post op ACL problem

[dale_moseley19]

HI all

After a bit of advice/ diagnosis if possible

I am post op ACL of left knee, I had the op 4 weeks ago and the op was said to be sucessful.

I attended a physiotherapy 3 weeks ago where I was said to have good movement (better than normal).

On monday this week while getting ready for my phsyio appointment I got a pain in my knee and sat down. Within minutes one of my incision scars had swelled up like a golf ball. Since then the brusing has come out and it is quite colourful, painful and still swollen

I have visited my hospital and am waiting to see my surgeon next week

I will try to put some pictures up of how it looks now

Any help on what the problem might be would be great

Thanks in advance for your help









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[physiobob]

I would get into your surgeon sooner rather than later. Just tell them it looks infected to get someone's arse into gear! Your images a rather blurred so it would be nice if you can upload some that we can see. The bruising looks lateral and potentially above the joint line. If could potentially be from the site of the graft's fixation through the femur but it's very hard to say from these images alone.

Did the swelling happen at the time of the pain? Was it very rapid or are we just seeing bruising on what was swollen any how? Also was this a hamstring graft?

A bit more information is needed to provide some more insite

[dale_moseley19]

Thanks for the response and sorry about the quality of the pics, i couldnt move to see the screeb it hurt that much at the time

Yes the graft was a hamstring graft

I was told by the reg it is the incision for the screw fixing, however i had an x-ray which apparantly showed the screw has not moved

I noticed a little pain then some swelling then the pain and swelling came together

Both myself and the reg had ruled out an infection, as the problem came on so fast and there has been no weeping

I have been to see my GP who's first impression ws it may be a haemotoma, but i still fear the worse that the graft may have snapped

[physiobob]

Yep that's exactly what it sounded like. The fixation to the femur. It is unlikely that the repair 'snapped' however it is possible that the tendon replacement has come unstuck from the fixation screw. This is hard to diagnose clincially when you have acute swelling and an injured hamstring as it is difficult to perform a Lachman's text (ACL test) without overactive hamstrings mimicking a good stable fixation. Also tests like pivot shift with any real pressure would be avoided in the early phases following the surgery as one would not want to compromise the graft while it is healing.

Tough one right now to say anymore without seeing the knee first hand. Maybe a followup MRI would show if the graft is in place correctly.