ACL Replacement Finally On Track

[Eric@ict]

Frozen water bottles worked well in the machine for my friends' knee replacements and my husband's shoulder surgery, too.

That’s what we use as well. 3 bottles is all it takes and they lay in there perfectly.

 

[PisteOff]

Here’s some before and after pics from the surgery. The donor ACL is a large, sturdy specimen. Doc is very aware of my skiing obsession. He said there was meniscus on the other side that was “flipped” and could see where cartilage was removed in the 1992 surgery. He put that in order the best he could. There is a little arthritis in the knee. There is some grooving/ridging wore into the ball but nothing extensive.

 

[Johnny V.]

Keep up the good work Jeff!

 

[PisteOff]

Keep up the good work Jeff!

Thanks!

 

[Jim Kenney]

Looks like the meat counter at Smith's Market, nothing that a little BBQ sauce won't fix

 

[PisteOff]

Looks like the meat counter at Smith's Market, nothing that a little BBQ sauce won't fix

Might want to find a new store

 

[PisteOff]

Made the move from crutches to a cane this morning. That is with the brace on. Getting around better everyday. I will do some more stretching and range of motion stuff this afternoon. Took it easy yesterday.

 

[Andy Mink]

Las Vegas

This is just north of town.

 

[PisteOff]

This is just north of town.

All things considered, Vegas is a good jumping off point for some great skiing. Lee is an hour, Brian Head is 3 hrs., Mammoth is 5 hrs., Alta/Bird is 6 hrs. (Add time as necessary for everything else in the greater SLC area), everything around Tahoe is 7-8 hrs., Sun Valley is 9 hrs., Jackson Hole is 10 hrs., Aspen/Snowmass is 9 hrs., Telluride is 9 hrs., Taos is 10-1/2 hrs.

To put it in perspective, Taos is 10-1/2 hrs. from my present location, A-Basin is 12-1/2 hrs., Aspen/Snowmass is 14-1/2 hrs., Alta/Bird is 18-1/2 hrs., Jackson Hole is 19-1/2 hrs.

This is definitely a location upgrade in my opinion. Pretty much everything I love to ski is an easy day drive. It’s also something that is being done for my wife’s health as the desert climate is easy on her rheumatoid arthritis. We also have 4 grandkids and a bunch of friends there as Suzanne was stationed there for 20 yrs. with the USAF.

 

[PisteOff]

My second PT day (I work it everyday at home) was today. I’ve reached 100* range of motion already. I’m one crutching it at a decent pace and barely load the crutch at all. I use a cane around the house. First half of the session was focused on stretching the ACL and range of motion. The second half was focused on the quads while maintaining a straight leg with toes back (dorsi-flexion), to stretch against the ACL. They incorporated TENS to fire the quad and you flex the quad tighter from there. Did a number of leg raises, abductor raises, etc in this fashion while the TENS unit cycled in an on/off pattern of several seconds per cycle. She seemed miffed that she didn’t wear me out. I told her I walked into surgery, I’ve not been on crutches for weeks prior to the graft. I’ve not atrophied at all. I go back again Thursday. My personal objective at this stage is to get the swelling down around the knee. I feel like the swelling hampers both my range of motion and weight bearing more than anything else at this stage.

 

[PisteOff]

A week later and the swelling and inflammation is down considerably. It would be better if I elevated it more. They tell me I have to sleep in my brace and elevate my knee but after a couple hours there’s a spot on the brace that is really annoying my leg. Even if I erect an elaborate soft pillow edifice there is still, at some point, a pressure point that causes discomfort. Last night I ditched the brace and slept with my leg elevated in the wedge. It went well but come 6 am I had had enough of it. Anyway, much improved. Perhaps a little off pace but I’m good with it.

 

[PisteOff]

Ok, 4/13/23 and my 3rd. PT day is in the books. One hour and 15 minutes today. The exact same format as Tuesday but with the addition of a resistance band and leg weights to make the leg lifts more difficult and to put more weight on the stretch.
Yesterday my calf was really sore and knotted up from the prior days PT. I had to stretch it out a number of times. I was curious how today was going to go with only a single day of recovery. It went well once I was stretched out. We didn’t dorsiflex every exercise either. She closed the session with some soft tissue work on my calf. I did remember to grab a couple photos and a short video.
In the video, the TENS unit isn’t enough to straighten the leg. It fires the quad, you have to fully flex the quad enough to raise the foot. The therapist will pull on the towel roll when you begin. The goal is to pin the towel roll to the table and get the leg straight with heel off the table. You hold it while TENS is on. You do reps for 3 minutes

Oh yea, my range of motion was 107* today. Added another 7*.

 

[OSD]

Are they not making you wear the compression socks?

 

[PisteOff]

Are they not making you wear the compression socks?

I had an embolism sock on the non-surgery leg for the first two days only. There was never an embolism sock on the surgery leg. Initially it had dressing and then a couple ace bandages. The swelling in the surgery leg was not going down fast enough. This was due to the discomfort of elevating in the brace. I was not elevating it enough. I pulled one of my leg compression sleeves out and began wearing that a lot and elevating without the brace. It had my lower leg back to normal size in less than 24 hours. (The doc and PR get really nervous about you being mobile or sleeping without the brace during the first 4-6 weeks.)

Anyway, no they want you to let it breathe. They just don’t want you up and moving about without the brace. You won’t wear the brace without something between it and your leg. I got two good size blisters from it on my thigh the first couple days where the brace was higher up on my thigh than the ace bandage was. Now, with that being said, I’m sure there are different sets of instructions for different people. What’s being recommended for me is going to be specific for me and will undoubtedly not be appropriate for all. I’m also known to make my own decisions regarding my healthcare. I strongly suggest everyone first listen intently to their orthopedic team and then go from there according to your own judgement.

Back on subject, I ace wrap it when I ice it because that ice pad direct on flesh is too painful. I ace wrap it when I go to PT with the brace on. The ace bandage is a lot easier to put on/take off than the compression sleeve. In the evening I wear the compression sleeve and ice a couple times while elevating. At bed time (11:00 to midnight) I put my brace on over the compression sleeve and elevate until it wakes me up and then just kick the wedge on the floor and go back to sleep. I’m getting 8 hours of sleep. There’s no swelling in the lower leg today after working it out so I will likely only ace wrap it good and snug tonight and put on my brace.

 

[OSD]

I had an embolism sock on the non-surgery leg for the first two days only. There was never an embolism sock on the surgery leg.

That's interesting, they told me to wear them at all times on both legs along with the sleeve and some electric squeezing gadgets for two weeks. It's a bit much.

 

[PisteOff]

That's interesting, they told me to wear them at all times on both legs along with the sleeve and some electric squeezing gadgets for two weeks. It's a bit much.

Do you have circulation issues? Heart issues? They’re obviously worried you’ll develop a DVT.

 

[OSD]

Do you have circulation issues? Heart issues? They’re obviously worried you’ll develop a DVT.

Not that I'm aware of and there was nothing in the exam or surgery notes about it. I figured this is their standard procedure but I'll ask at the followup.

 

[PisteOff]

13 days post-op and 4th visit to PT. Range of motion is 115* and 0. I’m well ahead of schedule and the knee is feeling good. Still some swelling on the top of the knee and around the cap but it’s slowly getting back to normal. Still concentrating on range of motion stretches and quad strength. Quad strength is good. I can flex, hold, and easily do any of the leg exercises they’ve asked of me thus far. Did full revolutions on the stationary bike for a few minutes today for the first time. They’ve started adding leg weights to the exercises because what they have me doing has been so easy for me the last couple visits. I’ve been getting .74 of a mile (walking/limping) on average daily here at home just putting around the house and out on the back patio. Mostly without the brace and with a cane which I really only use when going up or down steps. I am using excessive caution because one slip could be bad. I am constantly stretching and flexing everything throughout the day also. I do most of my icing at night now. Usually do a few one hour ice sessions and compression all night. I’m showering without protecting the site from water now.

I return to PT on Thursday and have a general consult with the surgeon. My PT and I are very happy with where I’m at.

 

[PisteOff]

2 weeks post-op. Put a mile on it for the first time today. PT and consult tomorrow. I usually don’t do much stretching and flexing on Wednesday as it’s my recovery day between my Tues/Thurs PT days. I stretch/flex it enough to keep it from being stiff. Wrap, ice, and keep moving…..

 

[Don't Skip Leg Day]

Incredible progress.