Sarah's ACL Surgery

by Sarah
(California)

Tore my ACL on January 31, 2009 skiing (43 year old mom in too much powder). Spent the next 4 weeks on crutches getting ready for surgery. Hoped that I might be able to walk without crutches before surgery but never really got the physical and emotional hang of it.


Had ACL replaced with cadaver ACL on Feb 25. I really stayed in bed on the CPM machine and ice machine and a lot of pain medication for 6 days 24 hours a day. My first doctors visit 6 days post op I had reached 0 and 85 (my doctor had wanted to me to get to 90degrees so I only got an A minus!)

I am now 10 days post op and am still in more pain then I want to be especially at night. I cannot find a comfortable position to sleep in. I am considering putting my leg back in the CPM at night just because maybe it will be more comfortable elevated.

I don't really want to go back to Vicodin and hoped that motrin and tylenol would do the job but when you realize you only are allowed to take 6 motrin pills a day it is not very much. I am on the recumbant bike 1 hour a day and do 30 leg raises a day. I go up and down my stairs on my rear end, absolutely do not trust crutches on stairs.

When did other people stop using the CPM? I can do a full rotation (not very elegantly) on the bike but think maybe the cpm at night will add to my rotation while easing night pain.

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Aug 16, 2010
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acl replacement
by: Lynn

I am 10 days post from acl replacement. I am having no pain at all, I totally believe the ice played a huge part in my "recovery". I did use a cpm machine and used it continually as often as possible. I am at approx 130-142 range without the cpm.. I also used a towel to pull my ankle in closer as I lay on my back to help with my range but very uncomfortable. I can pretty much straighten my leg too.. I am not sure but I believe that Ice played a huge part Most of the day and 5 hours while I am sleeping.. I am allowed to put 20% weight on my left foot still with crutches for the next 3 weeks.
I had a really hard time pre surgery I waited 3 month to have my surgery due to MCL also tore it took me that entire time to get my range of motion to only 142 and my knee would not go straight for the life of me.. I know your frustration, but hang in there and push through the pain without over doing it.. As oftern as you can try using the towel to help with range..
ICE ICE ICE.

Apr 15, 2009
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Went back to vicodin
by: Tricia

Hi Sarah,
I had my surgery April 3, and stopped taking vicodin on the 6th, but I could not get comfortable at night either. So after 3 days of not sleeping I went back to the vicodin, and what a difference. I got a great nights sleep last night. I had tried Advil pm with a sleep aide but that did not touch the pain. I did not get a CPM after my surgery and my range of motion is 0-100 degrees, but I had a patellar tendon graft which makes flexion tough. I think the bike is a great idea for you, if you can get all the way around, even if you can't get around you can go back and forth to stretch. Just don't over do it and increase the swelling, you have to walk a fine line between getting the flexibility early without increasing the swelling. I also am a Physical Therapist by trade (cruel twist of fate). The CPM is not used in my town for this surgery, but if you have it, use it, you can increase the ROM settings to meet your flexibility, try to ice while using the CPM. Good luck to you. I think we ore over the worst of it.
Tricia

Mar 28, 2009
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post op update
by: Sarah

I am now 4.5 weeks post op. My doctor was a bit bummed at my 4 week appt that my knee couldn't go to 0 degrees. I have started rehab and basically work all day trying to make my leg straight. I have a half dozen exercises I rotate through. I am now on one crutch and without crutch I definitely don't walk correctly but am happy to be allowed to put weight on it at all.

Mar 12, 2009
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CPM
by: Ben

I had an acl recon last Thurs mar 5 using an achillies tendon allograft and I'm recovering ok so far. I'm using the cpm machine everyday for at least 4 hours and i'm at 110 degrees just like what the doctor ordered. What I noticed is that I cannot seem to do 90 degree without a cpm machine. I guess I need to turn my quad bsck on to achieve this (Bart?). I totally agree with you having no confidence using the crutches on stairs. I tried going down with them and had a close call of falling down the stairs. I csannot wait to ditch these crutches! Good luck on your recovery!

Mar 10, 2009
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knee extension
by: Bart - SII

Your therapist should be able to give you some suggestions for helping with the knee extension. What I have done with patient in the past is focused quad contractions with the leg on the table. When you can achieve full active extension, you should be able to lift your heel off of the table without actually lifting your leg. This requires a lot of quad control, but if you focus on contracting just the quads and trying to get that terminal extension and lifting your heel off of the table, that can help. It may take a few tries to get it, but once you do, your extension becomes much easier.

It is all about turning the quad back on. Sometimes, if you contract both quads (on both sides) at the same time, that can help. Also, placing a pillow or towel under your knee so it just a little bent, and then lifting your heel off of the table without lifting your knee off the pillow or towel, that will help get things started.

Talk to your clinician about other ways to help with the active terminal extension.

Bart

Mar 10, 2009
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extended leg and quad questions
by: Sarah

Do you have suggestions for exercises to keep my leg extension strong. I do realize at night putting it back in the CPM at -5 does some of the work and I try to stay conscious of extended leg all day but definitely find myself out of that position more then I want. Also now have new concern from about making sure my quad stays strong.

Mar 10, 2009
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CPM
by: Bart - SII

The CPM may help keep you from getting as stiff overnight, but it may be harder to sleep with it going. 10 days out, it is still early in the recovery - your body is still in the inflammation stage - where pain and swelling fluctuate significantly and the injury has yet to "calm down". Most people turn the corner on pain around 2-3 weeks as the body gets out of the inflammatory phase.

Hang in there - the vicodin at night may help you get some rest. Keep that extension at 0 - that is so much more important than the flexion at this point. The flexion will come with time, but the extension will go away if you aren't diligent about maintaining it.

Bart

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