Post-Surgery Pain in Toes After Lateral Collateral Ligament Repair

Pain in the toes after lateral collateral ligament surgery?

Hello, Doctor.
I was in a car accident recently and suffered tears to my left knee's anterior and posterior cruciate ligaments, as well as the lateral collateral ligament.
After evaluation, the doctor decided to first perform surgery on the lateral collateral ligament and then assess the situation for the cruciate ligaments.
Due to other injuries (hip joint, mandible), I was hospitalized for about 15 days before undergoing the lateral collateral ligament surgery.
During my 15-day hospital stay, I did not experience any discomfort in my foot or toes.
However, the day after the lateral collateral ligament surgery, I noticed significant discomfort in my left big toe, including pain in the metatarsal area beneath the big toe and along the side from the big toe to the heel.
Initially, I thought it was due to the cast, but when the cast was reapplied, the technician mentioned that it was because my calf muscles were too tight.
I recalled that the surgeon had used a tendon from my calf to reconstruct the lateral collateral ligament.
I would like to ask if this pain is normal.
Later, when the cast was removed from the ankle area, I discovered bruising along the side from my big toe to my heel.
It has now been six weeks, and I have been following the doctor's advice to stretch (pulling the foot towards the body with a towel), but the pain remains constant and severe.
Is this normal? How long will it take to heal? Thank you.

Zhuzi, 20~29 year old female. Ask Date: 2016/01/08

Dr. Shi Guozheng reply Orthopedics

Post-surgical pain is normal and it may take about six weeks for the pain to lessen.
Complete recovery may take up to three months.

Reply Date: 2016/01/08

More Info

Post-surgery pain in the toes, especially after a lateral collateral ligament (LCL) repair, can be concerning and may arise from several factors. Given your situation, where you experienced discomfort in your left big toe and the surrounding areas after the surgery, it’s important to consider a few key points.

Firstly, it is not uncommon to experience pain in the toes and foot after knee surgery, particularly when the surgery involves the use of tendons from the calf to reconstruct ligaments. The tightness in your calf muscles, as mentioned by the cast technician, could contribute to discomfort in the foot. When the calf muscles are tight, they can place additional strain on the foot and toes, leading to pain, especially in the areas where the tendons and ligaments are interconnected.

The presence of bruising (or "瘀血") that you observed is also a common post-operative symptom. Bruising can occur due to the surgical procedure itself, as well as from the positioning of the leg during surgery. This can lead to localized swelling and pain, which may take time to resolve. The fact that you have been following your doctor’s advice regarding stretching and rehabilitation is a positive step, but it’s essential to be cautious and not overexert yourself during the recovery phase.

Regarding the timeline for recovery, it can vary significantly from person to person. Generally, after an LCL repair, patients can expect to experience some level of discomfort for several weeks to months as the body heals. The pain should gradually decrease as you continue with rehabilitation exercises and as the swelling subsides. However, if the pain persists or worsens, it may indicate an underlying issue that needs to be addressed.

In your case, it would be prudent to follow up with your orthopedic surgeon or physical therapist. They can assess your foot and ankle for any complications, such as nerve entrapment, tendon issues, or improper alignment due to the cast. They may also recommend adjustments to your rehabilitation program, including specific exercises to alleviate tightness in the calf and improve mobility in the foot.

In summary, while some pain and discomfort in the toes after LCL repair can be normal, persistent pain, especially if it interferes with your daily activities, warrants further evaluation. It’s crucial to communicate openly with your healthcare providers about your symptoms so they can provide the best care tailored to your recovery needs. Remember, recovery is a process, and patience is key.

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