|
Bob's ACL WWWBoard
Re: Hyperextended knee 12 weeks post-op - uh-oh? -- Need to see OS at once....
Posted By: Michael Frind
Date: Monday, 16 August 2010, at 3:10 p.m.
In Response To: hyperextended my knee 12wks post-op -- uh-oh? (amy mcginnis)
Dear Amy,
You noted that you are currently at 12 weeks post-op (hamstring autografted ACL, with meniscus repair), and that you have been progressing well. You also noted that, one week ago, you stepped into a hole, thus resulting in hyperextension-type forcing being exerted (indirectly) on the knee. You wrote that the knee now feels "stiff and achy", but that there is "no significant swelling".
I note that, from a biomechanical point of view, this type of hyperextension situation can be very unpredictable. How much hyperextension-type forcing was exerted on the knee depends not only on the depth and size of the hole into which you stepped, but also your gait (e.g. more running versus regular walking versus slow walking) as well as how far your knees naturally hyperextend. Other factors can also play a role in determining how much forcing was exerted on your reconstructed ACL. Furthermore, various factors will influence the vulnerability of the grafted ACL, for example the rate of graft ligamentization (i.e. the rate at which the implanted sliver of pilfered tendon is converted into a bona-fide living surrogate ligament varies from person to person, and also with the type of graft chosen), and so it is difficult to tell exactly how well-ligamentized your particular ACL graft was at the time of the incident one week ago. Clearly, this is a complex situation. I asked Sue Barber-Westin, a seasoned, internationally known clinical knee researcher with the Cincinnati Sportsmedicine Centre, for insight.
Sue immediately noted that her first recommendation is that you see your OS as soon as possible. She pointed out that, from your description alone, it is not possible to determine whether your graft has suffered damage or not. She noted that she has seen patients who have, soon after reconstruction, ruptured their grafts in situations involving less force than the situation you described. But she has also seen patients whose ACL grafts have survived more severe forcing situations. While there is reason to hope that your ACL graft is fine, only a careful examination of the knee by an orthopedist will tell for certain.
Please keep me posted with regards to the knee.
Yours truly,
Michael Frind.
Knee Library http://factotem.org/library
Messages In This Thread
Bob's ACL WWWBoard is maintained by virtual Bob with WebBBS 5.00.
|
|