Month: December 2014

The knee bone is connected to the… what?

On 18 November 2014 I had patellar tendon graft anterior cruciate ligament reconstruction surgery in my right knee. But I’m not going to be one of those people who blogs about their ordeal. Ok maybe just this once. The PTG “autograft” procedure means that they take a third of the tendon below my knee cap and turn it into a new ligament for my knee. Sounds like a bad idea for the missing piece but apparently there’s enough there to go around (or through, as it may be). This was from an old football (“soccer”) injury picked up in the NZ Masters Games in 2010. By the way Masters Games are a very bad idea – think: a bunch of men moving a lot slower than they actually think they are moving trying to relive their glory days, playing 9 games one weekend after not playing that many in the preceding calendar year. One of those men slid into my leg after (loooooooooong after) I had planted my foot following a shot on goal (yes, I scored that one! I’ll call my celebration “the crumpled heap”). Several years, including three misdiagnoses, two seasons of semi-competitive playing, and one hard-fought MRI later, I scheduled the surgery in between our semesters this year. And here I am. Two weeks post-op.

It actually hasn’t been an ordeal at all, if that word connotes misery. The toughest part is probably not knowing what to do, that is, how hard to push it, and getting the balance right between reducing swelling and working on regaining range of motion. And the confusion of trying to figure out what “full” extension means exactly for someone whose knees naturally hyperextend by 15 degrees. It’s easy to get sucked in to online forums and personal progress blogs, but the reality is that everyone is so different that these are ultimately a waste of time at best and misleading at worst. I have found that there’s conflicting opinion (even among surgeons) on how much hyperextension, if any, you should be getting back, as many believe that restoring a knee to 0 degrees extension is too arbitrary, and even endangers full functionality, especially given that most people hyperextend around 5 degrees. It did come as a bit of a shock when I realized I’d be somewhat asymmetrical in the knee department (perhaps a pre-op asymmetrically waiver?), but I get that the surgeon giving you back all that joint laxity is not a good idea.

Anyway, I find out officially where I stand with the range of motion thing when I see the physio (= physical therapist in NZ) next week. I think I’m at 0 degrees or a bit beyond for extension and around 120 flexion (obtained using the brace dial and a little protractor). That’s good for two weeks. But I want to hear a professional say it. The biggest lesson, and what everyone in the medical world and ACL blogosphere seems to agree on, is that you need to do whatever you can for full extension as early as you can. A few degrees off and you’re still gimping around.