It’s been more than three weeks since Tessa’s surgery in which she had an allograft, or cadaver MPFL, placed in her left knee, and so far her recovery has gone very well.
While I suspected that her condition was largely genetic since my oldest daughter, Callie, required the same surgery a few years ago, now I am not so sure. You see, Callie’s knee was tilted towards the outside and her lateral ligament on the outside of her knee was tight. As a result, in addition to the allograft, Callie also had a lateral release performed as well as a bit more work to straighten her patella. Tessa, on the other hand, required just the allograft and no additional work was performed on her knee to stabilize it.
The same doctor performed the surgery on both of my daughters. He said Callie’s ligaments were very tight while Tessa’s were extremely loose, so much so that her knee could almost be hyper-extended.
As a result of having less work done on her knee, Tessa had less internal irritation initially and seemed to recover even quicker than her sister immediately after the operation. The nerve block she came home with for two additional days of numbness also helped. Tessa was only on her prescription pain medications through Monday or 4 to 5 days, while Callie took the medication for one full week. Beyond that, their recovery has been very similar.
Tessa did not return to school until Thursday, Sept. 13, which was one full week after her operation. I believe she could have returned a little sooner, but she was concerned about being able to keep her leg elevated during classes. And keeping her leg up was key to keeping her swelling down.
After seeing her orthopedic surgeon for her first follow-up appointment on Monday, Sept. 17, Tessa abandoned her crutches. That was just 11 days after her surgery. The next day her physical therapist began to open her brace to bend up to 60 degrees at the knee. She then had it opened up to 90 degrees, even as she walked, one week later starting on Tuesday, Sept. 25.
Tessa experienced some serious muscle memory loss. It was over a week before she could reliably and consistently flex her left quad muscle, and even a little longer before she could lift her left leg without assistance. But she has been diligent about her physical therapy exercises, and we continue to see improvement.
Tessa leaves the brace off once in a while when she is lounging around the house, but generally she continues to wear it. She experiences some discomfort after a long day on her feet or if she moves wrong, and she still applies ice to her knee at night. But overall, she is doing well. Her wounds are about closed, and she has begun applying Mederma to them to keep her scaring at a minimum.
Even though her initial recovery was faster than her sister’s, I don’t expect Tessa to be released for full activity any sooner. The allograft was the most invasive procedure for both girls, requiring the most rehabilitation.
I still suspect it will be five months or more before Tessa can resume any joint-intensive activity such as hard running, jumping, twisting, etc. And it will probably be a year or so before she’s back to full strength and regains confidence her left knee.
And that’s all right. At least the most intense part of the fix is over. Now we just need to have patience and remain committed to her recovery, even when she starts to feel almost normal.
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