Pain a year after acl operation

[elsie1001]

About 18 months ago, i snapped my acl playing netball. 4months later I had reconstuction of the acl to fix it. The operation went well and I was quickly back on my feet and responding well to the physio I was recieving I have contantly having problems with the knee being really stiff. Every morning and if I sit down for more than 15minutes my knee will be still and won't go straights so i have this limp for about 10 minutes after. Also the other problem is I still can't kneel on it - if I do it will crack and I will be in agony for a few minutes. I would really appreciate any advise that anyone could give me - would it be sensible to look at joint vitamins and supplements. Has this worked for anyone else. I really just want to get back to playing sport again with out the constant niggle of my knee. Thanks

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[jwilso]

this doesnt sound right. by 18 months you should be back playing sport. i assume you have been discharged from physio now but it sound like you could do with an assessment.

do you have full range of movement?
does the leg give way or lock?
any swelling?
where was the ACL graft taken?
did you have an associated injury as well as the ACL? ie cartilage damage as this may have deteriorated or require further attention.

i would see you GP or a physio for a full knee assessment. you may have to be referred back to your surgeon.

[elsie1001]

Thanks for the reply the information was really useful. I think I will go see the GP as i've started doing more competitive sport but it slightly feels like I can't trust it 100%. When I did the injury i completly wrecked my knee - snapped the cruciate, strained the medial ligament and also damaged some of the cartalige - do you think this might be what is making it so stiff and sore. They took the graft from the hamstrings. Although my knee never locks if I put my foot down slightly wrong when walking it will make it jolt and causes pain down the front of the shin.

[jerryhesch]

You may have more scar tissue than is ideal. Are you ever able to get the knee straight? have you tried low-load long-duration stretches, say 30 minutes at a time? An example would be a rolled towel under the ankle, a weight above the knee and below the knee, you in long sit position. I would also screen the foot and ankle, an anterior override of distal tibia along with an anterior talar fixation are not uncommon with ACL injuries. These are treatable. I would also screen the hip, the pelvis, and on up the kinetic chain. I would even look for possible lower thoracic and upper lumbar inputs and screen the costovertebral joints - the lower 6. Recall that the sympathetic chain has a fascial attachment to the rib heads and rib joint dysfunction can have distal effects. A surgical scar release (probably notch plasty) is not unreasonable if all else fails. There is some current research going on regarding chondral enzymes (chondralaze????) to prevent scar formation or reduce exisitng scar formation. A web earch may help.
Best Regards
Jerry Hesch, MHS, PT
jerryhesch@cox.net

[karen.hankey]

It could be that your lower limb biomechanics have been altered at some point during your rehab process. The pain kneeling sounds like patello-femoral joint pain which is an altered tracking of the patella - could be strength related or due to tight quads.

What sort of things were you doing for you rehab?

[rockin ronnie]

your graft may have lengthened resulting in some increased laxity and i imagine that you still have some strength and proprioceptive deficits resulting in the lack of confidence in the knee. The stiffness post sitting is a hard one, likely due to the associated damage to the knee (MCL and MM) and i'm not sure how you would go about improving this.