Need help/advice

by Kate

I need some help or advice. But I guess I should start by explaining my story. I tore my ACl, LCL and meniscus, so I had surgery to repair and fix them in 09. So after surgery my knee wouldn't go straight, I was missing 20 degrees. So 3 months after my ACL reconstruction my doc went and scoped my knee removing scar tissue. It helped and now I was only missing 10 degrees.

After a year, he decided he wanted to try and remove more scar tissue so he scoped my knee again. It helped a little but still having troubles with my knee missing 7 degrees now. During basketball season this year I re-injured my knee. I got an MRI and it showed a lot of scar tissue in my knee, small tears in both lateral and medial meniscus. My knee hurts on the outside.

My surgeon says he typically does surgery on it, but he doesn't want to do surgery on my knee because he says its not that bad of an injury and he's afraid of making my knee worse if he goes in there.

I was wondering what I should do? I'm afraid that my knee wont get better, and I'm still having pain in my knee. Going down stairs hurts the most. I want my knee to get better because I'm on a basketball scholarship to a D1 university. So please give me advise on what I should do.

Thanks!

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Need help/advice

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Jan 20, 2012
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My solution to the same problem
by: Hayden

I have a very similar problem as you Kate. I have torn my ACl three times in the last 2 years. The last time when I was playing college basketball in Canada. I have spoken with many doctors about my inability to straighten and fully bend my knee. I also have a whole lot of scar tissue built up.

The best advice I have gotten has to do with working to strengthen other muscles to try and compensate. I got told that when you can't straighten or bend your leg the quad and hamstring muscles can't fully contract so they become weak. Focusing on those muscles in your gym program is a good way to combat the problem. I found doing really deep squats wit a low weight was very helpful. Hamtring curls focusing on being controlled was very helpful also. Getting your strength coach to work up a routine to focus on building strength could be beneficial.

Doing yoga also helped with flexibilty and balance. I am playing semi pro basketball and my knee feels strong even though I can't bend or straighten it fully. I can still dunk and change direction so the rehab has worked for me. Hopefully this has helped!

Dec 21, 2011
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Thanks Bart, Got a couple more questions
by: kate

Bart,
I should have gave you a little bit more info, but here is the answers to your questions. After my first surgery, I wasn’t put in a brace or anything, just a cryocuff. Then after my second surgery, I was put in a straight leg brace for a month. Then after my third surgery, I was put in a drop out cast for a week, followed by a straight leg brace for another month. After each surgery, I went to physio 3 times a week, and worked at home doing straightening exercises. We have tried everything to get it straight and nothings working. Its just that I heal to fast, and scar tissue keeps forming and is now not making it go straight. When at school, I seeked a second opinion. The doc there agreed that both my meniscus have a small tear in them and my knee was full of scar tissue. He gave me a injection in my knee and told me to come back to see him in 4 weeks and we would go from there. He said he wants to do surgery. So do you think I should have surgery or not? Im really frustrated and don’t know what to do. All I want is for my knee to get better, and play the sport I love. And what do you think I could do that could avoid scar tissue build up if I undergo another surgery?
Thank you so much for your help!

Dec 20, 2011
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Surgery or not...
by: Bart - Sports Injury Info

This is a hard decision to make for sure. The fact that you have already had three surgeries on your knee and that you are still missing range of motion, and you have meniscus tears makes it even harder to come to a decision.

There is probably a good chance, given your history, that it won't end up being a routine arthroscopy - there is a good chance you will develop scar tissue again, just as you have before, and that can complicate things during the rehab process, as you already know. But meniscus tears usually don't heal on their own, and a knee that is lacking seven to ten degrees of extension is not functioning normally from a biomechanical standpoint, and so that alters the stresses on the tissues.

After your first three surgeries, what kinds of things were you doing to maintain or gain your range of motion? I'm guessing that you did a lot of stretching, either on your own or in PT, and that for the two scopes, the range of motion was a MAJOR focus. Did your therapists do any type of muscle energy techniques, or any treatments to try to reduce the overall activity of the muscles? Something to try to "turn them off" so you could relax and improve your motion?

Does your doctor have any suggestions for how to decrease the amount of scarring that occurs? Or to improve your range of motion after surgery?

I'd recommend talking with your doctor about the benefits vs. the drawbacks of having an additional surgery for the meniscus tears. And it would be good to speak with the medical staff at your school, and get their opinions on your situation as well. You may also want to consider a second opinion from another surgeon, just so you know all of your options.

I have treated a few patients who were heavy scarrers, and it was very frustrating for both them and me.

Hopefully others who have had similar experiences will comment with some supportive advice.

Bart

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