Hello everyone, My name is Danny, thank you for sharing your stories. This blog has helped me to keep my eye on the prize for the last few months because, as you all know - there is little to no information about PCL Recovery on the internet.
I am, however dealing with some setbacks. Until 6 months ago I worked as an arborist in Seattle, and an old (3+ yr) injury kept giving me trouble while working. I felt like I couldn't trust my leg (And I often use a chainsaw in trees). Sometimes while out on a precarious limb walk, a client would ask me "have you ever fallen?" To which I would reply "only once, when my ladder failed while I was on the fourth step". I hate ladders. This fall resulted in a misdiagnosed ACL injury and finally diagnosed to PCL.
I had reconstructive surgery (PCL-achilles allograft and PLC hamstring allograft) in March of 2020 in Seattle. After the first hellish weeks, what with the numb, purple lower leg (I kept wiggling my toes and doing ankle pumps bc I thought I'd lose my leg, still have hemosiderin stains on my shin from all the internal bleeding), my recovery was going great. I graduated to cycling, and was walking without a limp! My surgeon advised me to wear my brace "as much as possible". I wore it all the time, but especially during PT, and cycling, where we were beginning to do some jumping and running in place. That's when my knee started to feel really bad. Crunching, pain with weighted flexion, just not capable of doing that kind of stuff.
After a visit with my surgeon he noted 2+ laxity. He also realized that I was wearing the wrong knee brace (Ossur CTi with PCL kit, not the Ossur Rebound PCL).He told me he'd be getting me the correct brace, but I still don't have it, or any way to stop the trend in my knee.
It's devastating for me to have the last six months down the toilet because my team messed up something as critical as the brace. I'm just trying to find out what others' experience was like.
Did you ever run into laxity problems that somehow resolved with time?
What model of brace did you use and for how long did you use it for?
Anyone out there have a revision reconstruction?
I don't think I've ever had a mistake in my life produce so much nausea whenever I think about it. I really regret having this surgery at all, because my laxity problems are the same, if not worse than before, plus I'm almost positive my meniscus is going to shreds. I know that my care could have been better, but is it too late for my knee?
I'm hopeful that at the very least, getting the correct brace will allow me to cycle, so that I can remain fit even if I have to hang up the spurs. Also I'm not giving up having a functional left leg. It's too important to me to let slide. I had hoped to be up in the cascades munching huckleberries with my daughter by now. Have to settle for blackberries down the road. 🤤
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13 comments:
I am so sorry to hear of your trials!
I wore a Breg Fusion brace 24 hours a day (except when bathing) for a full year post-op for PCL/MCL reconstructions. That brace fit me perfectly and didn't slide/move at all. My knee was very tight post-op - but that might have been because I developed arthrofibrosis (frozen knee) and had to have the scar tissue surgically removed at 5 months post-op. After that recovery, I settled in at a 1 laxity. But, after a couple of years, I measured 2+ laxity. I was able to ride my bike for several years after I recovered, even for 30-50 mile rides, but I always wore my brace.
My surgeon and PT told me to expect the following: I would probably never again kneel on that knee (I don't), I would probably develop laxity over several years (I did), it would best for me if I stayed away from any jumping/cutting type of exercise (I have), and I may need a knee replacement at some point in the future (I haven't yet 13 years post-op).
I recovered all of my extension and all but about 5 degrees of flexion within a year of surgery. I never did recover the ability to walk up and down stairs like a normal person. Going down the stairs is done one step at a time. Walking over uneven surfaces is iffy. My knee will give out (this happened on a very steep pathway in Jerusalem about a year ago). NO running or jumping. No dancing or high-impact exercise.
I developed a lot of pain in my knee beginning about 3 years post-op (ended up being progressive degradation of my meniscus and the head of my tibia). I was diagnosed about 7 years ago with post-traumatic arthritis grade 3/4 in the injured knee and was recommended to have a knee replacement.
I couldn't afford it with my limited medical insurance coverage. So, I looked into alternative pain control methods and found Capzasin HP (hot pepper lotion). After a couple of weeks of daily use, the pain was gone! I used that for several years and must have done a number on the nerve endings in my knee, because I no longer have to use it daily. I might use it for a few days every 3 months or so to take care of break-through pain. I'm sure the degradation has continued to develop since then, but I don't feel any pain with it thanks to the hot pepper lotion.
I am pretty sedentary at this point with activity limited to walking my chihuahua several times a day and some occasional gentle water exercise. Long walks will result in a lot of swelling and pain. I don't ride my bike anymore. I don't wear my brace because it no longer fits. Walking down slopes is hard. I have a sore area over the medial ligament, so I still sleep with a pillow between my knees even all these years later.
You might feel like I did back when I injured my knee. My life was divided into two parts: before and after the injury. It took me a while to really come to grips with the permanent nature of the injury, even with the surgery. For the first year, my focus was completely trained on fully recovery from the surgery. It really was all I thought about.
After 13 years, the residual effects of the injury and surgeries are just my reality and I've learned to manage. I don't even really think about it much anymore. But my life did not go back to 'normal.'
As for your situation, you probably want to do whatever you can to stop the developing laxity. Talk with your physical therapist and/or doctor. If I were you, I would stop all cutting/jumping/climbing activities and wear the appropriate brace 24/7. As you now know, this surgery takes a long time to recover from. I used to laugh with Skinnygurl about how it seemed like it was always a 'two steps forward - one step back' process. Skinnygurl is welcome to give you my email address if you want someone to 'talk' to.
Hi Molly thanks for relating your experience with me. What year did you have surgery? I've been reading about how they're really improving results with modern braces. Starting with the Jack PCL brace in 2012, then the Ossur Rebound PCL in 2015 and the more affordable Medi PCL brace in 2018. Your knee may benefit feom an updated brace, as it could slow down the arthritis. There's some interesting research out there. I appreciate the advice in tempering my expectations. However, I know in my heart that I cannot divide my life in two like that. My will to get better is too strong. I can't think of anything more important than being able to do my job. It's one profession that can never be done by robots. I'm willing to do everything it takes. I'll have Dr. LaPrade himself fix me up if that's what it takes. What kills me is how much better I felt around the 3 and a half month mark, cycling many times a week to PT and back. I got a taste of having a normal knee, but I truly feel like it fell apart because I was using an outdated brace. I can't tell myself the story that I have lost a part of my life and will have to be more sedentary from now on. I believe with a conservative protocol and the gold standard brace, plus the best surgeon and PT I can find, we can do better. I can just tell already that my knee isn't gonna ride like this.
Surgery #1 3/14/2007: arthroscopic cleanup and lateral release.
Surgery #2 10/31/2007: PCL reconstruction and MCL repair.
Surgery #3 3/25/2008: MUA and arthroscopic lysis of adhesions.
Surgery #4 10/28/2008: Tibia screw removal.
You are still so young that your recovery will likely be better than mine. I was 50 years old when I injured my knee, and the reconstruction took place when I was 51. If you really think you are going to need a revision surgery, you might want a consultation with your surgeon of choice right away. Not that you would have the second surgery right away, but that surgeon may be able to give you a timeline and options.
Thanks for the hot tips Molly. I'll be seeing a new surgeon September 15th here in Seattle. MRI confirmed the graft has a partial tear, plus new meniscus degeneration and patellofemoral changes. I kind of eyeball measured my posterior drawer at somewhere around 12mm, or grade iii (tibial plateau goes behind femoral condyles). That is as bad as it was before surgery. I really am hoping it's a clear-cut case for revision, because I just know my knee isn't gonna hold up if I try to work like this. If this guy in Seattle doesn't want to, I'ma have to travel to Dr. LaPrade in Minneapolis, which would be very inconvenient, as we have a two year old 😬. Either way, I'm hoping this new Medi PCL brace will help me start training again without causing too much more damage in my knee. This has been hands down the most frustrating couple months of my life, waiting for my surgeon's team to order a brace I should have had six months ago, failing to do so, bugging them almost daily, then finally breaking down and ordering one on my own, supply issues, shipment from Germany...ugh. it all kind of feels like they finished a very technically challenging surgery then immediately gave me two middle fingers for post-op care. I've identified at least 6 errors on the part of my PTs and surgeon. 1) ineffective brace (it was an ACL brace) 2) Assisted ROM by pushing on the front of the tibia 3) early hamstrings 4) instructing me to cycle as much as possible in an ineffective brace 5) failing to inform me or adjust protocol when laxity issues began 6) failing to quickly get me a PCL brace when they realized I was given an ACL brace. My surgeon is a fine guy, and has apologized for mistakes, but at the same time tries to minimize how bad my knee is. I have serious doubts about his ability to objectively evaluate my knee. Just crossing my fingers this guy at the UW sports med can offer me something.
Please keep us posted as things progress Danny and best of luck.
I vote for a different surgeon but you do what you think is best.
Thanks Pam will do. Definitely time for a different surgeon!
Yuck. I hope you get helpful news on the 15th.
Hi Danny,
My name is Suhaimi from Malaysia. I am a 49 years old retired naval officer. I had my PCL injury when I was still in the Malaysian Navy, on a rugby field on 2006 and had the surgery in 2008. I have benefitted so much from Pam’s and Molly’s sharing of their journey post-PCL surgery in this blog. I must echo what Molly said that my life has drastically changed since that eventful day. Not for the worse, it’s just different now, but definitely not worse.
If you wish, you may read about my journey in my comment to Pam’s previous posting about Mitch. I also wrote a few PCL posts in my own blog, one of them you can find here:
http://suhaimibinsani.blogspot.com/2010/05/pcl-recovery-exercises.html
Life doesn’t have to get worse just because we have PCL injury. You are young and I can sense your fighting spirit is very strong. You probably have a lot more chance of getting better; younger age, better PCL knowledge, better technology now (brace options you mentioned were not available during my recovery phase post-surgery), and your strong perseverance and desire to get better. I sincerely believe the combinations will work out well for you.
In my case, PCL surgery recovery was without any sophisticated measure of range of movement (ROM), no brace, no real measure of laxity other than pulling my lower leg and comparing it with my right. However, one thing I know I did right was working with my Ortho and PT to manage the recovery plan. Under their guidance I was pushed to gain the ROM, and as necessary was also told to slow down when the pain became a bit too much. Based on what you said, there might have been some incorrect/inaccurate recommendation that led to your deteriorating conditions. So sorry to hear about that.
If I may, my only advice is, in your eagerness to do the recovery exercises, you may want to also listen and feel a bit more how your knee is responding to the exercises. Pain is a given in post-surgery exercise, but I believe there are limits once crossed will trigger us to feel something is not right. I am sorry that in your case (as you mentioned) you might have been misinformed by the team in going through with certain exercises even when symptoms of extraordinary pain and laxity had developed despite the early positive progress.
I hope your appointment on 15th Sep have given you with better options in dealing with the earlier setbacks.
.... to be continued due to words limit:)
....continue from my previous comment
If I can share a bit about my journey and my adjusting to still enjoy life to the fullest:
a. I used to be able to jog for a few years after the surgery, but now I have stopped completely. I now brisk walk and do hiking in beautiful forest trails (abundant in Malaysia), I cycle and I swim. To me it’s not doing less, but mere adjusting to doing something else. I have climbed Mount Kinabalu (38km in 2 days reaching the peak of over 4000m), and have done hiking 10-15km regularly. I cannot run or play rugby anymore…. But hiking just opened a whole new adventure option for me. At the end we set ourselves as the limit… I get passed by much older guys on the hiking trails, I have my friends telling me stories of their latest triathlon/trail runs and other extreme adventures…. but I don’t let these things get to me. I am just happy if I get to see nature, waterfalls and beautiful view from mountain tops at the end of my snail pace hiking trip. What I am trying to say is that we must make the best of the cards handed over to us. Not easy at times… but when the benchmark is ourselves…everything is just a bit easier to handle I believe.
b. My knees are deteriorating, the PCL knee (left) is about okay (although in constant pain), and now my right knee is also in constant but much greater pain especially after a long hiking trip. I get fluid supplement injection to both knees every one and a half year. I religiously take glucosamine on daily basis. My next appointment with Ortho is 20th Oct, probably they will recommend to do a scope (knee arthroscopy) to clean up my meniscus and any wear and tear (early osteoarthritis). Another surgery and another recovery… I will be 50 soon, and the recovery definitely not going to be an easy one.
I spent 27 years in the Navy, I was a very competitive person in rugby (I played for the US Naval Academy, the Malaysian Navy, the Malaysian Armed Forces and eventually played for Malaysia). I also played many other physical sports before the PCL injury. It was never easy to think that PCL is the reason I had to give up on them, for good. However, had it not for the PCL injury, I would probably never consider hiking as an alternative…. I believe thorough accepting, and subsequently adjusting we can still enjoy life to the fullest.
All the best to you Danny, keep fighting your battle and hope you will recover well. Hope you get much clearer perspectives on your options now after seeing the new surgeon. Do keep us posted on your progress. Take care. Warmest regards from Malaysia and stay safe.
Suhaimi
Kuala Lumpur, Malaysia
Suhaimi,
Thank you for sharing your experience and offering wise words of encouragement. I can see how the perspective of measuring yourself against yourself, and not compared to others, is a choice that results in less suffering. I may not be able to do the same high-impact sports as before, but I can hopefully continue to explore trails and experience beauty in the world. It is a logical transition to swimming, cycling, and hiking. Unfortunately I will need two more surgeries to holefully improve my knee stability. First, graft bone tunnels from failed PCL surgery, osteotomy to correct malalignment, and meniscus root repair. Then after 6 to 9 months, double bundle PCL and posterolateral corner reconstruction. It has complerely upended my life to have a failed surgery. But I am hopeful that I'll come through mentally stronger and able to do the things that bring me joy (chasing huckleberries in the Cascade Range is at the top of that list).
I really appreciate you sharing your advice and wisdom from across the ocean. Happy trails and be well!
Danny
Hi Danny! I had knee pain due to a laxed PCl. A surgeon told me he could help buy repairing the PCL and enforcing the posterior lateral corner of the knee. Sadly, my knee was worse than before. Laxity is worse, sability is worse, muscle tone is worse. Now I have scar tissue and arthritis due to the surgery. Whoops! I feel for you!
Hi Lehua, Skinnygurl here. I sure am sorry to hear you had such a failed knee surgery. That's awful! I hope over time you find a doctor that can help you. I'm currently recovering from my 5th knee surgery (2nd knee - 2nd knee replacement) I feel for you too!
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