what to do with cyclops lesion 1 year after acl surgery?

[aclwi]

Hi, I torn my left knee's ACL back in the Dec of 2008 when skiing, also had some pretty bad damage on meniscus. Anyway, I had my surgery done about two weeks later in the Jan of 2009.

I always had pains in the front of the knee since the surgery, eps. when up and down stairs. The knee also makes a lot grinding sound/movement whenever bent. Had an MRI two weeks ago and diagnosed a 1.4cm cyclops lesion. The doc suggests an arthroscopic surgery to reomve it.

Before embarking another surgery and another PT, I wonder
1. My left knee never had the same ROM as my good/right knee after the surgery. My right knee had hyper-extension about a few degree but my left knee only got to 0 degree. Both the doc and my PT said their goals were 0 degree, not hyper-extension, and whatever I achieved was pretty good. I tried to extend my left knee more during PT, but after getting to 0 degree, it became almost impossible to go down further -- not just be painful, but felt impossible because blocked or something like that.

I read cyclops lesion would prevent a knee from full extension. I wonder in my case, is the cyclops lesion the cause or an effect? If do get it removed, and yet my knee does not get to the same ROM as my natural/good knee, will I have another lesion grown out?

2. How bad will the surgery be? The doc said I would be fully recovered in 2 weeks, any experiences?

3. What will happen if I don't do the surgery? I used to do a lot of sports(basketball, soccer) but stopped since the surgery, still I go to gym 2/3 times every week, although my knee hurts really bad when I do leg press/squat. It gets better after a few days rest and it does not bother me much in normal walking (although still bother me some, esp on stairs). Do I need to do the surgery?

Any comment is appreciated.

[Nick_C_123]

Yo dude:

Had a similar situation to yours. Cyclops lesion removed ~ 8 mo. post acl/mcl recon. I had full extension just had loud crepitus on active extension.

Compared to my 2 prev. knee surgeries (acl w/pattellar graft and acl/mcl with patellar and hammy grafts, respectively) the this one was ridiculously easy. Too easy in fact that I overdid afterwards. When I woke up the nurse asked how does it feel? I flexed and felt fine. Stood up and felt fine. Then walked around and felt fine. Then blood started to soak through the dressings so I laid back down. Two weeks later I was feeling good so I went out partying on halloween. All was fine but that flipped some some sort of inflammation switch and my knee was prone to swelling up a lot afterwards. At 5 weeks I tried going for a long tandem snomo ride and doing some b-c boarding. Total disaster swelling wise and setback again. But was able to skin up/ride down 2k+ feet a few days later.

Fully recovered in 2 weeks, no way. The doc said 4-6 for me. really took more like 8. But in some ways I think the surgery definitely set me back a bit. So if you do it its really no big deal but take it easy, do all your pt and icing, don't overdo it, and ease back into full activity afterwards.

Hope that helps. Feel free to PM me if you have more questions.

[aclwi]

Yo dude:

Had a similar situation to yours. Cyclops lesion removed ~ 8 mo. post acl/mcl recon. I had full extension just had loud crepitus on active extension.

Compared to my 2 prev. knee surgeries (acl w/pattellar graft and acl/mcl with patellar and hammy grafts, respectively) the this one was ridiculously easy. Too easy in fact that I overdid afterwards. When I woke up the nurse asked how does it feel? I flexed and felt fine. Stood up and felt fine. Then walked around and felt fine. Then blood started to soak through the dressings so I laid back down. Two weeks later I was feeling good so I went out partying on halloween. All was fine but that flipped some some sort of inflammation switch and my knee was prone to swelling up a lot afterwards. At 5 weeks I tried going for a long tandem snomo ride and doing some b-c boarding. Total disaster swelling wise and setback again. But was able to skin up/ride down 2k+ feet a few days later.

Fully recovered in 2 weeks, no way. The doc said 4-6 for me. really took more like 8. But in some ways I think the surgery definitely set me back a bit. So if you do it its really no big deal but take it easy, do all your pt and icing, don't overdo it, and ease back into full activity afterwards.

Hope that helps. Feel free to PM me if you have more questions.

Was the PT pretty much the same protocol as the one your had in the original acl recovery? Did you have difficulty going up and down stairs or squating ? Now I can't put much weight on my bad knee...
4-6 weeks is not that bad, definately worth it if it fixs the &@!#%*#&. I really miss playing sports...

My other concern is since my operated knee never had the same extension as the good knee (doc said that was intended), how likely a cyclops legion can grow back? Doc said no worry, but I am not comfortable about it and almost thinking to get a second option with a different doc...

[Nick_C_123]

Was the PT pretty much the same protocol as the one your had in the original acl recovery? Did you have difficulty going up and down stairs or squating ? Now I can't put much weight on my bad knee...
4-6 weeks is not that bad, definately worth it if it fixs the &@!#%*#&. I really miss playing sports...

My other concern is since my operated knee never had the same extension as the good knee (doc said that was intended), how likely a cyclops legion can grow back? Doc said no worry, but I am not comfortable about it and almost thinking to get a second option with a different doc...

The PT protocol, as far as exercises was more less the same. But again as far as swellling, pain, and everything else, the recovery form the cyclops removal, basically a very minor scoping/debridement was like 10% or less as bad as the acl/mcl. I don't know what kind of graft you had, but take it from me a combo hamstring patellar graft acl/mcl surgery on the same knee hurts like hell. Minor scoping, not so much. I think I was able to climb a few stairs the day after surgery, squatting, maybe a week or so later, can't remember exactly.

The question is your doctor, dude sounds a little suspect. The fact that he said he intended you to never have full extension post surgery sounds wrong. I've had acl surgeries on both knees, and both the doctors and therapists have emphasized a return to full extension as soon as possible, and made it sound much more important than full flexion. Also the fact that he said you could be fully recovered from the surgery in two weeks seems misinformed. Especially when you can't even bear weight right now. Maybe he meant 2 weeks for walking around, driving, sitting at a desk, etc. But sports, no way. 4-6 weeks sounds pretty standard across the board for arthroscopy. What I was told is that it takes that long for the fluids in your knee to return to normal. For me, it just took a little longer because I was a dumbass and pushed it.


Long story short, this procedures not a big deal. Not that its risk-free - you could die from the anesthesia or the guy could slip and cut through all you ligaments, but unlikely. If you made it through acl surgery then you got this. I even started a thread about mine but deleted it because I was up and about, not on the computer much, and didn't have anything to say. If you can't even bear weight on the leg you need to do something, and soon. That sucks. I'd get a 2nd opinion though, and hopefully use a different surgeon. After all you're the customer here, and allowed to shop around and find the product you want. Best of luck.

[Nick_C_123]

After re-reading your first post. I wonder if getting the surgery so soon after the injury may have contributed. Did you have full extension pre-surgery? For mine the doctor made me wait at least 6 weeks to let me regain full ROM, do PT to build up the muscles, and see if the mcl would heal itself sufficiently before going in to surgery.

For what its worth I've had both my acls done and have ~ -2 to -3 degrees extension on both. The key is don't put a pillow behind your knee after surgery, rest with it straight or hyperextended, and only flex it when your doing working on flexion. They said don't have it flexed while you rest for more than 5-10 minutes at most.

Not that it really matters now. But may be helpful to other reading this.

[aclwi]

After re-reading your first post. I wonder if getting the surgery so soon after the injury may have contributed. Did you have full extension pre-surgery? For mine the doctor made me wait at least 6 weeks to let me regain full ROM, do PT to build up the muscles, and see if the mcl would heal itself sufficiently before going in to surgery.

For what its worth I've had both my acls done and have ~ -2 to -3 degrees extension on both. The key is don't put a pillow behind your knee after surgery, rest with it straight or hyperextended, and only flex it when your doing working on flexion. They said don't have it flexed while you rest for more than 5-10 minutes at most.

Not that it really matters now. But may be helpful to other reading this.

Yeah, you are right. I did not have my full extension before I went for my surgery. The doc never mentioned it, and I only became aware of it when I looked thing up after the surgery. One reason I guess is that I also had pretty bad meniscus tears from the injury and it was hard to work out the knee. Anyway it does not really matter now and I will go for a second opinion and then decide what to do with it.