Hi all, just trying to see if anyone has any advice or been in this situation before... In Nov 2021 I had an accident from a medial blow to my leg and suffered a lateral tibial plateau depression fracture, some microfractures, a lot of trauma to soft tissues and ligaments, medial and lateral meniscus tears. Initially I was told I didn't need an operation and was non weightbearing for 6 weeks with a brace set at 45 degree flexion. Unfortunately, I wasn't told to do any exercises so my muscles severely atrophied. Following progressive weightbearing after the 6 weeks, I had multiple issues. Pain in the medial side of joint and patella when contracting quads, pain to the medial side of centre in the joint, along with feeling of obstruction (which I assumed was the meniscus tear), instability of the leg when walking where my leg swayed from side to side (which I assumed was the fracture). After 6 weeks of no improvement I saw a surgeon who said the fracture needed an ORIF plate/screws. On 22 Feb 2022 I had a plate and screws with hip bone graft and a stitched repair of lateral meniscus tear. No arthroscopy was done at the time and I was told the medial posterior horn meniscus tear was degenerative and didn't need debridement.
Following the operation I was non weightbearing for 4 weeks. Following progressive weightbearing it became apparent that none of the previous problems I'd had were rectified by the operation, and instead I had more problems. Now, 4 months on from the op and 7 months from the accident I have multiple issues.
The Plate/Screws: I have a big lump, swelling, pain, inflammation at the top of the plate and down the side and front of my leg. It constantly rubs on the soft tissue and I can feel the plate/screws through the skin. The muscles around the scar are solid and some parts seem as if they are stuck on the plate or with scar tissue. The ligaments rub when I move my knee. It's constantly painful resting but worse with any movement that involves the joint like walking or trying to do exercises. I've been advised I need to wait until it's been in for 6 months to get it removed to allow the fracture to heal, but the pain is becoming more unbearable and my leg less functional as the time goes on. It feels like it's doing a lot of damage the longer it is in and I need a balance between the problems it's causing and the pain/swelling.
Functional problems: Since the operation my patella has been unstable. I can't stand properly on the leg because I can't relax my patella when standing because it feels like my knee will collapse. My quad tendon keeps contracting. When I actively try and relax my patella, which only lasts a few seconds, my patella only goes half way down compared to my good knee. The patella feels like it's in the wrong place and twisted and is catching on something, and it sort of pops on and off whatever it's rubbing against. It doesn't glide up and down freely or completely. I don't remember having this problem prior to the operation. I can't put weight on my leg with it in a standing bent knee position because of pain/obstruction in medial side of joint, along with pain behind the kneecap and the patella tendon. I also have bone pain from the femur and tibia either side of the medial joint line.
It's very hard to even walk. There is something painful obstructing the joint just medial side of centre which feels more like bone, not meniscus. My leg doesn't flex and extend in a straight hinge movement anymore. It now goes medially and laterally when I bend my leg so when walking my knee leans inwards then out, causing pain in MCL/LCL area, as if they're being stretched. The pain from the plate is excruciating when walking. I'm using a brace and walking stick. My knee swells more after walking/exercises. I also have increasing pain down the front of my leg.
I also have pain and swelling in the area of the patellofemoral ligament, patellotibial ligament, patellomeniscal ligament, patella tendon, area medial to the patella tendon. No ligament tears have shown up on MRI. I've been advised the LCL/MCL/ACL are loose and wavy. There is also traumatic cartilage damage to the joint surfaces, and the patella, where the medial side of the patella has also completely lost cartilage. There is meniscus degeneration and possible tears, along with calcification of meniscus and loss of joint space.
I've been doing physio exercises for 6 months and although my muscles are stronger than they were, my leg function/pain/instability is not improving. I had trouble with quad exercises because of the pain on the area medial to the side of patella when contracting my vastus medialis or movement of patella. Every time I try to progress to functional exercises like step up/down, wall slides, mini squats, the pain gets worse due to the obstruction in medial side of joint, pain behind patella, instability, the joint not bending and extending in a straight line, and hardware pain. I can't walk up/down a slope or up/down stairs because of these problems.
Prior to this accident I was an active person and it has completely changed my life. I've been trying to get different opinions from other surgeons as I wasn't happy with my original surgeon who has basically said he can't do anything for me because it's too early for TKR. I have multiple problems with the plate, kneecap, and joint. 1 surgeon said he could remove the plate after it's been in there 12 months and arthroscopy to try and clean up the joint but he's not sure how much it will fix but he didn't want to do TKR because I was too young. Another surgeon has said the same or that he can go straight to TKR. Both have said the accident has changed the biomechanics of my kneecap and the plate may be hindering it's position and that there may be scar tissue also contributing but haven't really been forthcoming about whether a TKR would help reposition it. Any advice welcome...
Following the operation I was non weightbearing for 4 weeks. Following progressive weightbearing it became apparent that none of the previous problems I'd had were rectified by the operation, and instead I had more problems. Now, 4 months on from the op and 7 months from the accident I have multiple issues.
The Plate/Screws: I have a big lump, swelling, pain, inflammation at the top of the plate and down the side and front of my leg. It constantly rubs on the soft tissue and I can feel the plate/screws through the skin. The muscles around the scar are solid and some parts seem as if they are stuck on the plate or with scar tissue. The ligaments rub when I move my knee. It's constantly painful resting but worse with any movement that involves the joint like walking or trying to do exercises. I've been advised I need to wait until it's been in for 6 months to get it removed to allow the fracture to heal, but the pain is becoming more unbearable and my leg less functional as the time goes on. It feels like it's doing a lot of damage the longer it is in and I need a balance between the problems it's causing and the pain/swelling.
Functional problems: Since the operation my patella has been unstable. I can't stand properly on the leg because I can't relax my patella when standing because it feels like my knee will collapse. My quad tendon keeps contracting. When I actively try and relax my patella, which only lasts a few seconds, my patella only goes half way down compared to my good knee. The patella feels like it's in the wrong place and twisted and is catching on something, and it sort of pops on and off whatever it's rubbing against. It doesn't glide up and down freely or completely. I don't remember having this problem prior to the operation. I can't put weight on my leg with it in a standing bent knee position because of pain/obstruction in medial side of joint, along with pain behind the kneecap and the patella tendon. I also have bone pain from the femur and tibia either side of the medial joint line.
It's very hard to even walk. There is something painful obstructing the joint just medial side of centre which feels more like bone, not meniscus. My leg doesn't flex and extend in a straight hinge movement anymore. It now goes medially and laterally when I bend my leg so when walking my knee leans inwards then out, causing pain in MCL/LCL area, as if they're being stretched. The pain from the plate is excruciating when walking. I'm using a brace and walking stick. My knee swells more after walking/exercises. I also have increasing pain down the front of my leg.
I also have pain and swelling in the area of the patellofemoral ligament, patellotibial ligament, patellomeniscal ligament, patella tendon, area medial to the patella tendon. No ligament tears have shown up on MRI. I've been advised the LCL/MCL/ACL are loose and wavy. There is also traumatic cartilage damage to the joint surfaces, and the patella, where the medial side of the patella has also completely lost cartilage. There is meniscus degeneration and possible tears, along with calcification of meniscus and loss of joint space.
I've been doing physio exercises for 6 months and although my muscles are stronger than they were, my leg function/pain/instability is not improving. I had trouble with quad exercises because of the pain on the area medial to the side of patella when contracting my vastus medialis or movement of patella. Every time I try to progress to functional exercises like step up/down, wall slides, mini squats, the pain gets worse due to the obstruction in medial side of joint, pain behind patella, instability, the joint not bending and extending in a straight line, and hardware pain. I can't walk up/down a slope or up/down stairs because of these problems.
Prior to this accident I was an active person and it has completely changed my life. I've been trying to get different opinions from other surgeons as I wasn't happy with my original surgeon who has basically said he can't do anything for me because it's too early for TKR. I have multiple problems with the plate, kneecap, and joint. 1 surgeon said he could remove the plate after it's been in there 12 months and arthroscopy to try and clean up the joint but he's not sure how much it will fix but he didn't want to do TKR because I was too young. Another surgeon has said the same or that he can go straight to TKR. Both have said the accident has changed the biomechanics of my kneecap and the plate may be hindering it's position and that there may be scar tissue also contributing but haven't really been forthcoming about whether a TKR would help reposition it. Any advice welcome...
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