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Swelling after acl surgery

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huge-go
Posts: 1451 - Karma: 33
So I'm 7 weeks post op today, and my knee is still swollen. Not very, but there still just isn't any definition to the knee cap and stuff. My knee feels pretty good, like I'm walking on it just fine and still doing all my strengthening and ROM exercises, but it's really getting to me. It's holding me back in physio because apparently if I try to strengthen my quad too much while it's still swollen, it will only prolong the swelling. Other than that, the recovery is going fairly smoothly.
So how long did it take other NS'ers swelling to go down completely post op?
May 26 2010 2:20PM
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wskibum176
Posts: 1536 - Karma: 13
Im about 9 months post-op at this point and more or less completely healed so i dont remember exactly when the swelling went down completely, but i can tell you that, at least for me, it did take awhile. It was awhile before my left knee resembled anything remotely similar in shape or size to my healthy right knee.

I guess its important to remember that theres alot of fluid in there from the procedure and that icing it down after every work out is super super important. I still do it today after going to the gym

Hope yours feels better soon!
May 26 2010 2:32PM
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huge-go
Posts: 1451 - Karma: 33
Thanks man. The hardest part of this by far is to not get impatient with it. I know a speedy recovery is not necessarily a good recovery, but it would be nice to go full speed ahead:)
May 26 2010 3:22PM
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Posts: 2566 - Karma: 1,026

i'm about 7 months post op too and the swelling is still prominent. shitty times dude. so much for having fun during summer.

but icing it helps a shit ton

May 26 2010 3:29PM
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pRETTyLight5
Posts: 500 - Karma: 85
3 weeks post op, still bruising and swelling. best thing for swelling to go down is ice and elevation tho. if you have a cryocuff keep on that as much as you can. if you dont have one i suggest getting one, its been my best friend and definitely worth it http://www.orthoticsandbeyond.com/p-223-aircast-knee-cryo-cuff-ic-cold-therapy-system-with-pump.aspx id say ask friends who have had surgery they might have one laying around
May 26 2010 4:46PM
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Lemuel
Posts: 14477 - Karma: 10,515
I'm at 12 weeks tomorrow, and it has finally gone almost completely back to normal. Still swelling a little bit when I go to the gym, but other than that it is fine. Just keep icing it after PT. The swelling does affect ROM, but only because all that blood is still in there, once it is gone your knee will be able to bend to its maximum. It's definitely not preventing your leg from strengthening. My patella tendon is the only thing that is still swollen, and swollen just as much as it was right after surgery.
May 26 2010 5:12PM
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Lemuel
Posts: 14477 - Karma: 10,515
You're at 7 months and you haven't been cleared yet? You should have been cleared a month ago for activity.
May 26 2010 5:14PM
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huge-go
Posts: 1451 - Karma: 33
Swelling alone does affect strength. My physiotherapist told me about studies where they took someone healthy, and saw how much force they could exert with their leg. They then injected fluid into their knee(what swelling is), and they could not exert the same amount of force. This was with only swelling. You yourself have seen the result of how weak a leg is with the internal structure(torn ligaments) compromised, AND swelling. But yeah, I am continuing to ice it constantly and still elevating it. I tried to sleep with it elevated until about a week ago, but shifting in my sleep has made that a futile effort.
May 26 2010 5:47PM
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Waldo-
Posts: 1026 - Karma: 184
I had MCL surgery and was swollen for many months. I started to see it look like a knee again after two months and you should probly be longer. Everyone is different when it comes to swelling and the lymphatic system. My best advice is dont rush your recovery. The ROM is the most important in the first 3-6 months because flexibility cant be regained very well further down the line. Strength will come.

Good luck.
May 26 2010 6:33PM
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Posts: 2566 - Karma: 1,026
7 weeks. I mistyped sorry
May 26 2010 6:47PM
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sconniestyle
Posts: 3945 - Karma: 26
i had surgery on my acl (replaced with hammy) lcl and mcl (repaired) and meniscus (1/2 taken out, 1/2 repaired.)

i'm at 5 months and have started biking (not stationary)again as well as working out more normally. not running yet, but getting close.

for me the toughest time was at about 12 weeks. i was getting bored with the exercises, tired of being so immobile, and that was when it started dumping snow. just had to keep on working at it. i had a great PT though, that helped big time.

good luck to everyone else working to get back for next season.
May 26 2010 9:21PM
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Lemuel
Posts: 14477 - Karma: 10,515
Dam you had alot done. Ive heard the hammy replacement takes longer to recover from. I heard that it isn't as strong as a cadaver or patella but idk. I'm getting pretty bored seeing as I can't go mountain biking or cliff jumping or trampolining haha. I can ride my bike perfectly fine on the road though without even noticing that I had surgery.
May 26 2010 9:29PM
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pRETTyLight5
Posts: 500 - Karma: 85
cadaver is more for people who live less active lives, thus its an easier recovery. hammy is tougher recovery, but should hold up better in the long run (recommended for younger more active people). it also depends on your doctor and what they do more i guess. i personally chose the hamstring, and its also what my doc had seen better results with
May 27 2010 3:51PM
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sconniestyle
Posts: 3945 - Karma: 26
that's the exact reason i went with the hamstring too.

my doctor is actually publishing work on the increased rates of failure for cadaver graft in highly active people under a certain age (i forget exactly what the cutoff for the studies was), so he was very informative about the differences between the types of repair i could have chosen, and the pros and cons of each.

he also told me that another benifit of using your own tissue is the ease of acceptance of the graft. you aren't introducing foreign tissue into the environment.

all and all, with the activities i do and the amount of years i'd like to continue doing them, the cadaver option would have not provided as stable of a ligament in the long term as the hamstring will.
May 27 2010 4:13PM
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Caucasian_Asian
Posts: 2447 - Karma: 1,665
I had hammy replacement ACL surgery on July 30/09.  I still had some swelling in November.  My surgeon told me to go skiing on January 20. 


Happy physio.
May 27 2010 4:39PM
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JumboBum
Posts: 557 - Karma: 40
I'm a little over 2 weeks post-op with a hamstring graft. Getting my ROM back sucks.
May 27 2010 6:27PM
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DrZoidberg
Posts: 5674 - Karma: 4,227
I had that and a meniscus repaired 3 weeks ago, mine's still swollen. Just in time for summer!!! Mine was huge though, and I had crazy bruising up until like 5 days ago. People would stare at it in class, or get grossed out.
May 27 2010 6:28PM
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Isabelle
Posts: 947 - Karma: 1,582
good luck with the recovery, I just torn my ACL too.
May 27 2010 6:32PM
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Lemuel
Posts: 14477 - Karma: 10,515
Oh yea, that hurts alot when they push it twice as far as it wants to. I am halfway to clearance today, which is pretty sweet.

How do they do the hamstring graft? Do you guys have an incision or no? There was a girl in one of my classes who tore her ACL snowboarding and she got a cadaver, and she only had the arthroscopic holes. I have a massive scar down the front of my knee and my patella is still numb as shit.
May 27 2010 9:52PM
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DrZoidberg
Posts: 5674 - Karma: 4,227
I got hamstring, I have 3 arthro holes and an incision below my knee. That's distal of the knee yet proximal of the foot in anatomy terms, closer to the knee, on the shin... I need to look in my anatomy book to see where all the hamstrings are. It hurts when I stretch, and that electro shock therapy hurt it today too. I guess they can insert cadaver tissue through the holes or without making a large incision?
May 27 2010 10:02PM
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After SurgeryClick for larger image

Surgery March 31st and got home April 1st. 3 little holes plus the long incesion (obviously) they took part of my hammy i think. Oh and the writing on my leg by that little hole is the initials of the guy who sliced me open

After staples and still a bit swelled

Click for larger image

May 27 2010 10:13PM
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huge-go
Posts: 1451 - Karma: 33
I had a hamstring graft as well. I don't know about anyone else, but these are mine: About a 2.5 inch incision under my kneecap and towards the inside of my knee(medial), two arthroscopic holes where my knee cap is, and one arthroscopic hole to the outside just above the knee. They harvest the hamstring from the incision, and they also drill the tibial tunnel that they route the hamstring through. Very uninvasive.
One method that they do the hamstring with is actually stronger than the patella. They take a fairly large portion of your hamstring tendon, and fold it over either once or twice. This means that you are basically either getting a two or four banded acl. Very strong. The disadvantage with the hamstring is it takes longer for the tendon to initially fuse into the bone tunnels that they drill, because it's soft tissue, whereas a patella that is harvested has bone blocks on either end. Bone on bone healing occurs faster than tissue on bone. The second disadvantage to a hamstring is it takes greater surgical skill of the surgeon to do it.
So the initial recovery of the patella is faster, but the end result is about the same.
But it must be stressed, surgery is only half the battle, as anyone who has had knee surgery knows. Rehab is equally important. You can have the best surgeon in the world repair your knee with the gold equivalent of an acl, but if you slack off in physio, you can expect to be seeing your surgeon again very soon.
May 27 2010 10:21PM
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DrZoidberg
Posts: 5674 - Karma: 4,227
I have what you have ^^. One laterally placed hole (outside of knee) and two pretty much on the kneecap, lower portion. Here's the incision, I was gonna say it's a little gross but the staples kinda takes the cake right now.
Click for larger image

Yeah I try hard in pt too, I pedaled the bike like no other today and the guy was able to stretch it pretty far back. Getting range of motion back hurts. The way they described the patellar graft sounded like it would make surfing suck if I experienced the side effects they said could happen. Like pain while kneeling and such. Building muscle to stabilize the joint is the best way to keep it from re-tearing.
May 27 2010 10:52PM
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Black-Bandanna
Posts: 6680 - Karma: 1,602
Ice the fucking shit out of it man. Trust me. Icing cuts swelling and heal time like a motherfucker.
May 27 2010 10:56PM
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s.parker
Posts: 1041 - Karma: 259
yeah dude, keep icing it, it helps so much. i hate knee surgery
May 27 2010 11:01PM
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DrZoidberg
Posts: 5674 - Karma: 4,227
I have the cryo-cuff thing. Basically a bladder that you wrap around the affected area and cold water is circulated through it by a pump in a cooler filled with ice water for those who don't know. It gets really cold, I kinda stopped using after it got less swollen but maybe I'll use it tomorrow. When I was still out of school I used it like 20 of 24 hours each day.
May 27 2010 11:03PM
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Lemuel
Posts: 14477 - Karma: 10,515
I don't know why people say the patella hurts, I experienced zero pain at all from the actual surgery/incision. the only pain I had was standing up after sitting for a while and having the weight of all the bandages and shit push down on my knee, and that was only for the first week. Kneeling is difficult because the patella tendon is swollen and numb, but it doesn't hurt, it just feels strange. I'm not sure if my surgeon does hamstring ACL repair, my mom had hers done by the same surgeon and he did patella on her.

Those staples are making me cringe, why didn't they just stitch it up? I had stitches. Staples look so uncomfortable, and I would not want them taken out.

As far as my battle scars, I have 2 orthoscoptic holes on each side in front of the kneecap, and then a slice down the front.

May 27 2010 11:12PM
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