Follow-up, post-op (was: CONUNDRUM: 3 Top Knee Specialists... 3 Opinions!)

[Skinnycatz]

Chillydogs...

I don't need a plane ticket to Vegas...we live in Southern California so we drive there often!  In fact, we are in Vegas right now!

The last OS I saw offered me PRP injections...he was going to inject the whole area around the patella tendon and was going to charge me $1000!  I don't think that is a good deal...  tell me where to go in SoCal to get a good deal on PRP and I will! 

Francine

[CHILLYdogs]

Hey Skinnycats!

I've read some of your posts in the past. I know you know better than to assume good things will just come to you, or that you might rely on Lady Luck to give you your life back. 
It's a tooth and claw business, and you have to FIGHT for this.
I know you know this, though, but don't mind reminding a kitty who in spite of being a skinny one I am sure has some awesome claws at the ready. So, don't keep them retracted like that.  Bring them out!

My sincerest best wishes to you on fighting the good fight,

CHILLYdogs

[NotSuperhuman]

At $150/dose, it hardly seems you'd need to "get lucky in Vegas"!!!
Use the money you'd save on the plane ticket to find yourself a good doc (Yes! they DO exist!) and to buy yourself a chance for a life without knee issues.

Just want to let you know how much it costs me. I pay $215 per PRP session, which includes multiple injections. I'll probably have to have a minimum of four sessions per knee. That cost covers the kit (centrifuge, etc) but not the injections. My insurance (UHC) pays the rest, and I'm not sure how much that is.

[amy1]

I went through the same thing about three years ago.  I live in the tri- state area.  One doctor had done a successful arthriscopic proceedure on my other knee and while not nationally/internationally known is well regarded locally.  A second doctor had a good reputation but was one of the most egotistical people I ever met.  I would never want someone doing surgery when I did not feel that he/she would be willing to listen to me.  The third doctor is well regarded on a national level.  A few co workers and a local pt all fellt that he was excellent.  The fourth doctor is internationally regarded, part of the international pf study group, head of patella femoral reconstruction at a major hospital and was chosen as top docs in castle connoley for several consecutive years.  Even though the last doctor was about a 1 1/2 hour drive, I chose him.  Research confirmed that he is skilled.  Most important to me is that he is very into patient advocacy.  He was  very willing to answer questions and encourages his patients to do research and ask any questions that come up after doing research.  I did not feel at all presured into having surgery. All four doctors came up with the same diagnoses, and similar comments (your knee is a disa ster).  Three of the doctor's approaches to treatment were basically the same with some little twists.  I went with the doctor that was well veted and made me feel most comfortable.   I knew going into surgery that in the future, I am absolutely facing a knee replacement.  The doctor did a proximal realignment with removal of spurs on the edge of the knee cap iin hope of stalling off the need for a knee replacement for 7 or 8 years at which time I will be in my late 50s.  So far, I am feeling pretty good.  I get ocassional temporary flare ups but am quite functional and as long as I stick with nomal activities (no activities that put a lot of stress on joint), I am pretty much pain free. I had very good range of motion early on.  Hopefully when I eventually need a knee replacement, I will be a match for a partial Kinemade joint.  If you need the name of someone in NY, I will be glad to share his name with you.
Good luck

[Skinnycatz]

Hi Amy...

I wish I was in NY but I am at the total other end of the country...in Southern California.  I can't seem to find a doctor that specializes in PF issues here.  If you go back to your doctor anytime soon, could you please ask him if he knows anyone good out here?  I would really appreciate it!

Also, I was curious, you said you are pain free if you stick to normal activities...does this mean you aren't able to exercise?  To me, this would be totally unacceptable.  As it is now, I barely get any cardiovascular exercise and nothing that is weight bearing.  It is also very difficult for me to strengthen my legs although my upper body is looking pretty good! LOL

Take care...

Francine

[amy1]

I am able to exercise but I would be afraid to do very aggressive activities.  Then again I also have back issues going on also.  The doctor did not place restrictions on me but instead told me to let my body guide me.  I am able to function very well.  I work 48 hours a week and then I also am active. I am able to swim, hike, bike ride etc etc.  If I wanted to be involved in more aggressive activities, I could have had a knee replacement done but for me, my knee does not really limit me.  I do believe that I have heard good things about Dr. Scott Dye, however I have not had any personal experience with him.  I am pretty sure that the doctor I used would be able to give you the name of a doctor in California if you e-mailed him.  I do remember him saying that there are four doctors that he would recommend and I know one was in California.

[Aztec]

It's been 2 years since I saw the surgeons, and over 4 years since these symptoms started. I had never been in pain, just a lightly swollen knee with difficulty reaching full extension, stiffness, all made worse by loads like lifting or cycling.

4 months ago, I gave up and had the anterior interval release. I was delighted to hear that the suspected problems were legit (synovitis, scar tissue, adhered fat pad, etc). I had zero pain post op, never needed pain meds. 2 weeks on crutches, and then a week or so of one crutch.

Unfortunately, as I began loading the knee for rehab and even going up/down stairs, I developed pain. That has declined about 90% or more from the combo of time and strengthening. The bummer: the original symptom of a feeling of swelling in the knee has returned, along with a little visible swelling below the kneecap. By now, that quad is very atrophied.

Both the surgeon and a second opinion agree that it's highly likely to be the fat pad. It is either inflamed or has regrown to where it was before. I have the highest respect for and trust in these guys. I just wish they had something I could do to improve. Rehabbing that quad is a good place to start, but how am I to rehab a weak quad without making the fat pad problem worse? I've tried, various PTs have tried, nothing works.

Has anyone overcome a chronically inflamed fat pad?

[captainruss]

 A poster by the name of missmyknee has more information than any OS I have ever met.  Before you do anything or let one of these egomaniacs cut on your knee, look at her blog!  If you search "AF Research" the amount of information is outstanding.

Good luck.

Russ

[prech]

It's been 2 years since I saw the surgeons, and over 4 years since these symptoms started. I had never been in pain, just a lightly swollen knee with difficulty reaching full extension, stiffness, all made worse by loads like lifting or cycling.

4 months ago, I gave up and had the anterior interval release. I was delighted to hear that the suspected problems were legit (synovitis, scar tissue, adhered fat pad, etc). I had zero pain post op, never needed pain meds. 2 weeks on crutches, and then a week or so of one crutch.

Unfortunately, as I began loading the knee for rehab and even going up/down stairs, I developed pain. That has declined about 90% or more from the combo of time and strengthening. The bummer: the original symptom of a feeling of swelling in the knee has returned, along with a little visible swelling below the kneecap. By now, that quad is very atrophied.

Both the surgeon and a second opinion agree that it's highly likely to be the fat pad. It is either inflamed or has regrown to where it was before. I have the highest respect for and trust in these guys. I just wish they had something I could do to improve. Rehabbing that quad is a good place to start, but how am I to rehab a weak quad without making the fat pad problem worse? I've tried, various PTs have tried, nothing works.

Has anyone overcome a chronically inflamed fat pad?

How goes your knee these days?  Perhaps consider injection or oral cortisone in an attempt to shut off the inflammation?  Is it warm/hot, as well?  Possible to be low grade infection.

Was the procedure done by Dragoo?

[captainruss]

Prech,

It has been a year since anyone posted on this thread, although all of the issues remain relevant and important, especially if you have a knee and cannot get doctors to agree.  I had six agree and all six were wrong, but I still search for someone who has the answers.

Maybe you can start a new thread asking the same question you did with this post?

Happy New Year!

Russ