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Tuesday, July 29, 2014
Knee problems after surgery
I had a bad knee dislocation after my dog ran into me and went to the ER. They found nothing on the MRI. I went in for lapascopic surgery and found out that I tore( I think )Mensicus during the surgery. He stitched it back also stitched the ligament into my thigh muscle. It was a long recovery with a frozen knee. So they did another procedure to bend the knee to full flexion.
Its been a full year and my quads are still severely shut down and even tried electric shocks on it. When Im sitting I can not even lift my lower leg straight and now when Im walking my knee does not bend and stays straight when walking but bends when sitting. I am out of a brace but with one crutch. I have severe knee pain when I try to do leg raises. I dont like riding stationary bikes because my knee cap continously pops.(which is why I had surgery in the first place). I have had surgeries on both knees for knee dislocations.
What do you think is going on and is it possible some muscles are just gone.
By "knee dislocation," I would assume you are referring to patellar (kneecap) dislocation. A knee MRI scan, if images are not blurry, will usually show some evidence of tissue damage following a patellar dislocation, and usually reveals a torn meniscus. However, if you had surgery on your knee prior to the MRI scan, post-surgical changes can make the MR images more difficult to interpret.
You mentioned your quadriceps muscles are "shut down"... it is obviously difficult to "reactivate" these muscles as long as your knee pain and popping symptoms persist. Discuss with your orthopedist if anything else can be done to improve these symptoms including, if not already tried:
- trial use of a knee sleeve/brace (of perhaps a different design than the one you are no longer wearing),
- knee steroid injection,
- any untried physical modalities (such as ultrasound, iontophoresis, "kinesiotaping," soft tissue mobilization, TNS [a portable electrical stimulator for pain relief rather than muscle stimulation], aquatic therapy, etc.) as can be provided by a physical therapist,
- making sure you have regained normal strength in your hip and lower leg/ankle muscles,
- change in footwear (particularly adequate arch support), and
- such medications as anti-inflammatory as well as other pain-relieving medications. Additional medication categories may also help, as could be determined if you were to consult with a physician who specializes in Pain Management.
One final thought, if not already done, would be to discuss with your orthopedist whether it would be useful for you to undergo an EMG (electromyogram/nerve test) to be sure there is no damage to the nerve fibers going to your quadriceps muscles.
I hope the above comments and ideas are helpful.
Brian L Bowyer, MD
Clinical Associate Professor
Physical Medicine & Rehabilitation
College of Medicine
The Ohio State University