31st Update – 17th month

74 weeks after Knee ACI

The knee is generally stable although I still have slight occasional pain. I’ve continued to take the prescribed glucosamine 3 times a day and exercise conscientiously during the fortnightly physiotherapy session. Last week I was able to brisk walk about 600m to warm up and slow jog about 1.5 km on the rubberised track at the Ortho Gym. Someone recommended that I should jog on the beach – may be I’ll try it the next time. Nowadays, I don’t need the walking stick indoor, but I still use it outdoor, as a precaution. I intend to wean off this since I have not encountered any knee buckling recently. I’ll be seeing my doctor next month and hopefully, can resume most of my outdoor activities and perhaps play a round of golf.

30th Update – the 16th Month

70 weeks after Knee ACI

Today is the 70^th week since my knee operation. Someone whom I’ve not met for some time was surprised that I have still not recovered fully and commented that I should perhaps change doctor and seek alternative treatment. He said others recovered from knee surgery in much shorter time. I told him that for ACI cases, it might take 2 or even 3 years to fully recover. For my case, I’m making steady progress, but it is still early, being only 1 year and 4 months since the operation. I told him that I’ve read up a lot on this subject, including alternative treatment methods. Even Tiger Wood would probably need to rest his knee for more than a year before attempting to play golf again. His final comment that having too much information is also not good left me quite puzzled…

I told the physio that when ‘cold’, the knee was sometimes quite stiff, especially after sitting for a prolonged period of time. It would take some flexing to warm up the knee. He suggested some leg stretching exercises while sitting before getting up. In addition to all the exercises at the Otho Gym, I’ve also started brisk walking and slow jogging on the 150m soft rubberised track next to the Gym. Wearing my new ‘max cushion’ jogging shoes, my knee seemed to hold out quite well over 10 laps, about 1.5 km. I’m proceeding cautiously, as I do not want to stress up the knee. There was no pain and no knee buckling, although I felt a little soreness, afterward.

29th Update – the 15th month

65 weeks after Knee ACI

I just realised that I’d already attended the 40^th physiotherapy session this week. Although one of the physio has been attending to me most of the time, I’ve also seen 4 others, each with a slightly different approach and emphasis on the rehabilitation programme. I think this is all right, as I’ve learnt quite a variety of exercise techniques from them. My knee is growing stronger and it is more stable this month. Adjacent to, but outside the NUH Otho Gym, there is a winding 150m soft rubberised track that I’ve started practicing brisk-walking. I’ve even attempted a slow trot over several laps. Although the physio observed that I’m still limping and putting most of the weight on the good leg, I hope that I can progressively start my long awaited jogging session, a milestone in my recovery progress.

I didn’t use the Nintendo Wii Fit balance board for some times owing to the Beijing Olympics, as the TV was fully occupied for the live and delayed telecasts of the various events on the numerous cable channels. I should have resumed my Yoga sessions, but felt a little lethargic after 2 weeks of watching the Olympics.

28th Update – the 14th Month

61 weeks after Knee ACI

The knee is still not as strong as I wish it could be and I’ve still not gone for any jogging yet. At the 38th physiotherapy session, I was still trying to improve the strength and stability of the leg. Did more exercises with one leg, trying to balance without using the big toe. Walking-wise I can now walk quite briskly without tripping, although I still carry the walking stick just in case, and for climbing stairs.

I’ve also been using the Nintendo Wii Fit balance board to keep track of my training progress – with significant improvement in overall scores in the various exercises and double-digit decrease of my Wii fitness age (hey, I’m getting younger!). Just wish that I could spare more time for the various sessions.

27th Update – 1 year and 1 month

57 weeks after Knee ACI

The knee is generally stable with occasional pain if I over exert it. This month I’ve been very stressed up at work and did not have much time to exercise. However, I’ve been going to physiotherapy sessions fortnightly and increasing the level of intensity. This afternoon, I was able to do stationary jog on the mini trampoline for more than 10 minutes. The physio said I could try some brisk walking.

My kids bought the Nintendo Wii Fit pad for me to exercise the leg and body posture. Wii Fit comprises a pressure board for you to stand on and 4 main categories of exercises - various Yoga poses, strength training, aerobic exercises, and improving balance & agility. In each category, there are many levels of difficulty, starting from the simple, such as, deep-breathing exercise and as one progresses, more difficult levels are unlocked. The Wii console keeps track of your training progress, measuring your weight and calculates your Body-Mass-Index (BMI); asks you to set personal target and tracks your improvement over time in a graph. Based on your performance, the program even attempts to determine your Wii age (fitness age as compared to actual). It’s a fun way to keep fit and exercise the body muscles.

26th Update – The First Year

52 weeks after Knee ACI

Time passes by quickly – it’s already 12 months after my knee operation. There is no anniversary celebration – I’m still not ready to jog or restart my golf game. I still need the walking stick when getting around, mainly for negotiating steps and slope. My doctor, the professor said perhaps I should use a long umbrella, instead, as I don’t look good with a walking stick. Well, look doesn’t matter, safety is more important. I still have the occasional knee buckling although there is no more locking and the pain is minimal.

We discussed about the knee’s condition during the recent check-up. The newly regenerated cartilage is quite apparent in the MRI scan. The previous internal oedema (swelling with fluid) has subsided. The scan also revealed the old tear in the meniscus and some wear on the tibia (lower leg bone) as well as the knee cap. My leg can now be fully straightened and I can almost do a full squat. However, I still can’t do a single leg squat without pain. He suggested I continue with the fortnightly physiotherapy sessions and gave me six month supplies of glucosamine sulphate. He is quite satisfied with the progress of the healing, although it is a little slow.

25th Update – The Eleventh Month

48 weeks after Knee ACI

Went for follow-up appointment in NUH with the lung specialist, 3 weeks after my pneumonia episode. Chest x-ray was quickly taken before I went to see the specialist. Nowadays, things are handled quite efficiently - there is no physical handling of x-ray film. The doctor used his computer to call up the high-resolution images on a large LCD screen. He showed me the “Before” and “After” x-ray images of my chest, side-by-side. You could clearly see that the lung congestion had fully cleared up, which meant that I’ve fully recovered and need not go for any further appointment.

Resumed my physiotherapy sessions after a 5-week break. The physio introduced a circular balance board with a half-ball underneath and asked me to bend my knee while balancing. This is for strengthening the joint and thigh muscles. I was also placed on a mini-trampoline, to flex the knee while balancing and to do stationery marching (I could also do some slow jogging on the spot).

I did not experience any serious locking of the knee during the period, except for the occasional buckling when stepping onto uneven ground. Could walk fairly well unaided, although I still use the walking stick to prevent fall and for stairs. After easing off the exercises during the past 3 months, I hope to step up the intensity from now onward. Still hoping that I can go for some brisk walking or slow jog soon…

24th Update – The Tenth Month

43 weeks after Knee ACI

No progress report on the knee, but I did not have any serious buckling or locking during the month. Went to physiotherapy session only once earlier in the month and had to cancel all appointments for the rest of this month.

On Sat 15 Mar afternoon, I was quite energetic and decided to replace a faulty wall fan. Suddenly, I felt giddy, followed by fever. I went to bed early. Woke up on Sunday morning feeling well, but the fever returned in the evening, reaching a high of 39.5 C. That evening, I went to the neighbourhood clinic and the doctor said I had throat inflammation and prescribed antibiotic and lozenges. As the fever did not subside and I also had gastric pain, muscle and joints aches, I went to the same clinic again on Wed morning – another doctor changed the medicine to a stronger antibiotic. He also took blood samples for tests – but ruled out dengue, as my blood palette count was normal. However, my haemoglobin was abnormally low and white blood cells high. He warned that if fever still do not subside in another 2 days - to go to hospital. Couldn't sleep the whole of Wednesday & Thursday owing to severe back pain, fever and some breathlessness. On Good Friday, 21 Mar, I went to NUH’s A&E and was kept inside an isolation room. Portable x-ray and ECG machines were pushed into the room for my examination. Later in the afternoon, the duty doctor informed me that I had pneumonia and took blood samples for testing. I was subsequently hospitalized in an Isolation Ward for 3 days. Here, everyone who visited me, including doctors, nurses, visitors and even the cleaners have to wear mask when entering my room. Three young doctors came in on Sat morning and observed that I looked well with no fever, and asked whether I want to be discharged. Told them my symptoms of recurring fever in the afternoon and they told me to stay another day. True enough, the fever returned that afternoon. My consultant doctor, who is a Prof, visited me on Sunday and said my condition has stabilized and prescribed a strong antibiotic. I told him I also had blood in my sputum, but he said it is normal and should go away after a few days. He said I could stay until Monday or I could also be discharged and rest at home – I went home on Sunday and the doctor warned that I should stay home for the next 7 days and finished the full course of antibiotic and cough medicines.

My fever has subsided since Sat, but the coughing is still bad, although there is no more blood in the sputum. I still felt weak, after two weeks of illness, but is anxious to return back to work tomorrow. Hope everythings turn out well...

23rd Update – The Ninth Month

39 weeks after Knee ACI

I’ve to ease off some of the intensive physiotherapy exercises owing to the increased frequency of knee buckling and locking. Sometimes I also felt some low dull pain. Went for MRI with injection of radio opaque dye in mid February. The Doctor attempted to inject about 10 ml of dye into the knee with some difficulty as I felt extreme pain in the knee. In the end she did not use up all the dye. I was scanned twice, once with dye and another after the injection of the dye, a procedure called arthrography.

Saw my orthopaedic Prof the following week, and reviewed the results of the MRI scan. The good news is that it showed a newly regenerated cartilage layer covering the femoral knee bone. However, some lighter-shaded spots can be seen, indicating the lack of a uniformly smooth layer normally found in healthy knee. There were also some sign of over-growth at the edges, but the doctor is not too worried about it. The Prof said this is still early stage of recovery, being only 8 months plus. The uneven cartilage surface probably caused the occasional locking and buckling of the knee. The scan fortunately, did not show any injury in the meniscus cartilage which one of my physio suspected I might have. The Prof prescribed another 3 months’ supply of glucosamine pills to be taken trice daily.

22nd Update – The Eighth Month

35 weeks after Knee ACI

8 months have passed since my knee ACI operation. Although feeling stronger, I don’t feel that I’m making much progress. I’m still using the walking stick to protect against accidental falls, as I’m still experiencing several episodes of knee buckling, in particular, going down stairs and walking down slope. Up staircase and up slope are ok. On several nights, I was awakened when my right leg was momentary locked up and I couldn’t straighten it without pain. It would disappear after some flexing of the knee. This is a bit worrying. Hope the scheduled MRI scan next month would reveal the cause of the problem, if any.


During my last fortnightly physiotherapy session, I was asked to stand on one leg and attempt a single leg half squad, but couldn’t do it with the right leg, as the pain was unbearable. My physio said I still have some way to go. He put me on a new leg extension machine to strengthen the front thigh muscles. After the Lunar New Year next month, I would be seeing the physio again before the MRI scan. The Prof (Orthopaedic) will then review my progress after the results are in. I don’t think I’m ready for any jogging sessions as yet, sigh!