I am very grateful to find this organization and forum. My wife had ACL replacement surgery 5 months ago. During recovery, she developed arthrofibrosis and was never able to get her knee flexion beyond 80 degrees. She had been vigilant throughout her PT, so she definitely wasn't slacking.
Her surgeon recommended knee arthroscopy to remove the scar tissue. She would then immediately have much more flexibility in her knee, and the important thing for her to do in the 6 weeks following surgery is to "bend, bend, bend". She had that surgery 8 days ago. During the surgery he was able to flex her knee 140 degrees. After surgery, she went straight to PT and for the next couple of days was able to bend 120 degrees. That has now diminished to apx. 110 degrees, when her physical therapist applies strong pressure. She is flexing her knee and doing other exercises every waking hour for 10-15 minutes (to a point of discomfort but not exceeding pain), taking her meds including anti-inflammatories, using an ice machine religiously, etc. But (I'm sure you know where I'm going here), our concern is that her arthrofibrosis is returning and this recovery regimen may be doing more harm than good.
The surgeon said the surgery and PT has a 90% success rate. (Who are those 90% and shouldn't we roll the dice and hope she is one of them...?) But the way this may be trending leads us to believe she may not be among the 90%. We are grappling with whether she should stick to the regimen, even for another week, or two weeks, to see if there is increased flexion; or immediately adjust to only gentle flexion. I realize every patient is unique, but very much appreciate any thoughts.
Thank you! Mark
All, thank you again for your previous comments to this thread. My wife and I have some questions about IAA's PT guidance.
She is now 3-1/2 weeks post-surgery for scar tissue removal. She has followed IAA's post-op PT recommendations (gentle and passive only, CPM, etc.) My wife continues to have moderate swelling of IFP which has remained steady. She is comfortably at 124 degrees flexion and virtually at full extension. IAA AF PT guidance indicates no weight-bearing until inflammation has fully resolved, which usually takes 4-6 weeks (acknowledging that every patient is different).
if swelling doesn't abate at 6 weeks, is IAA's guidance that she should continue no weight-bearing until inflammation disappears? And, if so, what is a reasonable estimate as to how long inflammation may stick around (absent any weight bearing)?
At what point can we assume that she is free and clear? For example, if there is no inflammation at 6 weeks, and then she starts moderate weight-bearing and swelling reappears at Week 7, should that be a cause for concern? Same question at, say, Week 12? We're wondering if there is a "normal" amount of swelling that, at a certain point, is no longer a concern.
Again, thank you so much for sharing your thoughts!