Wednesday, November 17, 2010

KJ's PCL Story

Hello everyone and welcome to my blog.
Here is another pcl survivor story! Thanks for sharing KJ.
Skinnygurl

First, I love your blog! I just found it yesterday and I'm almost done reading the entire thing! Thank you for sharing your story and giving others a place to share theirs.

My story is a little long because it took me 6 years to get the surgery. A little history: Original tear occurred in April of ’03. I took an awkward tackle straight-on below my knee during our Midwest Rugby Championship match (we won at least).

The MRI showed a partial tear of my PCL so they advised PT only and no surgery. The next 5 years looked like this:

- Played at Nationals in June ’03 right after the injury (dumb & painful)
- Missed most of fall ’03 season due to pain but resumed regular playing in spring ‘04
- Played at the Midwest level in ’05-’06 (grueling training schedule) and attributed knee pain to over-training. I know now it was due to the original injury.

- Tweaked my knee playing volleyball in spring ’07. It sent shooting pain through my knee that radiated out into my upper leg and I had to stay out of activity for 3 days. After that it didn’t hurt anymore. In hindsight I should have had it checked because that’s most likely when I completely tore my PCL.

- Kept playing rugby and played my final season in fall ’08. I barely made it through that season though because of knee pain

I went back to my original ortho who basically did nothing; saw a 2nd ortho who ordered another MRI. Follow-up:
- He saw the complete tear so I tried PT for 2 months at the end of ’08 and cortisone injections but nothing relieved the pain.
- Was referred to a 3rd ortho, Dr. Noyes at Cincinnati Sports Medicine, who happens to do an incredible amount of research on PCLs
- Stress test revealed a 11 mm drop of my tibia from my knee. I was questioned on how I kept playing; surgery is generally done once the tibia drops 6-8 mm. I told him it was easy since I didn’t know there was actually something wrong :)
- I was scheduled for surgery 2 months later (March 25, 2009)

I’m not gonna lie, I had no idea what I was getting into with this surgery because I’d never had so much as a stitch in my life; that’s probably a good thing.
- They used my quad tendon for the graph and surgery surprisingly took under 4 hours.

- The next 2 weeks were full of plenty of tears at rehab because of the pain. I had scar tissue issues and couldn’t hit 90 degrees flexion by the end of the 2nd week so back to the hospital I went for manipulation under anesthesia. That may have been worse than the actual surgery!
- I immediately jumped up to 106 degrees after that and made steady progress from there on out. I never had issues with range of motion after that and never had a problem with getting my leg completely straight. That was the only thing I could do from day 1!
-I spent 9 weeks total on crutches with my hip to ankle brace (I think I got a sleeve the last 2 weeks). The first month my brace was locked straight which is awesome when you’re trying to sleep. In all, the healing process went well though and my knee is solid and stable. My stress test at 1 year showed my tibia only dropped 2 mm which is normal so the graph has held. However, my strength test at 1 year was depressing and still showed a 33% deficit.

I should probably mention that 2 months after my surgery (while still on crutches) I got engaged! I was married 4 months after that so admittedly my rehab suffered a bit from months 3-7! Heck, is suffered the 2 months after we got married too :)
Current Status:
I coach high school girl’s & senior side rugby now and ran around all spring with a limp. It caused enough pain that I headed to a new rehab place in July to see if I could do anything about it. Manual therapy helped some but I think it’s as good as it’s going to get.

I think I'm glad that I didn’t have this surgery at 23 years old but the downside of having a janky PCL for so long: grade 3 chondromalacia of the patella with chondral fissuring and suchondral reactive osteoedema. Basically the same grinding & snap, crackle, pop others have mentioned plus I'm awfully close to being bone on bone (grade 4). I have arthritis in 2 of the surfaces along with effusion (water on the knee) & a baker’s cyst (in the back of the knee) that came back pretty much as soon as they drained it. I've also developed painful tendonitis in my good knee. They say this put off knee replacement an extra 10 years though so I have to look at the bright side.

By 18 months out I was done babying my knee even though I continue to have a lot of pain. I could do quick starts and sprint at rugby but always paid for it with LOTS of pain afterward. I am back to boxing & zumba which haven't bothered my knee too much. Running a 5K isn’t in the picture yet and may never be (I never really liked just plain running anyway - ha!) and I have no plans to return to competitive rugby, although I still feel my 12-year career was brutally cut short. Strength is still a nagging issue but it's better; pain is still my number 1 nemesis!
The Future:
I go back in March '11 for my 2-year and final check-up. I’ve skipped all the strength tests since my 1-year mark because they are expensive and I don't need them to tell me that I'm weak. I may get another one at 2 years just to see where I am. I still have 1 1/4" difference in my quad size and the catch 22 is I can't do extensions because of pain and I'm not supposed to do squats (I still do them with <20 lbs). Tough to get my full quad back with just straight leg lifts!

Unlike you, I'm not always sure if I'd do this again! :) It changed my life forever.