Recovery and Rehab Update (Month 6)…Not Much Progress

There is not too much progress to report here. The synovitis and associated stiffness and swelling of my right knee are still there full force. I’ve improved my strength on a few individual exercises (most notably “mini-extensions” of the right knee), but I’ve had a few setbacks where I had to drop or change an exercise that was causing too much swelling. I’ve had periods where I have felt really down about my lack of progress (especially on the 6-month anniversary of my surgery). At 6 months the goal was to return to full activity...but I can't even walk that well yet. I can't do stairs. I can't drive. I’ve wondered (or rather worried) where this is going and how it will end. I did make one change to my routine that has lifted my spirits a little bit…I’ve started doing some weightlifting and core exercises every other day. It feels good to be in strengthening/building mode instead of lying-on-the-couch-gaining-weight mode.

The one thing I have not tried since I started physical therapy the week after my knee surgery is some time of total rest. I’m wondering if that might help get the synovitis under control. Then I could try to rebuild slowly enough not to reaggravate my synovial membranes. The danger of this approach is that I could lose range of motion and quad strength and thus be set back for no good reason if there is no significant reduction in inflammation. My orthopedic surgeon (OS) has other ideas for the short term.

Some changes in my treatment and PT regimen could be coming. I’m visiting my OS next week. I will have a full physical assessment by an onsite PT followed by the OS visit. The OS has brought up the possibility of a platelet-rich plasma (PRP) injection and then, if that doesn’t bring results, a synovectomy. I can’t say I’m excited about receiving PRP, but I think it is safe enough that I will give it a shot (if that is what my OS thinks is the next appropriate step). However, I’m not at all keen on synovectomy. I was overreactive to the first knee surgery…trying to cure it with another surgery doesn’t sound like a good idea to me. I would like to really exhaust more conservative measures before going that route. My OS sounds reluctant to just try a long course of an NSAID for the synovitis. This could have efficacy, but I think his worry is the NSAID will be bad for the cartilage grafts (and there is research to support that). Perhaps in a few months or so, I’ll get to a place where the grafts might be integrated and mature enough to handle NSAID therapy.