I first injured my left knee in late October 2000. I slipped, and hyperextended and locked my knee. My first fear was ACL/meniscus damage, as two of my friends had recently had ACL recons. I heard some good recommendations about an OS close to my house (30 miles from work, however), and I was able to get an appointment for 2 days later. I was in pain, and the knee was fairly swollen. The OS put me on crutches for a week, and prescribed some NSAIDs, and told me to come back in 2 weeks. I went back in 2 weeks, and he decided an MRI was in order. I had to wait until after Thanksgiving for the MRI, and was never pain or swelling-free. He also prescribed a different NSAID, since the first hadn't worked. At this point, my knee had not been straight since the injury.
The MRI showed no damage to the meniscus or ACL, but he said that the report indicated there may be swelling underneath the patella. First problem, he never even looked at the films, just the report! He decided PT was the next step, and wrote a prescription for that and another NSAID. PT aggravated the problem, and I still hadn't acheived full extension. The OS decided to stop PT and see what happened. I had to go on a 6 week business trip, so I made an appointment for the day I returned to continue the followups. While on the trip, I was extremely uncomfortable, and increasingly dissatisfied with my OS's course of treatment. I attempted to find another OS from afar, but never really had much luck. I even came home for a week to see my current OS because I was so uncomfortable. He did a cortisone shot at that time, but it didn't work. Still no extension. When I returned home at the end of the trip, I went to see the OS, and he essentially said this was all in my head, there was nothing wrong with me. That night, I got home, and started my search for another OS.
I ended up at Stanford, with one of the San Francisco 49ers team physicians. I saw him for the first time on March 21, and he scheduled me for an April 4 scope. During the surgery, he found severe inflammation (synovitis), articular cartilage damage, scar tissue, and the beginnings of some arthritis. He did the clean up and I was on my way to PT. PT progressed well for a month or so, and then progress stopped. I still had not acheived full extension, and there was still a large amount of pain. I fought through it for 2 more months, until I couldn't take it any more. I saw the OS for my 8 week post op, and he decided to send me to a rheumatologist just to rule everything else out. She saw right away it was nothing she could help with, and sent me back to my OS the next week. On July 16, he scheduled me for a July 25 surgery.
He was initially going to do a manipulation, but when I saw him before the surgery, I told him I would rather he be aggressive and if he had any doubts at all, to go ahead and go in and make sure everything was taken care of, so that I didn't end up back on the table in another 3 months. He did the manipulation, and then went in- all the inflammation was back, combined with scar tissue, and he also saw that my kneecap was tracking very poorly, so he did a lateral release. After this surgery, he locked a ROM brace at 0 degrees, to ensure my extension remained.
I am now working through PT, getting very close to full extension, but dealing with quads who were used to being scrunched up for 8 months- they don't want to support anything, so I'm still using one crutch along with the ROM brace. But my gut feeling tells me this surgery has done it- I think once I can beat this #*^$@ swelling, I'll be on my way.
