Thread: MBSC's knee goes kaput

glad to hear it went well! and if you need anybody to take that percocet off your hands...

update? How ya doin?

I am doing great! Four days after surgery, I'm back doing my tutoring for the local HS kids here. My PT guy is weaning me off my crutches (started at my PT session this morning). My knee feels stable- quad firing just fine. And I haven't been using a brace at all. My knee is still quite a bit swollen, but I have ice on it a lot- every hour or two. It helps that I have about 7 ice packs- some borrowed, some old, some purchased a couple of weeks ago. I'm also taking ibuprofen, but no other pain killers. My ROM is at 0 and 110. The pain is minimal and has been the whole time. In a couple of days I should be on the bike.

So, let me give a quick synopsis of the happenings over the last few days.

Wednesday- Day before surgery.
Try to call the docs office like 5 times to pay over the phone with the credit card the amount I'm supposed to pay before surgery. (Some of you may remember me discussing this in another thread). I can't reach the person I need over and over. Finally, at like 4:30 I pretty much freak out- because I was told I needed to pay the amount before the surgery, or I won't be having the surgery. So, a nurse calls me back, finally. She says that they've had an emergency there- a pipe burst in the surgery room. So, they were relocating my surgery to the hospital, same time, same doc, different nurses and anesthesiologist. When I ask about payments, she says not to worry about it . I didn't actually need to pay it. I am now told that since I will have a different anesthesiologist I can no longer drink water or eat past midnight, whereas the anesthesiologist I'd spoken to said I could eat before 6:30 am.

Thursday- Day of surgery.
I wake up, clean the house, and get things ready to be in a gimp state for a while. My surgery wasn't scheduled until 2:30 and they told me to arrive at the hospital in Gunnison at 1 pm. GB and I were going to do some grocery shopping in Gunnison before my surgery so we headed down early. On the way, the hospital called and asked if I could come in right away. So, I got there at 11:30 am instead of 1 pm. The nurse sucked at putting the IV in and my veins apparently suck for IV's, not making a good combo. That was the most painful part of the whole experience- more painful than anything post surgery. I kept wondering when I was going to see the anesthesiologist so I could make sure that the plan I made with my other anesthesiologist was still on track- a spinal with a femoral block. He came in thinking I was going to do general anesthesia with a femoral block. I said, "No, I want a spinal." But, apparently he didn't do spinals with femoral blocks. So, spinal it was, only- well, on top of the sedative which made me really goofy. They wheeled me into the surgery room and Dr. Griggs (Beim's assistant) showed my the allograft that was going into my knee. It was stringy and kind of looked like a really long piece of string cheese. I remember talking to the doctor and nurses off and on throughout the course of the surgery. I distinctly remember Dr Beim saying, "She has a bit of cartilage damage here." And I freaked out and said, "Cartilage damage??" She had warned me prior to surgery that some cartilage damage could require microfracture treatment which meant 6 weeks non-weight-bearing post-op and I wasn't really up for that. She replied back to me, "Oh, it's nothing really. We'll just scrape it out. It might be old. I'm not even sure you damaged it when you did your ACL. " Next thing I know, I'm sitting in recovery, hair-net off, glasses on, talking to a nurse that's friends with GB. I don't really remember a whole lot in between, but I do know I was awake. I just don't remember it! Dr. Griggs comes by and gives me these pictures from the scope.





Dr. Beim has a habit of bragging about how little time surgeries take her. I'm not sure if this is a good thing or a bad thing. But, she boasted a surgery time of 35 minutes. Recovery took much longer than anybody expected. The spinal didn't want to wear off. So, I waited for about 3 hours. Finally, I was able to stand and crutch around enough to go sit in a car for 45 minutes and then make my way up 2 big flights of stairs to my apartment on the third floor. Never in my life have I have wished that there was an elevator more than right then.

I was hungry. I ate. I took some percoset. I felt fine. Then around 10 pm things went downhill. I started getting nauseous. I took and anti-nausea pill and that helped some, but not completely. On top of that I was having the worst muscle spasms I'd ever had in my life- in the calf and hamstring of my newly-built knee. The pain of the surgery wasn't bothering me, but the muscles hurt like hell. So we called the doc. Dr. Griggs was on-call and said to take more percoset. So, I did. Which ended up in a major vomiting session around midnight. Two hours later I got up to go to the bathroom and nearly passed out because I was so dizzy from dehydration and lack of food. That night sucked. But, by morning I was feeling better.

Friday- Day after surgery.
Stopped taking pain killers. Decided I'd rather be in pain than puking, but the pain wasn't terrible anyway. Went to my first PT in the early afternoon. He had me stretching my calf and hamstring, which ended my spasming muscles. He had me working on firing my inner quad muscle, which fired right away with no problems. After that, I pretty much slept most of the rest of the day, and night. I didn't wake up until 10 am on Saturday.

Saturday and Sunday.
Things kept getting better and better. Knee was getting stronger, more stable, but still swollen. Took gauze off and took a bath. Baths are always so much appreciated after you can't have one for a while! I still have sutures , covered with white tape. The white tape should fall off on it's own, or they'll take it off in a couple of weeks.

All in all, I'm doing pretty well. I'm so happy the surgery is over. Now the real healing is beginning!

One more thing- this surgery is like 20 times easier than my patellar tendon graft ACL repair on my opposite knee done 12 years ago!

AWESOME to hear you are doing well! Keep it up!

Just tore the ACL in my right knee on Saturday - doc said to rest in a brace for two weeks and then ski the Easter break with a brace but I guess I'll be heading down the surgery road as well after that.

Hope everything goes well with the rehab - I remember my first as well!

Wow ... i would not get back on my skis until well after surgery. I wouldn't want to risk more damage than I already have ..... add another maggot to the list that blew out there ACL this season ... how many are we up to now!!!!

Awesome to hear, MBSC: heal quickly, nail the rehab and charge again!

people handle tears completely differently. Lots of people are able to ski and never have surgery.....

SEVERAL mags down with ACLs this year.

HAHA those lucky bastards .... BTW I am going under the knife on the 3rd. Work screwed me over for when i could have the surgery so it got pushed back almost 3 weeks.

It's so interesting to hear people's ACL stories. There is no way I could have skied with my ACL torn. I still couldn't walk 100% normal even after 3.5 weeks after the injury. There was always something kind of in the way when I was straightening my knee. It popped and cracked and really hurt sometimes. I think it might have been a small bit of cartilage or even the torn ACL in the way. That was the main problem for me. If that hadn't been there, my knee would have felt a lot better and I might have been able to actually ski.

Right now, I can tell they cleaned out whatever was bothering me before because straightening my knee doesn't bother me.

It's also interesting to hear people's recovery stories. Everyone recovers at a different rate also. I was lucky with my last ACL to have a fast recovery and was skiing 4 months post-op (dr approved ) That's not normal for a lot of people I think.

I also find it fascinating to hear how doctors and PT's can have such different philosophies about surgeries- when to have them in relation to the injury and what type of surgery to have. And then there's such different philosophies about recoveries- my doc and PT are basically anti-brace. They never even gave me a brace. I borrowed one. I used it after my injury but haven't used it after my surgery. There's no way in hell I would have done that with my last ACL. But part of the reason I can get away with it is because my knee was pretty strong going into the surgery and it didn't have a lot of time to lose the muscle memory. They had me starting to put a bit of weight on my knee as soon as I could stand up and crutch around. It's so different from my last ACL where my doc didn't want me to put hardly any weight on it for 2 weeks... and he wanted me to always wear the brace, even sleeping.

Yes, there sure are a lot of torn ACL's in the maggots this year. I feel bad when people get injured. But, there sure is a lot of support around here. And that I do like.

The doc I saw in Chamonix said he sees 4-5 torn ACL's every day and this isn't even Chamonix hospital. He said he knows of lots of instructors and guides without ACL's who manage just fine so I'm keeping my fingers crossed - it was bad enough missing 2.5 days of a four day trip - don't want to have to cancel 12 days over Easter as well. I'll be interested to hear what the surgeon and physios recommend as my last surgery was 8 years ago.

PT is amazing. My flexion is already at 120. I got on the bike today and soon will be able to work up some resistance. My PT guy also had me doing step-ups and leg presses. Couldn't believe it. My knee feels great, except I can't physically lift up my knee while standing much higher than it takes to lift it to a stair. It just hurts like hell when I try to lift it more. It hurts just to the right of my patella and below, where there's 2 incision points and a huge amount of bruising still from the surgery. So, I guess my body needs to heal before I'll be able to lift it higher. But, wow, if anyone had told me I'd be walking fine without crutches and doing step ups and leg presses within a week of having surgery, I would have thought they were crazy. Now, I'm doing it!

Wow sounds like fantastic progress - congrats

great job!!!!!!!!!!!!!!!!!!1

It's over two weeks post-op now. The first week I had amazing progress. That progress has slowed, but that's to be expected. My knee still keeps getting better and better. I'm largely off the crutches. I really only need them when it's snowing outside. The swelling continues to go down and nearly all of the bruising has gone away. On Monday the doctor removed the surgical tape covering the incision points. There were some of the dissolvable stitches poking through, but they said they should go away or they will cut them out in a few weeks. My ROM is over 125 now. I'm doing lots of physical therapy both with my PT guy and at home. I'm able to ride my bike on a trainer now with a higher resistance now so I can actually get a good workout. My PT consists of some stretching, massaging my scar tissue at the incision points, moving my knee cap around, straight leg raises, quad sets (tightening my inner quad muscle), step-ups, balancing on one leg on a pillow, leg presses, squats, calf raises, some exercises with a pilates band, and core strength exercises. I spend at least a couple of hours a day working on my PT exercises.

Other than that, I've been very busy working. My work load has increased since being injured in February. I suppose that's good. I would have had to turn some of these jobs down if I was still skiing. Might as well work a ton if I can't ski!

The hardest part has been not being able to ski. April is my favorite month, when ski mountaineering usually peaks. Knowing that it's right around the corner is hard for me to cope with. I will be going out of town for a week in April to visit my family in Ohio- trying to escape the April mountaineering scene. But, I can't take more time than that off as I just have too much work to do. Hopefully the work will keep my mind off of these things!

nice to hear you're doing well.
They replace your ACL with a tendon from the Patella?

keep on keepin on B.

Originally Posted by stuckathuntermtn

nice to hear you're doing well.
They replace your ACL with a tendon from the Patella?

This surgery they used an allograft- from a cadaver. When I was half sedated I was asking questions about it. I think they told me it comes from a tendon in your calf- but I could be wrong. I was half way to not really knowing what was going on at all. I remember them saying it was the longest one you have. And it was long, I will say that. Different from some other procedures, they drill holes all the way through my tibia and femur. They drove the tendon allograft (now ACL) all the way through my femur to the other side and it is secured with a more or less high tech toggle bolt. Then, it is all the way through the bone on my tibia too, secured with a plastic screw on the lower end. They need a long piece of tendon to do this because it goes through both bones (diagonally of course). A patellar tendon graft would not be long enough. But, this way, when the bone heals, it is really securing the graft as opposed to the common bone-plug method used for a lot of allografts. There the bone only secures a small amount of the tissue.

Way to get after it B!

Yes, Ohio will distract you from peak bagging corn skiing.

I suppose I'll do a quick update too. My ROM is -2 (w/in 1 degree of my other leg) and 133. I'm getting better at walking down the stairs but it's still tricky. Going up stairs is no problem. My PT still consists of most of the things mentioned a couple of posts ago, with some additions. I am now also doing some leg raises lying on my side and rotating the leg in circles in that position too. I'm also doing another pilates exercise, lying down, band around legs just above knees, feet together, raising my knee up. I did it all the time in ski conditioning so I'm familiar with it. It really strengthens the hips. Other than that I'm riding my bike more and more with more and more resistance. I'm working up to 30 minute sessions now. My PT guy basically said I can ride as much as I want (on my trainer) with as much resistance as I want as long as it doesn't hurt or irritate my knee, or cause swelling. My swelling is going down more and more. Now, it's more noticeable which areas are larger due to scar tissue, not just swelling.

The ibuprofen is causing my stomach to go haywire after taking it for awhile. So, I've decided I'm going off of it. I read on the Internet that something like 30% of long term NSAID users end up with stomach ulcers. I really don't want that. It would really really suck if I had to give up chocolate during a time like this So, I've looked into it and I'm going to try some herbal anti-inflammatories. My chiropractor gave me something called EnFlux which has a concoction of Boswellia and turmeric among other things, known to be natural anti-inflammatories. I'll try that. And of course, still icing regularly.

Recovery continues to go well. The improvements are less significant from day to day, and more noticeable from week to week. My PT consists of a lot of the same things I was doing before, but usually just a step higher. There's a lot of core exercises mixed in there too- calf raises, leg press, squats, lunges, leg raises, pilates exercises, bridges, balancing on one leg and throwing a ball against the wall and catching it. I no longer have to go quad sets and straight leg raises. I ride my bike 5-6 days a week for over 30 minutes a day. I would ride longer except I get really bored. I think I'll try to ride more like 45 minutes most days this week and try to dodge boredom by watching my Buffy the Vampire slayer DVD's. I am still massaging scar tissue. My knee doesn't get sore so much any more from being on my feet for long periods of time. Walking is becoming more and more natural and faster, although the ice still scares the crap out of me. My knee aches a bit, but sometimes it feels so good I forget that it's hurt. The stiffness in it continues to get better and better.

My PT says I can maybe begin to ride outside in mid-May, 3 months after surgery. He says riding single track on a mtn bike may be possible at 5 months. But, he keeps following everything he says with, "if it's okay with Dr. Beim". I know when I spoke with her before surgery she was really adamant about not riding single track until 6 months. Now that surgery is over and recovery is going well, I'll talk to her again. I have another follow up appointment with her on Tuesday.

wooohooo!!! I hope to progress as quickly as you have .....

glad to hear you are doing well Brittany!

Congrats on your progress. Stay well.

As of yesterday, I was 5 weeks post op. I saw the doctor earlier this week. She said recovery seems to be going well, which I already knew. She did the ACL test, so yes, my new ACL is working. And she approved me to ride outside on my road bike or on my mtn bike on dirt roads. For now, I'm supposed to stick to mostly flat terrain, eventually working up to hills. But, she squashed the idea of riding single track or getting on skis any earlier than 6 months post op which for me would mean mid-September. I pretty much knew she would say that though. It all just goes back to the fact that I have an allograft instead of an autograft and allografts take a bit longer to heal. I started asking her about it and she didn't really give me a good explanation. She said something about that my cells begin integrating themselves into the foreign tissue and we are just waiting for more of those cells to be mine. She said something like it really takes a year for the tissue to be 100%, but that it's usually strong enough to do stuff by six months post op.

At any rate, I'm going to play it conservative. If I can't really be on a mountain bike this summer, than at least I can road bike. My real passion is skiing anyway, and it's most important for me to be ready for next ski season than to be on my mountain bike this summer. I don't want to do anything to jeopardize my knee so that I can't ski next year. I think I would lose my mind if that happened

Before I left, she gave me copies of the xrays they took during my visit a few weeks ago. Here's one of them. You can see the hardware in my femur. The new ACL travels diagonally down all the way through the femur, through my knee, and then all the way through my tibia. A plastic screw is used in my tibia. Since it's plastic, it doesn't really show up on the the x-ray. But, it's there.


Overall, recovery is continuing to go well. My ROM is at 138. My walking continues to get smoother. I have a few more exercises added on to my PT but generally it's staying the same. I'm working my hamstring muscles more though and beginning to do lunges. I'll be happy to begin riding outside again. But, a trip to Ohio to visit my family and being overwhelmed with work will prevent me from riding outside until the beginning of May. But, at least I have something to look forward to!