My posts about my 14-year-old daughter’s knee surgery where surgeons used a cadaver ligament to replace her MPFL and a lateral release have attracted lots of readers and several comments. I am happy to report that Sports Girl continues to have a quick and painless recovery.
She goes back to her orthopedic surgeon for a follow-up appointment on Monday, March 1, where the doctor plans to x-ray her knee and give her a post-operative evaluation. We should know more then about how well she is progressing, but by all indications, she seems to be healing as well or better than we could possibly have expected.
Sports Girl has regained almost complete range of motion in her left knee, and she continues with aggressive closed-chain physical therapy weekly with the therapist and daily on her own. This means she does weight-bearing exercises on her leg while her foot is planted on the floor, but no jumping or running or anything where she picks up her leg.
It is amazing to me how quickly her left quadriceps atrophied, and she still has work to do to get them built back up. But she is working hard at her therapy, and while hurdles and the long jump are out of the question, according to her physical therapist, running distance in spring track may be a possibility for Sports Girl at this point. We plan to discuss this with the doctor next week as track will start almost exactly 3 months after the surgery, and this was the short end of the 3- to 6-month recovery time frame we were given.
While she is doing very well now, the surgery wasn’t entirely easy. Sports Girl spent one week taking the narcotic pain reliever, Oxycodone. The little white pills made her queasy and light headed, but she needed them – especially at night when the busyness of the day didn’t keep her mind off the throbbing pain. She had many pills leftover at the end of that first week, but she gradually weaned herself solely to Tylenol. She found that she didn’t actually need the potent pain pills to be comfortable. She didn’t like the way they made her feel in her head and her stomach, and she didn’t like knowing that they are classified as habit-forming drugs.
Sports Girl’s knee swelled to at least twice its normal size, but we diligently kept it elevated and iced almost non-stop for at least the first week, maybe longer. As someone who normally sleeps curled up in a ball, I know Sports Girl didn’t adapt well to being forced to sleep lying flat on her back. There was just no other way for her keep her knee stable and elevated.
Sports Girl also struggled with the lingering numbness she felt in her leg, probably a prolonged effect of the nerve block she had for surgery and also a possible side effect of the long hours she had her leg elevated. But after a couple of weeks, she finally regained complete feeling in all of her left leg and foot.
I think some of Sports Girls struggles involved getting past her own fears. For example, my fashion-conscious teenage daughter wore the absolutely ugly white TED compression hose/leggings even longer than instructed. She also continued to bandage her incisions long after anything was draining, and she covered them with plastic wrap before taking a shower much longer than the doctor ordered. I believe she actually dreaded losing the pieces of tape that covered the incisions.
And while Sports Girl was quick to ditch her crutches, she wasn’t as eager to leave her large black leg brace behind. She wore the brace for a few days longer than necessary, but that was fine with Handsome Hubby and I. The roads, sidewalks and walkways around here have been covered in ice for much of this winter, and the brace served as a small insurance policy in case she fell.
The surgeon attached the cadaver ligament to Sports Girl’s femur with one dissolvable screw and to her patella with two screws that will not dissolve. According to the doctor, the dissolvable screws are too soft to be driven into the kneecap. The fact that the ligament will eventually be naturally attached to Sports Girl is reassuring and weird at the same time.
The surgeon could have used a piece of Sports Girl’s hamstring to replace the MPFL, but he wanted to leave the hamstring intact in case Sports Girl ever needed an ACL repair. Evidently the hamstring is the preferred tissue of choice for this type of repair. The surgeon assured us there was no risk of rejection using a cadaver ligament, and the recovery time is a bit less as the hamstring is not further weakened.
Sports Girl applies lotion with vitamin E on her incision sites daily as well as Mederma to reduce scaring. She will also need to wear sunscreen faithfully all summer as the surgeon said sun exposure in the first year makes scare appear more pronounced. I am picturing a tanned teenager with a white knee — similiar to how she looked last summer when she was wearing the black knee brace while playing sports.
The initial news of being sidelined from basketball and spring soccer was devastating for Sports Girl. But as she watches her former teammates wind down this basketball season, I think she has actually gotten a bit accustomed to her free time and has actually somewhat enjoyed this break from her sporting activities.
I believe Sports Girl’s biggest obstacles from this point forward could be overcoming her own internal fears as she regains trust in her knee – that and finding the strength and time to recommit to the sports she loves. So now we hope and pray that Sports Girl has the drive and dedication necessary to get ready this summer for high school sports in the fall. But first we need the surgeon to release her for full participation. I don’t think this will happen next Monday, but it might happen in March or April …
Filed under: Patellar Subluxation