3.5 Weeks Post ACL Surgery: Skin Changes & Other Concerns
Hello everyone! I’m a 38-year-old woman, standing at 5'2" and weighing 137 pounds, generally in good health. My prescribed medications include meloxicam and Adderall. I underwent ACL surgery on June 4th, which went smoothly. I need to wear a locked brace for four weeks due to a bone graft. I’m diligently following my home physical therapy routine, but there are a few uncertainties I need help with since my doctor is currently away. 1) After my post-operative appointment with a Physician Assistant, X-rays revealed an avulsion fracture at my tibial tuberosity. What could this mean for my recovery process? The PA didn’t provide much insight, admitting he hadn’t encountered this issue before. 2) While performing heel raises as part of my therapy, I noticed my skin suddenly became red and purple in patches, and I experienced significant pain in my knee – not the good kind associated with exercise, but a sharp, nerve-like pain. The only other instance I’ve noticed this skin reaction was during leg lifts when a restrictive cuff was applied at PT. Should I be worried about this? Any feedback would be greatly appreciated. With my doctor away until mid-July, both my PT and the PA seemed baffled by the fracture and noted it was unfamiliar to them, which doesn’t exactly ease my concerns.
Answers (1)

6/28/2025, 10:10:41 PM
OpenHealth AI
It's understandable that you're feeling concerned about your recovery, especially with the recent findings after your ACL surgery. Let’s break down your questions and provide some clarity and guidance.
Main Points:
- Avulsion Fracture at Tibial Tuberosity: This can affect your recovery but is usually manageable with the right care.
- Skin Changes and Pain During Exercise: The sudden skin changes and sharp pain you experienced are concerning and should be monitored.
Explanation:
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Avulsion Fracture:
- An avulsion fracture occurs when a fragment of bone tears away from the main mass of bone due to the pull of a tendon or ligament. This type of fracture can sometimes happen during sports or physical activities.
- For your recovery, the importance lies in protecting the area where bone healing is occurring. While it might introduce additional caution regarding your physical therapy and activities, it doesn't necessarily mean that your overall recovery is compromised. It’s essential to follow your physical therapist’s instructions closely while you are healing.
-
Skin Changes and Pain:
- The red and purple patches on your skin, accompanied by sharp pain, may indicate a reaction to strain or excessive pressure, particularly if the color change occurs with certain exercises or braces. It could suggest possible issues with blood circulation or irritation of the nerves in the knee area.
- Differentiating between good post-exercise soreness and pain due to an adverse reaction is crucial. Pain that feels sharp and nerve-like isn’t typical for recovery and should be treated with caution.
Next Steps:
-
Immediately modify your physical activity:
- Pay attention to your body and avoid exercises that cause sharp pain or skin changes. Focus on low-impact exercises, and consider discussing which exercises are safest while you wait for further medical input.
-
Monitor and Document:
- Keep a detailed log of your symptoms, including when they occur, what activities you're doing at the time, and any changes in your skin condition. This information will be valuable for your doctor when they return.
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Elevate and Ice:
- To help manage inflammation and potential pain around your knee, elevate your leg when resting and apply ice for 15-20 minutes at a time, several times a day.
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Consult Available Resources:
- Since your doctor is away, consider speaking to a physical therapist or a different healthcare provider who may be available. They could offer insight regarding the avulsion fracture and provide modifications to your therapy regimen.
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Urgent Signs:
- If you experience increased swelling, persistent pain, fever, or further skin changes, seek medical attention sooner rather than later. These could be signs of complications needing prompt evaluation.
It’s completely normal to feel anxious about your recovery, particularly with conflicting information. Prioritize your comfort and safety as you heal, and remember that following the guidelines above can help you navigate this period effectively. If you have more questions or need further clarification, feel free to ask!
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