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!!

28 comments:

Matthew James said...

hello Deigo

I had a few tracking issues with my knee, due to my quad's basically shutting off, or i worked it too hard a few times,and not being able to work my hammies for a long time expecially with a hamstring graft didn't help it either.

My physio told me, that my quads won't come back while i'm experianceing pain, from my knee cap tracking, so she showed me how to strap it, so it didn't move, and this enabled me to do my excersizes and eventually i didn't need the strapping any longer.

If your able to, get a pysio to show you how to strap your knee to stop your knee cap tracking on you.

Dloperat Loper said...

Oh wow thank you so much for that info. I will bring that up during my next appointment to get some better results. It feels much better than before but that added touch should help a lot.
Thank you Matthew!

Molly said...

I hope you are recovering nicely Matthew.

I'm on the blog tonight to give an update as to the status of my post-op knee (PCL recon and MCL repair in 2006).

I was experiencing A LOT of pain and loss of function after stepping into a hole last Sept and hyperextending my knee. After 6 months of conservative treatment, I got to where I really couldn't walk more than a few blocks, and even that with a lot of pain.

My OS thought it could be a meniscus tear. The MRI indicated a small tear and a raggedy edge medially. Also identified was a ganglion cyst in the PCL itself that extended into the distal femur.

Thankfully I didn't have a large tear, so I've avoided surgery for now. But what was identified was a significant amount of post-traumatic arthritis graded III/IV. I've got full thickness cartilage fissuring and delamination, degeneration in three compartments with medial and lateral full thickness chondromalacia, with possible degenerative marrow changes in the tibia.

In short, 8 years post-injury, I've developed the degeneration and arthritis that we are warned about.

But the good news is that a cortisone shot has given me a lot of relief. I am able to walk without pain or limping and actually look forward to going about normal daily activities, going to the pool, and walking the neighborhood.

Beth Bailey said...

I also have a similar problem. I tore my pcl almost 8 months ago. Doctor recommended PT (no surgery). Things were going great with PT at first and then the dreaded kneecap pain started. I feels like someone is jamming a screwdriver under my kneecap and trying to pry it off. This basically stalled out PT exercises and strengthening. My PT tried a bunch of different taping techniques that are supposed to help hold your kneecap in place. None of them really helped all that much though. Its been 8 months and my knee still hurts all the time, i cant ride my bike, kneel or do basically anything that puts strain on the joint. Doctor told me that i am just screwed, and the dynamics of my knee have changed without a pcl.

Skinnygurl said...

Beth,
Try to find another surgeon.
Just because he won't do it doesn't mean it can't be done.
Best of luck to you
Skinnygurl

Dloperat Loper said...

Beth, I agree with skinnygurl, find a a good orthopedic surgeon that knows what he is talking about and that is willing to do the surgery. You should not have to deal with that pain.

Jake Lieb said...

I have a grade 3 PCL tear from 2 years ago. My knee doesnt really hurt or "give out" but is loose and has laxity. I could live with it how it is, I'm just really worried about arthritis down the road. My OS didnt reccommend surgery 2 years ago, but I"m going back for another consultation in a few weeks as I"m considering getting PCL recon. I have 2 questions: What questions should I ask my surgeon? and of those that have had PCL recon, do any of you regret it? Thanks a million!

saurabh rao said...

Hi Jake,

I am in the same boat as you are . Its been two years since a complete PCL rupture, as it was an isolated tear, doctors suggested physio rehab. However, its been just over 2 years now and as months have passed by, my knee function has been deteriorating and there is constant low intensity pain in the knee which is attributed to resultant cartilage damage. I am now considering a reconstruction to ensure that further cartilage damage doesnt occur

Skinnygurl said...

Hi Jake Lieb,

I'll never regret having my surgery. Please let us know what happened at your appointment and whether or not you'll be moving forward with the surgery.

The Fed said...

Hi Diego/All/ Skinnygurl, whatver happens patience is the secret to a PCL injury/surgery. After running half-marathons like crazy and playing soccer like mad, I did not listen to my knee and finally my PCL was torn completely by just changing direction during a match. I got operated in November last year (the doc didn't use tendon from another body but tissue and bone near my quad/knee, this technique is well developed here in Europe and apparently the ligament doesn't lose tension during the years, whatever right?). Post-OP, my quad shut off completely and I was looking like a stork to the point that I had to do some neurological tests to see that there wasn't any damage to the nerve. I am still limping a bit because my quad is not there yet 100%. The tests showed that I am completely ok. I was just too careful during the first months post OP, and that caused it. Now things are going much better, physio, gym, compex while watching TV to stimulate the muscle, etc. So my advice is, believe in your surgery, and don't look back or ahead, just day by day. I even had contact with a top athlete's doctor and he said PCL is very complicated and unless you are a professional athlete, it can take up to a year, and a bit more, to get there 100%. I miss my runs most of all but I will get there. Don't go crazy, keep working hard, and use others' examples as motivation but not as a comparison because we all take different routes and react differently to difficult moments in life and to physical injuries. Good luck all!

Skinnygurl said...

The Fed
Is 1000% correct!

Be patient ! :)

thanks for stopping by

Skinnygurl

sebastian quintero said...

Like Jake and Saurabh my doctor also prescribed physical therapy instead of doing surgery. It's nice to see others have went through this and are still currently going through it just like me. I can post a story about what happened to me it's kinda interesting/messed up ha(Slip and fall at my work, Sprint). I have a torn PCL and I have a slight bone avulsion on my tibia as well. I have this verified with an MRI already. I have a good amount of laxity in the knee and I show all the classic signs of torn PCL. It's cool to see how long to go your blog was started(it rocks) and how little there was on PCL information back then, and there's still not a lot out today on it, but there is a good amount now. This blog definitely has a great amount of information and very helpful stories as well. I think I've read almost every post and comments lol. It has definitely helped ease some of the nervousness about deciding if I want to have surgery or not. And I would like to have the surgery especially considering that I'm 24 years old and I like to be active and play sports! Thank you Skinnygurl.

-Sebastian Q.

sebastian quintero said...

Oh and I was injured Mar 31, 2015 originally.

Skinnygurl said...

Welcome Sebastian,
Thanks for the great comment. Yes - send me a rough draft with a couple pictures and we'll get your story out there.
I'm glad this blog has helped you.

Skinnygurl

You can reach me @
sprinter2fun
@
hotmail

sebastian quintero said...

I will send a draft when soon when I can. I have my appt This July 7th, and that's when I'm going to let my doc know that regardless of what he's been saying I want to progress to surgery. It's cool to see that you're still active on your site. Thank you once again!

-Sebastian Q.

Skinnygurl said...

Whenever you're ready will be perfect. Best of luck to you Sebastian.

Skinnygurl

sebastian quintero said...

Just had my PCL/LCL/PLC and menisectomey on my left knee done 2 days ago. Originally it was thought to be just minor isolated PCL tear. Yesterday was tough, bad reaction to some medications, now I'm off them and better. It's cool to reread everyone's experiences. I'm starting my own experience now. Ha. I'll definately be writing up to share my experiences with everyone so we can all have as much knowledge as possible. I was also able to go to one of the top orthopedic centers in southern California. Good luck to everyone!!

sebastian quintero said...
This comment has been removed by the author.
Skinnygurl said...

Hi Sebastian !!

So glad you're on the other side of surgery and getting better. Sorry to hear about that bad reaction though.
I'm so happy this blog is helping and I look forward to posting your experience very soon. This truly is a group effort !

Iamwhoiam said...

Good sharing, Knee pain is a common problem with many causes, from acute injuries to medical conditions. Normally people will believe surgery is the only way to relief knee pain, in fact, there are ways surgery free for relief knee pain. Example like using Unloading bracing technology, having ergo mattress etc. Read more at:
http://kidbuxblog.com/surgery-free-for-relief-knee-pain/

Unknown said...

Fed my name is Steve my son has a complete tear of PCL he's 20 and he's an American football player we're looking into going to Europe to have the artificial PCL bundle LARS and they do not use it in the United States not FDA approved. what did you find out and who did you use to do your surgery if anybody can help with this question we would appreciate it

shm said...

I'm new at this blogging thing my son is 20 and has a complete tear of the PCL looking to have the artificial Lars ligament surgery and wonder if anybody knows about it I know it's not fda-approved is Europe the only place and if so who's the best surgeon?

The Fed said...
This comment has been removed by the author.
The Fed said...

Hi Steve I am sorry, for some reason I missed your comment but here I am. To be honest PCL injuries is not an easy topic as they don't happen that often and the common assumption is that it's similar to ACL's. In other words I found more about it post OP. I did my OP at the Salem Hospital in Bern, Switzerland where I understand the technique used for my OP has been very successful, especially as time goes by: its reconstruction method which is using bone and tissue from the knee itself allows the ligament to not lose tension with the years which is very important. If taken from another body I've been told the ligament loses this vital tension with time among other problems. In any case I can tell you I've been feeling great, I have no pain at all and everything is working. My problem was muscle loss which is haunting me until today but it was partly my fault, so just make sure your son keeps getting those squads working before the OP. The OP requires only one screw which can be taken out later on. Not doing that! It's so easy to lose or waste muscle that my first recommendation is to look for that above all. First month was painful but all OPs are. Now, the recovery time if you aske me, shoukd take at least a year. But it can take up to a year and a half in cases such as mine. Some people don't agree with this technique but like all of this, it's a personal choice.Anyway, here's the hospital's website: https://www.hirslanden.ch/m/en/home/hospitals/salem-spital.html
My doctor was Dr Parli who you'll be able to find there. Don't hesitate to contact me if you have some more questions; federicorocha@hotmail.com

The Fed said...

Hi Steve I just replied to your previous post above.

OAKS Clinic said...

Knee pain is a common problem with many causes, from acute injuries to medical conditions. Normally people will believe surgery is the only way to relief knee pain, in fact, there are ways surgery free for relief knee pain. Knee arthroscopy is a surgical procedure during which the doctor will look inside the joint to evaluate damage and problems. Damages found during a knee arthroscopy can include cartilage tears, wearing or injury of cartilage cushioning and ligament tears.

Unknown said...

I had a complete rupture in my PCL and tore my lateral complex one week ago (21/09/2018) and had surgery yesterday. The docter did a hamstring graft for the PCL and put in a synthetic ligament on the side of my knee.

Reading all the complications you guys had scares me a bit as I play a contact sport for a living (rugby) and it makes me wonder if you ever really recover fully from such an injury..

Anyways Im still in the beginning of the rehab where the PT bends your knee passively and I can tell this is going to be a long process.

Good luck to you all though!

Skinnygurl said...

There are many complete recoveries that go unnoticed. I guess because for those people, life goes on and they don't seek my blog for help or advice.

As time goes on, if you're interested in telling your story I would be glad to feature you.

Best of luck

Skinnygurl