4 Weeks Post-Op

I am just about 4 weeks post-op from my left knee reconstruction. In that surgery I had a scope, lateral release, and MPFL reconstruction with a cadaver tendon. I have 3 pins in my knee--and this time they can't come out because they are holding the new tendon in place. I thought I'd post on my progress so far and end with an updated picture of my incisions (don't worry, they aren't gross).

I started PT (with Cam) at 2 weeks post-op. I have only had 3 sessions and an evaluation so far. In those sessions we learned once again that my quad went on a long vacation and hasn't made any indication of wanting to return. By that I mean that I still have ZERO quad strength--you can compare it to a newborn baby's thigh--and I cannot even begin to walk without crutches if the brace is unlocked. I cannot lift my leg up without physically picking it up, and I still have some major swelling in my knee (something I am not used to...as I don't typically have inflammation following trauma). Unfortunately this also means that instead of being off of crutches I am still on them (and for awhile). I have spoken with my surgeon and he wants me to walk more with the brace locked in extension--to prevent any further elbow damage, and to help strengthen my quad as much as possible. Weight-bearing does far more in terms of strengthening than any PT exercise. It also helps activate other muscles that have been inactive. I am set to travel back to Boston for a post-op in December and until then my only 2 goals are:

1) Strengthen the quad

2) Range of motion (ROM)/flexion

In terms of ROM/flexion, I am not a fan. I guess I expected that after going through a PAO where they literally broke my pelvis is 3 places (and placed 3 screws the size of a pen in my hip), that knee surgery would be a piece of cake. Well I was wrong. Honestly, the knee surgery recovery (so far) has been harder and more painful than both of my hip surgeries. I now understand how Total Knee Replacement patients feel when the therapist forces the knee to bend to a certain degree. I am still restricted to 60 degrees until Tuesday (when I am allowed 90 degrees..yikes), but Cam has only managed 45 degrees and even that was painful. If measured to my comfort I'd probably be somewhere around 30 degrees, but of course that would be too easy. Cam basically has to flex my knee for me and even with him working through the inflammation it still doesn't go very far. In terms of following post-op protocol--I am way behind on flexion/ROM. However, for me (having EDS), post-op protocol doesn't mean much.

Standard patients would be off of crutches, and walking with the brace unlocked. They'd typically have enough quad strength to support themselves and they'd most likely have around 60 degrees of flexion.

As for me (as I mentioned above)--I am still living with a newborns thigh and I'm working to try and strengthen that enough to support me. If I were to take a step with the brace unlocked my knee would give out, most likely resulting in a dislocation. I have about 30 degrees of active flexion, and 45 degrees of forced ROM. Instead of wearing the brace for 6 weeks, I will most likely be in the brace for 8-10 weeks. The brace can be discontinued once I have normal quad strength and at least 90 degrees of flexion.

So while I am not progressing at the rate I would like, I am still very thankful that I had this surgery (not that I really had a choice). I still have NO groin pain, and no left hip pain--which to me is a miracle. When I am going through flexion, my kneecap seems to be tracking normally and doesn't feel like it's going to dislocate--another satisfying and reassuring feeling.

Unfortunately my right hip is deteriorating and has become more unstable, which makes some exercises in therapy impossible. I can't have my right hip fixed until my left knee is fully recovered and at this point that could be months. My goal is late January or February, if possible.

As mentioned above, here is an updated picture of my incisions...