It has been a very long time since I have posted. I just had another appointment with my doctor, this is 14 months post surgery. While I was there I got a couple of pictures of my knee during the surgery. The first picture is of my knee before they implant the Carticil, it gives a very good picture of the area that is missing cartilage. The second picture is after they have sewn on the cover and injected the Carticil. I have an upcoming MRI to see how my knee has been healing. Hopefully I'll get back on in the future and give an update.

I met with the doctor this past Friday. The frustrating part of the cartilage replacement is that there is no way to tell how well it is going until I get to the point where I can really try it out. The only thing I can tell is if there is something going very wrong, thankfully that is not the case.

The doctor felt my knee and listened while I bent it to see if there were any crunchy sounds/feelings. There were not, on the occasion I still get that feeling but not very often. There is still swelling around the knee but that is normal for the procedure. I asked when the swelling should dissipate and I’m still looking at a couple of months before that happens. I then asked about the achy feeling and that will go away once the swelling does. I also asked if I was past the point of damaging the procedure and unless I do something foolish (like play basketball) or have a bad fall I am out of the woods.

The next thing the doctor checked was the ligament. He was very pleased with the graft and thinks that portion of the procedure went very well. At least I can know how one portion of the procedure went.

My last question for him was about a brace and they don’t start looking into that until I reach the six month area. That is when I can start doing more active things. The type of brace I would be fitted for is one that would take some of the load bearing off of the outside (where I had the cartilage replaced) of my knee.

At this point I am for the most part on my own. I don’t have another PT appointment until the mid of January and not another doctor’s appointment until the mid of February.

My leg seems to be getting stronger, I still have not progressed to weight lifting but I’m hopeful that is in the near future. I think by next week I’ll be starting lunges. Yesterdays PT session started out with a quick bike ride and then work on the ball doing both of the exercises I described last time. From there I moved to the disk, this is just a disk shaped object that is mounted on a half ball. I stand on that with one leg and rock it under control front to back. With two feet on it I rock it left to right. The next balancing exercise I did was stand on a snowboard shaped object that sits on two cushions. While balancing on that I play catch with Karen the Physical Therapist. The next exercise was side steps. With a tightly tied band around both legs a step to the side across the room. The next thing we did was walk on the treadmill backwards with tension on my leg. Not done yet, it was a long session. The last new exercise was I lay on a half cylinder with the flat side on the ground. I had to balance on that and march (lift both legs up and down in place). Surprisingly it was very difficult at first to balance when I lifted my right leg. The last thing I did before I left was work with the exercising balls again.

My home regiment has not changed much. I need to continue to do all of the exercise I had been doing and ad the side steps with the band tied to my legs.

It’s the day before Thanks Giving and I am working my but off. Karen had me doing a couple of new exercises today as well as riding the bike. She had me using one of the exercise balls. First I started in the sitting position on the ball and then slid down so that my shoulder blades were on the ball and I was making a table with my body. I needed to balance my shoulder blades while maintaining a flat surface. This exercise seemed like it was more work on my stomach than my knee. The second one we did was I was lying on the floor and I put my legs on the ball. I then raised my hips, this one was very similar to the bridges I am currently doing at home. To make it more difficult on my legs and less on the balancing I did it with my knees bent.

I hope everyone had a nice Thanks Giving (or weekend if you’re not from the States). Mine was very nice but I didn’t do many of my exercises. Really, the only exercising I did get in was walking my dog every day. Walking the dog tends to aggravate my knee and has been recommended by Karen not to do. I’ll have to get back into the swing of things this week.

The quads are very sore today. Better that than the knee itself. Once again started off the same way we always do, riding the bike. From there we worked on straighten my leg. Karen thought it was looking much better. Talked a bit about the how I think my knee is doing and what causes it pain. I mentioned that going down stairs still causes pain. We then proceeded to do stair exercises for about 15 minutes. From there I worked out on the treadmill while Karen put tension against my knee. I will be having PT again tomorrow.

I’m now at 10 weeks out from the surgery. If I look at stage II (6 – 12 weeks) of the rehabilitation the goals are gradual increase range of motion (ROM), gradual improve quadriceps strength/endurance, gradual increase functional activities. I have been working on all of the above. The criteria to progress to phase III is to gain full ROM, acceptable strength levels (hamstring 10-20% contra lateral leg, quadriceps 10-20% contra lateral leg), balance testing within 30% contra lateral leg, able to walk 1-2 miles or bike 30 min. Of the criteria I can understand, my ROM is now at 135°, so I am close. I can already walk over a mile and bike for 30 minutes. I’ll have to find out in understandable terms how to measure how close I am when it comes to strength and balance.

My next post will probably be on Monday so have a very nice Thanks Giving all.

Most of my PT yesterday was spent on straightening my knee (again). It started out like it almost always does with me warming up on the bike. From there I started a new exercise, I laid on my belly with a rubber band strapped to my ankle and the other end strapped to a table. I then had to bend my leg up toward my head and hold it. This is to help strengthen my hamstring. From there I went on one of the beds and Karen (the physical therapist) worked on my knee. This is probably the third time we have done this, I lay on my belly and she puts a foam cylinder or other object under my thigh and bends and massages my knee back (to straight). By the time she is done my knee hurts but I guess it is straighter. From there I went to the treadmill to walk backwards once again. This time I walked with tension on my knee. Again I used a rubber band wrapped behind my knee and Karen was holding the other two ends. She would then pull back on the strap forcing tension on my leg while making steps back.

For my daily exercises I can now drop the knee extensions as long as I get Mrs. Bentley to put tension on my knee while I do the treadmill. I have to also add the leg curls that I described above. So that makes it for strengthening: calf lifts, mini squats, leg curls, bridges, and stairs; for gait: treadmill with tension (walking backwards). I still need to continue to do balancing exercises and stretching.

As an added bonus this week I was sent home with an electrolysis unit (free use for one week). This is different than the micro-current unit I used earlier in the rehab. The electro-stim is the unit that will actually make your muscles contract. I actually enjoy this unit, I find it a really cool sensation having the muscles do that.

November 14 and the PT is starting to get long again. There is good and bad in this also (see my last two posts). The walking is getting better but it still doesn’t feel exactly right and when my leg gets tiered I start to limp in a big way.

I started off my session the same way I seem to always do, riding the bike for about 20 minutes. My right knee seems to bend back a bit and Karen (the physical therapist) seems to now think the left will never do that again but it should be able to make it to full straight. On the bright side it is probably a good thing that it does not bend back at all. From the bike Karen worked on my knee trying to increase the bend. From there I went to the treadmill. She had me walking backwards on it to help with my gait. I continued on the treadmill for about 15 minutes. We then worked a bit on balance and then step-ups; I am now doing side step-ups.

By the end of this session my leg was quite tired. By that evening my leg was once again screaming and I was totally wiped. Wow is it nice to be back to the old regiment!

My daily workout schedule is now riding the bike for 20 min. For strengthening I do calf lifts, mini-squats, bride and step-ups (front and side). For gait knee bends and walking on the treadmill backwards. For balance I stand on one leg, usually on a pillow so that it is not an even surface, and play catch with one of my boys. I also continue to bend the knee to increase its range of motion.