Thread: Knee Surgery
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Old 02-21-2005, 12:07 AM   #3
Janet Rosen
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Re: Knee Surgery

February 2005 knee updating

I had the allograft, so the procedure and healing/rehab are different if you have a graft from your own body
The postop priorities (beyond pain and infection control) are decrease swelling; minimize scar tissue formation; return knee joint to normal range of motion; return to required strength, balance and function. For swelling, elevation ABOVE THE HEART, for some reason is something folks seem to scrimp on. Puttin yer leg up on the couch ain't enough!!! You need to lie on the couch and stack pillows under your leg. Ice of course is a big help, and should be used whenever swelling returns. I found, as did my friend w/ the patellar graft, once we were cleared for stationary bike use, that not only was it the best way to remobilize for range of motion, but it seemed to get the swelling down. Icing before and after is helpful.
For minimizing scar tissue, there are a couple of basic hands-on things your P.T. can teach you. I will NOT tell you what they are because I have no idea whether or not there is a time that is too early to start doing them. But whenever you next see your P.T., if she has not said anything about it, ASK.
For range of motion, it is initially the swelling that is interfering, and as the swelling goes down, the stiffness and weakness. Before you are cleared for the stationary bike, you can just move the leg about in bed, or while standing on crutches. The stationary bike is wonderful to get the process started, and once you are getting some good results, the P.T. can decide if you need additional stretching work using rubber stretch bands to work against.
A proper full rehab program for an active, athletic person should not just focus on strengthening, but on balance and proprioception as well. I felt a little shortchanged at Kaiser, in that I was TAUGHT the rudiments of those things, but had few at home tools adequate to the task, and they would not let me keep coming once they had taught me the requisite scheduled postop knee class.
should have spent the money to join a gym. At the time, I had decided to stop working as a nurse, and was en route to being partly self-employed/partly part time employed, and did not want to spend the money. It was a foolish decision in the long run. Penny wise and pound foolish. The at home regimen without machines and without a clear time limit simply did not do the job. I shortchanged myself and paid for it with a leg that, once I had healed enough to be cleared for return to training, was not as strong and balanced as it could have been, and I've sustained some damage since then. The graft is intact, stretched a bit (though I do tend to laxity in a lot of my ligaments, so hard to say), but there is just enough functional instability that I've redamaged the meniscus to some degree at least a couple of time and I do have some pain along the tibial plateau most days I am active--even taking a good long walk--and standing still for over 1/2 hr makes the knee very stiff and achy. I blame myself for this and hold it up as an object lesson for anybody who asks!
What I'm doing now is seeing a Pilates rehab specialist who is working with me, first correcting all the little imbalances in gait and posture I've developed to live with the painful knee, then on an overall regimen. My goal is to improve the whole body's structure/function in order to keep doing aikido and avoid further arthroscopy until sometime in a remote future.

Janet Rosen
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"peace will enter when hate is gone"--percy mayfield
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