Sunday, January 17, 2010

T minus 4 days

If all goes as planned (I don't get sick between now and Thursday), I'll finally be going in for my anterior cruciate ligament (ACL) reconstruction surgery on my left knee. For the sake of any type of amateur comparative study, below is a picture of my current state. Post surgery images to follow soon. (I apologize for the ugly picture. I've decided there's no way to elegantly present this part my anatomy. For that matter, there's probably no way to present any part of me elegantly.)

As you can see, my right leg, in particular my quadriceps has significantly more muscle tone. It's also a little bit straighter. Since the injury occurred, I've been able to get most of my range of motion back. With a little pressure on my knee, and my heel elevated, it will fully straighten out, once warmed up. For flexion, I can get my foot about a hands width away from my rear before I have tension in my knee. I'm not 100% certain what is causing this, but my guess is that it is probably a combination of loss of flexibility in the muscles around the joint, and possibly scar tissue in my MCL needing to be stretched out. Maybe the crud of what's left of my ACL is getting in the way too, not sure. Regular use of the limb and performing of assigned physical therapy exercises have made good strides in improving my range of motion though. I'll be continuing them up until my surgery.

I'm not sure how much swelling there still is in my knee currently. It does look more swollen, but I'm not sure how much of that is from atrophy. To describe the current condition of my knee, it seems to work well enough. When I sit for a long time it does start to feel "lethargic" or as if the joint is full of molasses. The only pain I have is at the bottom of my patella, where it joins with the patellar tendon, and only to touch. It feels as if it's bruised, but not too bad. I don't have a whole lot of confidence in my knee. I'm comfortable hiking in relatively rough terrain, and on steep slopes. Snowshoeing is fine too, but when it comes to anything that might involve any kind of jarring, or stop and pivot type motion, I am definitely not comfortable. It's probably more perception than reality, but I'd rather play it safe than risk additional injury. I can tell that strength has certainly left my leg, but I've been able to ride my bike trainer for as long as I want to. I usually stop out of boredom, not physical limitation. On a side note, I've started pedaling with one leg to work the individual muscles, and I can last just as long on my injured leg, as I can on my non-injured leg. Where's the power cranks when you need them?

I believe that they will be harvesting the new ligament material from the part of the tendon that connects my hamstring to my tibia. Supposedly use of this site makes for a less painful recovery, though it takes a little longer for the tissue to bond with the bone.

Post operation recovery involves cructches for a week or so. They say I can put 50% of my weight on the knee as soon as I can tolerate it. I have my first PT session one week after surgery. They are also putting me on a continuously passive motion (CPM) machine as well. From the reading I've done, the machine makes no long term difference in a full recovery, but it does tend to help keep pain down, and get your range of motion back faster. I'm supposed to use that for at least 8 hours a day.

So with all that being said, I'll report back next when I'm lucid enough to put some thoughts down after surgery.

Thanks to everyone who has offered me and my family support during this time. It means a lot!

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