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Is Rejection Of Cadaver Possible Years After ACL Repair?

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Posted on Wed, 18 Feb 2015
Question: I had an ACL repair 2 years ago in my left knee. My MCL was also ruptured, however they said it would heal on its own. Used a cadaver for the ACL. Had a block done for the surgery where they went in thru the left groin to inject the stuff. I Have some screws. When the block finally wore off, approx. 12 hours later, I was in so much pain that I asked for my leg to be cut off. I came out of surgery in knee brace with instructions of non weight-baring, locked out in straight position and on crutches for 4 weeks. Went to Physical therapy as instructed. I came out of surgery with no feeling from the knee cap down to my ankle, still don't. I have seen a neuro and had nerve test, very painful, but no results found. Have had a second opinion stating that my ACL is a little lose and I could have 2 more surgeries to fix it, however had no idea what caused the "no feeling" in my lower leg. I have always had pain since the surgery, and soreness to touch and puffiness around where once of the screws is (lower righthand side of left knee cap).

I woke up this past XXXXXXX 5th with extreme pain, I couldn't bare any weight on my left leg. Had to put on my knee brace and use crutches. I had swelling around the area where my screw is located. I went to ER. Had bone xray, was given a muscle relaxant and told to wear my knee brace and follow-up with Ortho surgeon. I didn't take the muscle relaxant, as I felt I was not diagnosed properly. The first week ofJanuary I had constant swelling and severe pain throughout my knee, it hurt to touch my leg, like rub it with hands. This extreme pain lasted one week. The next week, the extreme pain went from being a 10 to a 5, however it felt like the swelling had gone into my shin (a place that I cannot feel). I had burning sensation when I would flex my left foot or stretched. The following week, the burning sensation left my shin area and started to itch inside, I can't relieve this as I can't feel me rubbing my leg to help with the itch. My knee is still swollen and I continue to see and report my symptoms to my Ortho surg. He decided that it's mechanical and set up appt for me to see a PT. As I wait for my appt with the PT (2 more weeks go by), today I wake up and my knee is entirely swollen all the way around. I can't bend my knee to 90 degrees, nor can I straighten my left leg at all due to the severe swelling. It feels like my leg wants to burst open. I have numbness throughout the entire leg today. I call and leave yet another report of my on-going, strange symptoms to my Ortho Surg. I have a follow-up appt. on Monday with PCP and PT. I'm extremely frustrasted and tired and want to know what is wrong with my knee and what is causing this swellen. It hasn't gone down regardless of me taking Advil, icing and elevating my leg up over my heart, been sleeping with it elevated too. I have a desk job and sit most of the day. Today I'm dragging my leg with me. Can anyone explain what it is that is going on? Can I be rejecting the cadaver after 2 years surgery, could I be reacting to the screws, is it mechanical, because the more I'm up and on it and doing things, the worse my knee gets. I have a prescription to take some nerve pain meds at night, and will start that this evening. Not sure that will help either. I'm looking for answers, I feel my doctors (1 entire month) have given me nothing to get better or illeviate the pain at all, or subside the swelling. I wake up this way.

Any help is greatly appreciated.

Mrs. XXXXXXX (age 46)
doctor
Answered by Dr. Vaibhav Gandhi (7 hours later)
Brief Answer:
further investigation required

Detailed Answer:
Hello
I have studied your case and history.
I have sympathy for long duration of pain.
persistent swelling after ACL reconstruction needs further investigation.
Yes this can be inflammatory response due to cadaveric graft.
PET scan will help you to find high uptake spot.
few investigation like knee aspirations and culture will rule out infection and inflammation.
Till time take high dose anti inflammatory and medicine like trypsin and chymotrypsin to reduce swelling .
Physiotherapy like ultrasound and Tens may give you relief.
I hope I have answered your questions. If you have further questions please feel free to contact us. I will be happy to answer. Take care.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
Answered by
Dr.
Dr. Vaibhav Gandhi

Orthopaedic Surgeon

Practicing since :1998

Answered : 5164 Questions

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Is Rejection Of Cadaver Possible Years After ACL Repair?

Brief Answer: further investigation required Detailed Answer: Hello I have studied your case and history. I have sympathy for long duration of pain. persistent swelling after ACL reconstruction needs further investigation. Yes this can be inflammatory response due to cadaveric graft. PET scan will help you to find high uptake spot. few investigation like knee aspirations and culture will rule out infection and inflammation. Till time take high dose anti inflammatory and medicine like trypsin and chymotrypsin to reduce swelling . Physiotherapy like ultrasound and Tens may give you relief. I hope I have answered your questions. If you have further questions please feel free to contact us. I will be happy to answer. Take care.