Had surgery; Question and thoughts

Hello everyone, I had surgery Friday 18/7 on my troublesome knee. Was planned as just an arthroscopy, but turned out to be necessary to screw part of my femur back in (not a part with cartilage, just above). The condition was diagnosed as osteochondritis - loose bone (although not separated).

Question. I have had a much larger incision than was expected for an arthroscopy (actual incision 1.5-2 inches), and therefore there is a helluva lot of swelling. I was not expecting swelling - was expecting keyhole surgery only, so was not warned by anyone before the op how long the swelling should last. So the actual question is, how long should the swelling last for (I can give measurements/details if it helps) until I can bend my leg again? Anyone with personal or reliable second-hand experience please comment.

Thoughts - I don’t think I have ever accepted the theory that surgery should always be considered as the last option, but now that argument seems weaker than ever to me. From what the surgeon has told me (one of the best knee surgeons in the country by all accounts), this problem cannot resolve with anything other than surgery, and can only get worse. What has added to the problem is the failure by my GPs to diagnose the problem (took 7 years to diagnose, only by the aforementioned surgeon) because they were not willing to refer me to a surgeon until it was absolutely necessary (even then I had to ‘twist the guy’s arm’ for half an hour).

To be explicit, my opinion is: Surgery should not always be considered a last option, because in some conditions delaying will reduce the chances of recovery. Instead, considerable efforts should be made to diagnose any injury as accurately as possible as early as possible, rather than just trying any treatment ‘just in case’ it helps. Without claiming to be an expert, IMO, the idea that surgery should only be considered as a last resort (if it is widely held and practiced) may in fact be damaging to the national health system in general, due to massive overall waste of time and resources for ineffective treatments that would not have been used if diagnosis was accurate early on. I do accept that with some/many conditions, it is appropriate to try treatments other than surgery first, but again, not all I would suggest.

Anyone’s thoughts appreciated.

aight, I had a knee surgery 2 months ago(ACL reconstrucion with semitendinosus plasty), and it took about 6 weeks until the swelling was completely gone (and 8 weeks til i had full ROM) , but i have to admit that i came up with the stupid idea to take a lil sunbath two days after surgey . the incision is about 1 inch and there are the two small incisions from the arthroscope.
I asked several guys at the clinic and the rehab center but they all said that there’s no rule of thumb how long the knee is swollen. everyone is different, a friend who had exactly the same type of surgery like me (on the same day, same surgeon) had no swelling at all and he had 130 degrees flex in the first week .
Also, if you aren’t allowed to move the leg the muscles will probably shorten which make full ROM nearly impossible.

[QUOTE]Originally posted by JimboUKdec


To clarify, my opinion is this: Surgery should not always be considered a last option, because in some conditions delaying will reduce the chances of recovery. Instead, considerable efforts should be made to diagnose any injury as accurately as possible as early as possible, rather than just trying any treatment ‘just in case’ it helps.

I agree JimboUKdec - DIAGNOSIS is very important. I broke my ankle (tibia) once, everyone in the gym heard the bone snap but the doctor in the ER didn´t x-ray! He saw little swelling, and not alot of pain. I was too stupid/in shock/relieved to continue to insist that an x-ray was needed (I DID suggest it). He was probably saving the health care system money. Hours later I was in agony and after spending the night in extreme pain had a screw put in the next day by a decent surgeon .

Question - what do you do when the GP or treating Dr. will not prescribe an MRI or x-ray or whatever is needed for a REAL diagnosis? Second opinions are very important. Sure we need docs, but I think we are ultimately responsible for ourselves to seek out better advice and/or expertise with medical issues. A very tricky subject, expecially for young athletes with no injury experience.

thanks for the quick replies

Carson, in my defense, I was 12/13 when I first developed the symptoms of this injury, only got my 1st x-ray, and subsequently MRI 7/8 years later, this May.

Can you imagine a doctor listening to a 12/13 year old boy (who if gifted in intelligence could actually know better what tests are needed to be done(with research))?

Another question: Will self massage of the thigh help when the swelling reduces, for regaining ROM, anyone?

Originally posted by JimboUKdec
[b]

Another question: Will self massage of the thigh help when the swelling reduces, for regaining ROM, anyone? [/b]

To reduce the swelling just elevate the leg. Ice and a TENS unit are helpful, too.
the self massage is useful if the muscles are tight and you can’t extend and bend the leg properly.

I agree JimboUKdec - DIAGNOSIS is very important. I broke my ankle (tibia) once, everyone in the gym heard the bone snap but the doctor in the ER didn´t x-ray! He saw little swelling, and not alot of pain. I was too stupid/in shock/relieved to continue to insist that an x-ray was needed (I DID suggest it). He was probably saving the health care system money. Hours later I was in agony and after spending the night in extreme pain had a screw put in the next day by a decent surgeon .

yeah, i had a very similar experience. After my injury I went to a well known but expensive surgeon because I thought he’s the best choice. I was like “i don’t care if it cost more because after all this is my health” . After he took a look at the MR images he said to me that there’s not only the torn ACL but there’s also a 3rd degree cartilage damage.
Then I got a hint from a guy who said that there’s an ACL expert somewhere in southeastern germany who might be better for me.
So I went to this guy and he came up with a totally different diagnosis: No torn ACL, just partially torn and no cartilage damage at all(!!!). and the pictures from the athroscopy proofed him right…

Yeah, it can be scary sometimes - doctors are only human. I think the best ones always remember that and are open to the possibility that they should look again or ask for another opinion themselves! Egos and shortage of time (direct contact with the patient) make this tough, I think.

JimboUKdec, you may want to look into lymph drainage massage. Maybe somebody here has had experience with it?

silky_smooth- how long can you elevate the leg for at a time, how much total per day, and are there any possible complications from reduction of blood flow (apart from numbness)?

Thanks, James.

@jimboUKdec: i’ve honestly never thought about that. I had two pillows, a small one under my knee and a bigger one under my feet. I was lying there perhaps about 3-6 hours a day, and I got up to fetch something to eat or so here and then.
The only problem I experienced was in the first days when I got up the water rushed down in my leg. this was extremely painful in the shin area.
the lymph drainage thing carson proposed is very good, i forgot that. I had 16 sessions, 30 minutes each and it felt great afterwards.

Yeah, it can be scary sometimes - doctors are only human. I think the best ones always remember that and are open to the possibility that they should look again or ask for another opinion themselves! Egos and shortage of time (direct contact with the patient) make this tough, I think.

yeah, and I have the suspicion that the motto of many docs is “C.R.E.A.M” (Cash Rules Everything Around Me)

What are the chances hamstring tear would require surgery? Would it have to be a pretty damn debilitating tear?