Allison's ACL Update (20 weeks later)... Please help!

by Allison Fontana
(Plantation, Florida)

I'll try to keep it short. I injured my right knee on March 28th, 2009. I had surgery on April 14th to reconstruct my ACL (with my pateller tendon) and repair my meniscus. Progress in therapy soon stalled, I couldn't fully extend or flex my knee, my knee cap was immobile, and I was experiencing a lot of pain. An MRI showed scar tissue under and around my kneecap. A second surgery to relieve the scar tissue and manipulate my knee was done on July 7th. It is now August 13th (5 1/2 weeks after the 2nd surgery)and I'm having problems again. Although I don't have as much pain as before, I'm constantly aware of my knee and am uncomfortable. I would describe my daily pain as a 2 or 3. My knee feels very hard and large and movement is slow. I can push my kneecap side-to-side but up-and-down is extremely difficult. I have what looks like a very large band of scar tissue running laterally across the front of my knee over my patellar tendon. You can see it under the skin by just looking at my flexed knee. My doctor told me he made cuts in that tissue during the 2nd surgery to relieve the pulling. I feel that same pulling again plus pain everytime I flex more than 90 degrees. Once I flex, my knee adjusts to the flexion, stretches and feels better. I believe that band of scar tissue might be what is making my knee immobile. My therapist has pushed my flexion to 150 degrees (on a good day) but my extension is lacking. I usually start my therapy session at negative 3-4 degrees. With much work by my therapist, we can get the extension to positive 2-3. I feel good walking at that number although the extension on my good leg is positve 4-5 degrees. However, as soon as I sit flexed or I wake up in the morning the progress is gone and I'm back to negative 3-4. Why , after 5 weeks, can't I maintain any of the progress I achieve in therapy? I suspect scar tissue problems again. My knee cap feels "stuck" and my knee mechanics feel just "wrong". Are there any other options for scar tissue besides surgery? How do I keep the scar tissue from returning again? Please help, Bart (or anyone else), I'm at my wit's end. I'm very depressed, it's been 5 months since my accident and I'm not recovering. I just want to return to my job as a firefighter and to my very active lifestyle. Most of my day is spent rehabbing, stretching, icing, massaging or thinking about my knee. I just don't know what else to do. I'll be out of town for the next 2 weeks and my next doctor's appt. is on Sept. 2nd. Do you have any experience with this or any advice for me?

Thanks.

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