So after tibial plateau surgery and physiotherapy, after pain and gym sessions, after exercise bikes and endless walks, the day will come when you have to go back to the surgeon to see if the operation he performed was successful. After all the work and the sleepless nights you will find out if it has been worthwhile. This will come for most patients about 10 months after surgery. It did for me.
At 10am I was shown into Dr Matt Lyons (now familiar) office at the Mater Hospital. Lot of water under the bridge since I sat in this same room in February after arriving back from Canada with a broken leg. Now, tightly clutched in my hand was a list of questions I had composed that I hoped he would answer. It was quiet in the room where I sat alone, inspecting the stuff on his desk. Surgeons have really neat stuff on their desks. He arrived after a time, same cheerful smile and R M Williams riding boots. I never thought about the whimsy of being cut open by someone wearing footwear designed for breaking horses. But hey, life is strange, right?
He did the expected examination and said my leg had made “an amazing recovery.” I have only a minimal amount of lateral movement in the broken knee. This is known as “laxity.” It can be from grade 1, which is very little sideways movement to grade 5, which is lots of sideways movement. If you had much more than about 3 you would have such a wobbly knee that I suspect it would be very difficult to go skiing. He pushed my thigh one way while pulling my shin the other, pushing back and forth. Even I could tell that there wasn’t much movement. I have grade 1 laxity. “You’ve done really well, There is a lot of muscle development around your knee,” he said.
We then got down to my detailed questions:
CAN I RESUME SKIING: “Yes, the leg is strong enough to go skiing.” I inquired whether it will hurt the first time and whether it will hurt when I have to twist out of bindings in a fall. “Probably,” he replied. “The only way you will find out is to go and give it a try. It will be trial and error in the beginning” That’s pretty good news. Montana, here I come.
WILL I BE MORE PRONE TO ARTHRITIS IN THE INJURED LEG? “Yes you will be more prone to arthritis in your broken leg. It was a significant injury with surgical intervention. However, when that presents itself is anyone’s guess. You can delay the impact by keeping your quad strong, keeping your weight down and only doing low impact exercises, so as not to stress the knee joint too much. No running from here on.” All of this was fine with me.
WILL MY LEG MAKE A COMPLETE RECOVERY? “No. You have made an amazing recovery in the last 10 months. However, the injured knee will never be as good as the other leg. There was some strain in the medial ligament which has left you with a grade 1 laxity. This is about as good as you can hope for after surgery. I expect the knee will continue to improve and get stronger if you keep up the exercises.”
SHOULD I HAVE THE PLATE OUT? IF NOT WHAT ARE THE RISKS? Depends if it is bothering you. I wouldn’t make a decision on that before about 18 months to 2 years. The major risk of leaving the plate in there is that if you have another traumatic accident while skiing you can get significant fractures around the plate.” When I said it’s not bothering me, I don’t even notice it, he suggested we just leave it alone, at least for the time being.
HAVE I DAMAGED THE MENISCUS? I asked this question as my daughter Catherine discovered that she had, not only broken her leg, but severely damaged her meniscus which required surgical repair. “No, you seem to have avoided that although you have strained the medial ligament.”
SHOULD I KEEP GOING WITH THE EXERCISES AND IF SO, FOR HOW LONG? Yes, I think to continue the exercise routine would be beneficial. You can increase the loads and resistance, in my opinion, as long as it is not causing any pain. You might like to change from such a target orientated exercise program to one concentrating more on lack of pain. Pain should become the guiding principle rather than specific targets.”
I thought this was an interesting view and one I will have to discuss with Belinda. “She who must be obeyed,” at the Virgin gym will have a view on this no doubt.