12 Weeks Post Knee Surgery

I dislocated my knee during a light sparring round April 17th, 2021. I didn’t let my partner know how bad it was because it was a freak accident and didn’t want him to feel badly. Thankfully I was able to quickly get in with one of the top Sports Orthopedic Surgeons in the area. He specializes in high impact athletes (16 years working for an NFL team) so I knew if anyone could get me back on the mats it would be him!

My diagnosis was a torn and frayed PCL (opposite of the ACL), torn LCL, several tendons torn, and basically the entire outside of my knee was mush (posterolateral corner/PLC). I have underlying hypermobility and joint instability (It’s a degenerative condition), so the Dr said it was difficult to tell how much of the instability was caused by the damage, and how much was just my normal baseline. (He said my “good” knee felt like a bad knee – but it is functional for me). He wanted to opt for more conservative treatment at first. “I have enough people to do surgery on. I don’t want to put you through surgery if I don’t have to.” I appreciated that approach since I do not have health insurance and would have to pay out of pocket for any expenses.

I did twice a week physical therapy, with regular check ins with the doctor. The idea was that we would let it heal and stabilize on its own as much as possible. When I plateaued that is where we would decide how functional I was. I hit the plateau early November and was able to walk around with a brace on, but my bones were shifting too much for me to be able to train safely. We scheduled surgery for December 16 (after I got back from coaching students at Worlds).

Surgery day was fun. I was actually a lot calmer than I thought I would be and looking forward to a nice nap. I was the doctor’s first surgery of the day – and must have really thrown off his schedule because it took him three hours to put my knee back together (his surgeries are usually about an hour). He said it was like trying to stabilize jello. I now have a few donor grafts and several screws holding my joints together, they also gave me a round of PRP in order to help speed healing. He had to drill through my bones 5 times in order to anchor everything. He had to get “very aggressive” and as a result they had to put me under very deep anesthesia; it took me 3 hours to properly wake up afterwards. He was however very pleased with the surgical outcome and confident it would heal strong and be more stable than my other knee.

The first week was super rough. They gave me opioid pain meds for 10 days, but I switched to Tylenol after the first few days. It was hard enough to get up to use the bathroom without dissociative drugs in my system. The anesthesiologist took me seriously when I told them I metabolize nerve blocks quickly so he must have given me an extra special dose – I couldn’t feel my lower leg for the entire first week. It’s probably a good thing based on all the work that the dr did.

I spent my first few weeks post-op with my leg locked out in a splint 24/7. I was allowed to be weight bearing “as tolerated” but until I regained sensation in my foot, I kept that to a minimum. I was on an ice sleeve machine for 5 out of every 6 hours and sleeping with my leg elevated to keep swelling to a minimum. Physical Therapy started the week after surgery right after I finished my first post-op visit where they removed my stitches and half of my staples (there were 39 total staples holding the side of my knee closed, the other half were removed a week later). Physical therapy at this point mostly focused on controlling swelling, isotonic muscle work, and passive prone mobility (bending my knee while I was face down).

At my 3 week checkup, I told the doctor that I had managed to complete a 300-hour game on my Nintendo switch (The Witcher), and he told his PA “Let’s get this girl moving”. He gave the PT clearance to start unlocking the hinge on my brace so I could start bending my knee while walking and pushing my range of motion more. He told me I could be as weight bearing as I was comfortable to do, so I found I could stand for a few seconds with my weight evenly distributed. I also got to remove the steri strips that were on my smaller incisions. The larger one (about the size of my hand from wrist to fingertips) I had to keep taped up a bit longer.

At the 7 week mark I hit a wall for range of motion. For the PCL ligament, they had to keep my leg locked out straight for the first 6 weeks because in that position there is no pressure on the new ligament. This enables all the bone grafts to start healing and the ligament to stabilize in its new home a little bit. The more the knee bends, the more pressure it puts on the ligament. Only time I was allowed to have my knee bent was twice a week under the direct supervision and application of my physical therapist. So now that it was anchored, we had to start stretching it out more aggressively. 90 degrees is what you need to sit in a chair with your feet flat on the floor. I was stalled out at 35 degrees and crying/sweating buckets when the PT would push to stretch it more. We were way behind schedule, so my PT called the dr’s office and they put me on a steroid pack for 6 days. With that we were able to get past the hurdle to 50 degrees. It’s very useful that my PT clinic is connected with my dr’s office, and they can share notes back and forth in the same system.

Since then, range of motion has still been a game of slow improvements. I see the doctor again tomorrow for my 12 week follow up and I know they were hoping I would be past 90 degrees by now but I’m barely passing 75 right now. I may be looking at another steroid pack, or possibly some injections. We shall see what the doctor says tomorrow!

On the positive side, I’ve been walking with a much more even gate. Doing light leg press exercises, single leg balances, and even walking across the floor without my brace on at PT. My hope for tomorrow’s appointment is that the doctor will okay me to get rid of this massive post-op brace and switch to my smaller custom brace for walking around. I plan to ask if he still thinks I have a chance of being able to safely compete at the World Pro tournament in November. Before surgery he said absolutely yes, but I know he had to do a lot more work in my knee than initially anticipated.

Here’s hoping!

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