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Author Topic: Plica surgery recovery problems  (Read 2628 times)

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Offline phoenixrunner

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Plica surgery recovery problems
« on: January 09, 2005, 07:04:47 PM »
Hi everyone,

I'm wondering if anyone out there has had a complicated recovery from plica surgery.  My doc said after surgery that it was obvious that an inflamed plica was keeping me from running.  He took out the plica and said the rest of the knee looked great. That was 8  months ago! I still have trouble going up stairs and I can't run.
I'm still doing knee strengthening exercises...and they seem to help...but only minimally.
I'm starting to loose hope that I'll have a working knee again. (Let along compete in triathlons and long distance running events!)
Any Advice?
L in Phoenix, Arizona, USA

Offline Heather M.

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Re: Plica surgery recovery problems
« Reply #1 on: January 09, 2005, 09:28:25 PM »
The problem with plica surgery in runners and other athletes is that plica syndrome can *sometimes* be a sign of an underlying tracking disorder--i.e. poor knee mechanics.  And if you have poor knee mechanics (also known as mal-tracking and PFS) then, impact and running sports will likely hurt your knee until you can build the muscles up enough to protect the joint.  Yet you are going to have trouble building the muscles up because of the pain...it's a really tough cycle to break.

Do you have a good PT?  I found a fantastic one in Scottsdale--I traveled 50 miles one way to see him.  That's how much he helped me!  He worked out of a great clinic at Scottsdale and Acoma, in a practice together with a neurologist, nutritionist, and performance enhancement therapy.  He is both a physical therapist and a certified athletic trainer.  He knows bum knees, and he knows how to tape them and trick them into breaking the pain cycle and building muscle.

Consider getting an opinion from a sports medicine specialist like this PT I used to see.  It will only take an hour or so of your life, and the benefits can be unbelievable.  One of the assistants there was a former marathoner who had mal-tracking surgery and was grounded for years...she worked with this PT for THREE YEARS before she was finally able to resume running with minimal pain.  She now does triathlons.  I can't recommend this center highly enough, and if I didn't live in Sedona I'd still be going!

Let me know if you are interested--I can send you a private message with the name of the place and the therapist.  I know there was talk when I was last there about a year ago of splitting the two practices (PT and neurology/spine clinic) but that was supposed to be on paper rather than physical.  Even if this guy isn't there any more, I'm sure they will give you contact info.

Heather
« Last Edit: January 09, 2005, 09:30:39 PM by hmaxwell »
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
http://www.flickr.com/photos/hmaxwell

Offline phoenixrunner

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Re: Plica surgery recovery problems - to Heather
« Reply #2 on: January 10, 2005, 03:32:32 AM »
To Heather who responded to my post,

Hey, i'm new to this website, and a bit behind technology in general...but,  I'd love to know the name of the Scottsdale Clinic that you went to! At this point, I'm willing to do just about anything to have a knee that works right....and my life has been really compromised due to not being able to race. (long distance running, triathlons.)  You said that you could give me the name of the clinic ....how does one go about this? Should I post my email address?

Thanks a ton!
Laura
central phoenix
Arizona, USA

Offline Heather M.

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Re: Plica surgery recovery problems
« Reply #3 on: January 10, 2005, 10:41:04 AM »
Laura,

We have a private message or email system on this web page.  When you first click on the 'bulletin board' link and the board opens up, if you look in the upper right hand corner of your screen you will see a greeting to you that says "good morning/afternoon/evening Phoenixrunner, you have X# messages."

The last bit after the comma is in blue text.  That means it's a link that you can click on it.  Once you do that, you will be taken to your private message inbox that you can only use on this board.  You should find my message there.  It's a little confusing sometimes to figure out who is sending you messages, because for some people the name listed in the to or from line of the private messages is not necessarily the name that they sign or that you see when you read their posts.  For example, when the Kneeguru posts a message in the regular bulletin board section, her name is listed as 'kneeguru.'  But when you get a message from her, or when you send one to her, the to or from line will say 'admin.'  Hope that's not too confusing, just wanted to warn you.  It took me the loooongest time to figure that out!!

Anyway, to get to your private message box, just click on the blue text that will be on the upper right hand corner of each page you view inside this bulletin board.  If you want to send a message to a person, the easiest way is to find one of their posts and click on their name as it appears to the left of their message text--that will take you to the person's profile, and if you go to the bottom, you will see blue text that says 'send this person a private message.'  Or you can just reply to someone who has sent you a message when you are inside your inbox.  Then, when you are done with the private message feature, click on the outline or 'tree' with little folder icons on the upper left corner of that appears just above messages and posts--all you have to do is go to the levels of the outline you want to travel to by putting your cursor over it and clicking.  So if I were to click right now on 'DAILY BULLETIN' (which is what I see in the upper left corner above all the smileys and the subject line of this post, since this 'general knee questions and comments' section is a sub-section of the Daily Bulletin) it would take me right back to the first screen you see when you enter the bulletin board.

It sounds confusing, but you'll get the hang of it by using the board more and more.  Anyway, I will send you the name and number of my fantastic former PT, and hopefully you can set up a consult with him ASAP.  Your OS or general physician will need to write you a prescription if you want insurance to cover the visit--the initial consult can get a bit pricey because the PT spends basically an hour to 90 minutes exclusively with you.  

In addition, there are several other sections you might want to visit.  Either you can use the 'search' feature which is found near the top left-center of the page and look up 'plica syndrome' and other keywords (this will pull up hundreds of posts where the word 'plica' appears), or you can concentrate on the main sections where those with plica syndrome post.  These include:  the crisis board, post-op diary, general knee questions (the section we are in right now), struggling with pain/rehab problems, soft tissue healing problems, and the patello-femoral joint section (this last one is several sections below the 'daily bulletin' under "Specific Knee Topics--Where troubles start."  This last section is the main place where you fill find LOTS of archived posts regarding plica syndrome, surgery, and recovery.

I would definitely read up on your problem and then go see Nate (my previous therapist) and get his take on what he feels is going on.  Likely he will do bio-feedback and patellar taping, E-stim assisted exercises like retro-treadmill and so forth--and maybe other stuff, depending on what he finds.  

Cont'd
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
http://www.flickr.com/photos/hmaxwell

Offline Heather M.

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Re: Plica surgery recovery problems
« Reply #4 on: January 10, 2005, 10:41:23 AM »
(Cont'd)

Also, for your research, there are a couple of culprits that you might want to read up on to see if the symptoms fit what you are going through.  These include PFS (patello-femoral syndrome or poorly tracking knees, tilted kneecaps, mal-alignment, and even the catch-all 'chondromalacia' or chondral defects or osteoarthritis--depending on your age and the state your knee was in at surgery time).  Another thing to consider would be one of a number of over-use problems:  IT band syndrome (this is a big one with runners, it's even called "runner's knee," tendinitis, tendinosis, etc.  Another possibility would be complications from the plica removal surgery you had--including arthrofibrosis/excessive scar tissue, severe muscle atrophy or imbalance, nerve damage (especially RSD), and a couple of other things.  Or, it could be that you simply have  a new, unrelated problem (like a torn meniscus).  You could even be experiencing delayed healing times--not everyone heals on a schedule, though I would say that someone who was in great shape pre-op would likely expect to be appreciably better by now!

I hope some of this information helps you.  Another incredibly helpful resource is the book "What your doctor might not tell you about knee pain and surgery" by Dr. Ronald Grelsamer.  He understands knees and has done extensive work with PFS and tracking problems.  You can see excerpts from his book at http://www.kneehippain.com

Another great site is http://www.steadman-hawkins.com/patientEducation.asp  Especially focus on the 'chondral defect' and 'patello-femoral pain syndrome' pages, though the meniscal injury section might also be helpful.  Finally, if you haven't already visited the kneeguru's 'general info' link at the top center of each page, check it out:  http://www.kneeguru.co.uk/html/steps/steps_menu.html Pay particular attention to step 5 and step 8.

Hope this info helps.  I would also ask Nate when you see him who he would recommend in town to give you a second opinion with respect to whatever he finds going on in your knee.  Unfortunately, I've been through just about every major practice in the Phoenix Metro Area...and didn't find a really good PFS specialist.  Most are sports medicine docs--and that's great.  But PFS and plica problems are a pretty specialized sub-group of orthopedics.  I saw a fantastic surgeon recommended by everyone I spoke to...but he didn't have a lot of experience with my crummy, mal-aligned kneecaps.  For someone with PFS as I had it, there are at least 6 different surgeries that a skilled PFS specialist orthopod would consider doing (depending on what he felt would help me most).  But the doctor I saw only knew one procedure to do for this problem (lateral release) and it turns out that was just the wrong thing to do!  And then I saw another doctor (Phoenix Suns' team physician) and he also didn't have much in his arsenal to battle PFS...so he couldn't point me in any different direction.  If I had just seen a PFS specialist in the first place, likely I wouldn't have had the lateral release at all, but instead would have had one of the other, more involved surgeries to reposition the kneecap!  Live and learn, right?

Not to scare you, but I eventually ended up traveling to Colorado (Vail) to see a specialist.  I wish I'd done it much sooner.  I'm sure there must be PFS specialists in the Phoenix metro area, but I certainly didn't find them when I saw at least one surgeon from each of the six most highly-regarded practices in the area...

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
http://www.flickr.com/photos/hmaxwell















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