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Author Topic: Back (finally) and back under the knife  (Read 914 times)

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Offline Beauzer

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Back (finally) and back under the knife
« on: January 14, 2005, 11:46:58 PM »
Hi kneefriends,

I've been gone for awhile.  Basically I've been taking a knee vacation (ever need to not think about your knees for a bit? ::))  Anyway, here's the scoop.  After getting scoped last January for bad post-traumatic arthritis, I did OK for a few months.  Then my unloader stretched out my medial capsule/MCL plication.  So, after getting the major run-around by the big sports group here in town, I finally found somebody who can address the problem.

So, I'm scheduled for yet another arthroscopy on 1/31 (this will be #7) to get a better assessment of the ligament laxity and cartilage damage.  Then it's off for a MCL re-reconstruction and mega-OATS (or ACI, or TKR) depending on how bad everything is.  Not thrilled, but relieved (I guess...) :P

Be well everybody.
Danielle
32 - R knee gone to hell
lat. meniscus 94
ACL, chondroplasty 98
Chondroplasty 99
Screw fell out into joint, med. meniscus, microfracture 99
MCL/med. capsule recon, med. meniscus 00
Chondroplasty 04
Chrondroplasty 1/05
OATS 4/05 for OCD lesion
AVN, MFC fracture 10/05

Offline Heather M.

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Re: Back (finally) and back under the knife
« Reply #1 on: January 15, 2005, 12:10:40 AM »
Danielle,

Good to hear from you.  I was hoping you'd gone because your knee was feeling great and you were out there treating patients.  Sorry to hear that it's still got you down.

A couple of thoughts on your diagnosis:

*Have you been asssessed for HMS (hypermobility syndrome) or generic connective tissue disorder?  I have what my doctor called (a made up term, he admitted ;-) ) gross joint hypermobility.  So I can't do the standard party tricks like touching my wrist with my thumb, hyper-extending my elbows, turning my feet around so the toes point in opposite directions.  BUT, all of my 6 largest joints are hyper-mobile:  hips, knees, shoulders.  My spine is as well--I can do my own chiropractic adjustments by simply maneuvering my body.  So my surgeon is actually able to dislocate my 'good' kneecap with slight pressure from his thumb.  Ewwwww.  And my shoulders hyper-extend and over rotate, which has led to chronic tendinitis.  The hips are so mobile that the PT has to put my foot up well over my forehead before I can feel any kind of hamstring stretch.

In short, they call me Gumby.  This can lead to chronic stretching and ligamentous laxity.  This might explain what's going on with your ligaments constantly getting stretched.  Though it sounds like this is also a side effect of the unloader brace?  That sounds terrible....darned if you do and darned if you don't.

Anyway, when you have ligamentous laxity that has resisted surgical treatment, sometimes a treatment called thermal shrinkage can be helpful.  I know someone who had a failed Maquet procedure--she kept dislocating despite all the medial reefing/tightening and the patellar tendon transfer to anchor her kneecap in place.  She was on crutches full time, and her old OS wanted to do a TKR!  She went to see Dr. Steadman and did a kinematic MRI (in motion) and they discovered she was essentially dislocating with each step.  He did the thermal shrinkage and she's much better--she's stopped posting entirely on Kneegeeks.  That's a great thing.

Also, I was wondering if you've had any luck with patellar taping using the newer generation of tape (Kinesio Tek is awesome)?  I did get a lot of relief from that during my PT exercises.  It is true that the tape loses its...ummph, for lack of a better term.  A lot of studies say it only lasts for a few hours or so.  But it really helped me a lot.  And it shouldn't stretch things like an unloader.  I've also heard that unloader and other types of braces can actually stretch to the point of being ineffective--how old is yours?

Keep me posted on the OATS or cartilage restoration.  I'd love to hear what your doctor has to say, and whether his technique can be done on the back of the kneecap.  I just found out I have a very deep lesions--ulcer--that is causing really debilitating pain.  The last doctor I saw (one of the best of the best, supposedly) says that until I get that taken care of I won't get relief.  So I'm very interested in following your doctor's treatment plan.  I also discussed TKR, but the doctor thougth it was overkill, since I have only a couple of areas of very deep damage.  The rest of it looks, and I quote "pretty good, all things considered."  Hrmmm.  Is this inscrutable doctor speak?  Maybe you can translate that for me.....;-)

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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Offline Beauzer

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Re: Back (finally) and back under the knife
« Reply #2 on: January 15, 2005, 02:52:47 PM »
Thanks Heather.

I'm pretty sure I don't have HMS.   I'm not particularly flexible anywhere.  I guess I could have some connective tissue problem, though, since I've torn a lot of ligaments (and strange ones, at that) with not-so traumatic events.

I'm not sure the shrinkage thing would work since I've already had a plication and it's a large surface area (MCL and medial capsule).  Patellar taping?  Never tried it.  Patellar tracking is the one thing I've never actually had any trouble with.  The unloader was for the medial compartment arthritis.  I'm not sure you could tape that (although, I'm getting some funny mental pictures on this one ;D).

Overall I'm "pretty good, all things considered".  Just means, it's better than expected.

Danielle
32 - R knee gone to hell
lat. meniscus 94
ACL, chondroplasty 98
Chondroplasty 99
Screw fell out into joint, med. meniscus, microfracture 99
MCL/med. capsule recon, med. meniscus 00
Chondroplasty 04
Chrondroplasty 1/05
OATS 4/05 for OCD lesion
AVN, MFC fracture 10/05















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