Question - ACL Injury (medial knee pain 4 months post-op)

by Rich
(England)

Hi, I am now 4 months post op after having an ACL Hamstring reconstruction (23 April 2008). The original injury was done playing football back in 1992. I was wrongly diagnosed, as I was told I hadn’t torn the ACL, I spent 6 months training hard in the gym only for it to give way within 5 minutes of playing football again!


I got referred to a London Hospital and had an MRI scan which confirmed a complete tear of the ACL. I had an arthroscopy, which I was under the impression was to repair the ACL but after the operation I was told I would need full "open knee" surgery if I wanted to get back to playing football.

Unfortunately I had just started a new job and we had bought a house, so I couldn’t afford to take the time off to recover. I have avoided playing football since then but I’ve still suffered with the knee giving way on me, sometimes with things as simple as walking down the stairs, or getting off a train. It got to the point where I needed to get something done.

I was initially told by my GP that because of the amount of time since the original injury it wasn’t possible to repair the ACL. I was obviously upset at this, but I decided I would call the surgeon who had done my original arthroscopy and he was very annoyed that I’d been wrongly informed. I was then told I could have the surgery and things had moved on and the recovery time was now much shorter.

Things are going well, I have had my 3 month strength test and it came out at as 80% strength of my unaffected leg which was really positive. Unfortunately I’ve had a few set backs where I have torn the hamstring.

The first incident was a matter of weeks after the op, the pain was excruciating. The pain was on the inside of my knee (which I now learn from your website is where the graft was taken from).

The second time was after my strength test, where, because of my good result I was told that I could begin light jogging. I went out jogging (about a mile) for three nights in a row without any problems but on the fourth night I pulled / tore my hamstring (not in the same place as before, higher up but still on the inside of my leg).

I presume, due to these subsequent injuries or maybe there would have been some anyway, but I found myself with a large amount of scar tissue on the hamstring. This was particularly noticeable when I tensed my knee. I decided at this point in addition to my hospital physio sessions I would attend a sports physiotherapist to try to reduce the amount of scar tissue and hopefully improve the strength / elasticity of the hamstring. This has been going very well and I am now doing light gym work with regular checks to ensure things are progressing normally.

I am still experiencing pain when straightening my knee, again this pain is mainly located on the inside of my knee but it also seems to be painful pretty much all around the knee. My physio has done the “drawer” test and confirmed that the ACL is strong, he thinks that I may have torn/damaged the MCL as when he holds my thigh and puts inward pressure on my lower leg I do feel some pain (as he applies pressure it makes me flinch – this is very difficult to explain in writing!) but he isn’t 100% sure as to the cause of the pain.

I don’t feel that I have done anything vigorous enough since the operation to have damaged the MCL? The best way I can explain how much knee feels at this stage is “heavy”, I’m not confident in the knee when turning (this is whilst walking not running) and so I’m starting to get a bit despondent.

My question (finally I get to the question!) Is this normal to experience this pain after four months? And would you say that the “heaviness” and lack of confidence is normal? I only ask as my physio, both at the hospital and the gym aren’t able to say. I know everyone is different and their recovery times will vary but any advice / help would be really welcome.

Many thanks

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Sep 07, 2008
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scar tissue
by: Bart - SII

I have seen similar complaints in my patients, although most of them were with a patellar tendon graft.

It was usually due to scar tissue, and was resolved with joint mobilizations to improve the anterior / posterior glide of the tibia and femur, as well as with friction massage over the painful area.

It doesn't sound like you have injured your MCL. The valgus stress test (what you described well in your post above where your therapist places stress on the outside of the knee and makes you flinch) is likely causing stress on the scar tissue around the MCL and joint capsule.

Bart

Jun 11, 2009
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Help?
by: Rich G

Hi i'm now 13 months post ACL reconstruction (Hamstring) and other than a few hamstring issues its been going very well. I'm back to running my 5k and have got down to some respectable times. I returned to 5-a-side football last week and took it very steady. I completed the game with no problems and was really happy with my progress. I few hours after playing I found it very painful to stand (straighten leg) and also seemed to have restricted flexability. I was obviously really worried that I had damaged the ACL again. I had no swelling at all and after a couple of days things improved slightly although I still had pain when leg was fully straighted and my flexabilty pretty much returned to 100%. I was then doing very light exercises when a sudden pain inside the knee returned my knee to the above problems. I did the whole RISE that night and there was slight improvement the next day but I still had pain when walking to work. Walking home that night the pain suddeny disappeared and it felt the best it had done since my surgery, I was so pleased but confused. This morning I had no pain when extending the leg out fully and I was able to bring my knee back 100% again with no pain but when extending the leg out again had sudden minor pain again and i'm back to square one (pain when extening the leg). I have had the drawer test done this morning and the ACL seems solid. Does anyone have any ideas as to what it mught be? Many thanks Rich

Feb 26, 2015
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Knee injury NEW
by: Richard

I am wondering why the issue of wrong diagnose is happening in the leading hospitals. I can understand your situation and I have also completed knee surgery due to the deformities in the knee bone. Mac : EHR Software

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ACL surgery NEW
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I am three months post op for ACL surgery with the hamstring graft, and the past few days I have had literally 'shocking' pains up either side of the knee. My physio has checked out my ACL and it is solid however this horribly electric shock pain won't go away. It is worse when I massage around the scars, the whole area seems very sensitive. My concern is the amount of pain I am in at this stage, similar to story above ^ and I know its early days but I do not trust my knee. Has anyone experienced this sort of pain before?

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