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Author Topic: Nick's 3in1 Diary FatPadTrim, Medial plica/Distal patella excision, AIR x2, LMR  (Read 262514 times)

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Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
16/03/18 Day 59 Two Months Post Op

Two months recovery is so far going to plan without any major setbacks slowly getting back my independence once again. Driving further distances is not an issue, do not feel any pain while driving apart from the odd twinge in my right hip. Straight Leg lifts can almost raise right up fully that was a struggle when I saw the physio last week Wednesday, which is why she was cautious to let me drive. Safe to drive have full control of the brake and accelerator pedal if it was my left knee had been scoped then I would struggle to push down onto the clutch pedal to engage the gears. 

Still, have got anterior pain and swelling around the 3 main portals that normal at just 8 weeks post-op. Was not an easy decision to pull out doing gardening jobs this year. Will mow my mum's lawn and next door neighbour starting in April who 87 she has got a small lawn, she going to have her whole garden landscaped removing the gravel where the lawn once laid. It easier to mow then having to crutch down and removed or the weeds or using a hoe that can be a backbreaking chore if weeds are hard to get out. Purchased a petrol rotary mower last year spring that far too heavy to carry into the boot of the car, easy pushing it next door is fine and safe never again lifting into carboot solo!

Doing my physio exercises 4 times a day 12 sets the most painful exercise is when I am lying on top of the bed and bring my leg back in towards me with my ROM at 110 degrees can be a struggle at times that I can get through by doing just 12 sets each exercise over the day. Mornings when I have woken up, after breakfast after having a shower, after lunch and bedtime. Know not to push myself too much and can feel scarring inside the portals not sure if I should ask my physio next week Wednesday if it safe and ok to do patella mobilisation that should be done within the 1st 6 weeks that I could not do wearing Don Joy Brace for 7 weeks 24/7 with ROM set at 90 degrees maybe after the 4th week should have had the ROM adjusted to 100 degrees?

No point looking back just cautious after having AIR done twice with extensive scarring in the anterior compartment was fully aware of the risks involved and should know 4 months post op if the surgery has been a success or a failure! Why I was so keen to see Prof Snow rather than the ANP for my next checkup. Arthrofibrosis of the knee is hard to get right again that is not seen every day in clinic, while a lateral meniscus repair is more of a common knee injury. Then it is plausible seeing the ANP for the 2nd post-op assessment review if I did not have the AIR surgery done twice.

[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
17/03/18 Day 60 Post Op

Day 60 post-op marks the ending of my daily blogging sticking to a weekly update on a Wednesday plus key events during my recovery period. Hopefully, the physio I am doing will soon have a positive impact towards my recovery that is a long and slow recovery that cannot be rushed. Still cannot walk too far that should gradually increase. My fashion sense right now looks odd wearing my summer sandals with socks that are easy to slip on and off with velcro straps even when it is freezing outside. Went to Wilko purchased a blue baby sponge for 30 pence wrapping the sponge in white tapping along the handle as my left hand was getting sore.

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« Last Edit: March 18, 2018, 07:46:25 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

Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
21/03/18 Day 64 Post Op

Today physio appointment this morning went really well and have progressed really well over the last two weeks since have my Don Joy Brace was thrown into the clinical waste bin. The physio said I no longer need to use 2 crutches and can walk without a crutch inside the house and using the 1 crutch when walking longer distances in public. My ROM is around 110 degrees that a slight improvement to a fortnight ago when it was hard to get between 105 and 110 degrees.

Can now do even more physio that will help to build up the quads up.

Bridge x10
Clam x10
Single leg stand 5 seconds hold x10
Foot to stand x10
Step up x10 each side


Was nice that she wrote it down without having to ask her, I asked her about my right hip impingement exercises and said she will include it in the exercises. Know bridging and clam are good for building up the hip muscles. Next PT session is Monday 9th April and told me should be ready for going to the gym sessions after she sees me again. Walking in the house without a stick is ok just have to take it easy still knee still gives out slightly and get the odd shooting pain. Still very tight around the three portals and painful if I try to increase the ROM over 110 degrees! Week 10 is still very early days, will not be rushing without walking without a crutch in public over longer distances knee still very weak compared to my previous 2 post op periods after 10 weeks I was walking without walking aids longer distances and was able to swim.

Still get comments saying you be back again soon doing the gardening that is not a great idea for at least the next 4 months. My mum needs so shrubs digging put that died from the cold snap replacing with new shrubs with some of the family saying Nick will soon be able to do it. Met the lady that I do gardening for at petrol station saying she will have to plod on by herself thinking will have recovered soon when I told her will take a while before I am back gardening again. Do not want to step back due to peer pressure saying to me you will soon be physically active again walking long distances and running before you know it.

Know they mean well to uplift my spirits that is a kind thought and gesture, we all know on KG Bulletin Board that recovery is never straightforward that takes time to recover and heal from all the trauma to the knee from the surgery. Have now added a  :) to my one remaining crutch protected with a waterproof laminate coating.

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« Last Edit: March 21, 2018, 10:30:03 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

Offline DogfacedGirl

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Hi Nick,

It's great to hear that your knee is progressing in the right direction! And that you're resisting pressure to do more than is recommended  :)

Kay
1999 Osteoarthritis both knees, chondroplasty
2004 MACI graft L knee
2005 MACI graft both knees
2007 MACI graft R knee
2007 Patella baja
2011 TKR both knees
2011 arthrofibrosis

Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
28/03/18 Day 71 Post Op

Hi Nick,

It's great to hear that your knee is progressing in the right direction! And that you're resisting pressure to do more than is recommended  :)

Kay

Thanks for checking in to see how I am getting 10 weeks post-op recovery period. My only concern is wearing the Don Joy Brace for over 7 weeks with limited movement as they were concerned about damaging the lateral meniscus repair. I might have overdone it slightly walking too far that is easily done thinking the distance is not that far if your knee feels ok walking around a garden centre.

My physio mentioned joining the post-op hospital gym class after my next appointment that I have reservations about joining the class. Too much leg lifts and bridge holds has caused hamstring pain with an increase in tightness around the portals. Can see why physio wants to push harder thinking it will lessen the stiffness that then creates excessive scar tissue. Have cut down to twice a day PT exercises listed by my physio. It very frustrating that PT's very little knowledge towards post-op care after AIR surgery x2 and cannot see myself do gym workouts too soon.

I am happy to do exercises strengthening exercises at home and my local swimming pool avoiding breaststroke and front crawl. Gentle kicking in the water holding onto the bar and wading through the water is a cheaper version of hydrotherapy that my trusted PT said after scope #1 that walking in the waist height water is a gentler form of physio. Still, early days and have reached the where I feel the pressure building to pain if try to get further than 110 degrees! Been doing all the PT exercises 4 times a day x10 now cut it back to 2 times a day x10 each exercise or would end up with pain behind my hamstring going down the back of my calf muscles.

Knew it was going to be an uphill battle to fight of the AF from returning wearing the Don Joy Brace during the 1st 6 weeks post-op the most critical level when it can return again with ROM set at 90 degrees. Do not regret having the surgery proving that I had more of a knee problem than just chronic patella tendonitis with an unexpected lateral tear repair during the surgery that the MRI failed to pick up on that might have been why I had an increase in effusion which giving the green light to go ahead with scope #3.

[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
04/04/18 Day 78 Post Op

Knee seems to be ok until I try to be more active going up and down the stairs more often that I thought would be ok at 11 weeks post-op. Still getting pain at the back of the knee by the hamstring. When doing leg raises feel pain around the 3 portals, still need to use one crutch as the knee gives out slightly if I walk further distances outside the house. Maybe I should be using the crutch inside the house when going up and down the stairs not ditching it indoors as my physio advised me to do.

Can see her point of view to get the muscle firing again and stronger not resting too much being more active inside the house. No way can I apply for any jobs for at least for the next 6 months. I have already filled out my PIP application form as the jobs I enjoy doing gardening and support work involves being on your feet all day and at times having to lift and squat.

Maybe was foolish of me to cancel the 2-month review after my 1st post-op appointment with the advanced nurse practitioner insisting that I see Prof Snow in 4 months in July that is now only 2 months away. I might have done too much over the Easter weekend with all my family get together, 27 in total for Easter Sunday lunch of 3 legs of roast lamb. Walked more the last five days that I last did pre-op. Need to start to slow and limit my distances once 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 DogfacedGirl

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Hi Nick,

Steady as she goes, it sounds like you're getting there  :)

Kay
1999 Osteoarthritis both knees, chondroplasty
2004 MACI graft L knee
2005 MACI graft both knees
2007 MACI graft R knee
2007 Patella baja
2011 TKR both knees
2011 arthrofibrosis

Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
11/04/18 Day 85 Post Op

12 weeks post-op and my recovery period is going really well gaining my ROM from 110 to 115 and can just about get to 118 which means have almost gained full ROM of 125 which is good enough to most daily activities. My physio is really pleased with my progress with extra exercises to loosen my tight calf and hamstring muscles.

Did try to walk outside without my crutch longer distances, struggle with a sharp pain at times that does not occur if I have my crutch. Will still use them outside when shopping. My physio will see me one more time before light gym classes that is not too intense. Why I was reluctant at first to attend the gym sessions that should be beneficial. Asked about swimming, can do a gentle swim not too many lengths avoiding breaststroke! Walking in the water is helpful in the recovery process that I will start doing after seeing the physio before attending the hospital gym classes.

[email protected]
« Last Edit: April 16, 2018, 08:04:27 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

Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
16/04/18 Day 90 Three Months Post Op

My recovery after scope #3 is going really well so far, three months into my recovery period everything is going to plan so far without any further complications to report so far. I can now walk ok without a crutch to support my right knee as my quads slowly building up again if I do not walk too far. I can walk up to the top of my road to my local corner shop that goes up a steady slope being careful walking back down again. Going up feels fine just a bit of niggling pain around the portals going down again.

I have arranged to have my physio sessions locally to where I live at a private hospital using NHS choice that has a large physio team and department. Nothing against the NHS just the traffic is a nightmare getting to Birmingham Royal Orthopaedic Hospital with roadworks along the M5 motorway and A38 the main road the hospital located on. Can get to the hospital in 30 minutes if traffic is light if it is bad can take up to 3hrs that is not worth the risk plus saving on petrol and can have a cappuccino at my favourite local cafe after physio in Droitwich Town Centre that around the corner of the hospital the former Droitwich Knee Clinic. Parking in The Droitwich Spa Hospital costs 1.00 for one hour at Birmingham Royal Orthopaedic Hospital is 3.80 for 2hrs parking plus the cost of a 30-mile round trip compared to a 2-mile round trip.

Still, have to be careful tempting and easy to overdo it too much, the right hip can be up and down one day hardly any pain then suddenly comes back with revenge having sudden sharp shooting pain carrying shopping bags from the car that I hope subsides. Seeing my OS again about my right hip for a 6-months review in June did not rebook to see the physio for my hip want to focus on my right knee recovery. Once Prof Snow refers me to Droitwich Spa Hospital for physio will call my hip OS secretary to have physio done by the same physio makes sense and is more practical.

If you do not ask you do not get and was surprised how straightforward NHS choice went this morning without any hesitation that it could pose a problem transferring to another hospital. Will still go to Birmingham for my follow up OS consultations.

Been busy last couple of weeks which is why I have not been on as often on KG with my book writing going really well. My talk last week Thursday went really well at the National Autistic Society about being wrongfully convicted while going through a breakdown period with my dad with terminal leukaemia with wrong meds and poor management with the audience really engaging with my story that made hit their emotions showing how badly I was mistreated. My sister saying what the family and I had to go through. 

Book chapter will come out on October 24th, 2018.

https://ercvoices.com/participants/nick-nell-chloe/

If you are on Twitter can see the latest news about my talk last week.

https://twitter.com/SuffolkPunchASC

Glad that people are finally realising that far too many autistic people of all ages are given a wrongful conviction with unfair negative labelling and biased opinions from the press, media and public that now seem to see the injustice.

[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
26/04/18 Day 100 Three Months Post Op

One hundred days, it all going well so far 14 weeks post-op with slow steady progress. My ROM is still around 118 when I saw my physio on Monday who printed of personal exercise program works sheet with illustrated diagrams using the website www.physiotools.com/ as it would struggle to remember all the 9 different exercises. 

It also for my right hip my personal exercise program doing calf and hamstring stretches with lots of tightness around the calf muscles and quads. Avoid doing one of the 9 that would be challenging for someone with a healthy knee! Sitting with your arms crossed standing up and sitting down again on my right operated leg single leg squats. I am doing it with both legs as the pain is around the same level around the portals as it was when the physio I saw after scope #2 forced my ROM over my pain bearing limit so will not be sitting up and down on my right leg only. 

My walking pace is slow even though my speed has improved since ditching the crutches get overtaken by the elderly that are 30 plus years older than me. The portals feel tight and sore with swelling around the bottom of my kneecap could try doing friction massage therapy to help break down the scar tissue that my physio suggested doing. it might not make much difference 14 weeks post-op, can hear the scar tissue cracking if I squat down and come back up again.

[email protected]
« Last Edit: May 09, 2018, 08:39:51 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

Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
02/05/18 Day 106 Three Months Post Op

15 weeks post-op and can now walk further distances with the knee holding up well as I can only go at a certain pace at the moment that should slowly improve. The right hip seems to be more of a problem, one day it fine think I do not have any hip impingement problems and other days feel pain and discomfort around the hip socket. Seeing the young adult OS on June 15th for the 3rd time, Have already had an cortisone injection in April 2017 that has helped a lot with no groin pain more bone pain on a bad day.

What he said on his YouTube video is that many patients around my age late 30s to early 40s that come and see him when it is too late! With patients in their 30s requiring a new hip that could have been prolonged if they came earlier when key hole surgery to clean out the cam joint that acts like a head gasket on a car when the seals goes then the problems start to escalate more. A small labrum tear, joint effusion and bilateral cam lesions came up on my MRI scan that basically means the cam socket might need to be smoothed over so hip socket glides better with less friction to help reduce wear and tear.

Will carry on for another 6 months again to see if it improves as it hard to know after my right knee surgery if the hip pain improves once my quads muscles become stronger again. Still want to work as a support worker for young people with additional needs, would like to be as physically active as I possible can that is not possible right now. Do at times feel a clunking sensation when my hip at a certain angle like when I was washing my car bending down, just weary to tell my OS as he might say he might want to scope the hip! Been told hip surgery is not as bad as knee surgery with more of a success with a faster recovery.

See what happens might do another review in 6 months time in December is my gut feeling. Has anyone else had the same type of hip injury, did PT help solve it or had to opt for surgery once it gets to a certain point.

[email protected]
« Last Edit: May 09, 2018, 08:40:09 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

Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
09/05/18 Day 113 Three Months Post Op

Not much to report back this week as the knee seems to have reached a stage where it just remains the same not improvements or setbacks. Keeping on top of my daily PT exercises just cannot see any improvement in my quads that are not becoming any firmer when I tighten the quads cannot see any quad muscles outline that is flat flabby. Cannot say if the knee surgery was a success unless I can start to see my quad muscle getting back into shape again.   

Soreness in the same spot around the three portals and walking at the same slow pace and distances reaching a certain distance before pain starts build up around the portals. Going down hill feel it more, not so bad going up hill or flat surface. Hip is behaving ok just a bit sore at times around the hip socket. The body adapts to the pain after a certain time period body becomes familiar with the pain that can suddenly increase without any pre-warnings.

[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
16/05/18 Day 120 Four Months Post Op

Four months post-op and would say at this stage I am at the same stage as I was pre-op to scope #3. My walking pace is slighter slower which is normal as it takes time to get the quads built up trying to fire them up once again. Doing my daily routine PT exercises not just for my knee also for my right hip cam impingement with caution towards single leg squats! Too many physiotherapists lack knowledge when it comes to AIR surgery and chronic patella tendonitis decompression surgery treating it as they would with any other type of knee surgery. When I had private physiotherapy after scope #2 he used an ultrasound with gel over the portals after deep friction massage therapy.

With more strain on my left side getting sharp shooting anterior pain on my left knee on the medial side that has some slight swelling around it. PFPS is the culprit along with maltracking that was spotted by Professor Snow a while ago when I had my 1st assessment with him. My age as well coming up to 40 at the end of the year, some slight wear and tear is normal. As long as the sharp shooting pain is not regular pain can live with it, won't have any kind of treatment carried out for some time hopefully.

Friction massage is painful and sore on the medial portal, in particular, the lateral and middle portals are not to sore when pressing down in a circular motion. Not sure if Graston technique is worth considering at 4 months post-op or leave it longer before trying it out or avoid it altogether. I doubt the NHS give patients the option to try out GT rather than trying deep friction massage therapy myself. Patella mobilisation needs to be done within the first 6 weeks post-op. This was not possible wearing a leg brace for 7 weeks post-op.

Up early tomorrow morning to celebrate my mum's 80th Birthday on Friday in Vienna for a long weekend with my sisters and brother. Hopefully my right knee will hold up well with lots of walking around at the airports and streets of Vienna.

[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
23/05/18 Day 127 Four Months Post Op

Right knee seems to be holding up well after walking a fair bit last week in Vienna with the whole family for my Mum's 80th Birthday celebration weekend. Longer distance walking is fine if I walk at a slow pace and stick to flat surfaces. At least I am no worse of post-op, just slightly slower in my walking pace than I was pre-op. Still the same pain and discomfort around the portals if I try to speed my walking pace that was the same pre-op anterior knee pain so can say surgery had not been a success or failure, it has been neutral. Have tried all options and accept the right knee as it is with not too much pain at the moment, more discomfort around the portals, the knee giving out slightly at times.

Hopefully it improves over the next couple of months so I can increase my walking speed. If I can jog short distances around this time next year, would be a big bonus. No luck with NHS choice at my local private hospital where my mum had her left knee and hip replacement and PT done on the NHS. When Prof Snow did a referral for my patella tendonitis was going to see someone at my local hospital PT department. Because it was more specialised, saw the head physio of the Birmingham ROH. Prof Snow secretary said to get my NHS physio to make a referral, she said I would have to be a private patient and can only have 5 appointments on 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
30/05/18 Day 134 Four Months Post Op

Recovery so far is going better than expected with minimal pain and discomfort walking on flat surfaces. Can feel the scarring around the portals when sitting down and straightening my right leg. Feel pressure around the three portals, causing anterior pain. Can take large strides without feeling any anterior pain that was more painful pre-op.

A good mixture of improvements and setbacks as one would expect at 19 weeks post-op. Doing my PT exercises with calf stretching to help loosen the hamstring muscles behind the knee. The damp humid thundery weather the UK is experiencing right now is highlighting the surgery carried out that is normal and acceptable after 3 surgeries. 

Have days when I think my right hip is ok until I feel sudden sharp shooting pain that is agitated if I am bending down, cleaning and doing light gardening. See what my OS says about my right hip cam impingement when I have my 3rd review with him next month. Might want to do another MRI scan to see how the arthritis is progressing? Hip pain is different to knee pain it not as obvious. My mum was doubting a few days before her left hip replacement if it was really necessary on good hip pain days, on a bad days she realised it best to go ahead with a left new hip.

[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