Case Study 2

Case Study 2

Anterior Cruciate Ligament

Approximately 10 years ago I hit the ski slopes and they hit me back. An ill fitting ski boot failed to release on a fall, and my left knee helicoptered with sickening pain. I realised immediately that it wasn't a simple sprain or strain, but that I had done some real damage. After the accident I had keyhole surgery to remove any problem pieces of my cruciate ligament.

I went to see a consultant who explained possible surgery with me, and offered the alternative of a fitted brace.

I decided against the operation as its description filled me with dread and decided to go down the route of a brace and exercise to build up what I thought was the remains of a ligament, as it turned out there was no ligament left.

The following years I alternated between the brace for golf or sports, and a variety of knee supports, sometimes wearing two or three at a time. The chunky metal brace does not look very elegant under golfing shorts, even if like mine it is edged in blue!

My knee's instability gave way two or three times a year, causing pain and swelling for weeks at a time. Then it would heal and I would "forget" about it. Except I never really did. I always kept to low impact exercise ensuring that one foot kept contact with the floor. It became second nature to compensate for my weak knee. I never forgot to wear some form of strapping for golf or even swimming as sometimes I would get a certain movement in my knee joint reminding me that it could destabilise at any time.

Heidi filled me with confidence about the forthcoming surgery

New Years Eve 2007 and my foot slipped off the stairs, down I went, and I hobbled painfully into 2008. It was a particularly bad episode and one day I found myself thinking that I must do something, the prospect of living another three of four decades with this cloud over me was simply too much.

I made a Doctors appointment and was surprised how strong I felt that the time was right. She referred me to Mr Weir, a Consultant hip and knee surgeon at the Nuffield in Newcastle , who talked through the current procedure (much to my relief a tighter and more compact operation than I was first offered). He sent me to Heidi for pre-op physiotherapy and much more. Heidi filled me with confidence about the forthcoming surgery and its benefits afterwards.

I'm no spring chicken but I was filled with the promise of stability and freedom from future knee straps.

Physiotherapy, if it's to work to its maximum, has to have commitment. Heidi instilled this in me from the very beginning by telling me that as a rule men stick to their physio regimes better than women. I realised that she was probably right, so to avoid excuses of not enough time etc, I wrote my exercises down and ticked them off daily as I did them. I found this worked for me both pre and post operative.

The surgery wasn't a "walk in the park" and the first 8 weeks following were full of worries, pain and wishing it would repair quicker, but Heidi let me know my recovery was good and the results from my physio were as they should be. Each week was like a different "injury" feeling to my knee - more skins than an onion. But slowly I could feel improvement, the physiotherapy exercises working to build up the bruised and battered bones, ligaments and muscles to full health and strength.

I'm not quite there yet, still a little swollen and I have a round numb area, but for 8 weeks down the line I feel that there is a strong, stable and full recovery in the near future.

N.B. It is now a year plus since I had the surgery. I do have a slight numb area which is no problem and that I think could still be repairing slowly. The knee itself is slightly different to the other one, in so much as it is "extra stable" - like a stronger elastic band running lengthways through the joint. Not an unpleasant feeling, in fact quite reassuring. I continue to flex and exercise it and am able to do all my sports such as golf and swimming with confidence and no knee support aids . Looking back I realise that it was a difficult decision to make to have the surgery but am so pleased that I did. It has given me a future free from worry about "putting my knee out" time and time again. I am very grateful to Mr Weir for taking my case on (he could easily have decided that I was too old or the knee not in good enough condition to proceed), and for Heidi for guiding me through pre and post surgery, with sensible and achievable physiotherapy.

Maureen Brindle


Physio's Comments:

Mrs Brindle is a good example of what can be achieved when the right patient has the right treatment. Although her initial injury was years in the past, the instability of the knee remained the problem.

Mrs Brindle was hugely motivated and dedicated to her exercise programme and in combination with the surgery, her hard work really paid off. Sometimes exercise programmes have to be undertaken for months to achieve the maximum benefit and the motivation to keep going can be hard to find.

Heidi Trundle MCSP

 

Treatments Used

Rehabilitation

Improves/maintains the benefit gained with treatment.
Helps with recovery of normal function.
Reduces the risk of the injury recurring.

Home Exercises

An integral part of treatment, an individualised home exercise programme is used to reinforce the benefits made during treatment and to progress recovery.

Conditions Treated

Upper Limb

Lower Limb

Spinal

Sports Injuries

Vertigo

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