Need advice/tips re: post-surgery care for adult DS [MPFL knee surgery]

Parent Cafe
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Ds, age 27, is scheduled for MPFL reconstruction surgery on February 11th.

We live around 9.5 hours away and will drive down. We are planing on renting an AirBnB where we can all stay since where he rents is third floor, no elevator.

I am unsure how long he needs someone with him, so I don’t know how long we need to stay. Pretty sure he will be locked into a brace with his straight for two weeks. It is his left leg.

A friend has graciously offered her spare bedroom in her apartment. Her building has an elevator. This would be after we leave. The timeline is unknown at the moment.

Any advice or tips about the particular surgery would be great. I know it’s a tough recovery. But I’m primarily looking for post surgical care tips and managing the dynamics of a VERY independent and stubborn 27-year-old man having to be taken care of by his mother. Unfortunately, dh cannot stay the entire time because of work, so he will probably fly back, and it will be just me. I’m concerned about assisting him with showering/bathroom issues. I’m also concerned about feeding us. And, about the frustration I know ds is going to feel. We tend to butt heads as it is because we are pretty similar personality-wise.

And, back to the friend. It’s one thing for me to help him with getting in the shower or to the toilet. It’s another thing for a female friend to do it. Thinking we may just have to set a time for the AirBnb and if I need to stay longer, move to a hotel. I know he’s going to be sick of needing my help, but I don’t want to abandon him too early. I don’t think he is grasping how hard this is going to be.

Do not misunderstand - he is very appreciative we are doing this for him, but the whole situation is just stressing me out.

Not exactly sure what I’m asking. Throw some ideas, tips, reassurance at me, please.

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Will the hospital or rehab place give training to you or any other family member who will be assisting the patient with moving around?

Installing a detachable shower head, getting a shower chair, and installing shower grab bars in the shower may be worth doing before the patient moves in.

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I would consult with the surgical team and see what they advise with post op care and then follow that advice

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He should receive guidance from either the home health folks who will visit him…or from a PT…if that is ordered.

I had a partial knee replacement and we have a two floor home. I did spend most of the first two weeks on the first floor…but was able to get around my house just fine.

I would find out what is planned post op…and see if your son can get info about that. That will put your mind at ease.

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Forget your ds … does that mean we can meet??? Doesn’t he live near me?

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I had my knee replaced in 2017. I was living in an apartment in a townhouse, many steps, no elevator.

I stayed with a friend who lived in an elevator building for less than a week after five days in the hospital. I am aware that now more of the surgery is done arthroscopically and patients go home much sooner. Plus of course I was 69 years old! For a few weeks, PTs came to where I was staying until I could take the bus to a PT office. I ditched the walker after a day and used a cane for five weeks. I was given a contraption to fit over the toilet so it wasn’t so low, with armrests to get up. I needed no hands-on personal care after the first day or two in the hospital. I took decreasing doses of opioids at home for a week or so.

After the five or six days with my friend, I was perfectly fine with the steps at home.

Hope this is helpful!

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My daughter had this surgery her senior year of high school. (2002–so a long time ago.) She was in a full length leg brace for 8 weeks, but was allowed to remove the brace to bathe and eventually to sleep.

She was able to use her crutches to get into the bathroom, then could balance and/or hop on one foot to get herself onto the toilet within the first week. She could also transfer herself from sitting on the closed toilet into a stall shower directly across from the toilet by the end of the first week. In the shower she sat on a shower stool/shower chair and was able to bathe herself. She was then able to push herself to standing on one foot, grab a crutch and get herself out of the shower so she could get dressed.

Stairs will be problematic for the first couple of weeks or until he becomes very proficient with his crutches. Staying with his friend w/ an elevator during his recovery will make his life much easier.

The first 2-3 days after surgery will be the most painful and most difficult. D slept in a recliner the first couple of nights because it was more comfortable for her and she could elevate her leg.

IIRC, she was back in school about 10 days post surgery.

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This is not knee replacement surgery. The knee part was added by a moderator. I should have put the surgical name in the description. It’s a procedure around his knee (I forget what the MPFL letters stand for). He has an unstable patella.

I don’t think we are having home health or anything remotely like that. I have no idea what kind (if any) of instructions we will receive about moving him. Isn’t it amazing they do these major surgeries and then send you on your way???

My understanding from what I have read online is that he will have a hinged brace that is locked in place to keep his leg completely straight for two weeks. It only comes off for bathing and PT. He will not be bending his knee at all for two weeks.

We had planned on a toilet seat raiser thing and a shower stool. We are going to be in an AirBnB so the shower head thing is what it is.

I talked to a friend today who is a retired orthopedic surgeon. He says it is best if he does not attempt stairs for four weeks. He also said he will likely be set at 30° at the two week mark. He says navigating the toilet and shower will be easier then. He used some strong words about attempting stairs. I will pass on to ds.

I think what dh and I are thinking is two weeks with us/me and then he needs to spend two weeks with his friend.

I just hope he will do as instructed.

Edit: no hospital stay.

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Not this trip - hopefully sometime in the future. :blush:

I think you are three hours away from him.

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I think his limitations are much more stringent. He cannot bend his knee at all further weeks. This will be an open surgery.

I appreciate your trying to help, though.

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I think Planning 2 weeks in the Airbnb makes sense. Your husband will be there first for the most difficult adjustment days and help with sons personal needs. If at two weeks you feel like he needs you longer maybe then you see about another week extension on the Airbnb or a other similar place. Deciding whether to stay with your friend might just seem a too far out in time decision for your son to make right now.

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One small nit. I am not sure whether this will be relevant.

After my surgery on my left knee, after a few days I was able to drive an automatic car but I was not not able to drive a manual for a few weeks longer. At one point I needed a car for a week and had to rent one because I owned a manual (and yes I was on crutches at the time).

It sounds like your son will not be driving for a bit longer.

Recovery took a while and was gradual, but was very successful.

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This is exactly what D had. It was the result of a soccer injury. This is very common injury among female soccer and basketball players.

Her knee cap used to randomly dislocate with no warning and it became dangerous for her. She fell down a 6 or 7 outdoor concrete stairs at school because her kneecap dislocated as she was walking down steps. Another time her knee locked and she fell off a hiking trail and slid about 6-10 ft down a slope.

Your son will probably have 2 or more screws placed in his tibia right below his knee to anchor the bottom of the tendon the surgeon will use to replace the damaged knee ligament. The screws have to stay in for 1 year. He will be able to feel them when he kneels. After a year he will have the option to have the screws removed, although most people just don’t bother to.

He’ll also a set of parallel scars about 6 inches long on both sides of knee. Makes for great “war stories” at the ski lodge.

And D was driving an automatic transmission car about 3 weeks after her surgery since it was her left knee. She got a handicapped parking placard and it was s wonderful help since using crutches to get around is PITA.

If your son’s surgery is on the left side and he has a car he’ll be driving, tell him to ask his surgeon for a letter of need for the DMV to get temporary handicapped parking permit.

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I have had too many foot surgeries which left me non weight-bearing for a month after each surgery. I realize this is nothing like a knee surgery where you cannot bend the knee, so the only comment I will make is that you might want to buy two shower stools: one to sit inside the shower, and one to sit outside the shower.

My five-sided glass shower has a five or six inch lip, so I had to scooch bench over to the shower entry, pivot myself from the bench outside the shower to the bench inside the shower using only the one good foot, and then reversing those steps to exit the shower. It was useful to place a towel down on the bench outside the shower to prevent slipping.

If the Airbnb has a different shower set up, there are also transfer shower benches, where a section of the bench sits outside the shower and another section inside, but that wouldn’t work for me because I needed to close the glass door. I have to say the most dangerous activity.

I am guessing that he would not be allowed to go up and down the stairs on his bottom? I used one of those knee scooters, and parked one at the bottom of the stairs and one at the top of the stairs, and then went up and down the stairs sitting on my bottom.

My son stayed with me this summer for three weeks after his ankle surgery, and went up and down the stairs on crutches. I could not watch.

Best of luck.

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He’s doing that now! Going up and down stairs with crutches :grimacing:

Not sure how feasible that is with his leg completely straight

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Our daughter had this surgery in 2018, and it took a little over 6 months total rehab to get back to where she as before the injury (JO Level 10 gymnast). That was PT 3x/week and meeting with her surgeon 1x/month to evaluate (after seeing surgeon every 2 weeks for first two months post op).

Not sure if your son’s surgeon is planning to harvest from your son’s hamstring or if they are planning on using cadaver donation. DD’s hamstring was in very good shape so they harvested from that; she had friends who had same procedure with cadaver donation that ultimately failed, and needed to be redone.

Surgeon offered a pain port to be inserted at the hip during the surgery for post-op recovery/pain management. Because of the fact that sport rehab was going to start the same week, we choose to not have pain port inserted and she took oral prescription pain killers the first two nights (to ensure good sleep) but nothing but OTC pain relief past that point.

The surgeon won’t know the true scope of the surgurical needs before going in. DD had massive scarring buildup that had caused her patella to be permanently shifted that needed to be remediated as well as rebuilding the MPFL. She has 3 total scars, each one about 1 1/2" - 2" in length. Scars took about 18 months to heal/fade as completely as they were going to. Mederma scar gel (and liberal sunscreen) was recommended to be used once the stitches were removed/the wounds were fully closed.

For the first two weeks, in addition to the brace keeping her leg fully straight/locked, she had a cooling system that wrapped around her knee to keep swelling down and promote healing. It was basically a plastic box that we filled with ice and water that connected to a series of tubes in velour wrapping and a motor that pushed the water through the tubes to constantly cool the knee area. If your surgeon uses that, they will give it to you at the hospital after the surgery and instruct on its use. Really a pretty awesome system, we still have it and she continued to use it for post practice recovery on other minor injuries.

DD was basically completely prone and only got up to use the bathroom the first week of recovery. At the end of the week was her first post-op visit to her PT, that was an evaluation of healing and light massage to work with the swelling, even with the cooling system. Also used some leg squeezer contraptions that fit from hip to toes (both legs) and provided gentle pressure to promote good circulation during the early PT sessions.

Second week she was able to move around a bit more though leg remained locked straight. She also began PT in earnest.

Post op, surgeon had locked leg braced and didn’t unlock the brace until I think the 6 - 8 week mark. He then only ‘unlocked’ the brace for a very reduce amount of flex (30 degrees or so total I think). It took 3 1/2 months for DD to really relearn to walk ‘normally’, then another 6 weeks or so of learning to run on it in a very systematic fashion. Last couple of rehabs months was ensuring all the prep work was complete to really start stress testing the knee again.

It is a hard injury, but if your son was in good physical shape before the injury, rehab will be smoother. Hardest part for our daughter was learning to trust that her knee would hold up even after completing rehab and being told by her surgeon that her knee was stronger than it had been before the injury.

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Thank you. This is all very helpful (if not somewhat stressful).

I really think ds is not anticipating the extent of his recovery, both physically and mentally. Not to mention the time needs for PT.

It’s very hard since he is an adult and lives 9 hours away. Tough since I obviously didn’t go to the P.A. appointment. He’s a smart guy, but not a medical guy with (thankfully) little experience in dealing with something like this. I have no doubt I would have asked more questions.

I’m going to plan on staying 12-14 days. Dh will only be there one week.

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Of course, but I’m trying to plan for those needs now. Not being in our own town for his recovery makes this a bit more logistically challenging.

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Are you sure your son hasn’t received info? I’m having surgery Tuesday on my thumb…and I received a folder with a packet of pre and post op directions from my doctor. They actually scheduled an appointment last week with a PA to give me this, and so I could ask questions.

When I had knee surgery (different doctor), likewise, I had pre and post op info given to me prior to the procedure. And it was then explained again to my husband who accompanied me to the surgery.

In both cases, the pre surgery info session included making sure they had my pharmacy for both ore and post op medications.

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Oh, he absolutely has received info! Sorry I was unclear. I just don’t have it. He was only seen late on Thursday afternoon.

He was flipping through papers when we FaceTimed him Thursday night.

I’m going to try and get him to scan it all to me (or send screen shots). He’ll grumble, but I’ll point out doing so would likely result in fewer questions from me.

He did not mention home health at all. I just can’t imagine he will have that.