Pregled posta

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Magnetic Resonance Imaging (MRI) of my left knee, pathology noted. I tore my anterior cruciate ligament skiing on March 18th, these images (in the form of digital stacks) were captured on March 24th, I didn't get the diagnosis until March 29th, and then underwent surgery to reconstruct the ACL on April 4th. Good times.

(Left) Bone bruising--an extreme valgus (inward twisting) force of the knee resulted in impact between the posterior-lateral part of the tibia and anterior-lateral part of the femur. Fluid infiltration, or bruising, in the bones shows up as those encircled diffuse white clouds. Arthroscopic examination during the surgery revealed no cartilage damage. While bone bruising is a common concomitant observation in ACL injuries, the consequences of it, if any, are unclear.

(Right) MRI slice depicting part of the ruptured ACL. An intact ligament shows up as solid black. My ACL shows up as gray and swirly throughout this and adjacent MRI slices.

Interestingly, torn medial collateral ligaments (MCLs) can heal themselves, but not ACLs because of the curious properties of the intra-articular environment that prevents platelet aggregation on the damaged ligament and the resultant secretion of growth hormones necessary to promote the initial healing process. Efforts to repair a torn ACL by suturing result in a 40% re-rupturing rate. Thus, an ACL must be reconstructed using a graft, either from one's own tissues (patellar tendon, hamstring tendon or quadricep thing) or a cadaver (Achille's tendon).

Self, or autografts, are much more resilient than cadaver grafts, heal faster, and have a lower failure rate. This, I am presuming is because cadaver grafts must be UV irradiated to kill potential contaminating viruses (HIV, hepatitis C, etc.), and further processed to remove all cellular material which would otherwise cause one's body to mount an immune response against the graft and reject it; plus, it's subsequently frozen for storage, and then later thawed for the surgery.

Taking a breather from physical therapy exercises and pondering longingly for those days of reckless abandon and racquetball fun. Before I am permitted to begin jogging, I need to master the technique of a single-leg squat on my left leg. It's just a squat with one leg, but my left leg refuses to cooperate. My patellar tendon is forever healing from the excision of its middle third that was use as my ACL graft, so it is easily irritable probably the major limiting factor in this whole process. The remaining limitations may likely be attributed to deficient quad and hip strength.

Shortcomings of my left leg single-leg squat as defined by my physical therapist:
1. Knee wobbles.
2. Unable to go down to 45 degrees.
3. Not sticking my butt out far enough (as if "sitting on a toilet").
4. Dropping my right hip, rather than keeping my hips level.
5. Balance. Proprioception. Whatever you want to call it.
6. Lacking the endurance to execute in good form continuously for 2-3 minutes.
7. I am so defective this list is never going to end. How am I still alive. Because there are no mountain lions in Chicago.

Until all this is reconciled, running will have to wait. And racquetball. All things fun, really. At least let me bike and go up stairs without my knee feeling like crap. Oh patellar tendon, how you torment me so...