Am I worrying for no reason?

[casey2291]

Hi,
I had ACI and HTO 5 months ago. I had a scope one week ago to clean out scar tissue from my knee. I have great extension and even have 4 degrees of hyperextension. The scope has helped my limp tremendously and I am walking almost completely normal now. I saw a huge difference in my gait from the first day out of surgery. I am concerned because I do not have my flexion back yet and my knee feels as if it is stuck in the same spot as it was before my scope. I am about 10-15 degrees from full flexion on my own and I can not push my knee to passively achieve full range. I have some swelling in my knee and my PT said that my swelling feels different now after my scope and that my knee feels more fluid filled verses a harder feeling prior to my scope. My knee feels quite stiff and I'm getting concerned that I am not going to get full ROM. I know that I am only a week out of my scope, but I thought that now that my knee is free of scar tissue that I would easily achieve full ROM. Should I be concerned or am I just being paranoid? I've been pushing my ROM as much as I can and am thinking about taking pain killers so I can just go at it. I am out of town this week, so I can't consult with my PT, although last week he told me not to push at it too much until the middle of this week. I admit, I have been pushing hard the past couple of days. Any advice...am I worrying for no reason? How quickly does your body reform scar tissue?

[catwoman88]

Hi,
I think everyone gets paranoid about the dreaded AF re-occurring and how quickly it can re-occur. I know in the tutuorials Dr Noyes says that it scar tissue can start to re-form as early as 2 weeks after surgery - at this stage though it can be broken up through PT exercises as it's wispy in formation. Your extension is great 1 week out and your flexion does not seem to be too bad at this early stage either. How many times are you having PT a week and were you using a CPM machine right after surgery?.

I had a scope to remove scar tissue just over 2 weeks ago and I am at 35 degrees ext and 112 flex - I was in a leg cast till last Thursday but I am too becoming paranoid that AF is starting to come back. My OS tells me today to again start to wear my immobilizer at nights - this is a déjxc3xa0 vu feeling for me and I am scared. I never had a flex issue so I reckon I can achieve more flex but my extension loss is making me limp again and I feel like I am back to square one. But I am going to give myself a good couple of weeks going to PT and then see where I am at otherwise I'll drive myself mad worrying!.

Try not to panic at this stage as you seem to be on track at one week post surgery. I'm sure one of the experienced AF kg's will also post their thoughts for you.

Thanks

Lianne

[Jaci]

Hey Casey!

Your extension is great and that is the main concern this early after your scope. Your flexion is very good also and it could be that swelling is keeping you from getting full flexion. The important thing is to find the balance between being vigilent with PT but not to the point that you irritate your knee and cause an increase in swelling and the inflammatory response. It's a constant two steps forward, one step back process.

If you haven't read up on arthrofibrosis using the tutorials and other info, you definitely should take some time to do so. Or it's good time for a review: You cannot know too much about the condition, and what you don't know can hurt you. KNEEguru has one of the largest collections of accurate info from credible sources available anywhere on the web; it saves you a lot of leg-work (ha! ha!)-- there's no reason to not learn everything you can. You can find that info through the Community Hub. Look under Keynotes and click on the arthrofibrosis heading. Or you can use this link:

http://www.kneeguru.co.uk/KNEEnotes/node/632

Best wishes,

Jaci

[Shaggy]

I had a lateral release and patella shave many years ago and my knee completely locked from adhesions. PT could not break it. I went in for manipulation and from the moment I woke up I had complete ROM. Of course I did not have extensive surgery to begin with. I would say that you are doing good considering all things. Take it slow.

Catwoman - I had an HTO 8 weeks ago today and just got off the brace and crutch. Not alot of pain unless I'm on it for awhile. How did your recovery go?

Shaggy

[catwoman88]

Hi Shaggy,

I did not have an HTO - Casey had this procedure 5 mths ago (just read up on the procedure though and it sounds like you're doing really well 8 weeks out). I only had a LOA, manipulation and cast 2 xc2xbd weeks ago - following a scope 7 weeks before - this was just to clean out the knee. On the second surgery the OS heard the scar tissue breaking up on the manipulation and then removed it. I feel from all of this like I should have had major surgery for the amount of problems I now have - don't get me wrong I am not saying I want major surgery, but from a 'simple' scope I now have serious extension loss issues. Hope my PT can get this knee moving soon, worries me already though that as soon as my PT told my OS what my ext loss was he told me to wear the immobilizer at nights again

I'm glad your manipulation was successful - great to hear success stories like this - it gives people hope!.

Thanks

Lianne

[casey2291]

Hi Everyone,

Thanks for all the info. When it comes to my knees, I can't help but worry. I'm such a laid back person about most things in life, except for my knees!

I feel better knowing that at 2 weeks out any new scar tissue can be broken up by PT. I was not given a cpm machine to use after surgery. I know that may be good for my knee, but quite honestly, I am glad that I don't have to use one. After spending 6 weeks in one for my ACI, I have no desire to go back to using it again. I am doing formal PT twice a week, although this week I am out of town and working on my ROM myself which is why I think I am a little paranoid. I won't see my PT again until Monday and I'm anxious to see what my flexion measures at. I'm definately struggling to find the balance between pushing the knee but not pushing too hard so that I increase the swelling.

Lianne...I hope that you can get your ROM back soon. It is frustrating isn't it?

Shaggy...my HTO went well. According to my OS, everything looks good. I don't really have any pain from my HTO with the exception of an occasional ache in my screws and that is pretty infrequent. I don't like that there is a lot of stiffness in the area where all my hardware is, but I guess that is a minor complaint. Have you achieved full ROM at 8 weeks out? It sounds like you are doing well. I was on crutches until 10 weeks post-op and wore a brace until at least 14 weeks post-op or so. Although, I also had the ACI done at the same time, so you will probably recover quicker than me.

Jaci...thanks for the link and info. I will check it out.

[Shaggy]

Casey I reached 120 degrees at PT last week. I'm excited, I'm very stiff when I take the first few steps after sitting awhile. I can walk without a limp if I walk slow and contrate. Otherwise I have a limp. I dont like the feeling like there is a tight band around my leg just brelow my knee. Does that ever go away?

Sheri

[casey2291]

Sheri,

120 degrees is good...good for you!! I too can feel the difference where my screws/plates are located. I still have a lack of feeling in the area over my screws which sometimes really bugs me. I too wonder what it will feel like as it heals more.

[Shaggy]

I'm more incouraged every day. I got through my work week ok. I did alot of walking for short peioeds of time yesterday and it wasn't very painful and most importatnly I didn't have a big amount of swelling. I ewnt to the dirving range and hit some golf balls. No pain to speak of and I'm liking the fact that I can be on my feet for a freminutes like I was before the surgery.

Sheri