Knee effusion after Arthroscopy

[brokk]

Hi,

I'm hoping for professional advice or at least comforting stories of fellow sufferers

Here's my story:

I'm 26 years old. One and a half months ago I had an accident during freestyle wrestling - a sport that I had taken up only in January.
My sparring partner applied a throw I landed very unfortunately with full force on the inner side of my knee.

While I hoped it was only a severe contusion my doc suspected a tear of the lateral collateral ligament. MRI about one week following the accident showed a partial tear of the lateral collateral ligament as well as a a tear in the posterior horn of the interior meniscus.

Arthroscopy was conducted three weeks following the accident in a specialised clinic. They were able to fix the meniscus with the RAPIDLOC System and the surgeon told me that the tear is in the are well supplied with blood and that he is confident that it will heal well. During Arthroscopy it became evidend that the ACL was also partially ruptured. As I had demanded that ther shall be done as much as needed yet as little as possible on the knee, they didnt fix that right away. They just microfractured the notch to created a healing response.

48h after Surgery the drain was removed, I was given a Donjoy Brace (set to 30° flexion and 0° extension) and crutches (20kg partial burden on the operated knee in the first week) and sent home. Also I was shown some exercises that I should do, low effort yet regularly. I also asked how much I was allowed to move around on crutches and was told that I could move about as long as there was no pain.

Well enough, I never had any pain in the knee. But six days after to surgery my knee began to swell up to enourmos proportions.

And thats when it got ugly for me. Another doc (as the first one was a hundred miles away) told me to stay in bed as much as possible, elevate the leg, use a compression bandage and cool the knee as well as take 150mg Diclofenac a day. Soon after that my lower leg and foot began to swell too so I wrapped them in compressive bandages as well.
I kept religiously to the docs orders and stayed in bed or on the couch pretty much 22 hours out of 24 for about ten days. Foot and lower leg went back to normal about three days after swelling and the knee got better slowly too. I started to move about a little more the last few days but still rest the leg most of the time.

The swelling has diminished very well and I stopped cooling the knee, as it doesnt feel hot anymore.
But the knee does'nt look anything like the uninjured one and there is still a lot of fluid in the joing gap (If i apply soft pressure on one side, the skind on the side of the joint gap will bulge visibly). My doc strongly advised against an aspiration.

Now, I'm very troubled by the long time this seems to take. Should'nt my knee be back to normal by now?
Is there anything I can do, to speed up recovery?

My Doc strongly adviced against physiotherapy until the amount of fluid in the joint gap is back to normal.
This sucks pretty bad, as the important time span to mobilise the joint after surgery is already lost. There is a high chance, that the knee will be stiff after this, right?


Thank you very much for your advice!

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[GrantP]

without knowing the full extent of the problem as i have not seen your knee, the swelling you got may have been a reactive synovitis or maybe an infection? either way my advice is to get into physio asap and have your knee assessed and some gentle hands on mobilisations performed and to ensure the swelling is well controlled and continuing to reduce. you are very right in your concerns over the knee becoming unecessarily stiff. a good physio wil be able to do what is right for the state of the knee and encourage movement and strength whilst respecting and controlling the swelling.

[brokk]

Hi GrantP,

thanks for your response. Swelling has'nt gone away completely but diminished to a extent that - i guess - excludes a infection as cause.
Probably I was just getting too impatient. I will see a physio-/manual therapist tomorrow to get the knee evaluated.

Thanks for your Help!

[GrantP]

Hi GrantP,

thanks for your response. Swelling has'nt gone away completely but diminished to a extent that - i guess - excludes a infection as cause.
Probably I was just getting too impatient. I will see a physio-/manual therapist tomorrow to get the knee evaluated.

Thanks for your Help!

May still be infected but is encouraging if swelling reducing without anti-biotics as means your body dealing with it, but more likely to have been synovitis. Physio will help,let us know how you get on

[violablue]

I definitely agree with Grant. Especially as a good physio can really aid in reducing swelling, as well as assess if there's trouble brewing. Physios have great tools to reduce knee swelling, such as cryo pumps (ice with excellent compression) that they can apply with your leg is elevated. Here's a great at-home use cryo cuff, which is like having the compressive forces of a blood pressure cuff on your knee. You put it on, elevate, pump it up, and relax for a 15 minutes. Amazon.com: Corflex Cryo Pneumatic Knee Splint - ONE GEL - Universal Fits up to 24" circumference: Health & Personal Care

---------- Post added at 07:47 PM ---------- Previous post was at 07:45 PM ----------

Also, have you been getting regular massage/trigger point release/etc of your leg? With trauma muscles knot up and this can cause a big decrease in lymph movement, increasing issues with swelling.

[brokk]

Hi,

the reason I bump this thread is that I'm not quite sure what to make of my "progress".

Last monday my doctor basically told me to try and see what the knee can take. So in the consecutive days I increased load gradually until I was able to walk without clutches three or four days later. He was reluctant but in the end agreed that I was fit to go to the office again too.
So today was my third day at work and I'm not quite sure what to make of it.

When standing or sitting my knee keeps swelling up significantly. Not as bad as before and - possibly more important - only above the kneecap (so, no fluid in the joint gap I think). I get a slight stinging pain on the inside and front part of the knee (mind you, the meniscus rapidloc is located on the rear part of the inner meniscus) when walking by now which I didnt get in the first few days.

ROM is back to 90° flexion and near 0° extension, whereas extension hurts a little sometimes.
applying a compression bandaid helps keeping swelling down but reduces ROM considerably, so I leave it off most of the day.

I have had three sessions of manaul therapy consisting of mobilising the kneecap and massage of surrounding tissues and muscles. I'm not sure if this has helped.
The therapists I have visited so far all told me that I'll have to wait until swelling goes down to start ROM and muscle work.
They didnt ice it or anything else.

Apart from being able to walk without clutches my condition has not gotten a lot better.
Should I consider staying away from work again?