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Noticed knee and ankle swelling after surgery. Placed on CPM. Feeling painful. Leg and foot turn blue when stand. Cure?

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Orthopaedic Surgeon
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Hi - I am post fractured left knee patella almost 4 months and still having problems. I had surgery on 13.4.2013 and discharged the next day with rigid brace to leave on for 6 weeks. At first Orth appt, my knee and ankle were still swollen and everytime I stood up, my whole leg would turn blue..I was told to continue with brace and weightbear as much as possible. Shown how to use crutches and given some pt exs to do. At 2nd Orth appt, 6 weeks later, registrar was concerned and booked me for an MUA next day. They achieved full ROM in MUA and I was placed on CPM overnight achieving 90 deg. Next day continued CPM but very very painful, so reduced to 80 deg - given PT exercises, mainly straight leg raises, XXXXXXX squats, knee bends sitting on chair.....never reached 90 deg at the most. Discharged with exercises but leg still very stiff and painful. 3rd Orth appt seen by actual surgeon who was concerned that I was still using crutches, but wasnt too concerned and said to continue with exercises and try to get off crutches and to see him in 3 months time (which was from 2.5 weeks ago) when the wire will be removed. He says once removed my ROM should be easier to achieve.

But now almost 4 mths post surgery my ROM is zero, my leg and foot still turn blue when I stand and - ankle always swells when I stand, leg also feels "heavy", muscle wasting in calf still prevalent and i am scared of having to have this done all over again. I visited my GP yesterday who was very concerned, said there could be infection in the knee as it felt warm, but it has always felt that way. I should note however, that attending pt sessions is difficult for me as I cannot drive and my husband often works away - and we need the money as I have lost my job because of this injury. We live in Queensland Australia.
Posted Fri, 23 Aug 2013 in Back Pain
Answered by Dr. Praveen Tayal 41 minutes later
Thanks for posting your query.
The persistent pain and swelling around the knee and the ankle is due to the stiffness caused by the fractured patella and mild inflammation in the area.
Since there was a full range of movement at MUA, there is no need to worry. Your surgeon is correct in saying that once they remove the tension band wiring, your pain and discomfort will decrease, and with the help of regular physiotherapy sessions and hot fomentation, you will gradually achieve a full range of movement.
You can start with some simple knee exercises at your home also after being guided by your physiotherapist.
In case of knee injuries like fracture patella, it often takes time and considerable effort to have a complete recovery.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Please accept my answer in case you do not have further queries.
Wishing you good health.
Dr. Praveen Tayal.
Above answer was peer-reviewed by
Follow-up: Noticed knee and ankle swelling after surgery. Placed on CPM. Feeling painful. Leg and foot turn blue when stand. Cure? 38 minutes later
Hello Dr Tayal

Thanks for your answer which has made me feel so much better but should I not be concerned especially at this stage about walking unaided, the stiffness and feeling heaviness and a tight "band" around my knee, or is it the tension band that is causing that?

Answered by Dr. Praveen Tayal 37 minutes later
Thanks for writing again.
The stiffness and the heaviness is due to the post traumatic stiffness which will ease down gradually. Do not force yourself to walk unaided. This will take time and you will feel better once the wiring is removed.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Above answer was peer-reviewed by
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