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Urgently need your advise for the sake of my knee

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Hi,

I am 4 weeks post-op from Left Knee Double Bundle PCL Reconstruction using Allograft with Autograft and Medial Menisco-capsular Separation Repair. I was issued with this useless GII Universal brace that doesn't feel any support at all, unstable and definitely have no confidence wearing it. Few occasions where I accidentally slip and it hurts my recovering left knee so much! There are cases where patients had to undergo second surgery because their allograft snaps due to unforeseen mishaps. I wouldn't want that to happen to me, I prefer prevention, can't go through another surgery.

I really need your help and advise on how do I convince my Dr to prescribe me the medically proven best brace, CTI2 brace. A pair would be great since Dr said my recovery will take 8-9mths time before I can start running, so at the mean time I am using tremendous strength from my non-injured right leg/knee to support my whole body for my daily routine movement and exercises. I wouldn't want my right knee to get hurt either. My company paid for the surgery because I injured my left knee during while on duty, so the CTI2 brace will be paid by them too only with the Dr prescription. I’m meeting my Dr this Thursday, keeping my fingers cross....

Looking forward for your advise. Thanks.

Best Regards. Ride safe.

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Hi Dr Mark,

Thank goodness, they did not repair the ACL because it was uninjured based on the MRI.

Currently my knee hurts a lot and the GII Universal brace doesn't help at all neither gives any support. Walking to rehab is miserable; honestly I rather walk without it.

Ok, maybe I should inform you how I got these injuries. Last year I under estimated & over-cleared a triple therefore crashed brutally (just wearing normal FOX knee guard) hurting my left knee mostly. However I’m able to get up much later pack up and head home. Rested few weeks and then started riding again but not so hard. Felt the pain, but figured it must be the swell so ignored it and kept blasting the throttle enjoying my ride. March this year while at work, jumped across my ship to another ship and didn’t get a good landing due to the choppy sea state, my left knee hurts so very bad that I decided to have it checked after my shift. Process was very slow, and later discovered that my PCL was torn & medial meniscus separation.

So hope this info is sufficient and looking forward to ride again. But first I prefer using a good brace during my recovery period so I can resume my activities as well prevent further injury. Really hope to try convincing my Dr to prescribe me a pair of CTI2.

Appreciate your kind advice Dr Mark. Thank you.

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There is no brace that can prevent backward subluxation of the knee. I do not put any of my patients into braces in the post op period.

Only an extenal fixator, a device consisting of pins going through the bones attached to a outside rod, can prevent backward subluxation of the knee. Doubtful that you want one of those.

Any doc who is clever enough to do a double bundle PCL recostruction is smart enough to know this.

Neither has bracing ever been scientifically shown to decrease knee injury in MX or any other sport. For that reason, I don't perscribe braces for MX, except at patient's request. Since I don't think any of them work worth a darn, I let the guy choose his brace, if he wants one, so if another injury causes his knee to fall apart, he can tell me is becase of the brace that I selected.

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Yup, you are right. I wouldn't want that device consisting of pins going through my bones attached to a outside rod on me.

So my current worries are; while recovering now without brace if I accidentally exert too much force again can the double bundle PCL reconstruction done in my knee give-way or snap? Or will it do much more damaged than just snap?

Ok, if without brace how would you suggest that I keep my injured knee healthy again so I can resume my activities as well as help prevent further injury?

For your info, I’m doing my rehab 3x a week. And am trying not to depend on these two crutches I’ve been clinging-on to for 4 weeeks now….,but in vain it’s like I’m jumping rather than walking without the crutches.

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If the work was done correctly, ordinary activities will not cause damage. You should be on a program of stationary biking, one hour per day.

BTW, what tendons were used in the reconstruction?

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For the first 6 weeks I am on light exercises basically on fist, leg-raises 4 rotations, bridging, calf-raises and ice. Not yet on stationary biking because bending of the knee are to be avoided for this 6 weeks after surgery, counting down to 9 more days now…, but however I did bend it 20-30 degrees sometimes, hope that it doesn’t do any damage…

Tendons used in the reconstruction were Peroneus, size: 270mm x 6mm, folded diameter: 8mm. Plus took my hamstring as well joining it to make it fatter, supposed to make it stronger??

Initially my Dr wanted to use Posterior Tibialis but not available. Next choice was Anterior Tibialis but again not available, so eventually they used Peroneus. Is it ok Doc?

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I never use allografts. I think they are not for collision athletes, but may be ok for people who work out at heath clubs.

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