Question - After a Knee Arthroscopy

by Karen
(Australia)

Six months ago playing sport I fell. My knee swelled and I had a locking feeling (there was no pain or indication at the time that it was more than just a fall).


I continued to play the next two days although there was swelling and pain; once I warmed up it wasn't to bad.

After physio, ice and rest it was no better. After an MRI I was sent to the surgeon who did knee arthroscopy with a patella release, removed a a large bit of bone that was floating, cleaned the knee up, and also removed a part of the meniscus.

That was six weeks ago. The doctor has also told me I have degenerative arthritis and to stop playing sport. He has also told me I will need a knee replacement in 10years. I am 46yrs old.

While stopping sport has upset me beyond words, my concern now is that I can not straighten my knee. I did all the iceing and exercises that were asked of me and more.

I am still having physio (with a great physio) twice a week and now there seems to be no further improvement. I can ride the bike, do leg raises, lunges and there also isn't much pain. I cannot squat still.

What am I doing wrong, can you suggest any thing that may help. If I can get back to sport what are the consequences?

I would appreciate any information you can give me.

Thanks

Karen

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Apr 01, 2008
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Active or passive extension?
by: Anonymous

Karen thanks for the submission.

Are you having trouble straightening your knee actively or passively? Does it straighten all the way out if you completely relax your muscles?

If you are having problems with extension passively, then the best treatment is probably some type of tibial or femoral joint mobilization (ask your physio about this). This is something that your physio can do with you to restore the normal accessory motions of the knee (the rolling, gliding, and sliding of the bones against each other). Loss of passive extension is very common and can be caused by a lot of different things.

If you can straighten it out all the way when you relax but then cannot straighten it out when you contract your quadriceps, then it is more likely a strength and neuromuscular control issue.

The use of electrical stimulation to help the quadriceps contract can increase your ability to straighten out your knee. Also, exercises that focus on knee extension while you are standing are a great way to improve your quad function. Again, I would talk to your physio about this.

Figuring out what is restricting your joint motion is the first key - passive motion loss usually means the capsule or joint accessory motions - active loss usually means muscle weakness or control issues.

This extension loss is something that needs to be addresses soon, because the longer out from surgery you are, the harder it is to restore easily. I would also recommend talking to your surgeon about this and see if they have any suggestions.

As far as returning to sports - the consequences are continued degeneration of your knee, probably faster than if you weren't playing. That means you could need a replacement sooner - the problem with knee replacements is that they only last for a certain number of years before they wear out. And then you have to have another one. If you had a replacement at 56 years old, you would probably need another one by 71 years. Also, knee replacement significantly alters your normal daily life activities - something to think about. You may be able to just modify your sports and still participate and prolong the health of your knee.

Hope this helps - comment back with other questions.


Apr 08, 2008
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Active and Passive!!
by: Karen

Thanks for the reply.
Now seven weeks on and still trying to straighten my knee. It is actively and passively. I am at the point that I think it is as good as it is going to get.
I still wake at night and take pain relief. I dont need pain relief through the day. The knee is worse if I sit or lie for a long time and by the end of the day. I am on it all day at work.
My Physio says it will take time and I still have a long way to go.
Have you got specific exercises I could try, perhaps you have some different ones I could try.
I have read all the entrys on your site and they have kept me positive. Thank-you to every-one sharing their stories.
Still being slowed down after being so active does make you depressed after awhile.
Thankyou for your advice.

Karen

Sep 14, 2008
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Muscle damage??
by: Anonymous

I had a arthroscopy on my knee 10 days ago, after surgery I could mobilse well and I was strictly following the exercise programme, now I am mobile I feel at times the muscle at the top of my leg just goes and I fall? I get a sharp pain in the back of my knee too?
Im very concerned.
I have not returned to driving as I am afraid it does this when driving.

Please advise

Sep 14, 2008
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Muscle Inhibition
by: Bart - SII

It is common to have a lack of quadriceps muscle control after arthroscopy - it is a kind of protective mechanism that your body has when there is fluid or swelling inside the joint. Your body will inhibit the quads, making them a bit unreliable when it comes to contracting. This should continue to get better as your swelling subsides and your strength increases.

Bart

Sep 15, 2008
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Thanks for the Reply Bill
by: Anonymous

Bill,
Thanks for replying, I attended my local gp this am and he advised me that I have tissue damage, just above my knee.
He made me aware that by doing the exercises etc it should improve.
any comments???


Thanks Again

Aug 22, 2015
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