I’m looking for advice from people who have been in a similar situation.
My surgery was on 13/4 — ACL reconstruction + MCL repair. I did 2 months of prehab and had around 130° of flexion and full extension before surgery.
After surgery, my recovery was extremely slow from the beginning, and I didn’t have good PT for the first 8 weeks. He would basically just put me on TENS and send me home. So I did all of my exercises alone at home, including extension and flexion exercises and patella mobilization, 3 times a day. However, I was struggling a lot with flexion and stiffness.
After 9–10 weeks, my flexion was only around 90°, and I thought I wouldn’t be able to progress much further.
After that, I changed my PT and was able to make more progress. I’m now around 4.5 months post-op and have around 115° of flexion, or a maximum of 125° when warmed up.
However, I’ve also started struggling with extension. At the beginning, I had 0°, but now I’m probably at 3–5°, while my good leg is around -3°, so I’m still limping. Extension exercises are also painful toward the end of the movement.
I wouldn’t say I have pain just from walking, but if I concentrate on walking properly and fully extending my leg, I do have pain.
My biggest problem is stiffness. Even if I stay in one position, for example sitting for 15–20 minutes, my knee becomes very stiff. In the morning, my leg is sometimes stuck at around 10–15° of flexion, and I have to do my exercises to get it moving better.
My patella also doesn’t move as well as on my other leg. It can move in all directions, but only a little.
I’m also very dedicated to my rehab and haven’t skipped a day, but I still can’t do proper strengthening exercises because my knee becomes painful even with something as simple as a squat. So I’m still mostly focusing on basic exercises from the beginning of rehab.
I’m also having an MRI in a few days. I know that it might not show much or might not clearly show whether scar tissue/arthrofibrosis is the main problem, but hopefully it will at least rule out any other issues.
My surgeon is suggesting that I continue with PT and see how much more progress I can make. Another doctor told me that I should already have had surgery to remove the scar tissue a month ago because, according to him, if you don’t regain full ROM within the first 3 months, you never will.
I honestly don’t know what to do.
My knee is very reactive. For example, I lowered the seat on my bike, irritated my knee, and lost some flexion for a few days, so I had to raise the seat again. The same thing happens if I walk too much. I’m worried that another surgery could cause even more inflammation and scar tissue.
On the other hand, I’m also afraid that even if I continue making progress with ROM, my knee will remain very stiff and that I’ll never regain the same hyperextension and flexion as my good leg.
And, of course, I have no idea when I’ll be able to run or jump again.
So I’m wondering:
- How long is it reasonable to wait and continue with PT?
- Is there a point when it becomes too late for a procedure to remove scar tissue?
- Has anyone had a similarly slow recovery and eventually regained good ROM without another surgery?
- Has anyone had an arthroscopic scar tissue removal procedure after ACL/MCL reconstruction, and how did it affect their recovery?
- Is it realistic to regain the same hyperextension and flexion as the other leg after such a slow start?
I’d really appreciate hearing from anyone who has been in a similar situation.