Compilation of Arthrofibrosis Success Stories Timelines

[EdD]

I understand that it takes a lot of patience and diligence to deal with AF but it sure can get frustrating at times. It's like that old Dunkin doughnut commercial where the guy had to get up every day -day after day--at 4 AM to make the doughnuts "Time to make the doughnuts" or like the movie Groundhog Day the same thing day after day.

Sometimes I feel that it would be helpful if there was a protocol or set of benchmarks for a LOA like the well developed protocols that exist for ACL reconstructions. For example, certain ACL protocols call for 135 degrees of flexion by 6-12 weeks post-op and a return to sports by 9-12 months.

I know that AF is different than a ACL reconstruction, but it would be nice to know if things go well what progress people have made 6, 9, 12, 15 months after surgery. If you think this is worth while, please respond with your story and I will try to summarize the responses. It would be great if you included milestones such as ROM, activities, swelling, signs of inflammation, return to sport etc.

Thanks in advance!

Edward

[missmyknee]

Hello Edward

I had to chuckle at your Ground Hog Day analogy....I often have thought of it this way ...ha!

I have done all the correct protocals under the supervision of Dr N and his PTs and still got it back....there are no guarantees it won't come back. Sometimes it's come back within a few weeks and others 2-3 months. If I can stay 1 yr without it, I will consider it successful.

My latest go round of AF is from surgery in May from severe MCL injury with spacer exchange and scar tissue removal ( this scar tissue developed after surgery the July before), developed scar tissue within 3 weeks post op, had surgery in Oct for open debridement with med and lat releases and now having surgery April 2nd because scar tissue came back compressing the infrapatellar branch of the saphenous nerve in several places. OUCH !

Pam

[EdD]

Thanks very much Pam.

I am not sure if my post was clear. I am not looking for a rehab protocol, but I am looking for as many success stories as possible and I will look at the link you provided. I would like to see a number of real world examples that might show, for example, that if things go well, people have returned to running 9 months after surgery. It could be 12 months or 15. I guess I'm trying to get a benchmark to gauge my progress against. Am I asking for too much too soon or should I be able to run by now? So for instance if 3 people respond that they could not play tennis 6 months post op but they could at 12 that would be helpful. I'm looking for progressions. I could not walk down stairs 1 month post op, but I could at 2 months. If others have the same type of experience and we can make some generalizations, then the next person that cannot walk down stairs 1 month post op may get some comfort.

I was trying to make an analogy to ACL reconstructions. There is so much experience with ACL's now that the docs are able to say, for example, that you can not play football until 9-12 months post op. So an athlete will know if he cannot play football 6 months post op no worries it is too early, but if he is 18 months post-op and cannot play there may be problems.

Part of my problem is that I have 2 complications -AF and quad atrophy caused by nerve damage. I'm trying to determine which one is the primary cause of my limitations at this point and if I should consider another surgery down the road. I'm trying to figure out where I am in the timeline. I'm hoping that I am like the football player that is 6 months after ACL surgery it is too early. If I knew that there were a number of people that were able to return to sports 15 months after a LOA but 6-8 months had an activity level similar to mine, that would be comforting. But if the majority of the people with AF who returned to sports did so by 12 months, for example, and I am at the same level of activity I am now after 15 months, it would be time to consider other treatment options.
Does this make any sense?

I can't believe all of the things you have been through and now spring break in Cincinnati and surgery April 2! Good luck! I'll be thinking about you and sending you best wishes for a successful surgery and speedy recovery!! If there is any silver lining, one is that you and Jaci and others have helped many people by passing on your hard gained knowledge and experience.

[Jaci]

Hello Ed,

Good idea. Unfortunately I think whether one has primary arthrofibrosis or secondary arthrofibrosis would influence the recovery. For the most part, secondary AF can be dealt with using a single surgery and rehab that eliminate the original trigger of the exagerated healing response. If that's dealt with and there is no new trigger they generally go on to have a full recovery, hence they are long gone from posting on KNEEgeeks.

For those of us with primary AF, the recovery has been as individual as the people who have AF. I don't know about others, but I don't really have any sort of benchmarks other than: I finally got off crutches last July after 3+ years of using them, July was roughly 1 year from my last procedure an insufflation. I still use a cane due to pain, catching and giving out. I know I have scar tissue again and I have on going issues due to patella infera.

I think one of the great challenges of AF, particularly primary AF, is that it doesn't fit neatly into any treatment/ recovery algorithm. A few of the medical journal articles I've read have step-by-step decision trees to take the OS through certain intervention techniques to surgery to post-op rehab. But not a single source gives any detail on exactly how to get that blasted inflammatory immune response to stop. There is no formula. Sure there certain things that can be done like steroid injections, visco-supplement injections, anti-inflammatories, and oral steroids, but there is no one protocol that works for all or even most.

I do think this is a good idea. Perhaps you or someone could peruse some of the old success stories to look for some generalized bench marks. Or another idea-- I'm thinking out loud here:

Question: If someone starts a blog on the community hub can others add onto it? If so that might be a way to bench mark. Someone could email some of the old posters (the ones in the success stories on the "Great threads about AF" page) who have moved on in their lives to see if they would contribute to the "Bench Marking AF" blog.

Or, of course, all that could be done here on the bulletin board as well.

Okay, was just starting to hit "Post" and had another thought that I want to add. Caution: One person's inability to go down stairs at X point may not be cause for concern, while another person's inability to go down stairs may be a sign that scar tissue has returned. Thus I think benchmarking should be approached cautiously since waiting too long to see an OS can be detrimental. I understand the desire to provide comfort to people, however I would rather suggest that people see their OS or one of the experts when they have doubts about their recovery. Only an experienced OS can determine whether it's slow progress or scar tissue or some other problem. Afterall, there is far more at stake if one waits too long, than if one goes to a qualified OS and is told that scar tissue is not the problem. I don't ever want to give people a false sense of security.

Take care,

Jaci

[missmyknee]

I agree with Jaci. Since AF is a rare complication, there aren't as many cases to study ( compared to ACLs) to form a one-for-all treatment plan. We do know the symptoms and the triggers but how it affects the unlucky one to have it is very individual and so is the treatment. Those of us who are here discussing this have AF, but it has affected all of us differently in regards to if you have primary or secondary or both, how soon it started, our triggers, ROM , location of scar tissue and our responses to PT and treatment modalities such as medications and surgical treatment options.. We all go thru a different sequence as to when medications are started, what our ROM expectations and timelines occur. We are all different in how we react and respond to the inflammatory process and progress thru our rehab program. I don't know how many times I've had to go back to square 1 in rehab, to the very basics, to let the inflammatory response calm down. I never know where the scar tissue is going to show up, although my patella/patella tendon area have been the most common areas... but I've had it on every part of my knee over the yrs.

That's why this is so horrible to get.

Pam

[EdD]

Thanks Jaci and Pam. As you suggested, I reviewed a number of success stories and summarized them. Four of the five success stories had a LOA performed by Dr Steadman or a recognized AF specialist (3 by Steadman and one by Folk). First, I will describe the time line for achievement of full range of motion or near full ROM and return to sports and then I will post the summary of each success story. Full ROM (or close to it) was generally achieved anywhere from 2 months post- op to 8 months post op. One regained ROM in 2 months ( Will), one 2.5 months ( Bob) two in 4 months post op ( Laurie and Lynne), one in 8 months (Bob). So the average time to return to near full ROM was 4.1 months. Return to full activities like running or sports was achieved 7 months post op to 24 months post op. One returned to full activities in 7 months ( Bear) one in 9 months(Lynne), one in 10 months ( Will), one in 12 months ( Bob) and one in 24 months (Laurie). So the average time to return to full activities was 12.4 months.

BOB
8 months post-op. 144 degrees of flexion and still 2 degrees extension. He was doing 2 spin classes, 2 step classes, and 2 bodyworks classes per week. Bob still had a small hitch in his walk from some patellar pain and felt very mild stiffness. He had no pain at all on the bike or doing step classes. He was still not running or playing tennis. He could press 75 pounds with his bad leg up from 35 pounds 3 months ago.

1/3/ 2008 - 1 year since knee injury. He played a singles tennis match.

1/26/2008 Bob is playing tennis, riding bikes, doing aerobics classes, walking - no running, but he never was a runner anyway.


BEAR

March, 2006- 2.5 months post op- she had full ROM (143), full extension and hyperextension, and "graduated" from PT.

May, 2006 -4 months post-op -she biked 5 miles to work, and was slowly jogging again.

July 25, 2006-7 months post op she jogged 3 miles

LAURIE

3/3/2002 -4 months post op. After taking an antibiotic, extension was 0 and flexion was 150.
It took 2 years --from November of 2001 to November of 2003 to fully recover.

2/2004-25 months post op -Laurie is currently doing all the activities she did prior to surgery. She is running, biking, hiking, skiing, volleyball, tap dancing, etc; without pain. She currently runs, Stairmaster, Leg Press 160lbs, Leg Extensions 50lbs, Hamstring Curls 50lbs, Ball Lunges with free weights 15lbs in each hand and all is well.

LYNE (TRI-SPORT)

1/18/2006 4 months post -op-flexion at 145 degrees and 0 extension.

3/15/2006-6 months post -op. She was able to do step downs from an 18 inch stair smoothly

5/22/2006 -8 months post -op. She's training for a triathlon in June so she was swimming and biking.
6/11/2006 -9 months post-op- Lynne did a triathlon! She was in first place after swim (1/2 mile), still in 4th after the bike (13 mile), and then did the 3.1 mile walk.



WILL P
2/16/2007-2 months post -op .Full ROM, about 148 - -1 (but he was only ever missing 10 degrees of flexion and a couple of degrees hyperextension.)

6/15/2007 -6 months post-op. He was riding the bike outdoors and was up to 25 miles. He started running on the treadmill. 1 min on, 1 off.

10/7/2007- 10 months post-op. Will did a fairly serious hike on one day and a bike ride into the next day. He started running again, and was able to get up to about 4 miles now.

[EdD]

BOB:
When Bob was 14 years old in 9th grade gym class he injured his knee bracing for a football snap and impending collision with the guy on the other side. It may have been a kneecap dislocation. Fast forward to Jan 1 2007. While watching TV, he sat with the left knee curled up compressing the kneecap to his lateral femoral condyle for about an hour. The next day the knee got stiff, painful and swollen. The next day the doctor tried to aspirate the knee but it was filled with blood. Bob had surgery on January 18, 2007. All of the blood was flushed out and the OS found two quarter-sized bone bruises on the patella and lateral femoral condyle, no meniscus tears or ligament damage. The osteoarthritis was level IV. After the surgery, the knee was predictably swollen and remained so for three more weeks. At that point Bob began to try to bend my knee but it would not bend more than a few degrees. Bob then went to see Dr. Folk at the Steadman-Hawkings clinic in Greenville South Carolina on Feb 28,2007. The doc said the knee was still smoldering from the initial injury and surgery. The MRI indicated a lot of scar tissue warranting an LOA procedure sometime in the near future.

April 9 2007 - LOA. Dr. Folk said the knee was totally packed with scar tissue. He removed tissue above the knee first then below the knee. With each release the knee bent more and more on its own. Full flexion achieved during surgery.

May 28, 2007- 2 months post-op. The stiffness was getting a little better every week - but only a little. Went for a 4 1/2 mile walk. Using the JAS splint 3 times a day. Flexion: around 70 degrees.

June 26 2007- 3 months post-op. Dr. Folk recommended starting the Synvisc injections as progress has slowed. Immediately after in PT the therapist pushed the knee to 85 degrees. Bob continued to do the PT routines 3 times per day as well as the JAS brace 3 times per day. He attended aqua classes 3 times a week and took daily walks and gait was getting more normal looking.

July 27, 2007- 4 months post-op. 90 degrees of flexion.

August 23, 2007, 5 months post-op. Dr Folk was pleased with Bob's progress. He thought the knee was more mobile, softer and felt less wooden. 105 degrees of flexion. Started more advanced strengthening exercises, squats and lunges. Bob continued to take classes 6 days a week (step, aqua, and bodyworks). He used a 6-inch step for cardio as well as quad strengthening and used the leg press, leg curl machines, etc. to develop quad strength. He used the JAS splint 3 times per day and did 1/2 hour on the stationary bike with shortened powercranks in the morning and evening. He could not run at all but could skip which is a little plyometric.

Sep 11, 2007 - 5 months post-op. Still gaining flexion slowly but surely about 110. He added the Stairmaster 15 minutes at level 3. He was able to leg press 55 pounds with surgical leg - up from 35 pounds. He was doing a lot of squats as well.

Sep 16, 2007 5 months post-op- 130 degrees of flexion. He gained 25 degrees in just three weeks.

Sep 20 2007 -5 months post-op. Bob went for a bike ride outdoors for the first time.

Dec 1 2007 - 8 months post-op. 144 degrees of flexion and still 2 degrees extension. Dr Folk was very happy and impressed with how far and fast the knee has improved and wanted to know Bob's secret. He told him he was doing 2 spin classes, 2 step classes, and 2 bodyworks classes per week at LA Fitness. Dr Folk said "to keep doing what I'm doing and come back in six months for the final visit". Bob still had a small hitch in his walk from some patellar pain and felt very mild stiffness. He had no pain at all on the bike or doing step classes. He was still not running or playing tennis. He could press 75 pounds with his bad leg up from 35 pounds 3 months ago.

1/3/ 2008 - 1 year since knee injury. He played a singles tennis match on Jan 1.

1/26/2008 Bob is playing tennis, riding bikes, doing aerobics classes, walking - no running, but he never was a runner anyway.

[EdD]

BEAR:
On 8/1/05, Bear completely tore her ACL playing indoor soccer. The initial MRI showed a possible tear of the MCL as well. Four days after the surgery she was scheduled to go to New Hampshire for ten days for her honeymoon. So she was given a hinged brace and crutches, told to set the brace to 30 degrees flexion, and put no weight on the leg until she returned. Her knee was very swollen, and she did RICE while on vacation. She tore her ACL but did not have reconstructive surgery. She developed arthrofibrosis just from the injury.

12/14/2005- Bear had an MUA with a lateral release and a shot of steroids/cortisone. She used a CPM for 3 weeks at night, and most of the day for the first week. She went to the gym three times a day, and did the exercises religiously, and carefully. Patellar mobilizations every two hours, lots of ice, CPM, quad sets, straight leg raises, everything else. She went to PT 3 days a week.

12/28/2005 - She had the knee drained and 3 days later ROM was to 100. After 5 days, 117. After a week, 120!!! She biked every day, twice a day, too.

March, 2006- 2.5 months post op- she had full ROM (143), full extension and hyperextension, and "graduated" from PT.

May, 2006 -4 months post-op -she biked 5 miles to work, and was slowly jogging again. Her knee felt great, and had no problems since the surgery. She biked to work twice, jogged (on and off) for ~3 miles, and then did a 5 mile hike on the weekend. She was a little sore the next couple days, but generally everything was great.

July 25, 2006-7 months post op she jogged 3 miles. She was usually jogging three times a week. She biked to work ~4 days a week, 10 miles round trip. On a recent vacation she did a couple decent hikes (5+ miles), one with 2000ft elevation gain in 2.5 miles, and swam over a mile across a lake and back.

August 28, 2006 -8 months post op and she just returned from another backpacking trip, this one 3 days and 23 miles, with about 4200 ft of elevation gain. She went off trail for much of the trip and traversed some very steep, rocky, uneven terrain and the knee never gave her a problem.

[EdD]

LAURIE:
In April of 2001 she had ACL reconstruction from the patellar tendon, repaired meniscus and a repaired PCL. Things went horribly wrong from the get go. Extension was at 10 and flexion was 95. She had a MUA- manipulation under anesthesia in September of 2001. After the manipulation, extension was still 10 and flexion at one point went up to 120, which she did not keep. She was walking with a severe limp at 10 degrees and had only 95 degrees of flexion. The knee was swollen and hot. She had pain and could not do a stair step either up or down.

11/12/2001-- scar tissue removal in Vail by Dr. Steadman. Lysis of adhesions in the suprapatellar pouch, lysis of adhesions and excision of post surgical scar, infrapatellar plica and anterior interval, anterior interval release. He said at the time it was the 2nd worst case of arthrofibrosis he had ever seen: Directly after surgery she had 5 degrees extension and 120 degrees flexion.

12/12/2001 1 month post op. The knee was very swollen still and starting to get very stiff again. There was a lot of heat still in the knee. They gave her a Cortisone shot to help stop the scar tissue from returning. This really helped. No strength training; just stretching and ROM. Extension was 3 degrees, Flexion was 130.

1/ 10/2002- 2 months post-op. Laurie was still having significant amounts of heat, swelling and stiffness. She received the 1st of 3 synvisc shots over the next 3 weeks. .
There was no change in PT protocol. No strength training; just stretching and ROM.
Extension was 0 and flexion was 135.

2/5/ 2002 -3 months post -op, No change in PT protocol since she was still having significant amounts of heat, swelling and stiffness and pain shooting down the back of the calf. Acupuncture at this time for the nerve pain in the rear of the knee shooting down the calf. The acupuncturist found the nerve pain and turned it off. There was no change in PT protocol. No strength training just stretching and ROM.
Extension was 0 and flexion was 135.


3/3/2002 -4 months post op. Still heat, swelling not improving on ROM. Although the tests for infection were negative took an antibiotic 10 days due to all the heat still in the knee. This was by far one of the biggest improvements she had. Day 3 of the antibiotics and NO heat in the knee. There was no change in PT protocol. No strength training; just stretching and ROM. Extension was 0 and flexion was 150.

7/2002- 7 months post-op. Dr Steadman finally released her for strength training. Must work in the pain free zone. She added walking on the treadmill at 7% grade. Elliptical trainer level 2, Ride the bike level 1. Leg press machine 30 lbs, swimming with kick board. More straight leg raises. She did a combination of these 5 x a week. In the beginning this was all too much. Her knee became very irritated. So she backed off and got into a rhythm that did not irritate the knee. PT protocol included strength training, plus stretching. Extension was 0 and flexion was 150.


1/2003- 14 months post op she still had swelling and weakness and pain issues. The biggest problem was going down stairs. She started to do step downs in the pain free zone. She had to start with a book that was less than 1 inch thick, anything larger caused pain. She did 4 sets of 25 5 x a week. Gradually over time she increased the thickness of the book. It took about 4 -5 months of doing these exercises before she had no pain and could do a full step. PT protocol included strength training, plus stretching.
Extension was 0 and flexion was 150.

2/2004-25 months post op -Laurie is currently doing all the activities she did prior to surgery. She is running, biking, hiking, skiing, volleyball, tap dancing, etc; without pain. She currently runs, Stairmaster, Leg Press 160lbs, Leg Extensions 50lbs, Hamstring Curls 50lbs, Ball Lunges with free weights 15lbs in each hand and all is well.

It took 2 years --from November of 2001 to November of 2003 to fully recover.

[EdD]

LYNE (TRI-SPORT)

In December 2004 Lynne blew out her ACL playing flag football. She was a D-1 athlete in college and at the time was competitive in triathlons. She got an allograft ACL replacement from a donor about 3 weeks after the initial injury and everything appeared to go perfectly. Two weeks post op she had been doing everything the PT had told her to do but was informed that she was behind in range of motion (ROM). She only got to 93 degrees flexion and 6 degrees extension. The OS put her on a 6 day cycle of Prednisone. After 2 days she got the knee to flex 101 but then it went back to 90. Finally it was determined that she would have to go in for a manipulation.

During MUA surgery, the OS got it to 153 and had to go in and remove scar tissue and cut the posterior capsule. She was in the hospital for 2 days on an epidural and a CPM machine and kept ROM at about 130 and 0. After 2 1/2 weeks, she was at about 90 and 7. She could not bike, go up and down stairs, or walk.
9/6/2005. Lynne had a LOA at Steadman- Hawkins in Vail. Two days post-op she was about -2 and got to 130 from just wall slides.

11/14/2005 -2 months post-op -she can walk down stairs now without walking sideways or using support.

11/18/2005.- 2 months post-op -136 degrees of flexion. Dr Steadman was very happy with her progress. After 4 days of PT in Vail, she had 144 degrees of flexion up from 130. Extension was at about 0 at PT, but still he still had a limp. She did not have that much pain and 10 weeks post-op she had a little swelling but not much.

1/18/2006 4 months post -op-flexion at 145 degrees and 0 extension.

3/15/2006-6 months post -op. Everything appears to still be going well. Active flexion was now 139 (passive remained at 145). Today for the first time she was able to do step downs from an 18 inch stair smoothly. Extension is about 0 (although the 0 is only at PT, otherwise it's probably about 2-3).

5/22/2006 -8 months post -op Steady was very happy with her progress-She's training for a triathlon in June so she was swimming and biking and has been able to get some muscle tone back.

5/30/2006 8 months post -op biked 35 miles with minimal pain.

6/11/2006 -9 months post-op- Lynne did a triathlon! She did the mandatory "walk" instead of run that was ordered by Dr. Steadman. She was in first place after swim (1/2 mile), still in 4th after the bike (13 mile), and then did the 3.1 mile walk.

9/30/2006 -13 months post -op --Lynne continued to do very well. She did 4 triathlons in the summer (with the run being replaced by a walk).

7/6/2007 -22 months post-op --Lynne's still doing really well. She no longer goes to PT, but was cleared to do whatever she wanted by Dr. Steadman. Extension and flexion were at what they were a year ago (probably around 0 and 145), but the knee is functional. She still has small amounts of pain every day (about a 1 on the scale) and the knee gets stiff if she does not use it for a while, but she has a fully functional knee.

[EdD]

WILL P

Will had arthroscopy on April 12, 2006. It was primarily diagnostic, to discover the reason for a nagging pain that irritated his right knee nearly every time he ran. The pain came about as a result of over training for a marathon in 2004. MRI's showed nothing, X rays showed nothing, and PT didn't seem to work. The OS removed the plica, and also found a small (5%) tear in the meniscus, which he repaired. The OS said "You're active and fit....you don't need a specialized PT program." Eight weeks into recovery, Will was a lot worse than before the op. He could walk, but going down stairs was very difficult. He had moderate pain below the patella. He was very stiff, the knee was hot all the time, and the quad was still very weak. On October 12, 2006, Will saw Dr. Steadman who immediately diagnosed anterior interval scarring. His ROM was 0-135,

12/15/2006- Dr Steadman performed an LOA. He had a severely compartmentalized suprapatellar pouch, Chrondomalacia of the medial femoral condyle (grade 2) measuring approx 8mm by 8mm, Anterior interval scarring. Dr. Steadman released both areas of scarring and tidied up the cartilage. The good news was that his ROM seems back to near normal. He was only ever missing 10 degrees of flexion and a couple of degrees hyperextension.

1/19/2007 - 1 month post-op. Things have gone well. Flexion and extension are back to normal (148 - 150 and 0- -1), He was still stiff and had a fair bit of soreness on the medial and lateral sides of the patella.

2/16/2007-2 months post -op .Full ROM, about 148 - -1). Pain levels were also good. While he had soreness throughout the day, it was completely bearable. Certain exercises would bring a spike in pain or soreness, but if he backed off, it tended to go down. However, the patella was quite stiff and did not seem to be moving properly

4/6/2007 -4 months post-op-Overall, things are positive. Flexion is the same as the normal knee, and extension is only a couple of degrees off. He notices a slight difference when walking, but nothing major.

He started the strengthening phase of his rehab. He did the bike with resistance for 45 mins 3 days a week and walked on the treadmill for 45 mins at an 11% incline twice a week. One day was off, and one was gentle spinning on the bike for 30 mins He did ROM every day, normally twice. ROM exercises were wall slides, heel slides, mobes, stork stretches and some quad sets. Will had near constant minor pain. Occasionally a strengthening exercise would produce a sharp stab out of nowhere, and he immediately back off. He tried outdoor biking for the first time post op (walking anything that resembled a hill). He was very, very sore afterwards, but managed to do 17 miles, slowly. The big issue at this time was the mechanics of patellar movement and the knee often got stiff compared to the other one.

5/4/2007-5 months post-op. Follow up with Dr S. Basically, the news was pretty good. Patella mobility has stayed within the functional range (though it's still a lot stiffer than the good leg), and there was an improvement compared to the my pre-surgical condition. The quad remained very weak, despite near daily PT, and Dr S cleared him to start doing plyometric strengthening exercises. Pain was extremely variable.

6/15/2007 -6 months post-op. The news was essentially very good. Will was strengthening his quads since February, and was doing plyometric sports cord exercises for the last 6 weeks. He was much stronger and can now do limited single leg knee bends. He was starting to be more aggressive with the sports cord. Pain levels were variable, but he did not have heat or swelling after exercising. Overall, pain was decreased. He was riding the bike outdoors and was up to 25 miles. He started running on the treadmill. 1 min on, 1 off. He built up to 2 mins on 1 min off for 8 mins. It felt weird doing this (and he used to run competitively!), but he had no sharp pains. There were horrible aches after the first time, but they weren't nearly so pronounced subsequently. Negative symptoms were an ongoing ache on both sides of the patella. Mechanics that felt slightly off. Patella was still a lot stiffer than the good knee. A residual stiffness in the bad knee.

10/7/2007- 10 months post-op. Will did a fairly serious hike on one day and a bike ride into Vail Pass the next day. Flexion remains full, and while passive extension was a couple of degrees off, active extension was 100%. Patellar mobility was pretty good side to side, but slightly restricted up and down. He started running again, and was able to get up to about 4 miles now. Mechanics felt a bit off and if he sits down straight after finishing, he would get a very sharp, vice like pain around the knee. But, he can run. About a month ago he was able to do a sprint triathlon. He was sore as anything afterwards, but he did it. He still had some problems - the right knee was a lot stiffer than the good knee, and sometimes the kneecap would catch and jump doing the leg press, for example. Exercises like the single leg squat, plyometric jumping and running sometimes led to sharp pains around the knee (mainly the lateral side). The quad muscle was still 2cm smaller than the other leg. He was told in Vail that he essentially made a good recovery, and can finally reduce PT from 6 days a week to 3.

12/18/2007 - 12 months post-op. Will made big improvements. While the knee was still somewhat stiff, (and occasionally very sore) he was 70 - 80% better than he was this time last year. He was able to walk, crouch and do day to day activities with very few problems, though he did not have the speed and flexibility that he used to. He can run again and got up to six miles. He has been able to cycle 60 miles. Swimming poses (almost) no problems. He was still doing his own PT, and the right quad remains smaller than the left.

[Jaci]

Hi Edward,

Wow! Great job on the compilation of recovery timelines. I think it will help people know that success is possible with proper care, patience and perseverance. Thanks for putting it together.

Jaci

PS-- I sent you a private message. To check your mailbox: go to the user info box in the upper left-hand corner of the page and click where it says "You have X messages."

[missmyknee]

Hi Edward

What wonderful work you did !

I will add it to the Great Threads of AF in the Community Hub, so it can always be referred to, when searching for AF info.

Thanks for a tremendous amount of hard work !

Pam

[skibum9]

Great posts!! Now I guess I'm going to have to learn to be patient and diligent with my rehab and not start expecting too much too soon.

Thanks for the work.

Sharon

[Janet]

Wow! That's impressive. But I also want to mention that there are varying amounts of success. For one it may be a return to sports, for others it may just being able to do their daily routines without pain. After dealing with AF for so many years, I fell into the latter category.

Janet