KT's Long ACL Surgery and Frustrating Rehab

by KT Long
(Jackson WY)

I blew out my left knee for the first time when I was 15. The surgery went very smooth and re-hab was tough, but it went pretty fast. I was full weight baring within 2.5 weeks. I blew my left knee out again on December 19th, 2009 while skiing. I had surgery on January 30th, 2009. The doc told my husband it would be about an hour and half surgery. Well it didn't go well. The doc couldn't get the first set of screws out and after about an hour and a half of wrenching and wrenching he moved to plan B. He cut my leg all the way open. The incision is about 10 inches with 5 portals all around it. The doc wanted to make sure he got a really good hold with the femur screw this time and really wrenched it in and then he heard a pop. He thought that he had broken the top of the screw off so he anchored my ACL in using a different stronger method. He finally stapled me back up 4.5 hours later and coincedently it took 45 staples to sew me back up. I was admitted to the hospital for pain control, which the pain was tolerable. At some point during the day, the doc came in to check on me and touched my leg and I couldn't feel it. I couldn't feel anything from the tummy down. Completely numb. The scariest thing I have ever gone through. The doc was sure he hit a nerve and scheduled and MRI for the next morning. The MRI was excrusiating. 45 staples in your leg and having to sit in a magnetic machine for 45 minutes is not fun at all. It turns out that when he heard the pop and thought that he broke the head off the screw, he actully poped the screw all the way through my femur and lodged the screw in the back of my knee. So I have a screw floating around the back of my knee and an extra hole in my femur. My leg was numb from the turnicate he had to put on a couple times through out surgery. I spent 3 days in the hospital and was sent home with a walker and crutches and a lot of pain meds. The pain was manageable. I was released on New years day, 2010 and was off the pain meds by Monday. I started PT in a SwimEX pool on that Wednesday. It was nice to move around and start working on ROM.

I am now 1 month post op and doing pretty well. I do PT for 2 hours 3 times a week. My flexion is at 96, but I cannot fully straigten the leg. I am also still on crutches which is extremely frustrating. I do my exercises everyday and my quad just does not seem to be getting stronger. I am also still extremely swollen. I work on my platella mobilization everyday too, but the swelling is still there. My knee looks like what other people's look like the day after surgery and it has been a month. Needless to say my mood and attitude is starting to suffer. Any suggestions on how to stay positive? How to strengthen the quad more?

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Sep 08, 2015
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May 06, 2011
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Another recovery
by: KT

Well it has been a while since I posted and a lot has happened. I rehabbed the ACL injury all summer, fall and winter long and was able to get back on my skis for opening day! It was a long road. I hired a personal trainer in August and saw him 3-4 times a week. He helped me gain all strength back and my confidence and I lost 30 lbs. I was in great shape and when I clicked back into my skis on November 27, I felt like I really accomplished my goals and fear. I skied every weekend and felt great. I still saw the trainer 3-4 times a week and was in the best shape of my life. Then on Feb 4, 2011, I was taking my nephew skiing and was walking with him to the lift and I slipped slightly and caught myself on my affected leg. I had my brace on and it popped a bit, but nothing major. I skied that day and continued with my workouts, but something didn't feel right. It felt like my knee cap was always out of place and catching. I saw my OS on Feb 14, 2011 and he thought I had torn my quad and so I took some time off skiing and rested the quad. It never got better. I had an MRI March 16 and saw my OS on March 21. The MRI showed a large defect in my articulate cartilage. My OS said the piece that broke off had lodged in the top of my knee and the defect was large enough that I needed an OATS procedure (transplant of the cartilage)and the piece needed to be removed. So after all my rehab and diligence I had to go back to surgery. I had surgery on April 20. The doc did the OATS procedure, removed the cartilage piece, found and cleaned up more torn meniscus, removed my scar tissue from my previous surgery 15 months ago, tightened and realigned my kneecap (he said I dislocated my kneecap when I slipped and it never settled back in the grooves properly and was really loose). I started PT the following week and have been coming along. I have about 2-4 more weeks left of non-weight bearing to minimal weight bearing. Luckily I hired a trainer and i'm in good shape because my muscle memory is very good and they say my recovery will be much quicker. I'm crossing my fingers. So frustrating. I did everything I could to get in shape and avoid another knee injury and it still happened. I'm rethinking skiing this upcoming season. My body needs and injury free year!

Mar 17, 2010
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Week 11 progress
by: KT

I finally got to 115 degrees today. It was great. I also was able to ride 6.5 miles on the bike in 25 minutes so my PT said that I could now ride my beach cruiser outside, since it is nice. I have to wear the brace, but thats okay. I'm out of the brace now at all times except for crowded places and if it is slippery and for activities. I see the doc in two weeks and hopefully I can go to PT once a week or once every other week.

Feb 10, 2010
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week 6
by: KT

Today has been 6 weeks since surgery. I started doing "land" PT once a week and the hydro therapy twice a week. The "land" therapy has helped with the quad and calf strength. We have also worked on my gate so I don't lean forward when I walk. I also got released today to keep the brace off while indoors and I no longer need the crutches unless it is icy outside, which I live in Jackson and the whole town is covered in ice. (They said I could use a cane or ski poles outside instead of the crutches.) My inflexion is still only 5 (I just can't seem to get to 0) and the flexion got to 91 today. I seem to gain flexion and then loose it, but they think that is due to all the swelling.

Feb 08, 2010
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motivation
by: Bart - SII

WOW! that is not a pleasant story to tell. But, it sounds like you are doing well. The swelling and quad strength will resolve with time. Given the nature of your surgery, it is going to be a bit slower rehab than the "normal" ACL reconstruction.

One thing that I found to help with quad activation with my patients was getting them to engage their core muscles. We did this by having them lay on their backs and then pull an elastic band down from above with their arms, then trying to lift the leg. The resistance from the bands through their hands forced their core muscles to engage, and that helps to stabilize the pelvis and to give the quads an extra bit of help.

The other thing to try is poking your quad as you try to contract. The stimulation of the muscles you provide with your fingers can also help it to engage better.

Good luck with your continued recovery!

Bart

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