The ACL Repair Blog Firsthand accounts of ACL surgery and recovery

ACL Repair incisions after two weeks.

My second post-op appointment was today, two weeks and a day since the surgery.  First the doctor cut off the dressing and removed the sani-strips that had been on the incision since the surgery. He said the incisions were looking good, let me snap a picture and (most excitingly) told me i could start showering.  I almost hugged him right then.

After putting on some new sani strips (without a gause dressing) the doctor checked the movement in my knee joint and was pleased with how tight it felt.

Other exciting points are that I can now sleep without my brace and I can start going on walks for exercise next week.

Couldn’t sleep this morning between my girlfriend’s coughing and the neighbor’s dog barking so I went for a walk.  It’s a cold morning in Seattle but it felt fantastic to be moving around outside.  I couldn’t help but think of the days of summer when I was up early every day for a run before work and wonder if and when i’ll be running again.

Two weeks after surgery I’m remarkably pain free in my knee.  I still get rather stiff when i’m sitting for long periods but I have no constant acheing.

I’m going in to the Doctor’s this morning,  a visit which I’m hoping will find them removing my dressings so I can take a shower or a bath.

I apologize deeply for my lack of posts, between an increasingly busy work schedule and my “get well soon” gift to myself (a shiny new …. er old … bass) I haven’t had a lot of free time online.

I walk freely now with now pain, but still get pretty stiff at work.  I’m a software engineer by trade so that means lots of long hours at a desk (taxing!).  Per doctor’s orders I haven’t really been working on increasing my range of motion, i seemed to get 0-90 degrees pretty quickly and apparently there’s no hurry to go further than that.  I’ve been doing my leg lifts daily and am looking forward to getting in to PT.

I have my second post op visit on Thursday and my first PT next Tuesday.

I’m growing rather weary of my brace and have been making more of an effort to loosen it when I’m sitting still.   The garbage bag - half shower thing is also getting really old, but so it goes.

In any case i feel I’m still well on the road to recovery and am looking forward to getting back on the bike, the skis and the trails of the beautiful state of Washington.

Last note: Amazon fresh is a life saver for me. I hate going to the grocery store as it is and when it’s uncomfortable to stand or walk it’s much, much worse.  Having fresh produce and other groceries delivered while i’m sleeping a couple times a week makes the world a much better (and healthier!) place.

SO I am convinced that the severe pain in my shin that runs down to my toes is nerve damage from the peroneal nerve during surgery. Like most cases I can find about it online, my dr seems to be in denial (but at least he didn’t claim it was just from the brace being on too tight like one patient). Luckily, this nerve damage seems like it should be temporary. Unluckily, it could take TWO YEARS! The rate of recovery I found (albeit not from a dr or science journal) was an inch a month recovery. Great.

Yesterday was day 11 for me. I finally dropped down to one crutch (as per day 9’s doctor orders) during my PT. Being able to carry things in one hand is better than a few fingers clutching a crutch. PT was grueling and my leg hurt all day afterwards. I finally broke down and took some Tylenol (I hadn’t taken anything, for better or worse since ending the percocet on day 5). The tylenol really eased the pain, though. (Note that I took acetaminophin and Henry took ibuprofen. Out of curiousity, I just looked it up and ibuprofen should be better at relieving ACL pain: http://cat.inist.fr/?aModele=afficheN&cpsidt=15895663 so I’ll take that next time).

Walking with one crutch is a little odd too, especially navigating around my 20-month-olds toys all over the floor. Poor boy is still kinda confused and throws a fit every time I put ice on my leg (”No! No!”). 

In other news, I can’t believe how amazing a shower felt after 8 days of not showering (on day 8, per dr orders), even though my leg hurt during the shower and it was kinda awkward. Now if I only stop being lazy and shave.

I just had a bit of an idea.  Since it’s still uncomfortable to walk and i’m definately quite slow, i’ve been bringing a lunch to work.  This practice has well documented health and financial rewards in addition to keeping me of the mean streets of Downtown Seattle with a less than perfect knee.

My idea is this: As an incentive to keep bringing my lunch even after I’m walking at full tilt I’ll promise myself to transfer $8 into my savings each day that I bring my lunch in. I figure $8 is about an average lunch downtown, although i could probably figure out a more precise average by looking through my mint.com records.

Anyway, the changes i’m having to make to my physical routines can definately be harnessed for good.

Today is day seven and I can proudly say I haven’t used a crutch in two days.  I have some pain when i’m walking but it’s light and already feels better day over day.

I started watching the video of my surgery tonight, which i wasn’t sure i could do.   I’ll eventually package it up and get it online, but it’s probably not prime dinner time entertainment.  It is very cool to hear the doctor’s commentary of the surgery.

I have to admit that i haven’t been all that good about doing my exercises.  I resolve to step it up starting now!  I have been very strict with my diet because i know it will help the joint a lot to minimize the amout of weight it’s bearing.  I’m usually rather active, riding my bike to work daily and trying to get out to the mountains most every weekend.  So as you can imagine a lifestyle where my most strenuous exercise is the walk from the bus stop is a big change for me.

I’ve also been cutting back to almost zero with the ibuprofen making me largely medication free.

First, thank you for Henry in letting me share his blog, which is probably all I can manage being a 35-year-old graduate student, a dad and a dad-to-be while recovering from ACL surgery (feel sorry for my pregnant wife yet?). I found Henry’s blog and was initially interested because my surgery was on 11/24, two days before Henry’s so we can share in the triumphs and pain along the way.

My acl: I tore it in a freak accident involving furniture and some stairs and thankfully a railing (it was a very heavy dresser). Like Henry, I had a previous ACL replacement, but it was in my other knee. That was an allograft, from a cadaver. This one is from my hamstring.

Day 8: First post-op Dr visit: Interestingly, I am getting different Dr feedback than Henry. My post-op appt was this morning (day 8). My doc is happy I can do 90 degrees, I took my own bandages off days ago and I no longer ‘need’ a dressing (nor did I ever have a brace). I have a LOT of pain from where they took the hamstring pieces out (goes by a nerve) from my shin down to my toes. Which, as I told the doc, keeps me from doing much walking. He thought that was ok and they often have to keep patients from doing too much.

I did find out that I was wrong about what I thought they did to my cartilage (damn drug-induced hallucination!). My meniscus cartilage had a big gash, but not a complete rip so was only shaved (i.e. its thinner than it was but that’s all). I had a hole in my articular cartilage under my tibia which is where I had a microfracture done (they drill into the bone, let stem cells out and they form a slightly different type of cartilage). Makes me wish I had one of those leg machines cause I have to do hundreds of leg slides a day to get good new cartilage there. And I can am allowed use 1 crutch instead of 2, but cause of the microfracture, I need to use the crutch for another month. I haven’t started using 1 crutch yet but will at my next Physical Therapy appt on Thurs. That’s another difference, I’ve be at PT since day 2 post-op twice a week - guess each doctor is different. I remember my last knee doc swore by the allograft and this guy hates them.

I’m excited to say that Eric will be writing about his recovery experiences here as well.  I think it’s awesome to get the opinions and experiences of a few people together, so if you’re interested in writing drop me an email or leave a comment.

Today I went back to the Doctor’s office for my first post-op visit. I wasn’t too sure what to expect, so I thought i’d share it all so others know what to expect.

This is my knee 5 days after surgery. Note that this image is taken from my perspective so it would be upside down if you were looking at me.

First the Nurse came in and changed the dressing on my knee. It was fun to see the incisions on my knee. The doctor basically used the same cuts as the last time i had this done so my old scars have become fresh wounds again.  The nurse told me it’s quite important to basically not touch these incisions until they have healed.  When i left they provided me with materials to replace the dressing later on.

The nurse noticed that i had some blistering around the bandage on the uppermost cut (not pictured). She said this is fairly normal and is a result of the swelling.

In the image to the left you can see the two small incisions where the arthoscope went in, and the one larger cut where the actual ligament was placed and the hardware was inserted.

I was prescribed physical therapy starting in two weeks. This therapy is supposed to last about a month. The doctor also prescribed some exercises to star right away including straight leglifts. It feels good to have some things to do.  Now the onus is of course on me, to get these exercises into my daily routine.

My knee as dressed by the nurse 6 days after surgery

I was scolded for getting the flex on my CPM up to 90 too quickly. They recommended that I backtrack to a 0-70 degree range. They said that I should be slowly getting up to 90 over the course of the next week or

One main theme of the instructions i got was not to extend the joint past 0 degrees. I naturally hyperextend my knees to 7-10 degrees, but both the doctor and his nurse made a point of telling me that such an extension would stretch the graft out.

Additionally they said i could walk but strictly with the brace on. I’ll be wearing this brace religiously for six weeks, which could start to get a little unpleasant.  I’m wondering if there are third-party replacements available?

That’s all for now.  If you read this and think you’d like to share your experiences leave a comment and i’ll contact you about writing on this blog.