Recovering from Knee dislocation

[caddah]

went to the doc again yesterday. finalized surgury. should be around 6-8 hours long. 5 ligament reconstruction. using all allograft. asked him about skiing. he didnt seem very optimistic. he said very gentle skiing would be fine. but high impact would be a bad idea. i wouldnt expect a doctor to give me the green light after an injury like this, but still not the greatest thing to hear.

well the operation is lined up for the first week in december. check back then and i should have alot more nasty pictures to show everyone...

[here2day]

I've been following your progress - good luck with the upcoming surgery.

You may find this article interesting:

http://www.skimag.com/skimag/feature...561042,00.html

At 15 months post-op I finally feel strong again. Hang in there, it will happen for you.

[beaterdit]

Good luck in surgery Caddah! You'll be back to skiing eventually. Keep up the hard work.

[caddah]

here2day good to hear your feelin strong. link doesnt seem to work. does skimag.com exist anymore...

[here2day]

Caddah - sorry about the link. It's been redirected somehow. If I can find the article somewhere I'll post it. It was about Chad Fliescher's total knee dislocation while running downhill training in Europe. I read back in this thread and it looks like I tried to point you to it last summer (so you may have read it). Anyway... his injury was similar to yours. He made it back on skis but never back to World Cup downhill form. It's an interesting read and you may get some inspiration from it...

[pnutbtrcup]

Hey caddah-

Not sure if you still check this forum, but I came across this site randomly searching for knee dislocations. I was/am in a very similar situation you are in. This past August (06) I was in a jet ski accident, dislocated my knee. I didn't have to undergo skin grafts, but I did end up tearing all of my knee ligaments; ACL, PCL, LCL, MCL and patella ligament. When I was rushed to the ER they did an open knee surgery stapling my MCL and patella ligament in place to keep my tibia and phibula from falling back. After reading many articles on knee dislocations, we are truly lucky that we didn't have to undergo amputation. 80% of patients who are not operated on within the first 8 hrs. of injury result in amputation, which I'm sure you already knew, I wasn't operated on until the next morning-7 am, accident happened 3 pm. Anyways, I'm digressing.

I had to undergo a 2nd surgery to fix my PCL, ACL and LCL, and with that came a lot of mental and physical challenges that you have witnessed. Before going into the 2nd surgery, I had a ROM of about 125 and my quad muscle wasn't as strong as my good leg, but I was able to walk with one crutch. It's going to take about a year to build up your quad muscle...so I have been told. My knee has been popping which is good as long as it doesn't create additional pain. The popping is scar tissue breaking up.

I went through about 3 mths of PT before they operated on me again. I just had my 2nd surgery this past Oct. (23) and the original plan was to use an autograft that was to be taken from my good leg, 1/3 of the middle quad tendon, to use as my PCL, the ACL and LCL were going to be from allografts. Have you discussed this with you doc yet? The scope was to be used to reconstruct my ACL and PCL and another incision would be made to reconstrct my LCL. I was suppose to be in two leg splints and in a wheelchair for a while. Turned out, my PCL healed on its own. They didn't have to autograft my quad tendon and they just used allografts for my ACL and LCL. That may, hopefully, be the case for you considering when the doc did the 'knee' test the first time around, your PCL wasn't completely torn. A month before my 2nd surgery X-Ray's showed that my PCL was completely torn. SO, a month could do a lot.

After the 2nd surgery, there will be swelling, but not as much as the first time around. Pain won't be half as bad, and I started PT the week after. At first they restricted my ROM to 40 degrees to protect my LCL, after the second week they increased it to 60 degrees. The most frustrating part after surgery is, you feel 'antsy.' Kinda like 'been there, done that, let's get this s@#t over with attitude.' But, it's important to protect you ligaments esp. if they are allografts, because blood vessels need to rebuild. Next week I have PT and a doc's appt. I'm hoping they will increase my ROM to 90 and they are fitting me into a new knee brace...one that protects the LCL. I am not weight bearing yet, you need at least 6 wks post-op w/allografts to begin weight bearing. I have another doc's 12/5, hopefully that will be the day I can start walking again.

Hopefully this has helped you a little bit. I know when I was going through it, I had no idea what to expect. Good luck with your next surgery. You will and have been doing great.

[str8line]

Wow, amazing thread Caddah. Your complete breakdown of your recovery is fascinating. You are a trooper!

I went through a 7 hour surgery in 2001 to repair tears of the four ligaments in my left knee suffered while getting taken for a slough ride in Alaska. I basically had just skin holding my knee together for a 1000 vertical ft. ride and my ski boot was beating me about my body in totally gross out unatural ways. I thought my injury and recovery were tough, but you have re-defined the word tough. It took me about two years post-op to really feel like I do now.

My knee is not 100% for skiing(but feels great for moto and mt. biking) and has its good and bad days, but overall I am pretty happy with the recovery considering the severity of the injury.

I hope your great attitude leads to a 100% recovery(or as close to one as possible).

Good luck to you too Pnutbtrcup.

[elevens]

I just read this entire thread (real slow in work today) and all I can say is WOW.

Best of luck Caddish and stay positive.

elevens

[caddah]

Havnt checked up here in like a week. been real busy. But come december ill be camping out here and in the padded room, checkin out the nsfw threads while Im recovering again. i love laptops.

Anyway. Im glad that a couple of you guys saw this thread. One of the main reasons I started it is becuase when this happened to me it was real hard to find any information or personal stories on injuries like this.


pnutbtrcup, Glad to hear your doing well and good luck with recovering. We both are relatively lucky to still have our legs. you actually lucked out even more becuase you did not injur any arteries or nerves i am guessing. when i dislocated my knee i severed the artery and vein in my left leg which was the reason for the compartment syndrome and hence the skin grafts and bypasses. this has cause things to be a lot more complicated. Now that i have recovered from all of that i can finally focus on my knee. It has been over a year since my accident and i am walking normally. the knee is still very loose however. So i am basically having done what happened to you in the first or second surgury. open knee ligament reconstruction. I have spoken to my doctor and he is comfortable with allograft so thats what i am doing. the plan for recovery is also similar. ROM will be limited to 10 degrees every week for 6 weeks. and i will be non weight bearing for that time. how long did you wait between your first and second surgeries? let me know how PT is going. I am definately interested to see what they have you doing.

str8line i know the hanging by the skin feeling, and it is not a good one. glad to hear that it is possible to come back after tearing all ligaments. I plan on givin it everything i got after this surgery to get back. my leg now finally feels strong and i feel like my balance and reactions are good. its just the lack of ligaments thats holding me back now.

surgury is less than a month off now. so ill be sure to post up some pre and post op pics and report back.

[caddah]

1 WEEK till the big surgery. Just got the call askin if i had gotten a physical and had crutches ready for next thursday. going for the final vascular check up before the big day. deffinately got some butterflies before this one.

its tough thinking about being immobile again and going through rehab again after finally getting back on my feet. but this has to be done.

EPIC 5 ligament knee reconstruction TR comming in approx 8 days...

[SnowTigress]

good luck caddah!
and i was bummed to have a 2nd ACL repair this winter...
my tail is between my legs after reading your saga.
+++++VIBES+++++

[caddah]

Hmmm... well theres some new developments in the story here. Just got a phone call from my surgeon. This is a complicated surgery that involves the vascular department as well as orthopeadics because of my bypass's in my leg. So originially my ortho thought the surgery (which involves using a turnicate s that he can properly see where he is placing my new ligaments) could be completed with out a hitch. he said there is a slight possibility that my bypass could go down, in which case, no big deal, fix the bypass before i get sewn up and no problems.

well i just got a call saying that is not the case. upon further conversations with the vascular team....there is a high probability of my bypass going down if a turnicate is used in the surgery. if this was to happen, to repair the bypass by blood would have to be anti-coagulated, cause massive bleeding to my open knee. my knee would fill with blood and eventually scar and become basically usless.

SOOOOOO....looks like surgery is off right now. I am not going to risk this...no way....i can walk right now and that is cool. Im going to have to discuss other options to tighten up my knee as this open reconstruction does not seem like the thing to do right. I have been planning this surgery for like a year and was really looking forward to getting the knee all fixed and finally gearing up to ski next year. however, i think i need to rethink this one.

so im on wind hold for now....should know this week what the verdict is becuase I definately still want to replace some ligaments, but these new developments need to be considered.

[soul_skier]

best of luck on the surgery, I leave for home on friday, but get back on the 16th of jan, so if you ever need anything, don't hesitate to pm me. Also, i'm calling it right now, opening day next season, we'll be together somewhere skiing.

[caddah]

FUCK ASS

not good apointment today.

doc says anything involving turnicate (SP?) is BAD. high risk due to my bypass. if the bypass ever failed the knee would bleed out, and eventually scar up to shit.

So now im back at base line. no idea what to do for surgery. doctor said it is possible to do a bloody acl surgery with no turnicate. and also a lcl, but pcl is out of the question, way to hard to drill the right spots with blood all over the place. it would be a staged process. thats the best i have right now.

i asked the doc about skiing. he said cross country?. FUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUCK

he gave me the fatherly advice to not ski again and deal with the cards ive been deal. And yes I am lucky and doing very well right now, but i want to get back to doing some of this.....



SO SOME ONE OUT THERE TELL ME

how to do you do a knee ligament reconstruction with out using a turnicate. Im thinking about getting some second and third opinions. I need this knee tightened up. waaaaaaaaaaaaaaay to early to give up. Ill update when i hear something...hopefully good

[Vinman]

so bummed for you. Definitely dont' give up. I know a pretty talented ortho over here in Morrisville. Drop me a pm if you want his phone number.

[here2day]

caddah - i've been following your thread and am bummed for you.

there are some docs/clinics that have big reputations like steadman/hawkins in vail, and noyes (somewhere in the midwest like ohio).

you may want to post a question to:

http://www.factotem.org/cgi-bin/kneebbs.pl

it's a knee specific forum.

good luck brah..

[pnutbtrcup]

Dang caddah, I'm really bummed for you. If you want my doc's information I'd be happy to give it to you. He's huge, works at u of m with all college athletes, he's even worked with noyes, the doc here2day mentioned. His name is Edward Wojtys. Drop me a line if you need anything else. Best of luck to you.

[caddah]

Figured I would Post just to update since I have not in a while. I am in the process of getting some second opinions on the whole knee situation. Want to say thanks to all of you for the support and to those of you that have offered me contacts to your ortho's....I might be PM'ing you shortly.

I have found some information on reconstruction procedures that do not involve tourniquets but still am not clear as to what i am doing right now.

Although the knee is SLOPPY LOOSE, i have regained enough of my muscle and over all control of my leg that I can walk normally. I even sprinted a little the other day...felt good. not the best for the knee but you gotta live a little.

For right now while I am waiting on what to do with the knee I'll be enjoying the winter, becuase last year this time i was bed ridden unable to walk, and showering with my leg in a trash bag all hopped up on oxy's...yea actually the whole bathroom situation was pretty terrible.

I have been thinkin about actually headin up to stowe to try a groomer possibly. worst comes to worst i could just ski on one leg right...

I NEED SOME ADRENALINE

[cloudpeak]

I just stumbled on this thread today. I can't even begin to imagine what you've been through. You've shown amazing fortitude throughout this thing. The progress you've made under these difficult circumstances is amazing!! You are truly an inspiration.

If you ski some groomers today, please post and let us know how your day went.

++++++Vibes++++++

[drmark]

I just stumbled onto this website. Some of you guy who race motorcylcles may know me. Anyway, I am an orthopaedic surgeon from Houston Texas who is, and works on exteme athletes. (Mostly MX)

Cloudspeak, you are not in need of any surgery on your knee at this point. Before any ligament surgery can be done, you need to have an unstable joint. From what you have said, you have a stiff joint. The only good thing about a stiff joint is that is isn't unstable. You need to keep up the ROM exercises. Maybe in the future you will need surgery but now is certainly not the time.

drmark
Mark Sanders MD
www.sandersclinic.net

[here2day]

caddah - while i was recovering last winter i'd go out on snowmobiles while friends and family skiied. i hadn't done that in something like 20 years and had forgetten how much fun it is. if you have access and some reasonable snowpack in no. vt. these days then i really recommend it. i liked it much more than the carefull groomer runs i took last spring.

i'm strong again on skis but i'll still go out on a sled some days this winter. lots of thrills for little effort...

[caddah]

Yeah, its hard to have or keep snomobiles while at college, but I have been known to blow donuts in the parking lots for way too long....its the closest I have to a sled.

Dr. Mark, i responded to you in another forum mentioned on this thread. my knee is not stiff at all, the opposite is true actually. i have been reading about various ways to avoid using a tourniquet during the reconstruction. everything from stopping my heart for a while to......

if blood is allowed to flow (i.e. no turnicate), isnt it difficult to place grafts especially since alignment is paramount for good knee kinematics

[drmark]

I could do a ligament reconstruction without a tourniquet like nothing. Maybe you should buy a SWA ticket to Houston.

[caddah]

So no update right now as to when or how surgery is going to happen. but i did take the opportunity this weekend to throw on the ol' beevahs and play some pond hockey. First time on skates since before i hurt the leg ~ about a year and a half. It went alot better than i ever would have thought. I was able to support my weight on the bad leg, cross over, skate backwards and all with basically the same precision i used to have. The funny thing is that i have gotten used to walking slightly differently with my leg, but this was the first time i had skated since the injury. my brain was telling my leg to do things that it wasnt exactly ready for. Its hard to describe but my brain was sending out the signal....the leg was just a little behind. there were a couple times where i would transfer weight totally to my bad leg and basically have it collapse, but all in all i felt FUCKIN GREAT . will definately be adding this to my routine to try to strengthen more secondary muscles in the leg.

anyway...i couldnt believe it...and im glad my leg didnt fold, and I'm pretty stoked that i can skate...who knows, maybe next weekend ill try skiing, but i dont want to get ahead of myself with nothing really holding my leg bones together other than muscle.

edit: one quick thing about the skiing. I tried my boots on the other day. bad leg, first two bottom buckles...no problem...i move up to the upper two and as i tighten the first one the force of trying to buckle my boots makes my shin start to rotate. so basically no resistance to rotation. i had to hold my boot with one hand and buckle with the other to get it buckled up. is that bad? im wondering if the rotation of heavy boots and the leverage of 180cm skiis is going to be too much for the leg. if i do try skiing its gonna be some real easy stuff.

[Vinman]

not going to tell you what to do but I don't think skiing is such a good idea. I think your knee would give out to the inside as soon as you get up on edge in a carve.