excessive play s/p acl reconstruction??

a ? for Dr Mark--

I noticed before my surgery I could swing my leg laterally and actually feel how loose the joint was. I figured it was my MCL since I had sprained it at the same time as my acl rupture. Well I'm 11 weeks post op now and still can replicate that motion. Had a PT at work today test my knee out today and he said the odd thing is my anterior excursion (straight leg lachman) is the same as my donor knee and he can feel the acl is intact, when testing my PCL he said it very strong. However while going posterior with teh lachmans test displayed excessive play compared to my donor knee, and quite significant.. Said he has never come across that before. Guessing that would have to deal with the post. compartment?? What are your thoughts on that? I have no problems with my knee functionally at all, but am concerned about if that will cause problems when I get back into competitive running in teh summer. Have ridden twice now with no problems at all.

Thanks

If its functionally ok, I would stop screwing with it. My guess is that you aso have a PCL injury which, usually doens't amount to much trouble.

ahh another update.. didn't want to keep adding to this but I did happen to go out on a run the other night and pushed through 2.5 miles of pain on the medial side.

We checked it out again the other day and same findings. From what I understand the posterior capsule is taut while in full extension, and thats when I have greater poster excursion compared to my other leg. And testing for the PCL @ 90 degrees flexion was rock solid.. Like I said my MCL was sprained in the initial injury so I'm almost thinking that's contributing to the lax feeling -- how long does that take to tighten up, weeks, months?

A portion of the MCL connects to the capsule, is it common at all to see capsular injuries stemming from the stretching of that attachment?

The pain I got from running -- I can't explain where that came from.. I couldn't pinpoint where other than it was above or at jointline at the medial condyle. If I palpated around I couldn't feel any sore spots.. mcmurrays test was positive for a clicking on the medial side but I had no pain with it. Nor do I have pain when twisting single legged on that knee in either direction. The only other time I can feel a click is when I sit or lay and extend my knee from about 5deg to 0--and thats only when I exagerate my quad contraction, if its a light motion then I dont feel it. Same thing with standing.

Not meaning to ask a whole lot of questions here, but I seem to have everyone stumped.. I would have been fine with it but I think its way too loose to do any activity as of right now.. The running the other night didnt feel very good, I could barely do a single legged press after it. I'd rather get it tightened back up before i put my meniscus and ligaments at risk.. Thanks doc

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