Arthrofibrosis - OS

[Shenagh]

Does anyone know of an orthopaedic surgeon in Australia who specialises or at least knows something about arthrofibrosis? I'm in Melbourne, but doesn't have to be local.

Thanks.

[injuryupdate]

Most of the knee surgeons could deal with this. A rare complication of knee surgery, infection, rheumatological diseases or combinations of the above. If the joint gets too stiff a procedure called a synovectomy can be performed to get movement back. Unfortunately the knee is probably never going to be 100% after a case of this.

I know that Merv Cross in Sydney (who is a knee subspecialist) has dealt with a few severe cases of this complication that have been referred on to him by other surgeons.

[Alla]

Shen,

you arent still having problems are you??

Alla

[Shenagh]

Yep - patella is stuck (adhesions/scar tissue) again which is limiting my ROM. If the patella can't move, the rest of the knee can't flex or extend fully and the scar tissue is now growing back on the top of the knee where quad meets knee because of this. It's a nightmare.

Physio told me Friday night and I just broke down on the treatment table, first time I've done that (in front of people anyway!). I asked if PT will fix it, get the patella moving he said most cases no, it's surgery again.

Don't know what to do, hence my looking for another surgeon for another opinion.

How are you tracking?

[Alla]

Im sorry to hear that you are having a bad time Buddy..... I hope that you sort something out.... I've PMed you some stuff.... hope it helps.

I'm getting along nicely at the moment. Had a good few days.... dumped the crutches at the end of last week.... had heaps of swelling and freaked out about it for a while.... OS says that some swelling is ok.... so I feel ok about it. Straight leg lifts some ok to me at the moment.... but PT says that when I walk I look like Im dragging a tree stump. Hee hee.... I feel like I am too! Apparently I;ve forgotten when to bend my knee.... so now Im down to he mind games that being injured so long are playing with me..... I'm quite confident that my knee is cool.... and getting more confident every day with it.... just have to get the strength back....

Alla

[Shenagh]

Ah, the walking is tough and you're right, it's because you've been injured for awhile you have to actually train your body how to walk properly again! It's hard to do but it is just a matter of concentrating and going "heel, toe, flex" with every step. Once you're allowed to, the treadmill will really help you out. I find that after I've been driving or sitting down for awhile I limp quite badly when I get up initially because it takes awhile to warm up and fully extend to walk.

Fun and games hey?! Sounds like you're progressing well and all the pool work will pay off too. Strength takes the longest to return, I hear some people say that even after 6 months their quad is only 75% of the uninjured knee. Once again, it's a patience & persistence game and soudns liek you've got both so you'll keep improving!

[Alla]

Funly enough, I dont think I do have much patience.....or persistance.... I am really forcing myself. I get so bored with the repetative gym like exercises..... but Im making myself do them otherwise I'll not be playing netball again. And I've never been more frustrated in all my life... but the past 8 weeks have forced me to learn that I need to be more patient and persistent. It is developing, but taking time. Getting off the crutches was the biggest break through.... I feel much better about the whole thing now.... but I wish people would stop telling me how much I am limping.... I know I am limping, and when I get reminded of it I start thinking about it and then I limp more.... I do way better when Im not thinking about it.... especially trying to carry a cup of tea....I focus on the tea, not my knee.

So I'm feeling quite comfortable with where I am with my knee at the moment.... more strength would be nice, but I cant have everything. My PT and I are hoping that I will be almost right by the new year....although I dont think I will have a matching pair of quads by then..... not quite matching anyway..I have to be realistic......but hopefully close.

I hope you sort out your arthrofibrosis.... don't stress about breaking down.... it might have been a good thing..... sometimes you have to let out your frustration... and to make it visual for others to see might be a good thing. I find that after I have a cry... my knee gets its butt into gear and does something really good the next day......(like my first straight leg raise!!) If it helps any, I have a "tight" patella.... I'm hoping that it is just because my knee is still a bit swollen inside... PT says it is maltracking a bit.... it seems ok when knee swelling is down.... but it is quite sore when knee swelling is up.

Hugs to you (and your knee)!

Alla

[Shenagh]

Yes, in my case a predisposed condition - basically it's in my genes. I had a synovectomy last time during my MUA and arthroscope.

My physio last night said to leave it a month with intense treatment and if it doesn't improve then we will consider surgical options. I have been supplied with some good surgeons who have dealt with an arthrofibrotic knee and will be giving them a call. I feel bad giving my OS the flick but if I'm looking at 3 surgeries in 6 months then I think I need a second opinion. It's not that he's an incompetent surgeon, I just don't know how many patients like me he's dealt with and if he truly knows how to treat me. That being said, most patients who have scar tissue problems are generally fixed after another scrape or MUA, my case is unusual or rare - lucky me!

[Alla]

You did luck out didnt you.... I guess that we have to deal with lifes blows... but Im sure that you will get it sorted soon... make you stronger in the long term

Alla

[Shenagh]

Okay, saw my OS yesterday and his advice was to keep working...like I'm not! He's happy with my flexion at 120 but not thrilled with my extension and lack of quad strength.

Anyway, his advice was to weight the knee to push it down and really work at getting the extension. I mentioned at how painful it is to walk, SLR and basically move and he said it's just breaking teh adhesions and getting everyting moving again and taht will hurt.

So, my issues are:


His closing comment was a doozy though..."You're out of teh mold"

[Shenagh]

oops, pressed something then without spell checking or completing.

Okay, gotta work on
1. extension
2. VMO (non-existent)
3. Patella mobility

My PT rang me on Monday and gave me the name of another surgeon who he wants me to see and he wants to accompany me on that visit too so they can talk. Wonder if that's a hint?!

After spitting the dummy the other week I'm back into things, in the pool, on the bike and just trying everything, as my surgeon said I'm out of the mould so give anything go! Who knows, but what have you got to lose?

It's now 5 months post-reco and 2 months post-scope...if I can jog one day I would be happy, I would forgo my hockey comeback just to be able to jog.

[Unregistered]

Hi Shen,

Well, at least you are getting to see someone else about your knee problem. I dont think I've heard of the referring Dr going with you though.... maybe he's truley intregued by your ability to grow scar tissue and is keen to see what another Dr says??

Hee hee.... join the "lack of strength" club.... hopefully the pool and bike will help with that!!

Just a query.... what is VMO? Im not sure I've come across the term....

Keep your chin up.. and keep working.... you'll get an answer soon. Good luck buddy!

Alla

[Shenagh]

Hey Alla,

Yeah, I know! My PT is very keen and eager to see me progress and coming to visit the new surgeon with me was his idea. I don't mind, let them speak their knee jargon....I suppose he can explain exactly what my issues are quicker and clearer than I can. Got PT man tonight although he called me last week to see how my OS visit went and then to make sure I had an appointment to see the new OS! I think I'm one of his prize/problem patients that he wants to resolve!!

VMO is the Vastus Medialis Oblique muscle, basically the inner quadriceps muscle. I did the water aerobics class last week which was a bit of fun, and also 1km worth of laps the next night which was good.

Hear you're doing well at 3 months....full flexion and out there umpiring netball games! Great to hear and a reminder that there are always lots of positive stories too!

Shen.

[Alla]

Yeah, had a bash at the netball umpiring... but it was a junior match... no need to run really.... although they tested me some of the time.... At least Im only running striaght lines when umpiring.... or walking them as the case may be. I was finding myself wanting to run, but not quite able to bring myself to do it just yet. it still feels a little jarring at the moment, but I guess that I have to try it properly first. Need a nice patch of grass... which are few and far between at the moment... bit soggy and wet up here.

Glad that you got into the water aerobics class.... you sound a bit happier about that?!?! How did you pull up?? I've been contimplating it... but not quite there yet.

Good luck with your OS visit. Im off to see my guy this week as well for the 3 month review. I only hope he is as happy with it was I am. Atleast while you are your PT's prize patient you are getting his attention. I hope that you get some answers with the new OS. Good luck with it! And of course.... keep us posted!

Alla

[Shenagh]

Hi Alla,

How did your 3 month review go with your OS? Is all good and is he happy? I'm sure you'll graduate form the swift walking up and down the netball sidelines into a slow jog and before you know it you'll be at full pace.

Nah, the water aerobics was a bit slow for me so I've stuck to the lap swimming and hydro work afterwards. I found the movements okay in the class, but I favoured my good leg too much and found it jarred quite a bit. Fine with the side kicks and everything else, just jogging up and down and moving too quickly on it. Going to try deep water running class next week as I hear that’s a good work out and no jarring at all.

I'm putting off seeing another OS for as long as possible. I'm just working hard on the quaddie & VMO and weighting my leg down to get that full extension. Hit a hockey ball for the first time since Jan this week. Rather awkward and rusty but a great feeling!!

Hope all's well with you, enjoy the weekend.

Shen.

[Alla]

Hi there Shen,

Went really well with the OS. He asked how I felt it was, said that I was really happy with it, except that I was weaker then I would like.... he said not to worry because it is still early days yet. So that was good to hear. It is actually feeling the best it has since I hurt it. He said that my movement was good and that it my knee was very stable...I ws suprised when he did the lachmans test he said,... hmm that is very solid. So that was nice to hear.... after hearing how sloppy it was before.

I am still not able to run just yet. We discussed that... I said that it still jars a bit to try running more then a few steps so I'd not pushed it..... he said that was wise. So I think all is well.... now I just need to keep up the strengthening stuff for the next review in 3 months time!

I asked about the Petello femoral syndrome stuff my PT reckons I will have problems with.... OS seemed to think that would resolve as I get my quadies back.... and I think he is right.... as my quadies improve, the petella pain seems to go away.

Have only been to the pool once this week, will have to get there tomorrow as well.... started some new resistance exercises that feel really good in the water.... considering going for a water aereobics class, but ot too sure yet.... still dont deal with the going sideways thing real well yet.

So all in all Im pretty happy, and I think that he was.... my visit lasted 5 minutes I'd say.... and I got straight in to see him too.... not even time to warm up the stiff knee I'd had from 2 hours in the car!

So Im all good, how are you going?? Not still wanting to cut your knee off by the sounds of it?? Good that you got a hit of Hockey in.... I could imagine that even though you say you felt rusty... that it would have been a fantastic feeling to play the sport you love again.... even if it was just a hit.

Catch you soon,

Alla

[Shenagh]

Hey Alla,

That's great news from your OS, and hopefully your patella pain will subside as the quad gets stronger. BTW, what kind of resistance exercises are you doing in the pool? I'm just winging it at the moment and dragging my leg through the water (toes pointing out) holding onto the side of the pool...it feels like I'm doing ballet! What other exercises do you do for resistance and to help build the quad? Is there a link somewhere? I just do lots of stride throughs, jog on the spot, use a kick board but it would be great to know specific exercises.

I've been getting to the pool a couple of times a week, doing my 1km laps and the jumping in the hydro pool for half hour. I went for my 1st ride on Sat and I am suffering now. My knee is swollen, very sore and I am limping so prominently everyone keeps commenting. I don't know if it should be this bad. I did 20kms and iced straight afterwards...prob should have taken an anti inflam before hand but didn't. Do you reckon that's normal/standard? How did yours react the first time you REALLY did something on it? Got PT man tonight, will ask him too.

So, do you have full flexion as in heel to bum? Do you have hyper extension too? Hmm, I'm still trying to assess where I'm at and when I should seek that 2nd opinion.

Shen.

[Unregistered]

Hey there Shen,

Wow!! Lots of questions.... I was thinging about sharing some new pool exercises that I've come up with... so here goes. Up til recently I just did the same as you.... running on the spot, walking, etc, as well as the horiible squats and lunges.... Oh, and step ups on the steps into the pool. After a while I got bored with those and I need to start doing more resistance stuff to compensate for the fact that Im not coughing up $300 for a 3 month Gym membership to use one piece of equipment.... but anyway.... You know those noodle floaty things that you can get for the pool?? Well I get one of those fold it in a U shape and put my foot in the botom of the u and just push down from a bent knee to a straight knee. When I am finding it too easy I add a second noodle and I really struggle getting that down. Also the deeper the water the harder it seems. I also have put the U shaped noodle behind my ankle and done like reverse straight leg raises... so trying to push down against the noodle.... I had very sore quads after that one.... Do they help??? I havent been game enough to swim properly yet... still not sure if I have the open and closed chain thing to worry about.... I suspect not, but I've not had that confirmed yet....

ALso to answer your other questions,.... I have full extension... there is no issue there. I cant touch my butt with my heal yet, but I cant do that with my good leg either. Something else I do in the pool are all those quad stretches that you do to warm up for othe sports.... my knee loves them.. they feel great after jogging etc. My hammys are still a bit weak too, they really struggle to pull my leg up to my butt with out help..... got to bend down and pick up my ankles....knealing down is an issue, my knee doesnt like the strain of doing that..... but Im not too worried yet.

My knee really complains if I try to do too much... it doesnt really swell but it hurts on the medial side a bit and went through a pulling phase last week on a 2 km walk... I just listen to it and stop as soon as I can when it tells me. So it isnt 100% and as I said.... still not running yet.. to jarring, but I figure if I take it easy I'll get there. The first time I do something new it complains a bit, but the next few times it improves. I try not to demand too much of it too soon though... because I pay for it if I do....

Hope that helps?

Alla

[Shenagh]

Sorry for the bombardment of questions Alla! The noodles sound like a good idea, I hadn't thought of using them to add more resistance. Thanks for the different exercises, I will try them tomorrow night. I'm off for a deep water running class tomorrow instead of the laps so I'll let you know how suitable that is too. As for lap swimming, I use flippers which add more buoyancy to the legs and you don't kick as hard or severely than without them. Also, a pool buoy that you stick between your thighs is good too, I used that pre-reco when I wanted to stay fit but couldn't kick.

PT man said all was good with the knee swelling & soreness but to def take the anti-inflams next time. I did fail to mention that I stood on it all afternoon at hockey (after the 20km ride) and then went dancing on it until 5am - that wouldn't have helped it much either!

PT said for the 2nd week in a row that I'm improving! That's the first time he's said that in the 5 months that I've known him! The patella is less stuck, my control in quad exercises is good and my extension is improving each week. He said last week that he thinks we've turned a corner, it's pleasing to hear but I'm not getting too ahead of myself just yet! I was on the mini trampoline last night - that was fun and a good change from the usual regime. Although when he told me to jump, initially I'd just jump with my good leg but by the end I was equaling it out. It's confidence mostly.

So, I'm still around 120-130 flexion and almost to full extension (sitting anyway, standing is still bent) and am REALLY hoping I can just keep working and plugging away and keep improving rather than staying stationary.

Thanks again for the hydro rehab tips, that really helps. Hope you get to running soon as well.

Shen.

[Alla]

Hey great news Shen!

I bet that you are rapt that PT says that you are improving. I feel really happy for you that things are looking up! It all takes time I guess and I know that as far as I was concerend it has taken longer then I thought for me..... it was a big learning that it isnt always as fast as youd like

But that is great news.... I think the trick is to vary what we are doing so that we dont get sick of ourselves and work our way slowly back to the sports that we love. I've taken a new liking to swimming through this too, so I guess that is a good thing. People keep telling me I have swimmers shoulders.... even though I struggle to get to 25 metres swimming freestyle.... maybe it is time that I start using my swimmers shoulders!!!

Im glad that your knee cap feels a bit looser... I was wondering how that was going....

Gosh, that is fantatic news.... Im nearly getting to a stage where I want to run... and am confident that it isnt too far away.... I can run a few steps now, but because it has been over 8 months since I have run anywhere (except to stop the dog from chasing the neighbours cat some months ago) it is really hard to get my head around the fact that it shouldnt hurt to much. OS says that the jarring is because of lack of Quad.... so Im a little scared of trying too much till I get some of that damned quad back. I'll get there....

Alla

[ELLA]

HI Shen,

How are you travelling at the moment???

Alla

[Shenagh]

So, so. Still struggling. How are you going? Back & running? Gave my OS the "I don't think we should see each other anymore" talk last week!! It was pointless our visits, there's nothing that he can do for me at this stage and even if there was, I wouldn't chose him again.

In summary, I'm gradually getting there, just really, really struggling. It's slow. Get to the gym 3x week which is helping but driving me nuts. And my girls have made it to the hockey finals which will be hard to watch, but I'm happy for them. I've been to all of their games this year, even 2 days after my scope I sat there drugged & cheering them on!

So what's news with you and your progress?

Shen.

[Unregistered]

Hey there,

Yeah, Im doing ok.... getting a bit frustrated myself.... was hoping to be running by now but Im not.... wanted to have a go at umpiring finals and have been asked heaps to do it but I cant umpire anything that requires me to run..... so basically I can only do juniors and first year juniors at that.

I still have a gaping big hole at the moment where my quad used to be.... sometimes I think it is looking good and other times I think it looks really bad. There is a noticable difference between them.... people are actually commenting on it because you can see the difference through jeans. I feel like Im working really hard on it and not getting the results.... I guess that Im expecting too much too soon again....

Today is my 4 month aniversary. A friend was asking me if I could do a certain exercise yesterday that she was doing at the same stage (she had a reco last october)... and I cant get even close to doing it.... it is the same motion that you use to lift your foot to the excellerator in the car.. I cant do either.... so I guess that made me a bit annoyed that I was hoping I was more advanced then I am. But on the positive side I have been able to go on longer walks and dont limp quite so much. My friend and I have about the same limp and she is some 6 months ahead of me.... so we do all heal differently.

Went off to the pool again tonight. Since saturday my knee has been playing up... acting like I;ve been doing too much on it. I coached my U15 netball side on saturday.... I must have gotten a little excited and jumped around a bit or something.... they got into the grand final.... I went for my ritual swim after and when I got home knee was really unhappy. It was unhappy on sunday as well... and monday wasnt too rapt about going for a walk.... and I went for a wlak tonight and then the swim.... and it is all hot and unhappy again.... I couldnt do my hamstring curls tonight its that upset.

How did OS react to the "dont think we should see each other anymore" talk??? Think you might try someone else??

Alla

[Unregistered]

Yup, it is a frustrating and a very very slow process isn't it? You'll know when you're ready to start running and I think it has a lot to do psychologically as well. You don't have the confidence in your knee perhaps? I didn't initially. I've found the treadmill good as you can work up gradually to jogging a few steps and then ease off.

Yesterday was my 6 month anniversary! Things are improving ever so slowly for me a little bit more extension each week, a little less of a prominent limp. I've stopped aiming for dates when I should be doing things as it only lets me down. I just keep working at it and am hoping that eventually it will all come. I don't have any expectations any more, not in a defeatist way but I know that I am slowly improving and slowly it will happen.

I have an agreement with my physio that as soon as he notices that I've stopped improving or things have remained stationary he's to let me know. I see him once a week and all he does for the full half hour is move the patella, move the capsule of the knee and work on flexion. I still need that manipulation for the patella - the rest, as in strength is all up to me.

My OS was relieved I think! I will only head to another surgeon if things stop improving and I stop making any progress. At this stage I am slowly breaking the scar tissue on my own (it snap crackles and pops all the time, very odd sensation!) but might need another clean out/scope later once I've reached all I can do on my own.

My knee plays up dreadfully too after any exertion - swelling, pain, lack of movement. I presume it is 'normal'? I understand when you say it's unhappy and takes a day or 2 to get under control. The days I know I'm going to the gym or a ride, I take an anti-inflam at lunch. Just Voltaren over the counter from the chemist. It really helps, perhaps you should give it a go? I don't take them daily just when I know I'll be exercising on my knee, it recovers a lot quicker.

So you're pretty much there as in full flexion & extension? How's the limp? Can you lock the knee?

[Alla]

My Flexion and extension is ok..... pretty much what I had before the injury. I havent seen my PT since week 10 so that is a while ago now. He was satisfied that my flexion and extension was ok.... and the knee cap had loosened up enough.... he poked and prodded it too on the last few visits..... it only hurt after he'd poked it too much.... take several hours to get over that! I saw my OS not long after that last visit and asked about the knee cap stuff.... PT had said that he thought I was going to have some petello femoral issues,.... OS said that I will until I get quaddie back... then it will be ok. And I think he is right... as quaddie comes back the knee cap is less of an issue.

So I've been left to do the strengthening stuff myself. I so hate squats!! I really struggle with them.... and trying to do one legged squats just about kills me! Still hitting the pool 2-3 times a week. I can run in water up to my hips pretty well now.... trying to get into shallower and shallower water to get used to carrying my full weight. I ran the few steps down the hallway the other day.... I was rapt! I have to run on my toes though.... and more of my foot invovled and I get painful jarring. I've also gotten hold of some aerobic bands....... big bits of latex...... that you can do resistance work with..... my knees were quite sore after a few days of that stuff..... I also started riding my bike to work again last week. It is an 8km round trip and I so dont like it. I still favour the good leg really badly.... I think it is habit, so I try to force the recovering one to work harder. Funly enough, it is easier to make the recovering one work now then it was before the surgery. It just wouldnt even try before.... I refered to it as being a lazy sod.... but now it does work a bit.

So I guess that while there is still a big difference between the size of my thigh muscles I can see some improvement. I was checking it out last night.... it seems that the muscle around the knee joint itself is nearly back to a simialr size to the other, although that could also be a bit of swelling still.... the quaddie on the outside is coming along nicely.... but still a little underdone, and the quaddie on the inside of my leg is not happy.... he's taking a little longer to get back... although Im noticing he is the one that feels it after a 8km bike ride!!! so that has to be good. Hammys are ok..... they are feeling the bike work a bit too.... so that is ok.

6 months hey. Well..... things sound like they are coming along. I've also stopped with the official progress dates. they do just dissapoint if you dont make it. Some stuff I've acheived early, some on time and others still havent gotten to (damned that running!!!) I just think that we are all different and we heal at different rates.... I know that eventually I'll get there.... and that is good enough for now. Might be different next week if I have a frustrating one! The other thing I've stopped doing is comparing my progress to others... for the same reasons.

I think that it still is normal for knees to play up after activity. Mine hasnt been too bad, but I wonder sometimes if I dont push it enough. It certainly doesnt play up after the pool, but it does get a bit nasty after land based stuff..... the bike riding loosens it up and it feels nice after the ride, but it doesnt like me about 15 minutes later. I must say that my petella doesnt pull much anymore. I can get a good 40 minute walk in with out too much hastle now too. You are right about the mind having probably as bigger influence on the running thing..... I think that it does.... although I've found myself trying to get into a trot at times,,... is still hurts a bit... ahhhh,,, I'll get there.

So I guess that Im going ok.... sometimes I still wish that I hadnt taken the court that night when I hurt it... I didnt have to play that night but I did.... maybe I would have just done it the next time I took the court regardless of where I was. I guess there is no way of knowing, and I cant change it now. So I smile and get on with it....... just do that extra squat while forcing a smile and pretending that Im happy I tore my ACL! Hee hee.

Alla

PS. Glad to hear that you still have a bit of a limp.... not for your sake but I thought that was just me that still had a limp!! Sometimes Im ok and other times people make comments like "you werent limping that much before". Usually that is after I've worked it hard or had to track up a slope or across a paddock... which I generally refuse to do at this point unless I have a clear view of the surface Im walking on. Went out to umpire a junior netball final last weekend.... only littlies so I didint have to run.... several of the other umpires commented "you're not going to umpire with that limp are you??"... at that point I realised I was limping!! oops, forgotten to cover the limp up!! Hee hee.... makes me giggle a bit to myself....

[Shenagh]

Hey Alla,

I've just posted a new thread as I am back at my frustration stage. I need 3 more degrees extension and it ain't coming. My physio just wants to keep going and working but I am frustrated and desperate. I want a second opinion to confirm that it will eventuate and there's not a blockage, i.e. scar tissue restricting extension, so I've asked the rest of the board for their opinions. I asked my physio if I should go and get a 2nd opinion from another OS (the one you recommended) and perhaps an MRI, and he's like no, no need. I don't know if that's for his benefit that I keep spending $300/month with him or maybe I'm just being cynical!

Your recovery sounds great, you're really getting there. Running in the water and working your way into shallower areas is a great way of doing it. The inside quad muscle is the VMO, the last part to come back and that is linked with the patella and the patella femoral syndrome your talking about. It's a buggar trying to target it too, but it will happen. I reckon you'll be light jogging in the next few weeks by the sound.

My rehab at the moment consists of gym 3x week, physio x 1 and a 20km ride on the weekends weather permitting. At the gym I do bike, treadmill, rower and weights specifically for my quaddie & VMO. I've really been pushing things lately and being quite brutal to my knee. This lack of extension which makes me limp, so on the treadmill I'm really pushing the 'heel toe' thing and trying to get that long stride. I feel a twang when it does do the right thing and it's at the graft and back of the knee as it pushes back. My physio says my graft needs stretching which will help gain the extension. I hope he's right! Also, to try and get that extension I lay on the bed with my knee hanging over with a 2.5kg weight on my heel - that doesn't tickle!

Grrr - things are just back at that what the devil is going on inside my knee. I just want to know that I'm on the right track that everything is alright in there. Do you know what I mean? If I had no issues with extension or flexion and was just working, I'd be fine and keep quiet and go about my rehab. But I know things are NQR and it kills me.

If I had my time again (knowing what I do now) I seriously don't think I would have had a reco. I would have stuck to my triathlons, jogging and kept away from the hockey pitch. I know for certain if I did my knee again, or the other one, I won't get a reco. Sorry for the off-load but I'm in a real bad patch at the moment and I can't see the silver lining.

Keep me posted on your recovery, I do enjoy hearing the positive side of it all, honestly.

Shen.

[deegee]

I know the feeling, not being able to gain full extension, i also had significant quad astrophy, even my hammy's werent too flash either. 2 years later i can still tell the difference in size. was limping for ages, was off crutches at 6 weeks... resumed playing sport at 13 months however had another layoff to remove scar tissue that was causing a bit of pinching and grinding when i extended my leg. providing all goes well on sunday, will have completed a season of soccer, however, my knee swells a bit after each game/training etc and im seeing my surgeon again to find out what the fudge is going on, possibly get an mri... extension is still not FULLY there but quite good nonetheless from what it was before i had the scar tissue removed. flexion is ok, a bit off my good leg. now if i require another scope to fix any possible meniscus damage or remove more scar tissue, what can be done in the rehab phase to minimise scar tissue re-occuring? how soon, and how hard can u push urself to get the knee moving and minimise problems, and eliminate the problem of swelling. Or am i dreaming in thinking i can have a knee from swelling? coz it is worse now than what it was at the stage leading up to the scope.

[SPK]

All this "positive" talk about Knee Recos and rehab is making it sound like a pretty damned undesirable thing to go through.

I can't wait for mine!

*Insert Sarcasm here*

[Alla]

Hey there Shen Buddy...... Hang in there!!!

I know that it is hard, but you have to hang in there. I had a frustrating day yesterday too.....and I dont have the complications of scar tissue.... Yesterday we thought that we would go for a walk to look at some waterfalls.... we spent the weekend at Apollo Bay. All wsa a great idea except I was a little aprehensive about the walking bit. The walk we decided to take was apparently an easy walk that took about one hour return. Got to the water fall ok...... even though there were some creek crossings that had me scared to death.... not because they were difficult, but because they were over slippery rocks that had angles on them that I cant take too well. I had visions of myself landing in the water bum first! Anyhow it was all quite good until about half way back when my knee started to let me know he didnt want ot play anymore. It was the weirdest sensation..... kinda like a suction cup being pulled on (no pop though) inside my knee. I guess it scared me a bit and there was a bit of pain..... took ages to get back to the start of the walk because I was stopping to relieve the knee a bit.... and crying tears of frustration all the way. Still suffering today.....

Hey with your situation, Im wondering if a second opinion wouldnt hurt.... especially if you are already spending heaps on your knee per month?? I can pass on the details of the Dr I saw in melbourne if you like, he's a general practitioner that specialises in sports injuries, he referred me to my OS, but I thought that he might be able to suggest what you should perhaps do next.... see if it is different from what your PT says.... And I think from memory it was about $50 -$60 to see him. I think that if I wsa in your situation that I'd be looking for a second opinion.... but then again, I'm pretty dogged when I doubt what Im being told.... I have some training in a medical background no where near the experts but enough to know when Im satisfied with what Im being told. I'll send you a PM.

I know that it is tough Shen...... and that you are really having a bad time of the whole knee thing... but try to keep your chin up. I think we've both said before how much harder this was then we thought, but we've had it done and we have to keep moving through it. Im sure that once you are back and going that you will look back on this and feel quietly satisfied that you got through it knowing how tough it was. Im trying to make it a challenge, and am trying my best to remain up beat about it. Know also that you have some friends out here that understand what you are going through. I still am glad that I had the reco, there is no way that I would have been able to function with what I had..... there is no way I would have been able to do any of that walk yesterday.... but having said that.... I've been frustrated many times.... I certainly understand what you are saying and dont for one minute worry about unloading your feelings.... it is ok to do that too.... that is what Im here for!!!!

Keep us posted!

Smiles and Hugs
Alla

[Shenagh]

SPK,

I am an unusual case. You have two ends of the recovery spectrum here on this board. Alla who has recovered exceptionally well and me, who has struggled.

It may be negative my case, dammit it is, but wouldn't you rather be aware of the battles that may lie ahead rather than thinking it's going to be a breeze?

Good luck with your reco and I hope you have a very successful recovery.

Shen.

may

[SPK]

I hadn't really thought about it like that Shen.

I guess I've always known it would be a hard thing to go through but I didn't really think so much about the mental and psychological side of things.

That's something no amount of research can prepare you for.

I know it's easy for me to say this because I'm not the one standing on your side of the fence, but you have just got to stay positive about everything. Even if everything looks so bleak that it's pitch black.

Remember, no matter how bad you think you are, there is always always someone in a worse position then you. I think that rings true for all of us.

Shen please remember that you don't have to go through it all alone. There are plenty of people here, myself included, who are more then happy to give you a kick up the arse when you're down in the dumps.

Stay positive Shen. I wish you the very best of luck with everything.

[Shenagh]

Hey there,

Thanks for all the positive support and thoughts. Have been lying low over the last few weeks and just concentrating on getting things right.

Things are the same, no improvement. Saw my physio last night for our weekly visit and I just mentioned that I kind of wanted to get everything sorted by January as that's when the hockey insurance runs out, 12 months from the injury (I don't have private health insurance so all the $$ I can get back through sports cover is a massive bonus). So I asked him what he thought and whether we should go & get another opinion from an OS. He said probably, but let's assess it over the next 2 weeks. Sigh.

Anyway, I'm more comfortable with the idea of having to have another scope as I know myself that things are NQR in there. Plus I know the huge amount of difference the first scope made and that maybe this next one will be the end of it all and it will allow me to gain that extra extension and flexion. The main problem is my patella which is restricting full extension and causing me much pain.

So, will wait and see how the knee pulls up over the next few weeks and go from there. My physio wants to send me to Dr John Bartlett, supposedly the guru of knees, pioneer of knee surgery in Melbourne and a master with problem knees. Anyone know much about him?

That's it, keep you posted on the next 2 weeks.

Shen.

[Alla]

Hey there Shen,

I beleive that John Bartlet is very good, infact I've heard what you wrote about him before. I know the father of one of my netball buddies had him do a reco some 17 years ago. He's since blown out his knee again (a keen footballer in his day) and wanted another reco but thought that John no longer did it (had retired). I happened to notice his name on this web site and gave them the phone number and I hear that he had his reco a fortnight ago and all was going pretty well.

I also have another netball buddy who swears by him.... she did something to her knee this year and dashed off to see him as soon as she did it.

My surgeon (Julian Feller) was apparently a student of John Bartlets as well. Im still rapt with the work he did. Highly recommend him too.

Alla

[Shenagh]

Hi there,

Well have my appointment to see Bartlett on the 24th Nov, a 6 week waiting period but I'm happy as that gives me more time to keep working on things. Mini-milestone on Tuesday night, weekly physio visit. I was able to jog on the spot, on hard ground without favouring the good leg too much. Then I was able to kind of move forward on it but with a definite limp. I'm able to jog on a mini trampoline no probs. So I'm working up to jogging properly, my physio is pushing me to do so and although he said it's not going to be a pretty sight, he wants me to start and it may help break some of the minor scar tissue apart from the knee. But oh dear, was the knee cranky when I got home!! Very, very painful - not at the time but afterwards.

I'm still lacking my last 3 degrees extension and lacking 5 on a straight leg raise. You should see the effort I have to exert to even do a straight leg raise - it's pathetic thanks to the wasted quaddie. I don't have the ability to 'lock' my knee, a combination of muscle strength and scar tissue blockage (so we think). Unfortunately my flexion has halted at 140 and it's stiff, no laxity at all beyond that without excruciating pain.

I've been walking better this last week than I have ever and my limp is slowly diminishing. I'm up beat about things and will keep working hard and look forward to my 2nd opinion with Bartlett next month. The only thing that bites is the girl from my hockey team who had her reco 2 weeks after me is already on the side lines ready to play Summer comp which started last night. That's a reality check for me. My goal is still late Jan for the second half of the comp, all going well.

That's all for me, it's Friday arvo and beer o'clock I say! Hope everyone's knees are doing well.

Shen.

[Alla]

Hey there Shen,
Sounds like you are making progress... that is a good thing. And after you se Dr Bartlet you will have a better idea of what is going on.... and having a goal is a good thing too. Im hoping to be able to play tennis after christmas. I can actually now, but I cant run properly to chase anything down.... Im able to hit ok as long as it is hit too me... oh, and I cant get out of the way of a fast serve! I think we are at the same stage.... do fine on the minitramp and on the spot, but the minute I go forward.... limp like crazy. I think it is my head that is doing it though.... I dont think it is really painful.

I've had the flu and a serious chest infection over the last 2-3 weeks.... not been as active on the rehab side as I should have. Took out a trial gym membership today (free at our local gym for the month of October).... but because it is is a special offer I dont get an assessment, and cant use some of the equipment until I do (gym rules apparently)... and it costs me money. Ahhh well..... we'll see what happens, might end up coughing up for it. I wanted to try the gym gear before I went for the spending money thing..... I have some of the equipment at home, but not other stuff.

I have my 6 month review on the 7th November. I have a feeling that I might get in strife as the muscle hasnt come back as much as I'd like yet. Although I think the VMO is quite good the rest of the Quad is still quite deficient. there is a huge visual difference..... given that the weather has been a bit warmer, people have actually commented on the difference when I've worn shorts. Having said that, there is some definition there now... there wasnt before... so that is a start.

People have also been commenting that Im not limping any more too.... although I've had the few comment that I am. Usually I dont notice that I am until it is mentioned then I think "yeah is it hurting a bit at the moment so that would explain it". Im just so used to the knee feeling a bit weird that I dont notice it anymore.

So Im ok with where I am, although itching to play tennis. Im hoping that I might get the all clear on the 7th, but am trying not to get my hopes up. I was asked if I'd fill in for netball last week.... first time since december last year that I actually stopped and considered it, so it must be getting better. (for the record, I declined it, tempting as it was...plus it was in the same comp that I injured it in.... I feel jinxed by that comp!)

Cheers
Alla