL Surgery And His Struggles, Let's Help



Sorry for the long story, I have two questions at the end please help me


I am looking for some advise. Over ten years ago when I was in my teens I crashed training for a mountain bike downhill race and completely tore the PCL in my left knee. The doctor at the time told me the same story that most of you may be familiar with. That I could function without my PCL as long as I kept my leg muscles strong because they would act as the stabilizers in the absence of the PCL. He said I could have the surgery much later if I started feeling pain and instability. I listened to his advise. I have always been extremely active and an adrenaline junkie so I worked out my legs pretty hard at the gym and when riding my bike. My quads and gluteus grew and my legs got very strong which also helped me during my Downhill races and for protection I would ride with a custom PCL Cti brace for my knee which became my best friend. All was fine and dandy till last year when during a strenuous hike I felt like something was not right with my knee, it just did not feel stable and I remembered what my old doc had told me a long time ago.



I will tell you that February of last year I had my first bundle of joy so the working out all the time had to be replaced with taking care of the baby and going for walks and not sleeping enough and changing diapers, which by the way made me extremely happy and I enjoyed being a first time dad. But as my schedule changed my leg muscles started shrinking; I was not able to work out as much. I decided to go to a doctor to see what would be the verdict. I knew deep inside that the time for surgery had come. Long story short I ended up needing surgery to avoid wearing off my knee and developing arthritis later on. Fortunately since I worked out pretty frequently my Knee was still in good condition with no cartilage degeneration. Surgery was a no brainer since I would not be able to work out my leg as much and keep my muscles strong would mean a life of being tied to the gym and with a family that can be a challenge.



My surgery was a success according to the doctor. He used an aquilles tendon from a cadaver since it is a very strong tissue. I had a nerve block so the first 2 days were not painful at all and I started taking the pain meds the moment I got home the same day after my surgery. I was very excited and motivated and the first 3 months I was doing great going to PT 3 times a week, my quad was getting its definition back I was doing light leg work outs at the gym doing different type of light leg presses with different angles, calf raises , light weight squats in addition to going to PT 3 days a week and my knee was at 90% compared to the other according to the Physical therapist. But then one day I started feeling a lot of pain under my knee cap, like something scraping the crap out of it when i would bend it or tried to raise my leg and bend it. That is when i started getting worried, I started reading stories about people and patellar arthritis and how the instability degenerated their knee cap etc, etc... so obviously i was thinking that was happening to me. The doctor said that was not my case since i did not have arthritis to begin with according to MRIs and when he performed the surgery he said the meniscus and knee cap looked very clean and healthy. He said it was a case of my knee cap not tracking correctly. Seems like i may have over done my excersises trying to get better so my quad was getting stronger but my hamstrings were not so my quad was grabbing my knee cap and causing an imbalance not letting it track correctly. I was concerned and still am. Since we are no supposed to do any hamstring exercises like leg curls and don't even mention leg extensions because that one is the worst, it will stretch the graft, or open chain ones because they pull on the graft it is quite a challenge to get that balance back.



The pain lasted for 2 months and I had to pretty much go back to the basic exercises with the PT guy, it sucked. Finally it got manageable and i was able to start working out at the gym but my quad definition was totally gone it is like jello, the leg is getting stronger but no matter what i do the quad is being very stubborn and not wanting to come back to life therefore my knee cap is not being able to track correctly. I can walk normally and ride my bike with my baby in the child trailer but i still can't go hiking or go snowboarding or do more fun stuff. Some days it hurts some days it does not. Working out definitely makes me feel much better, at least for a few hours following the workout.



It has been 7 and a half months since my surgery and I am trying to stay patient because the doctor says that my tracking issues will get better but sometimes it takes a year to 18 months for my knee muscles to get back to normal. At first he said 9 months.



SO... my question is, has anyone experienced the knee cap tracking problems due to the quad being weak? Is it just a matter of time before it gets better or am I screwed?



Thank you!!

Thursday, March 27, 2014

Suspect PCL Tear

I'm hoping you can share this on your blog and your readers can give me some advice. I injured my PCL in a collision on the soccer field. I fell hard on my bent knee and had immediate pain. To my surprise I was able to get up and jog and played a few more minutes before coming out. That was 2 and a half months ago. My knee hasn't gotten much better since then. The most pain is in sprinting and cutting hard, kneeling with my knee fully bent, and pulling down on my foot like taking off a shoe. I finally went to the doctor who suspected a torn PCL due to some movement and possibly a torn meniscus. He prescribed an MRI which I had and returned today for consultation. The diagnosis is a high grade tear and he suggests surgery. I can see on the MRI image what looks like a pretty bad tear, but not complete. I'm surprised because the pain doesn't seem that extreme and I'm not having a lot of instability. After reading the comments I think I will get a second opinion. My main questions are around the options. I'm looking for experiences using a graft from quad vs hamstring vs cadaver. Thank you! *PLEASE LEAVE COMMENTS FOR JOE Thanks, Skinnygurl

Friday, November 29, 2013

Mathew's Story

Hi My name’s Matthew, I’m a full time university student, studying Agriculture in Adelaide, Australia.


I’m pretty big on my sports including Aussie rules football , cricket and just running and keeping fit in general.

My story started about 12 months ago, I was mustering cattle on a dirt bike, when I was knocked of by a cranky cow, my knee got caught underneath the motorbike, and was forced into some into some rocks. At the time I was more worried about making sure the cow wasn’t chasing rather than any pain in my knee.

That night I noticed my knee was quite swollen and it was sore, so sore that is was a struggle to take my boots on or off, running or lifting heavy objects was also quite a task.

The pain did ease over the coming weeks, but the swelling didn’t and my ability to run didn’t return and I guess my knee just didn’t feel right.

So booked into see an orthopaedic surgeon to see what the issue was, he initially though I had just torn a little bit of meniscus, but he sent me for an MRI just to be sure. When I returned he and I where both shocked to see that I had a completely torn PCL and it was an isolated tear so there appeared to be no damage to any other structures.

He explained to me that because I was young and active that he would recommend I have it reconstructed, he said that recently there had been a change from surgeons recommending straight physio, to recommending reconstruction for younger patients as the chances of doing further damage to the knee are high. So I booked in for surgery about 2 months down the track as this was during my university holidays.

Before my surgery the surgeon recommended I see a physio, and work on strengthening my legs in particular my quads and calves. I was able use a bike and cross trainer as well as doing light weights with no pain, so I focused on getting as fit and getting my leg in as good a condition as I could before the surgery. I truly believe this had a hugely beneficial to my recovery, so if I could give one piece of advice it would be if possible to see a physio and get a exercise routine to do before surgery

I had my reconstruction using on April the 8th 2013 using my own hamstring graft. The anaesthetist gave me a nerve bloke before I woke up so I felt very little pain besides a little tingling in my hamstring.

I was sent home the next day in a straight leg brace, with a pair of crutches and some pain killers. I only used the pain killers at night for the first week and was pretty well hobbling around without crutches in two days. The only real pain I got was when I stood up, I’d get an almighty pain in my shins, which would eventually go away if I just walked through it.

I was told to where the brace at all times except for a brief shower, and to just take it easy for the next 4 weeks before going back to the Dr, where I was fitted into a hinged brace and given an initial range of motion of 90 degrees .

I had to were this brace for a further 9 weeks taking it very easy on stairs and I was also not allowed to drive. I was able to some simple exercises.

After 9 weeks I went back to the surgeon took the brace off and the physio was the able to amp up me rehab. I was doing leg raises, leg presses and extensions, and also a lot of work of the stationary bike, and also swimming. The exercises all focused on building up my quad muscles, and being sure not to work my hamstring, which would pull against my graft.

I went back for my final visit to my surgeon in late September, where he gave me permission to begin straight line running and to basically start living normally again.

At the time of writing this it is the 27th of November and back running and kicking the football, and pretty well doing everything I was doing before the injury and I also passed university. I’m aiming to play football again in April next year. I’m not in the clear yet, but so far so good. It is certainly a time consuming injury, but if you don’t rush it, follow your doctors and your physio’s instructions there is no reason you shouldn’t be able to get back to living a pretty well normal life.

Any questions feel free to ask.

Yours Sincerely Matthew James



Wednesday, June 19, 2013

Melissa The Soccer Player

Hello and welcome to my blog. 
Melissa is asking for help. 
Please read her story and leave comments.

Thanks,
Skinnygurl





On June 11, 2012 I blew my PCL out during a coed soccer game. I went into a challenge with a guy on the other team and he nailed me, cleats up, straight in the knee. I felt an intense burning sensation. and what I can best describe as feeling like my knee bent the wrong way.
A trip to the ER resulted in a diagnosis of no tears, just some strain from the hyper-extension. I got an appointment with an orthopedist and a manual exam and MRI confirmed a torn PCL. Initially my injury was graded at a 1.5-2+, which I was told is right on the edge of what you can live with and rehab without surgical intervention. I was locked out and no-weight-bearing in an immobilizing brace for 3 weeks, but the tibial sag didn't seem to be improving at all. They locked me out for another 3 weeks, and felt like there was sufficient progress to be begin physical therapy. As with everyone else on here, my muscles had atrophied so quickly that I had to rebuild all of the strength in my leg. I made good progress, and within a few months my physical therapists allowed me to do some very tentative jogging to see how things held up.
Unfortunately, they didn't hold up at all. The tibial sag returned and worsened. By my next orthopedic appointment I was graded at a 3+ and told I had no other option but surgery.

I got a call on December 27, 2012 that a donor ligament had come available and I had the surgery on January 15, 2013 during which my surgeon removed my PCL (apparently one end of it had completely torn off the bone, and there was a tear about 3/4 of the way through the middle of the ligament as well) and used the tibial inlay technique to replace it with the allograft in addition to tightening my LCL and MCL, which had both been stretched enough during the accident to not really provide much in the way of stability anymore.

The first few days were brutal. The polar care was the only thing that kept me sane. I was locked out with no weight bearing for 3 weeks. After that I spent 3 weeks still locked out, but able to bear 50% weight on my bad leg using crutches. At the 6 week mark my surgeon told me to lose the brace and crutches and go my own. It was really weird- my nerve endings had been severed and then I hadn't put any weight on my foot at all for weeks- it felt like my foot was all pins and needles for the first few days. I'd say it was a week before I felt comfortable enough to really walk without being overly tentative.

My first few appointments post-op were great and my physical therapists were happy with my recovery. I was able to get through my wedding with no issues, took a 2 week break from physical therapy to head to London and then got back to work. However, at about the 4.5 month mark I started to notice that I could feel a little shifting in my knee at times. It wasn't anywhere as bad as the initial tear instability, but enough to worry me given what happened the first time through my PT sequence. I went in for an emergency check with PT, and they confirmed that I had regained some tibial sag. While they said a little of loosening was to be expected after the transition from lock out to ROM exercises, this was more than they felt comfortable with. No one has ever been able to explain to me why this happened- their only guess would be a fall or a blow to my knee, but I never experienced either of them.

Around this time, I was cleared to jog for 1 minute intervals at PT to try and regain my running form. I never had any pain in the back of my knee, but I started to have a stab of pain in one spot on the front of my knee (right over the top of my fat pad) upon impact while running. After ruling out fat pad issues and instability resulting from muscles that weren't quite back to 100%, my therapists had me run with a tape job that pulled my tibia forward when i flexed my quad- I was able to run with little to no pain. The working theory is that the sag is causing my femur and tibia to contact each other "off" from where they normally would in a solid knee.

So that's where I am right now- 5 months out and fully functional in day to day activities, but only able to run with a tape job or my playmaker PCL brace. It's pretty devastating to make such great progress and work so hard, only to have everything fall apart for no apparent reason twice. I have my next appointment with my surgeon in a month and a half, at which point I can bring up my concerns, but there isn't much he could do short of redoing the surgery. Instead, my therapists have me working on strengthening my quads, hamstring and glutes as much as possible to try and provide the maximum amount of stability to my knee.
I guess my questions would be:

1) Has anyone else had a PCL repair kind of flame out after progressing perfectly for months without experiencing any sort of impact injury or other factor that would stretch the ligament out?

2) Is anyone else competing at a high level in soccer or running moderate distances (I was running 5 miles a day pre-injury) with a sag of probably 1-1.5+?


Thank you,
Melissa