Thursday, December 29, 2005

To knee or not to knee?

Well the dust has finally settled somewhat on the whole knee thing so it's time to report (okay, you saw through me, I've just been slack about writing about it). Paul had his surgery last Tuesday night (despite being scheduled for 4pm, he finally made it into surgery around 7pm). All went as well as these things do, I gather. That is to say, his anterior cruciate ligament was completely torn apart, but it's a fairly routine (if painful) procedure to replace that. For the queasy among us, I won't mention it involves taking a third of the patella tendon complete with bone plugs, drilling holes through femur and tibia, threading the donor tendon through the holes and securing it with screws. That part was simple. The complicating factor is the stress fracture of the femur... This is not common (one in 25o, the surgeon said) and there is not a whole lot that can be done about it at this stage. Paul has to stay on crutches for four weeks (in a standard ACL op, often they don't get any crutches at all) and avoid any weight-bearing or pivoting. After that, he will have an MRI to check on the healing of the stress fracture (which is not technically on the bone, but in the hardened cartilage right on the end of the bone - think the shiny white end of a chicken leg). If it doesn't heal properly by itself, he will probably have to have a bone graft. I'm guessing that's not a fun operation.
By all accounts, Sportsmed and Dr Keene were great (as you would expect with an url like as were the nurses. I don't think he was so fond of the passive movement machine which continually forced his knee up to 90 degrees almost immediately after the operation, for three hours. Ouch. One cool thing is that the doctor took photos as he did the operation and Paul got a neat little write-up of what happened. That's this pretty photo right here.

Recovery has been slow and arduous. He has a bunch of exercises to do several times every day. He is just now able to get the leg to 90 degrees himself, but still can't straighten it fully. The pain was and is constant and strong, helped now somewhat by the illegal possession of very strong painkillers courtesy of Stan 'in the hospital they call these morphine' F. The leg swelled up big time, and along both sides of the foot it looks like a giant bruise where I assume the blood has pooled. Swelling has gone down now, and there is more movement with a little less pain, so things are slowly improving. Next week is the physio appointment, where they will be expecting him to be able to do the straighten and 90 degrees thing, then the week after is the follow-up with the surgeon. From there, they will book the MRI to see how the stress fracture is doing.
So no prospect of returning to work any time soon, although he did drive today for the first time.

No comments: