Tarkman1 - Grade III MCL and complete PCL tear

**tarkman1** · 03-06-2006, 03:22 PM

My ACL held up. The MCL and PCL didn't. Also, I do have bruising to both tissue and bone. I'm not sure whether the edema mentioned in the MRI report refers to the swelling that I have (that is coming down). I'm looking for a second opinion regarding treatment (this doctor is a US Ski Team physician). My current doctor has me in an immobilizer even though I can take my knee through about 90 degrees for range of motion and also bear weight without pain. From what I've gathered about knee immobilization it seems to be that I'm past the point where I need that. Still, I'm dealing with a compound injury so I don't quite understand how things work in concert.

I'll see what I learn from the other doctor.

See Page 2 for the MRI Synopsis

**hemlock hiker** · 03-06-2006, 03:35 PM

+++++ VIBES +++++ sent your way Tarkman.

What kind of surgery (if any) or treatment are you looking at?

I'm having a brain fart right now, but I had a CPM (something passive movement) after my last ACL reconstruction and it helped alot in recuperation time. As well as the stationary bike. Stay strong!!

**Bodhi** · 03-06-2006, 03:38 PM

Originally Posted by tarkman1

My ACL held up...

Good news...

The MCL and PCL didn't...

Fack, huge bummer, heal up mang.

I'll see what I learn from the other doctor.

Good idea.

Take care and get better.

++++++vibes++++++

peace,
D.

**GT40** · 03-06-2006, 03:42 PM

So what treatment is the Doc reccomending?

Hope you can get back out skiing soon.

**Ridgehippy** · 03-06-2006, 03:45 PM

Not what any of us wanted to hear but at least it wasn't the worst the Doc could have told you. It'll be a long season, get on the PT and heal up quick. +++++++ sent.

Shout if you need anything....I'm just down the road.

**DJSapp** · 03-06-2006, 03:50 PM

That's terrible man. Heal up fast and straight and get back to Gordy's camp.

**Mulletizer** · 03-06-2006, 03:51 PM

That sounds very ouch. Sorry to hear about it and hope it heals fast. ++++++

**Tyrone Shoelaces** · 03-06-2006, 03:51 PM

Sorry to hear this man. But like others have said, at least your ACL is intact.

I'd be interested in hearing what the docs prescribe for your recovery too. I've done my MCL in the past as well, and that injury was 6 weeks of rest with lots of bike riding. I'm curious to see how they treat this with the PCL injury along with it.

Regardless, take it from someone who just came back from ACL reconstruction...hit the PT/rehab with more ferocity than you think you have in you, stay more positive than you've ever been before, and keep your eye on the light at the end of the tunnel....because there is one. Who knows...you're next season coming back from injury could just be one of the best ones you've ever had....

**tarkman1** · 03-06-2006, 03:52 PM

Surgery is a question mark.

I read the MRI report that mentioned possible compression fractures to the tibia plateau. I had the x-rays with me when I saw his colleague previously. I don't know that the doctor from today knew that I had an x-ray come out negative for the tibia and tibia plateau.

I'll let the next doctor know for sure what I can and what I cannot do with my knee. I'll have the x-rays. As far as I'm concerned, an MRI write up is only one piece of the puzzle.

**cold_smoke** · 03-06-2006, 04:09 PM

PCL is bad news as you already know. It is a rare tear with very few specialists that have even performed the reconstruction (would have been 'better' to tear the ACL/MCL). My friend did his ACL/PCL a few years back and re-tore them. He was going to have an osteotomy to remove part of the tibial plateu to minimize the stress on the future PCL, as reconstruction has something like an 80% failure rate. He opted out of the painful and long rehab of the osteotomy and is now two weeks out of ACL/LCL/PCL/Posterior Corner/Parial removal of the medial meniscus surgery. The doctor did a double cadaver wrapped PCL graft.
In short, be really careful with the PCL and if surgery is needed, seek out a specialist and don't over exert the knee in any way.
Good Luck with everything, keep us posted, +++vibes for a strong recovery.

**Mulletizer** · 03-06-2006, 04:11 PM

Originally Posted by tarkman1

I read the MRI report that mentioned possible compression fractures to the tibia plateau. I had the x-rays with me when I saw his colleague previously. I don't know that the doctor from today knew that I had an x-ray come out negative for the tibia and tibia plateau.

I think this came up when Samwich hurt himself a while ago; the distinction between compression fracture and bone bruising is slight and depends mostly on the doctor. In fact, I think they amount to more or less the same thing. Perhaps a medic will be able to help.

Here's hoping you will not need surgery.

**hop** · 03-06-2006, 04:16 PM

+++++++++++++++++++++++++++++++++

**mtnbikerskierchick** · 03-06-2006, 04:17 PM

Sorry to hear about your injury. Yeah, I would surely check with another doc about the immobilizer. It's my understanding that unless you have a lot of bone or meniscus damage, you shouldn't be in an immobilizer..... You should be in a brace that will keep you from hyperextending, but not in an immobilizer. Immobilizers can cause more scar tissue to build up, which can inhibit rehab. Also, immobilizers cause your muscles to atrophy even more and it's better to prevent that b/c it also lengthens rehab. I remember I lost 10 lbs of muscle during my knee surgery (ACL reconstruction), and they tried preventing atrophy by having me ride the stationary bike and swim before surgery. Anyway, good luck to you! You will heal soon I'm sure!!!!!

**tarkman1** · 03-06-2006, 04:36 PM

Thanks all.

I don't like the immobilizer. I've found that I can stand on my bad leg without pain and without difficulty. IYeah, I'm not too stable but I can do it. Really, given what I can do now what I really need. I'm not the 'classic case' nor do I have classic symptoms right now.

My whole problem with the immobilizer is that it seems to be a step backwards where I'm not convinced that such restriction is necessary. With the restriction, I'm limited to leg raises and flexing my quads. I'm certain my legs bring a lot of stability to my knee. Immobilization just seems wrong if it's not necessary for the MCL to heal. I'd like to start rehab as soon as I can.

**ptavv** · 03-06-2006, 04:39 PM

Sorry to hear about that man. You'll make it through the rehab, you just have to perservere. Remember, the most epic winter is always the next one.

**caddah** · 03-06-2006, 04:55 PM

good luck with the injury. multiligament tears are tough. I've been trying to get through a complete knee dislocation since september. Talk to your doctor and get in to rehab. I ended up being immobilized for 2 months and lost all my muscles in my left leg. keep as strong as you can and do the excersizes religously.

I'm not a doctor, but the immobilizer seems wierd. scar tissue build up is one of the most painful and difficult things to get rid of.

keep us posted....interested in seeing what the doc says.

**Jim S** · 03-06-2006, 05:09 PM

Originally Posted by tarkman1

My ACL held up. The MCL and PCL didn't. Also, I do have bruising to both tissue and bone. I'm not sure whether the edema mentioned in the MRI report refers to the swelling that I have (that is coming down). I'm looking for a second opinion regarding treatment (this doctor is a US Ski Team physician). My current doctor has me in an immobilizer even though I can take my knee through about 90 degrees for range of motion and also bear weight without pain. From what I've gathered about knee immobilization it seems to be that I'm past the point where I need that. Still, I'm dealing with a compound injury so I don't quite understand how things work in concert.

I'll see what I learn from the other doctor.

Can you get the report and post it? Edema could be in the marrow (bone bruise) or in the ligaments. Rarely cartilage edema. We usually don't mention edema of the menisci.

Tibial plateau fractures are easily missed and often not well seen on xrays. They are much more readily seen on MRIs. It's common to have a normal xray and then see fractures on the MRI (common: I see it nearly every day at work).

Most )not all) PCL and MCL injuries are treated conservatively (non surgical therapy).

MCL strains and bone bruising can really hurt. Been there done that. Feel better.

**Raps** · 03-06-2006, 05:14 PM

hey tark sorry to hear that man, definately get a few different looks at it from a couple docs - hope you are back out there soon and at Gordys camp again next year....

**WhiteHunter** · 03-06-2006, 05:15 PM

Sorry to hear this news. Also tough to hear that the course of action is still uncertain. The waiting has to be more unnerving than anything else at this point. Hope you get some better news soon.

**Mr. Altagirl** · 03-06-2006, 05:29 PM

Sucks to hear this. I had a grade III MCL and a fractured Tib-Plateau last year (plus some other crap thrown in to make it that much more enjoyable) and did not use an immobilizer. I did have to go 6 weeks of complete non-load bearing due to the fracture; that was the hard part; hopefully you can stay away from that. Even though I couldn't do any load bearing exercises or movement, my PT was VERY aggressive and I skied about 6 weeks after the injury (and continued for about 100 days last year). Make sure your PT uses the E-Stim machine and try to abuse it; I really think I was able to ski last year because of the lack of atrophy I had due to the aggressive PT and especially the vast amounts of E-Stim I did. Plus, it is really fun to make the other patients in PT freak out as you make your leg go ballistic working out with the E-Stim. Good luck!

**Barnballs** · 03-06-2006, 05:37 PM

that blows dude.

On the bright side...looks like we'll be skiing till the 4th again though.

**Jim S** · 03-06-2006, 05:59 PM

Isn't that from the topsheet of the 06-07 K2 Maden AK?

**skier0178** · 03-06-2006, 07:39 PM

Heal up quick Matt. You're a strong guy, it's not going to be easy but you'll get through it. Put up a big picture of TOTW focused on Balls wherever you do rehab, that will get your juices following. Let me know if you need anything to help the process....

**Vinman** · 03-06-2006, 07:55 PM

For the most part the PCL probably is not as much of a concern as the MCL. Although the PCL is a major ligament in the knee it is a much less devastating injury when compared to an ACL tear.

The possibility of compression fractures does complicate things some. But as you already know they may or may not do surgery on a grade 3 MCL. If they feel it is completely torn then they may go ahead and fix it. If it is not complete the may hold off and see how well it heals on its own.