Recovery and Rehab Update (Weeks 9 to 14)…Follow-Up MRI and a Gel/Steroid Shot

From weeks 9-12 I continued to have issues with knee swelling but managed to make some progress on range of motion and quad strength. I began to do partial squats and modified split squats and other more intense exercises. Exactly 12 weeks out from the surgery, I had a follow up MRI. Originally the plan was not to have an MRI until a year after the surgery, but the continued swelling and lack of kneecap mobility were clearly concerning to my orthopedist. I was worried I was experiencing a graft failure of some sort. I began to fear revision surgery. One knee surgery is already more than enough for me to deal with.

The MRI showed that the grafts were doing well. A relief for sure, but there was some not great news in the MRI as well. From the MRI report: “Note is made of severe scarring within Hoffa's fat pad as well as marked thickening of the synovium, with a joint effusion. There is fairly intense edema within Hoffa's fat pad as well related to synovitis.”

My orthopedist responded to this MRI finding (synovitis) by suggesting a gel shot with 40 mg of Kenalog (a steroid) added. I (somewhat reluctantly) agreed. In the two weeks between the MRI and the injection my swelling declined a bit and I had some of my best strength workouts. Worried a bit about potentially reversing the progress I seemed to be making, I went to NYC and received the shot (6 ml/3 injections worth of Orthovisc + Kenalog) just yesterday morning.

The shot was painless, but the large volume (usually Orthovisc is administered in three 2-ml shots each separated by a week) left me knee feeling kind of stuffed. By the time I went to bed last night my knee was very swollen. Today it was a little less swollen and I was able to do some light exercises (quad sets, SLRs, etc.) and 20 minutes of very easy cycling. I’m hoping that swelling goes down and I can resume making good progress in the coming days.

Oh well, no one said this would be easy. I started this blog more to describe the running comeback…not the details of surgery rehab. Being able to run again feels like it is still a long way off.