Orthoscopic Surgery and Possible Lateral Retinecular Release of Right Knee

[Myrightkneehurts]

     I have this surgery scheduled for this coming Thursday after an injury to my knee that occurred 8 months ago when I was involved in a head on collision.  I have been doing Physiotherapy on it since shortly after the accident and for the past month and a half I have been doing Acupuncture, Active Release Therapy, Massage Therapy and Exercise Rehabilitation as well.  It did somewhat recover but eventually it seemed to hit a brick wall and not improve whatsoever.  That is when I started the other types of recovery techniques.  My Orthopedic Surgeon now wants to preform this surgery on it and I am a little nervous about the whole idea. 

     To start, here is the MRI results that were taken Just shy of 2 months after the accident:

Menisci, collateral ligaments and cruciate ligaments are intact.
2x1 cm ossification is noted in the distal patellar tendon.  It has increased T@ signal suggesting edema.  Chronic Osgood-Schlatter Disease is suspected.  No evidence of patellar tendon tear.  Small amount of fluid in deep infrapatellar bursa suggests bursitis.  Hot f a's fat is noral.
There is edema in the prepatellar sort tissue.
Increased T2 signal is seen in patellar tendon.  Anterior fibers appear rayed.
Finding suggests partial tear.  Mild edema is noted in anterior superior patella.
Edema along the lateral retinacculun suggests sprain.

Impression
Chronic Osgood-Schlatter disease
Deep infra-patella bursitis
Tendonosis and partial tear of quadriceps tendon.  Sprain medial retinaculum

Most of the pain that still remains occurs on the inside of the knee as well as below the knee cap where the shin bone meets the knee.  My concern is the my OS said that he was 80% sure that he would need to perform the Lateral Retinecular Release. 

Something just isn't sitting right because why would he want to cut into a part of the knee that was not injured and ad more injuries to an already unstable knee?  My chiropractor, who also performs the Active Release Treatment, said that he thinks that he could help to stretch or loosen that tendon without actually having to cut into it......

Any help, advice, or reassurance would be great!

Thanks in advance,
Dan

[Lottiefox]

Dan

You are right to be worried.

A lateral release is indicated in cases of significant patella TILT only. As a standalone procedure it has fallen out of favour apart from in isolated cases where the issue is the tilt and the knee has no instability. Why create more instability in an already unstable knee? What else is he planning on doing during the arthroscopy? Personally this seems like a OS who is looking at a knee 8 months post injury, hearing that things have "stalled" and digging out his "OS quick fix possible ways to surgery the knee" handbook.

I may be cynical but a lateral release will not help unless you have tilt. Even then it is usually combined with a realignment of the patella. Nothing in your description indicates you have a clinical picture that warrants such invasions. A lateral release shifts the dynamics of your kneecap, for good. I'm no doctor and maybe your other inujuries warrant some form of surgery but I'd not be signing up to consent to the lateral release at this time (and I DO have a severe patella tilt but have managed to avoid it so far!!).

Soft tissue injuries can take a LONG time to improve. They stall, get better, stall.....knees themselves appear to take longer than the creation of the world to start to improve....

I can't tell you what to do, but I might be seeking a 2nd opinion....your instincts are saying something isn't right, trust them. You have one knee (well, two but you know what I mean). Be sure before you let someone cut it up.

All the best

Lottie