Saturday, 21 November 2009

Knee Surgery Part 1

I injured my knee the week I started this blog in February, mentioning it in my first post.

What I don't mention is exactly what caused it. It was this. Skip to the 4-minute point in the video. This is a fantastic exercise, but after about 15 reps done at full effort, my form starts to slip.

On this occasion, my left foot placement was not correct when I pivoted the dumbbells over my head to move into the squat thrust. My leg was fully flexed but not at a good angle, so when I quickly extended it to thrust, something popped out.

To get it back in, I had to fully extend my leg. Ouch. Once it was back in, it felt okay, so I did a Tabata on the rowing machine. I have no idea whether this did any more damage, but in retrospect it seems like a really stupid thing to do. At home I iced, elevated and compressed, and it seemed okay the next day - just a little tender.

10 days later it popped out again when I was stretching. At this point I was referring to the problem as "my medial collateral ligament popping over my knee cap", which I later found out not to be true.

Over the next few months, it happened a few times. I got quite good at popping it back in. Then I got quite good at avoiding it popping out in the first place. All I had to do was ensure good form and avoid excessive knee flexion. I was even doing pistols.

When I visited the physio, he manipulated my leg in various ways and announced himself to be unsure. When he inadvertently popped it out himself and heard the 'kerchunk' sound it made when it went back in, he immediately referred me for an MRI scan.

For the scan, they strapped me to a stretcher, stuck a pair of headphones on me with the radio channel of choice, cranked me into a huge, cylindrical device that looked like the Hadron Collider, then asked me to keep totally still while it made so much noise I couldn't hear the radio anyway.
This was not the machine I went into, but it looked the same: . Sadly this was not the nurse who looked after me either ;-)

Weeks later, the specialist scratched his chin before the startlingly detailed 3D representation of my knee this ordeal had yielded, then pronounced himself convinced. I had caused a small but significant tear in the shock absorber between by calf bone and the knee.

Bottom line: I could have a small operation now, or a large one in 30 years. The small one would be easy peasy - keyhole surgery, in and out in a day. Knee brace for a couple of weeks. If I were a footballer, I'd be back on the pitch in 6 weeks. So I booked the operation for the beginning of this month.

The surgery was a pretty slick affair. They knocked me out with propofol while asking me superfluous questions I now realise was to distract my attention while they administered the drug. I awoke 45 minutes later.

As I sat drowsily contemplating my strapped up, post-operative leg, the surgeon swung by to tell me the good news and the bad. Good news: he had found the interior of the knee to be healthier than expected - a good blood supply, apparently. He was therefore able to stitch up the tear rather than remove some tissue.

The bad news: this now meant I would need to wear the knee brace for 6 weeks... and if I were a footballer, it would be 3 months before I was back on the pitch. Since I was high on morphine and residual propafol when he delivered this news, I thanked him warmly and told him how pleased I was.

When I was alert enough to be driven home by Mrs M later, it was a struggle to get into the car. The brace holds the leg almost entirely rigid.
At home, I inspected the damage and took some photos. This is the brace on the knee: . Fashion was going to have to take second place for a while.
I would, of course need crutches to get around at any speed: .

Underneath the brace and the bandage, this was the scene. You can see the arrow drawn pre-operatively to ensure the surgeon got the correct knee: . It's difficult not to be amused by this apparently crude approach - but if it had been an amputation they were performing I think I would have welcomed every possible precaution, however basic.

Finally, the wounds underneath, complete with neatly tied sutures: .

I had gone into the operation without any real thought about the practicalities of recovery. This was partly because I had expected it to be relatively brief.

In fact there have been some significant challenges. The two small holes over my knee cap, which after 2 weeks are little more than small scars, belie considerable turmoil beneath.

In part 2:
  • Battling to prevent my left quad from wasting away
  • Reluctantly taking the meds and treating the swelling
  • Some good workouts using crutches
  • A video of the operation? I have been told that most operations like this are recorded and DVDs are often provided. I've emailed the specialist's secretary to ask for mine, and will of course share it with you if she obliges.
Knee Surgery Part 2: Drugs, Muscle Wastage & Crutch Workout Videos


Chris said...

Interesting stuff!

The original exercise that you hurt yourself on looked like a recipe for a back injury (for me at least!)

Hope things improve soon

best wishes

Methuselah said...

Thanks Chris. Things are definately on the mend. One thing this kind of experience teaches you is patience!

Felix said...

Get well soon, M!

Calvin said...


Sorry to hear about your injury, but glad that to hear that you opted for the short-term minor surgery, rather than the long-term major one. With your dedication to health, fitness, and applied knowledge, I'm sure that you'll well on the road to recovery in half the expected time.

Best wishes for a speedy recovery,

In health and fitness,


Methuselah said...

Thanks Felix and Calvin - nice to have the support. Will keep you posted on progress.

Alexandra said...

I've had ACL replacement on both knees. I'll weigh in on your story once I get home and give it a proper read through!