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Author Topic: new knee problems post surgery  (Read 1142 times)

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Offline Lisa K. Fisher

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new knee problems post surgery
« on: January 04, 2005, 08:25:32 PM »
I am almost 2 years post surgery on my right knee...the doc performed a lateral release, and he scraped my patella to "clean up" the cartilage...I had the same performed on my left knee.

I'm now having problems extending my right leg...almost like it has to get over a hump before it will straighten.

Any thoughts on what the problem could be?  I went back to school and am now without insurance, so I don't want to go to the doc until I find out how bad this might be...

Thanks for any comments...
-LKF

Offline Lisa K. Fisher

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Re: new knee problems post surgery
« Reply #1 on: January 09, 2005, 10:37:33 AM »
anyone?

Offline Heather M.

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Re: new knee problems post surgery
« Reply #2 on: January 09, 2005, 11:43:32 AM »
The reasons for pain after a lateral release are simply too numerous to completely cover in a post--read through the PAGES of posts in the patello-femoral joint section and you will see.

But in general, things you need to be concerned about are continued poor mechanics, cartilage damage, scar tissue, nerve damage, or a completely unrelated problem like a torn meniscus or something.  With the problems you are having with extension, you will want to pay special attention to cartilage damage/chondral lesions, scar tissue/arthrofibrosis, plica syndrome, and even patella baja/infrapatellar contracture.  You can take each of these key words above and plug them into the search engine on this web page first--that way you can find posts that reference these words.  After that, you can go to google.com and look there.  Be prepared to spend time researching....

As for what exactly is going on in your bad knee, only a doctor can tell you for sure.  And you need to see a good one, preferrably an orthopedic surgeon who specializes in KNEES only.  Because PFS (which is likely what you have given your history of lateral release and damaged cartilage) is one of the toughest problems you can encounter in orthopedics.  It takes a genius of a a surgeon--one who is an artist, too--to develop a plan that will help the patient get back to a new state of normal.

Some good links follow which will help point you in the right direction in terms of your research:

(For general info on PFS and patella problems)
http://www.kneeguru.co.uk/html/steps/step_05_patella/mechanics.html

(For specific info on lateral release and failures)
http://www.kneeguru.co.uk/html/steps/step_05_patella/lat_release.html

(Overview of PFS)
http://www.steadman-hawkins.com/pate/overview.asp

(Overview of damage to articular cartilage, which would require the 'cleanup' that you described)
http://www.steadman-hawkins.com/pate/overview.asp

(A great overview of knees and what to look for in a surgeon or diagnostic process--be sure to go to the 'for patients link down the left side of the page, and put your cursor over each of the subjects that appear in a drop down menu--there are multiple sublinks dealing with patellar pain and problems.)
http://www.kneehippain.com

You may also want to look at the book written by Dr. Grelsamer (who runs the last site I listed), called "What your doctor may not tell you about knee pain and surgery."  It's a great general overview of how to be involved with your own knee issues and in developing a plan to get better.

Don't forget the patello-femoral section, where those of us with PFS post most regularly (though of course other posts are including in many other sections, including the crisis board, post-op, general questions, and struggling with pain and rehab).
http://www.kneeguru.co.uk/cgi-bin/KNEEtalk/YaBB.pl?board=PF_joint

You may want to look at some of the other sections, like the soft-tissue healing problems area where several of us who developed complications from our lateral releases 'live' on this board.  That's because the complication that I have, excessive scar tissue, is one which replicates or has symptoms in common with many other diagnoses, especially chondral damage and even meniscal tear.  That's why you need a real knee specialist to help you figure out what's going on.  It doesn't necessarily mean surgery, so you should really try to see a good knee doctor even if you don't have insurance.  Then, work on getting insurance ASAP.....

As for when to go to the doctor, that's up to you...you'll know.  I was originally diagnosed at age 13 in 1982-3, and didn't have surgery until 2001--because I had a good rehab program and did some lifestyle changes to reduce stress on my knee.  Conservative measures are always the way to start, and these are usually pretty affordable.  It's much easier to be proactive now than to wait for the problem to get so bad it needs surgery!  

So anyway, I'd recommend that you do some serious research and find the right doctor to see...to be honest, seeing some surgeon because he/she is the official team physician of the local pro football team isn't really all it's cracked up to be.  It sounds like, with your history, you've got some mechanical issues and genetic problems with the way your knee is put together and the way it moves.  This is leading to early wear and tear on your cartilage, because your kneecap just isn't moving correctly.  That problem requires a special kind of orthopedic surgeon--a patello-femoral specialist--who can work with you to devise a physical therapy regimen that will keep your knee going as long as possible.   Other things you can do to help yourself include:  considering a course of anti-inflammatories, either OTC or prescription; losing weight if you are more than 10 pounds over your ideal weight (I know, it's easier said than done when you can't exercise, but could take lots of stress off your knee--I'm working on it myself....); reducing or giving up impact sports like running, basketball, skiing, etc.; and working with a trainer or physical therapist to target your mechanical issues and get you doing appropriate muscles to strengthen and/or balance your muscles.

You'll find lots more information in the links above.  Hope this information helps.

Heather
Scope #1: LR, part. menisectomy w/cyst, chondroplasty
#2-#5: Lysis of adhesions/scar tissue, AIR, patellar tendon debridement, infections, MUA, insufflation
#6: IT band release / Z-Plasty, synovectomy, LOA/AIR, chondroplasty
2006 Arthrofibrosis, patella baja
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