This was my Right knee before the Transplant fully bone on bone arthritis.. As you can see in the x rays above they have now managed to create some space between my bone surfaces again, although this is somewhat deceptive as I am standing straight legged which affects the view a bit. But the meniscus which does not show up on xray is definitely creating a space that was not there before. I am going to do everything I can to strengthen this and let it heal as well as possible
As you can see My left knee has 8 screws which are anchors for the 4 main structural ligaments in my knee ACL, PCL MCL Cruciate ligaments and posterolateral quarter ligament,..include torn meniscus that is also beginning to go bone on bone and you have a pretty destroyed knee joint. However I did the injury in one severe hyperextension aged 25 and now aged 40 it still feels good and strong. So if you have torn an ACL or PCL do not worry. So for me God willing I am hoping that when the right knee is recovered hopefully its game on again skateboarding!
Week 1
Hospitalised Morphine 4 days intravenous
knee brace 0-90 degrees in bed super painful
catheter following op
vomited 6 times day after surgery
medication after
Week 2 -Week 6
Crutches non weight bearing status brace every day and evening
tubigrip doubled over mid shin to mid thigh
Medication
Tramadol 50mg x2 4 x day
100mg paracetemol x2 4x day
400mg ibuprofen 3x a day.
exercises limited to bending and straightening knee 0-90 with contraction of quads through out the day.
Dressings, Tubigrip full length doubled over
Staples from femoral osteotomy and stitches for keyhole surgery removed on day 10. However wound from osteotemy was not completely healed and needed redressing with steer strips for a further 7 days.
Mild swelling and fluid would accumulate in top of knee capsule ofter quad contraction in extension and in order to bend knee again I would have to massage
fluid manually and push to lower half of knee capsule either side of patella. I could see the fluid move and feel a release which allowed me to bend my knee freely again.
I would experience swelling if I spent too much time during the day walking on crutches. If I slept with my leg raised the swelling would greatly reduce.
Leg (quad and calf ) contractions including walking on crutches with a 5% weight bearing heel toe strike on the floor (to continue natural walking range of motion) were the only exercise for 6 weeks.
Other body exercises
I would lean against a wall with my crutches and perform 3 sets 0f 10 reps bent and straight leg raises to my chest to exercise and strengthen my core. However not everyday just when ever I felt strong and full of energy.
Scar tissue.
At week six consultation
4 of 5 entry points into my knee for keyhole surgery had healed well and skin was moving freely over knee. However I entry point on the lateral side where the damaged meniscus was replaced. The scar had fused all the way down to the bone and when my knee would swell would take on the appearance of a “potato eye” This was also painful area and restrictive. I massaged this scar tissue for 7 weeks post up and on approx week 8 I pushed it really hard down towards my foot and I felt it tear and begin to release with bait more of a push with two pop pop it released completely and my skin over my knee has been moving freely since pain free. A very satisfying moment in my recovery.
Week 6 Consultation,
all had healed well weight bearing x rays and concerns from Mr James Robinson Southmead Hospital that he felt that he had over corrected my leg on the ostotemy in to valgus (bow leg) status by a few too many degrees. He explained the knee was far more damaged than he had expected and wanted to protect the new meniscus transplant by removing the weight/ load forces through the joint as far to the medial compartment as possible. He decided to correct my alignment with a 10mm wedge removed from my femur then plated and screwed. This combined with the new meniscus opening up the joint space somewhat as well has moved my foot approximately 5-5.5 inches over to the left from where it was previously aligned. This has successfully transferred the load bearing well over to the medial side. However he feels the aim to have it through the centre of the knee would be better.
I personally am happy to try for a year and will decide if I experience ankle hip or back pain then I will be prepared to undergo an opening femoral osteotemy with a 5mm wedge to realign my bio mechanics to their optimum. However I feel there is no rush to do this because the longer the meniscal transplant has to heal with a reduced load and force through it is actual y more beneficial. However if upon my return to increased activity I feel pain in other areas this will be essential to re correct my biomechanical alignment.
Week 6 -12 Partial weight bearing 0-90 degree rom in brace
At my physio appointment I was told to stand with my well leg on the floor and my post op leg on a floor scale and was told to weight bear until I understood what 50% weight bearing felt like. In my case this was 50% my body weight that day 40kg. I discovered I had gained about 3 kilos in 6 weeks from inactivity.
Week 6-9
Knee brace 24 hours a day, taken off when resting on sofas and seats. exercise same as week 0-6 just muscle flexion and contractions.
Scar tissue healing nicely, uneventful period, not much swelling.
week 10- 12 I had a general feeling that I wanted to increase my weight bearing progressively each day so that at week 12 the full weight bearing stage in my recovery it would be a smooth transition to removing the knee brace and crutches and walking without them. This progressive weight bearing was basically walking to the toilet and kitchen at home without crutches.
Week 11
I was walking up and down stairs with a brace but no crutches however walking up felt fine but walking down was not one at a time rather foot to foot, meeting on each step.
Pain has decreased through out this period slightly each day and I had a struggle coming off tramadol at week 8, reduced dose to two a day for about a week then two every other day for about 5 days. Highly physiologically addictive with withdrawal symptoms simulate to other opiates such as heroin and morphine according to the research I read.
The pain in my knee increases if there is swelling after activity of any kind and feels sore all over with sharpness occasionally in the lateral compartment where I had the transplant. This does worry me sometimes however the pain does move location so I think its a general result of the trauma from surgery 5 hrs total rather than any acute knee problem.
Week 12.
Off crutches, knee brace returned to the hospital. range of motion unassisted is approximately 125 degrees with no pain. Now full weight bearing and learning to walk with a correct gait pattern. I feel stiffness in full extension which makes me walk with a slight unevenness not quite a limp.
Week 13-14
walking for 30 minutes twice a day, cycling for 30 minutes every other day, Cycling painful in the upper part of the pedal stroke as knee is bent at 125 degrees and feels stiff, however I feel much stronger the following day so I am continuing. Cycling standing up eg. up hills is still painful and I chooses to lower my gear ratio and cycle uphill sitting or walking.
Started stair training in the multi story car park 10 flights of stairs (18 steps each flight) walk up stairs 2 seeps at a time 10 flights, take elevator/lift to ground floor then repeat. Managed to do this 6 times had to stop because my friend Avril kept complaining she was tired. I wanted to do 10 times 100 flights total and I think I could have but she had the car keys so I stopped.. Knee feels ok the day after
