Hi Mike,
I was surfing the web for myself when I came across this thread which interests me greatly and here's why.
I underwent ACL reconstruction on my left knee 19 months ago here in England with the graft coming from my hamstring, the preferred method these days I believe. All seemed to be going well and I settled into a long recovery which included bi-weekly specialist knee rehab classes plus light exercise in between to build up the strength and movement in the joint.
Strength and range of movement increased well and my physio seemed happy but fairly soon I noticed that during the program, when standing straight and dropping into squats, my knee would lock out so I'd have to slowly lower my weight and some of the time it would work it's way through the lock but sometimes i'd have to restraighten the knee and try and bend again a few times till it passed the lock, the physio wasn't too concerned as she said that another patient had similar issues and one time her knee 'snapped' and this permanently solved the problem. I did notice as time went on that this occured from my 'hyperextended' position of the knee, whilst either standing or sitting, i observed in the bath that during a lock, if i slowly straightened the knee it would work past the lock and I could see the lower part of the knee cap shift.
In the end, after about 5 months of physio, the problem was still happening and through a routine follow-up appointment with a specialist and some pressure from the physio I had an MRI, when it came back there was nothing to suggest a problem with the graft or the operation. Over the next few months I had another MRI, an appointment with the surgeon and in the end the surgeon authorised an orthroscopy to try to find out the problem as nothing was showing up on MRIs, the problem increased to affect me in excess of 30 times a day so was really impacting my day to day life but annoyingly I wasn't able to replicate the problem in the very short appointment times I had so the surgeon was uncertain as to wether he would be able to replicate the problem in surgery to discover the problem.
In the wait for surgery which happened 3 weeks ago, I decided I had nothing to lose and during a lockout, I dropped my weight and there was a loud crack and some pain but nothing lasting, in the next couple of weeks I noticed that it wasn't locking as often, maybe 50% better.
After surgery, they did not find anything but did flush the joint, the first week back and with expected bruising I had locking but I didn't expect full movement yet, the next week and there seemed to be a big improvement with my increased movement and this coincided with the follow up appointment, the registrar admitted they hadn't found anything and the suprfaces were all smooth and they couldn't replicate the locking under anaesthetic. Unfortunately the next week the locking started again, so no improvement from before this last operation.
The sensations I feel are this: The knee feels like there's a wrapped up cloth in the lower part of the knee constantly, so some tissue I guess, it would not bend all the way so sitting on my shins isn't possible comfortably, when the locking occurs, the resistance feels like a hard substance with a little give in it, like gristle caught in gears. I did wonder that the 'breaking' of the lock had broken up this foreign body a bit, easing the amount of locking but i'd assume that they would have found something but no. I did notice that maybe the knee has a little more movement as regards bending it almost as much as the good leg and maybe not as much of a squeezing sensation in the lower kneecap as i've gotten used to.
There was speculation by my phsyio that I may have had meniscal damage but the first MRI and appointment suggested otherwise but as I will be pursuing this further I may try to push the meniscal possibility, I cannot replicate the lock on demand unfortunately but I may have to pay for a long consultation with a specialist to try to replciate it there and then but in the recent appointment after surgery, the registrar suggested that he doubted they would be able to help me further as they could not see any problem and they did spend along time trying to create the lock whilst I was under.
Slightly depressing but I found the more excerice I do, the better and the only improvement came from forcing through the lock but it didn't solve it...blank looks on the faces of my doctors alas!
Let me know any thoughts.
Apologies for the essay!
Regards
Dan
