Monday, January 4, 2016

Knee Scope

The second Christmas Drew has been not working in most of our married life and what do I do but schedule arthroscopic knee surgery for the Friday before Christmas.

I'd had nagging pain whenever I exercised hard for a couple of years.  Way back in 1985-86 I tore my ACL clean out so I've been living life with no ACL, which creates a lot of instability.  I can't count the number of times I have re-injured this knee since then, most recently that big hike I did two years ago Thanksgiving.  An MRI revealed a probable tear in the medial meniscus and potentially the start of a bone spur on the front of the knee.

 Doctor Mark Scholl went in there after it on Dec 18.  Here's what he found.
The piece of tissue to the right of the metal probe is the flap of torn meniscus that had folded underneath the rest of the meniscus.  This medial half of my left knee meniscus is about 1/3 the volume of a healthy meniscus. The good news is that the femur and tibia surfaces (the top and bottom flat white surfaces in the photo) look to be in good shape, i.e. no arthritis.
The video below show the doc trying to maneuver the flap so he can cut it off. There is not sound, but you can click in the lower right of the video to make it full screen.

In this one, he has separated the nickle-sized hunk of meniscus and is pulling it out of the joint.

The bone spur turned out to not be a bone spur, but just an area of damage to the soft tissue that wouldn't heal, so he cut slits in that area to get some healthy inflammation and blood flow to it.  This video shows that area while he is articulating my knee.

Drew was not due home until late that evening so my friend Shelly retrieved me from the hospital.  I had my recovery room all set up the day before so that I could just get kicked to the curb (well, not really, Shelly escorted me into the house and made sure I had everything I needed) to recover until nursemaid Drew came home at 8 pm that night.

I felt pretty good with my kitty nursemaids by my side.
After three days I was putting weight on it but still using crutches.  I was allowed to take the bandages off.  Here are before and after surgery pics. 


3 days post-op. Not too swollen, really.
 My sisters and Mom sent me gorgeous flowers to brighten my bedside.
By the following Wednesday I was able to go to work and not use crutches.  Christmas came and went with a lot of limping, but not much pain.  Then I went to work two days the next week and Kapow! my knee swelled up like a puff ball mushroom and became really painful.  Back to crutches and laying around.  Max and Marley didn't mind that at all, especially in the warm back bedroom.

I brought some work home. I like these office mates.
So today, after nearly a week of being really careful, I was able to walk a little and went to my first PT appointment.  The PT really helped; although the knee is sore, I have a lot more movement in the joint.

I hope to have no more set backs so we can have fun in February.

Feeling pretty good. PT helps. I'm able to go around a full pedal stroke on the stationary bike.  Still limping a little. No cardio exercise but I'm able to get a decent upper body work out in at the gym.

Same as last week except that the knee feels less weird and I'm walking almost without a limp now. I can spin easily on the stationary bike and I've done yoga a couple of times.  Still being careful, but I occasionally forget I had the surgery and just do normal things.

I had a PT appointment at 5 weeks. The very best PT in the valley, Dr. Colin Bywaters (who also helped us coach high school mountain biking) gave me a good session today.  He pushed on the top of the knee to stretch the back of the knee, which helped immensely in being able to straighten almost fully. He then made me lift actual weight by doing leg extensions and curls with 30-40 pounds.  I was afraid the knee would be really sore and swell up, but it didn't. He also gave me the go ahead to do easy cardio, so in the following days I did 20 -30 minutes on the spin bike with some moderate resistance. 

I feel SO much better about the recovery now.  I am walking almost normally most of the time and my knee feels almost strong.  I can go up stairs with no problems; coming down is still odd because I'm at about 100 degrees of bend.  It is still stiff after I have been sitting in one place for a long time, but perhaps that's just the body's way of telling me to get off my butt and move. 

I think I'm gonna live.

Feeling pretty strong, but not 100%. 

Dr Bywaters said I was good to go on vacation. I have full extension and I can flex 127°. The swelling is hard for someone who doesn't know which knee was operated on to tell. Some of the quad muscles are still atrophied and it feels funny going down stairs. I do moderate cardio. I still feel that it is pretty far from being able to ride a hard effort on a real bike, but we are leaving on vacation and I'm going to walk and hike as much as I can!

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