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Author Topic: Nick's 3in1 Diary FatPadTrim, Medial plica/Distal patella excision, AIR x2, LMR  (Read 266712 times)

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Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
03/03/18 Day 46 Post Op

Not really done much walking since Wednesday when the weather turned cold that now warming up again with a foot of snow to thaw now it has gone above zero degrees again. Straightening the knee and straight leg raises would be easier without the knee brace. Tempted to take it off during exercising, with my track record best to wait until I have seen Prof Snow before pushing the knee too far without support. Still doing RICE twice a day instead of 4 times a day that I did during the very early stages post-op. NSAIDs limited down to just the occasional ibuprofen when my right hip becomes sore or have done too much walking on the knee.

[email protected]
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
04/03/18 Day 47 Post Op

Three more days to go until my knee brace should finally be removed, can then really start my recovery programme making gradual progress. When having a full body wash without the leg brace my ROM is very limited compared to the last 2 scopes. At least this time around was not forced through my ROM limitations with aggressive physio 5 weeks post-op.

I will not be able to start doing any gardening towards the end of this month with the surgery I had done, do not want to strain it too much for the next couple of months. Not even the charity shop for a while unless am upstairs all day sorting through all the donations doing a couple of hours rather than the usual full day. Will feel less guilty if I do not show up for the opening and closing of the shop taking items in and out to the front of the shop heavy boxes of books etc.

Might give it up with annoying customers, one said to me I have too long breaks when I am doing it for free helping out doing a 36 miles round trip. Need my breaks to lower my anxiety levels being autistic it is important to get away from the shop or could end up like I did at the autism young peoples holiday club last year flustering and making silly costly mistakes due to no breaks during the working day.

[email protected]
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
05/03/18 Day 48 Post Op

Hopefully in 48hrs time writing my daily post-op diary after my consultation will be knee brace free for the 1st time in 50 days. Becoming increasingly restless wanting my independence back again back to my daily routine patterns. After being stuck indoors during the beast from the east cold stormy weather took a bus journey with my mum to a small quaint Worcestershire town that was mainly sitting on 4 buses admiring the open English countryside.

At the bus terminal in Worcester nearly slipped a couple of times as the tiled flooring was damp and slippery as both crutches skidded sideways with my mum holding onto my arm. Then we arrived at the town and found that the high street was closed due to a burst water pipe had to be diverted walking a lot further than we planned. Most cafes are closed on a Monday, walking even further to find one that was open. Ended up talking to a nice lady that had knee surgery done by the same OS that did scope #1 back in November 2009.

When I got back home slight shooting pain in my right knee and right hip a little sore not helped now that it raining on and off since 4pm. Ice and maybe take one ibuprofen before going to bed. At least it was dry on the bus trip that did not go to plan.

[email protected]
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
06/03/18 Day 49 Post Op

Less than 15 hours until my first post-op consultation tomorrow morning at 09:15 that the earliest OS appointment in over a decade and a half. Will ask for a letter so I can claim benefits as I am not able to work in the specialist areas I good at horticulture and health and social care in young people with disabilities. Will only be short-term staying well clear doing gardening work in my local neighbourhood. My heart and passion are still geared towards part-time residential care work for young people as I would be at the same location with no sudden changes of staff and service users and have finally found a support worker to help me claim benefits and finding employment once my knee is more stable again.

Also will ask for physiotherapy at my local private hospital where my mum had both her left knee and hip replaced 2 years ago. She used NHS choice and live locally and have had ongoing knee problems for the last 15 years so should be entitled/ Makes sense to see one physio for my right knee and hip be silly going twice when I can go once saving time and money for the NHS.

[email protected]
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
07/03/18 Day 50 Post Op

This morning and ended up seeing the advanced practice nurse, she had good knowledge of 7 weeks post-op recovery. Prof Snow was not in clinic even though I said hello to him in reception as he was coming in when I arrived at around 8:50am asking me how the knee holding up and said be nice to get the ROM back without the knee brace while waiting at the front for my sister to park her car with my mum. Said see you in soon as he went upstairs to consultation suite. I remember seeing an advanced practice nurse after scope#2 so expect it is a standard practice the 1st post-op consultation to ease pressure away from OS's.

She was really good just would have liked to have gone through what has been done during the surgery going through the MRI scan images and how likely the success rate is depending how much cartilage was removed with Prof Snow. She got me to lye on the couch and to undo the velcro to take the knee brace off. My knee examination went well saying I need to get my right knee more straight and to work on the upper muscles that need strengthening that has wasted away.

Can now fully weight bare with two crutches gradually going down to one. She slammed the knee brace into the yellow bag incineration bin after telling her all the problems I had with it, liked her style of execution of my knee brace ;D will not be missing it in any way. Need to walk heel to toe with my right leg straight after getting into a bad stance of waking with my right knee bending out too much. Will have another review in 2 months time making sure I get to see Prof Snow even though the advanced practice nurse was good like to see the expert after a fairly invasive surgery. Should happen at the next review or with his registrar.

Then went over to the physiotherapy department with a lovely nurse showing me where to go and making sure I was ok walking without the knee brace. Did not have to wait long to see one of the physios who turned out to be a good pick as the previous ones lacked experience and people skills. She was fantastic explaining and writing down what exercises to do and observing how I do it and saying to relax and not tense up.

She even said she can do both knee and hip exercises, will contact my hip surgeons secretary for an official referral. Now I have found a physio I was impressed with straight away, will stick to the hospital even though it's a 30-mile round trip it is worth it now I have given approval to my new OS that was covering for the one I saw last week. She must be good and well-liked she booked out until Thursday 21st March when I see her again at 10:00 the other one had more slots available.

[email protected]
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
08/03/18 Day 51 Post Op

Was great sleeping without the knee brace that was disturbing my sleeping patterns over the last 7 weeks. Still sleeping on my left side rather than my usual right side of sleeping pre-op, putting less pressure on my right knee and hip. Already have received my letter for my next consultation on Thursday 2nd May @09:00 that is early, phoned up for a later time to miss out the work and school high peak traffic, the next later appointment was not until July. My previous consultations were either late morning or early afternoon raising my suspicions that I will not see Prof Snow or one of his registrars might see the Advanced Practice Nurse again. There were only 5 people in the waiting area yesterday usually rammed with 40 plus patients with relatives.

Took my 1st post-op bath this morning filling it up deeper than usual with plenty of bubbles had a nice soak for half an hour. Was fine getting in and out of the bath with the aid of my Aldi anti-slip mat to soak the water into my flaky and itchy skin on my right leg where the brace was fixed. Will go back to my daily shower routine in my mum's ensuite bathroom with better floor grip than the main family bathroom. Also has a plastic chair if I feel I need to take the weight off my right knee.

List of physio exercises.

knee joint extension x10

Push knee down and hold for 5 x10

Leg raises x5

Standing straight holding onto chair lift leg sideways and backwards keeping the leg straight x5-10


Walking heel to toe with two crutches at a slow pace attending coffee morning with my friend, was nice to see familiar faces saying they are missing my company. Forgot to mention yesterday still not allowed to drive my car for the next 2 weeks until I get the ok from my physio. Think they are being too cautious, know plenty of people with worse joints than me that drive a manual car and can easily do an emergency braking stop with my ROM at around 105 to 110 degrees. Better do what they say as they are the experts.

[email protected]
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
09/03/18 Day 52 Post Op

After a few days going out had a day staying indoors with the weather turning wet, making it damp and cold. The cold spell at least it was a dry cold that is better than damp cold. Noticed the last two nights I am turning around in my sleep more without the knee brace. Go to sleep on my left side not to put too much pressure on my right knee and hip and wake up on my right side with my cat Ellie curled up beside me and right knee felt painful. Will use the pillow again between my leg that I did when I had my knee brace so I do not turn over onto my operated knee.

Keeping on top of my PT exercises and have been writing my book today, that will take a while until I am satisfied to send to a book publisher. Got to prepare for a presentation next month for the National Autistic Society. Have already done 3 presentations in public on autism and criminal responsibility. Might look into doing it paid for a part-time job if this one goes well. Travel expenses and accommodation paid for is a nice job to do in an area I am knowledgeable about.

[email protected]
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
10/03/18 Day 53 Post Op

Feeling a lot more active and can walk without the two crutches for short distances inside the house where I can grab onto something in case the knee gives out. The kitchen is a good place to walk unaided with plenty of surfaces and heavy objects to grab onto when required. Did venture outside the front of the house up the road about 20 yards and back down again, feels fine going up not so great going down with anterior knee pain. It should ease and improve once I build up my quads. Tempted to walk with just one crutch rather than two that I do for short distances when shutting an open door or grabbing my laptop. Longer distances and going outside will always stick to 2 crutches until I been told it is safe to go down to 1 crutch.

[email protected]
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
11/03/18 Day 54 Post Op

Had a nice day with my mum and some of my sisters celebrating Mothers Day that is celebrated earlier in the UK. I prefer the countries that celebrate in May a month where the weather is a lot warmer and longer daylight hours. Might celebrate twice with my Mum's 80th in May would be a nice surprise for her.

The knee is ok just have to be careful doing leg lifts and bringing kneecap from 180 legs lying flat to 90 degrees causes pain and discomfort. Right hip is sore from the weakness in the quads will then put the strain on the hip that not helped by a labral tear. See how it goes next week, cannot see why I cannot drive again that driving me nuts relying on family and taxis would give me back my independence and could help out again at the Young Peoples Disability Group.

Lady that runs it supporting me to get some benefits. Have to inform all my clients I do gardening for not able to do it this season. Best to be cautious see no point started halfway through the growing season. If did still have the job as an autism Saturday Club Playworker would have been on sick pay for 12 weeks. Was given another statutory sick pay note for another 6 weeks for the benefits office.

Hope to be supported to get my job back again just doing Saturdays only not holiday clubs was unfairly dismissed during my probation when I had a 100% track record volunteering for 2 years and working for 6 weeks. More peed off about it than my right knee and hip problems as I was good at doing it under less pressure and anxiety working once a week that I would slowly increase to evening weekday clubs.

[email protected]
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
12/03/18 Day 55 Post Op

Have had a successful positive start to the new week getting my PIP benefit form filled out by my support worker that runs the young peoples' disability group that I volunteer at every 2 weeks. My eldest sister visited for the day from Nottingham a 75 miles drive to help gather information about my mental and physical disabilities. Then went out for a late lunch and had my 1st post-op haircut just ahead of the school kid rush to the barbers.   

Started to walk with just 1 crutch indoors at home, my right knee feels stable enough, still use 2 crutches when going outside in public. My sister that works as an orthopaedic nurse said should be ok driving again and my mum remembered that the advanced practice nurse said if I feel confident enough and the knee feels ok to drive to give it a go driving locally. I drove with my sister, straight away was confident as soon I pulled away from the car porch where the car was parked up for the last eight weeks. Drove 12 miles around the fast A roads to power up the battery and to warm the engine and break the rust away from the brake discs. If I had surgery on my left knee would not be able to drive yet a manual car. The right hip was hurting more than my right knee that hurts slightly when getting out of the car.

My independence is back was becoming moody and irritable during the last 3 weeks not being able to do my support volunteering jobs. Now I can drive again feel less of a burden not relying on family for lifts to places anymore. Had a letter saying my 2nd post-op consultation has been put back from 2nd May at 09:00 to July 4th at 10:20 a more respectable time missing out on the rush hour traffic.
 
[email protected]
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline kcknee

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I'm glad to read that your recovery is going well. Don't rush things faster than your physio or surgeon have advised. You are still early in the recovery process.

You may not be covered by insurance in case of a car accident if you drive before you are cleared by your doctor or physio. I know you feel ready to be more independent, but make sure you get cleared to drive medically before you start driving alone. I think your physio told you no driving for another two weeks.
12/31/08 - Skiing injury L knee
6/1/09 - ACL stump removed from joint
8/31/09 - ACLr - Hamstring Graft
12/21/09 - Ant Fasciotomy 
8/26/10 - Anterior Interval Release
12/6/10, 5/5/11, 12/22/11 - Fasciotomy
12/7/12 - Nerve Decompression
6/3/13(m), 7/29/13(l), 12/13/13(m & foot) 2/3/14(l) Fasciotomy

Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
13/03/18 Day 56 Post Op

I'm glad to read that your recovery is going well. Don't rush things faster than your physio or surgeon have advised. You are still early in the recovery process.

You may not be covered by insurance in case of a car accident if you drive before you are cleared by your doctor or physio. I know you feel ready to be more independent, but make sure you get cleared to drive medically before you start driving alone. I think your physio told you no driving for another two weeks.


Hi Kristin,

Good point about that I might not be covered if I try and drive before being given the all clear. Some confusion between the Advanced Nurse Practitioner that said if you feel ok to drive then can drive locally, then I saw the physiotherapist afterwards telling me not to drive yet. Agree that it is unwise and risky to drive longer distances at only 9 weeks post-op.

I went out to a cafe and lovely pub overlooking the river seven with my mum and her friend that drove us both, she had her right hip replaced just before Christmas who drives an automatic. Think she was ok to drive 10 weeks post-op shorter distances and she had a more major surgery than I did. Knee surgery always takes longer to recover from than hip surgery or replacement.

Will stick to local driving feel confident with the way my right knee is to drive 1 or 3 miles. Was more of a struggle getting out of the car and walking to pay for petrol than it was for driving. Will only drive for now with someone sitting beside me like I did yesterday with my sister. My ROM limitation remains at 110 degrees if I push any further feel pressure building up around the bottom of the kneecap by the three incisions. Doing the PT exercises daily hopefully will improve over time without creating scar tissue building up again excessively.

Have already got the report from last week Wednesday which is a big surprise for the NHS, my previous reports waited over up to 3 months plus. Will type it out tomorrow of to my weekly small bingo club group shortly and will be picked up. Basically saying there was extensive scarring in the anterior compartment. Confirming Arthrofibrosis for the 2nd time. Still being sceptical at this stage despite praise from my family saying the knee surgery seems to be a success seeing me walking with one crutch in the house and driving. I know my knee best and who knows might be a success after all. We both know how evil AF can be once you have it hard to totally eradicate!

[email protected] 
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
14/03/18 Day 57 Post Op

Letter already from last week Wednesday after my 1st post-op assessment with the Advanced Nurse Practitioner. Glad I stuck to my instinctive thought postponing the 2nd post-op assessment from May to July at a later time When I am more likely to see Prof Snow or his Registrar. Happy to pay to see him privately if they send me back to see Advanced Nurse Practitioner that I have no problems with just be more reassured seeing the top expert that actually saw what was wrong inside my right knee. My 3rd scope has been far more extensive than the previous 2 scopes. If Prof Snow was not in Clinic on July 4th I am more than happy to see his registrar the 2nd best person to who also did the surgery partially that met me to mark up my right knee with a black arrow and explain what will be done in theatre. 


Dear Dr ****

Nicholas returns to clinic today with his mum. He has now almost 7 weeks on from his right knee anterior release distal pole excision and lateral meniscal repair with synovial biopsy. There was extensive scarring in the anterior compartment. His histology has returned confirming hypoplastic synovial tissue showing reactive changes and features of lipoma. There was no evidence of infection.

On examination today Nicholas remains partially weight bearing with crutches. He came to clinic with his knee immobilised in a Don Joy Brace. His portal wounds have healed with no signs of any infection. He has a range of emotion on the bed from 0-110 degree. He has significant muscle wasting but could just about manage a small straight leg raise.

I have talked to him about his operative findings and usual recovery. I have explained to him that he can now discard his Don Joy brace and build up to fully weight bearing status. He should reduce down from his crutches with the physiotherapist as his muscle and stability improves.

I have arranged to see him in 2 months' for review.

Yours sincerely,

**** ******

Advanced Nurse Practitioner to Professor M Snow



Because it says I have arranged to see him again in clinic in 2 months' time for a review. Makes me think will be seeing her again?

[email protected]
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline Vickster

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  • Neelie knee!
Quite possible if she does the follow ups of his straightforward surgeries and issue free  recoveries   :)
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
LK New MRI shows lat & medial meniscus tear & other stuff
RK MRI lat meniscus tear
8/1/15 RK Steroid jab,
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation

Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
15/03/18 Day 58 Post Op

Quite possible if she does the follow ups of his straightforward surgeries and issue free  recoveries   :)

You are right Vicky an Advanced Nurse Practitioner do a great job easing the pressure away from the OS's with a university degree and are highly qualified to assist a consultant. It is fine to see them for the first post-clinic then seeing Prof Snow or his registrar gives more added reassurance psychologically. Patients having the freedom of choice who they wish to see in the clinic even if it means waiting longer to see the main OS several months down the line worth the wait.

Works out better to give it 4 months rather than 2 months as I am now in the hands of the hospital physio, can ask her nearer the time if it is possible to see Prof Snow if he available on the 4th July or his registrar. Do not really see any point seeing the Advanced Nurse Practitioner or Prof Snow in 2 months time unless I have complications with my recovery would then pay privately.

Increasing my PT exercises from today after a week of fairly less intense physio pushing to the pain limits stopping when I know I am straining the knee out. Feel safe to drive moderate distances from next week onwards, driving is one activity I can do without feeling pain and discomfort with the leg and seat set at the right type of angle.

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« Last Edit: March 16, 2018, 05:12:41 PM by Clarkey »
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming