Stage 1 of ACL 2 stage revision surgery - what should recovery look like
January 5, 2015 1:38 PM Subscribe
Can you share your experience with 2 stage ACL revision surgery? I would primarily like to know about the first stage.
The surgeon will be cleaning out my scar tissue, the old donor tendon, and filling the old screw tunnels with a bone graft. Fortunately, I won't have the bone taken from my hip, it will synthetic. Bad news, my knee will be even less stable than it is right now. I already have arthritis in that knee.
I work from home so that's good and I have kindergartener who can ride the bus. But, my husband travels for work. I have my mom to help the first week, but beyond that, no one. Family is far away, and we just moved, so friends are far too. Will I be able to manage? My biggest worry is getting to and from PT. My area (Cobb County, Georgia) doesn't have transit where I live.
If you've had this surgery, how long were you on crutches? How soon could you drive? (It's my right knee). What did you find most helpful? Thanks!
The surgeon will be cleaning out my scar tissue, the old donor tendon, and filling the old screw tunnels with a bone graft. Fortunately, I won't have the bone taken from my hip, it will synthetic. Bad news, my knee will be even less stable than it is right now. I already have arthritis in that knee.
I work from home so that's good and I have kindergartener who can ride the bus. But, my husband travels for work. I have my mom to help the first week, but beyond that, no one. Family is far away, and we just moved, so friends are far too. Will I be able to manage? My biggest worry is getting to and from PT. My area (Cobb County, Georgia) doesn't have transit where I live.
If you've had this surgery, how long were you on crutches? How soon could you drive? (It's my right knee). What did you find most helpful? Thanks!
I didn't have this specific surgery, but I'm 5 weeks out from a tibial tubercle osteotomy, lateral release, and MPFL reconstruction. The TTO includes cutting a strip of bone from my tibia and screwing it down in another location. I was non-weight bearing for two weeks and am partial weight bearing for four weeks. At week six, I'll have x-rays and a check-up and, if there are no unexpected complications, I can ditch the crutches and brace. I'm hoping I'll be able to drive then, too (it's my left leg, but I drive a stick shift).
One thing I want to stress is to prepare for the crutches by working on balance and upper body strength as much as possible. I thought I'd done enough, but ended up with acute rotator cuff tendinitis in one shoulder because, as it turns out, my arms are not good substitutes for legs. Also, get a small backpack for transporting things you need. My lunch routine includes crutching to the kitchen, making a sandwich (make sure everything is in easy reach), putting it in a sandwich bag, putting the bag in the backpack, and crutching to the dining room or couch where I unpack and eat. If you're a coffee drinker, get a small thermos that will fit in the backpack.
I rented a cold therapy unit and it was a huge help in the first couple of weeks. It's great at relieving pain and swelling.
As for PT, I can't drive yet (it's my left knee, but I drive a stick shift) and I haven't been brave enough to venture onto the bus, so I've only had a couple of visits supplemented with email check-ins. Are cabs a possibility for you? See if your PT is open to email or skype after your initial appointment. Until I get out of the brace and off crutches, I can really only work on easy strength and ROM exercises, which don't require a lot of supervision.
Spend the last few days of your mom's visit trying to do everything you can for yourself. You'll quickly figure out what modifications you'll need. Are your dishes and cups in easy reach? Can you handle the laundry? Do you have pets? If so, arrange a dog-walker or cat box scooper. Enlist your child's help. I have a 2 year old who is now a pro at bringing me gel ice packs and even helps feed the dog. You will get through this. It will be hard but you can do it.
posted by subluxor at 3:43 PM on January 5, 2015
One thing I want to stress is to prepare for the crutches by working on balance and upper body strength as much as possible. I thought I'd done enough, but ended up with acute rotator cuff tendinitis in one shoulder because, as it turns out, my arms are not good substitutes for legs. Also, get a small backpack for transporting things you need. My lunch routine includes crutching to the kitchen, making a sandwich (make sure everything is in easy reach), putting it in a sandwich bag, putting the bag in the backpack, and crutching to the dining room or couch where I unpack and eat. If you're a coffee drinker, get a small thermos that will fit in the backpack.
I rented a cold therapy unit and it was a huge help in the first couple of weeks. It's great at relieving pain and swelling.
As for PT, I can't drive yet (it's my left knee, but I drive a stick shift) and I haven't been brave enough to venture onto the bus, so I've only had a couple of visits supplemented with email check-ins. Are cabs a possibility for you? See if your PT is open to email or skype after your initial appointment. Until I get out of the brace and off crutches, I can really only work on easy strength and ROM exercises, which don't require a lot of supervision.
Spend the last few days of your mom's visit trying to do everything you can for yourself. You'll quickly figure out what modifications you'll need. Are your dishes and cups in easy reach? Can you handle the laundry? Do you have pets? If so, arrange a dog-walker or cat box scooper. Enlist your child's help. I have a 2 year old who is now a pro at bringing me gel ice packs and even helps feed the dog. You will get through this. It will be hard but you can do it.
posted by subluxor at 3:43 PM on January 5, 2015
Response by poster: Thank you for some great coping strategies. I left out lots of details because I didn't want to lead an answer.
I had an ACL reconstruction and meniscus repair in 4/12 after slipping and falling while at the gym. (The only positive is that I was at a Crossfit box and was working on a weightlifting move with a trainer. It was a move called the snatch and made for great jokes through the pain). During recovery, a pin worked its way out and snagged my IT band every time I did PT. Plus, a screw head was loose in the joint causing trouble. PT thought I was a wimp and kept pushing, but after 13 weeks I still was on crutches, not driving, and had a lot of pain and swelling.
Dr. Took x-Rays and found the problems so I had a second surgery in 7/12. Long story short, the ACL was loose from then on. Dr. denied it was loose and a new PT pushed me based on his info. Every time my knee was challenged it slipped and hurt and caused so much pain. I switched docs and PT groups and am now so happy with this medical team. I've done all the PT I can to avoid a revision surgery, but it still collapses easily unless I'm 100% focused on not letting it. I now have a non functioning ACL, other loose ligaments, meniscus torn to shreds and arthritis.
Pain meds make me sick now, so I'll be on a bare minimum. I'll have a stocked freezer and an Amazon acct, I'm a pro at crutches but will start practicing again. I already have a loving relationship with my ice blankets, but I may get more. I love the Remote PT idea, the good news is that I know the exercises well at this point.
I'm still hoping to hear about this exact surgery though. Just how long did recovery really take? Could you drive even while you were still on crutches?
posted by banjonaut at 4:55 AM on January 6, 2015
I had an ACL reconstruction and meniscus repair in 4/12 after slipping and falling while at the gym. (The only positive is that I was at a Crossfit box and was working on a weightlifting move with a trainer. It was a move called the snatch and made for great jokes through the pain). During recovery, a pin worked its way out and snagged my IT band every time I did PT. Plus, a screw head was loose in the joint causing trouble. PT thought I was a wimp and kept pushing, but after 13 weeks I still was on crutches, not driving, and had a lot of pain and swelling.
Dr. Took x-Rays and found the problems so I had a second surgery in 7/12. Long story short, the ACL was loose from then on. Dr. denied it was loose and a new PT pushed me based on his info. Every time my knee was challenged it slipped and hurt and caused so much pain. I switched docs and PT groups and am now so happy with this medical team. I've done all the PT I can to avoid a revision surgery, but it still collapses easily unless I'm 100% focused on not letting it. I now have a non functioning ACL, other loose ligaments, meniscus torn to shreds and arthritis.
Pain meds make me sick now, so I'll be on a bare minimum. I'll have a stocked freezer and an Amazon acct, I'm a pro at crutches but will start practicing again. I already have a loving relationship with my ice blankets, but I may get more. I love the Remote PT idea, the good news is that I know the exercises well at this point.
I'm still hoping to hear about this exact surgery though. Just how long did recovery really take? Could you drive even while you were still on crutches?
posted by banjonaut at 4:55 AM on January 6, 2015
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Practice crutches now. There is a pretty good learning curve, and I'm sure you spent some time on them before, but probably not as non-weight bearing, which I suspect you would be while the bone graft settles in. Non-weight-bearing crutching is very different from partial-weight-bearing. This means thinking about stairs in your household, how you'll get to the bathroom, fix a meal, etc. YouTube taught me what the (incompetent) ER did not.
A small microwave very close to the fridge with some prepared plates inside and a rolling cart helped me get my own lunches. See if your mom could pack your fridge or freezer with some simple meals. Keep in mind you need to be doubling your protein intake. Healing takes calories. I had bags of nuts strategically placed around the apartment.
While you are non-weight bearing, you will be unable to drive. Ask your hospital about in-home PT. See if you can nail down your husband's travel schedule, and schedule in-office PT around it. You'll get "homework" sheets to do daily. In the office you'll be evaluated (range of motion, pain levels, muscle stress, etc) and taking a week off of office visits is not such a big deal later on.
Speaking of PT, find out now what your insurance limits are around PT. Most insurance should be "as long as medically necessary", but some have hard limits around what that means, some have yearly caps (like 14 sessions), some have dollar limits. You can call the number on the back of your insurance card, or find your summary plan document online.
Get in shape now. You'll be surprised how quickly you'll loose muscle tone and stamina. An exercise bike will be very helpful in your recovery if you've got the room for it.
Lets talk about pain management. If you're on opiates for any amount of time, you need to be on stool softeners at a minimum, if not some miralax. Best idea is to get off opiates when possible. I'm not going to say "as soon as possible", because pain can really limit your recovery, in many physiological and psychological ways. Anti-inflammatories can limit bone healing, (after all, inflammation is the healing response) but some surgeons don't care or don't think it is such a big concern. I'd ask for prescription NSAIDS like celebrex once you're off Vicodin. They're safer to take long term than tylenol or advil.
The best idea though is ice. "all natural" pain relief. I got 4 long lasting gel ice packs and rotated through them in a day. They came with a little sleeve, though you could rig something up with towels and velcro too.
Shower chair. If you happen to live in the DC Metro I'd give you mine. Also get an extra long shower hose.
Amazon Prime, Peapod, get everything delivered that you can. I wanted to take some burden off my husband so I tried to at least get all the shopping done while he was doing all the cleaning, laundry, cooking, working, etc.
Lastly, oddly enough, search facebook for ACL recovery groups. I know, eww, facebook. But I found a hugely helpful TPF group. They will be going through the exact same thing, probably at the same time as you, and will also be up at 2 am, or home all day.
posted by fontophilic at 2:30 PM on January 5, 2015 [1 favorite]