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Author Topic: ARTHOFIBROSIS specialisted recommended in Australia  (Read 3114 times)

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Offline sportychic

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ARTHOFIBROSIS specialisted recommended in Australia
« on: July 07, 2005, 12:06:20 PM »
I have been trying to find an orthopaedic surgeon who specialises in arthrofibrosis in Australia and every clinic or office I ring give me grief.

Any suggestions?

I had ACL reconstruction april 05
septic arthritis 2 weeks later with debridement (followed by 40 and 0)
4 weeks later MUA (90 and 10)


Now my OS wants to do another MUA followed by a cast??     

I need a second opinion but don't know who to go to.


HELP
ACL April 05
Infection May 05
Manipulation June 05
Still on Crutches
?RSD

Offline favouritesearcher

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Re: ARTHOFIBROSIS specialisted recommended in Australia
« Reply #1 on: July 10, 2005, 09:25:25 AM »
Hi,

I've also looked for an arthrofibrosis specialist in Australia without finding one.  In fact, I wrote to Shenagh just two days ago.

Heather M suggested looking in Australian medical journals for surgeons who have written about it.  I looked in the AMA journal but there was nothing.  I also looked in a few databases of journals under the "medical" subject in "Australia" but that also came up with no useful journals.

I also looked on the Steadman-Hawkins site for an Australian doctor who might have done a fellowship with an arthrofibrosis specialist but again couldn't find one in the last five years.  There are other arthrofibrosis experts apart from Dr Steadman but I haven't looked for Australian doctors who have done fellowships with the other experts.

You don't necessarily need a surgeon who has done research on arthrofibrosis, just someone who has an excellent knowledge of the knee and who understands how it works and where scar tissue can be causing problems (and has done his/her reading on arthrofibrosis).  At the very least, an excellent knee surgeon, not a general orthopaedic surgeon.  I couldn't find an arthofibrosis specialist in Australia when I was looking last year, and I couldn't find one when I looked last weekend either.

1.   The kneeguru web page has the names of some clinics in Sydney:
http://www.kneeguru.co.uk/html/knee_clinics/antipodes/australia.html

I also had trouble getting in to see a knee specialist because the good ones are booked up for months in advance and my GP was reluctant to give me a referral; none of the knee surgeons' receptionists would let me see them.

2.   I changed physio and the new one had had a serious knee injury himself; he pulled some strings and I got in to a decent knee surgeon within 4 days and had the scar tissue cut out three days later.

3.   Another idea (apart from changing physios) could be to go to a GP at a sports clinic and get them to refer you on (and make some phone calls to get you in).  You probably need someone batting for you.

4.   Or ask around your friends.

Putting an arthrofibrotic knee into a cast just to maintain extension is an odd thing to do.  There are removeable braces which keep your leg straight, and you can take them off to allow you to bend the leg.  There are also special ones which apply pressure to increase the extension.  Also, extension cannot be fixed without cutting out the scar tissue - MUAs don't work on this.

After the surgery, follow up with the arthrofibrosis protocol, described in the 'Soft Tissue' section.

(I live in Canberra, had ROM of 20-70/75 after fracture and immobilisation, and now have 3-125+.)

John
Mar 04 - Tibial spine avulsion fracture (skiing). Open surgery to fix, 1 screw.  Max passive ROM 20-75, active ROM 30-45
Aug 04 - Diag. severe arthro. Scar tissue clean up (LOA, removal of scar tissue).
Feb 05 - Discharged from surgeon's care. ROM 3-125.
Apr 05 - Discharged from physio. Same ROM

Offline Alla

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Re: ARTHOFIBROSIS specialisted recommended in Australia
« Reply #2 on: July 10, 2005, 10:23:37 AM »
HI there

Not sure that I have an answer for you, but my surgeon in Melbourne is apparently one of the best...He specialises in ACL reconstruction. He did my ACL reco in May and was very good... gave me the warning about scar tissue.... for me it hasnt been an issue to date... but if you are after another OS to try I'll let you know who he is...

Alla
Torn ACL December 04
ACL Reco May 05
Cleared to return to sport May 06

Offline three_screws

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Re: ARTHOFIBROSIS specialisted recommended in Australia
« Reply #3 on: July 10, 2005, 11:41:53 AM »
Hey... :) my surgeon who did my hip is in Melbourne. He also specialises in knees apparently and is one of the recommended surgeons on the list :) His name is Anthony Dunin, maybe you could call him up and see what he could do for you? I'm not sure what his specialisations are but it might be worth a try? I travelled from Tassie to have my surgery done. I don't know if he is the one for you or not. Travelling is worth it tho, not only if the surgery or treatment can't be done in your home state but so you can be treated by someone who knows their stuff inside and out.
« Last Edit: September 18, 2005, 06:29:25 AM by three_screws »
Bilateral Hip Dysplasia
Closed reduction on hip '85'
Salters Osteotomy on hip '87',
Osgood Schlatters 1996,
Several subluxes- right knee, meninscal cyst 1998,
Full patella dislocation left knee/cracked knee cap,
Arthroscopy on knee *2 '02', '04',
Full Hip Recon (PAO) Jan '05'

Offline sportychic

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Re: ARTHOFIBROSIS specialisted recommended in Australia
« Reply #4 on: July 11, 2005, 01:46:43 PM »
Thanks for your help guys, I had tried to see Merv Cross at Crows Nes (Im from Sydney), but because it is workers comp, his secretary was extremely rude and said he doesn't do 2nd opinions with workers comp.   I tried to ask her if she could find some others but she just hung up on me.

I'm having a second opinion on Thursday with an unknown knee specialist who, when i enquired about complications and arthofibrosis, was willing to see me.  His secretary said to bring everything along.   She sounded suprised no x-rays, scans or MRI have been taken at all despite having a ROM 40 - 0 for 4 whole weeks, and now ROM 110 - 30 post MUA. 

Man, its such a battle just getting information. 

I feel extremely uneasy about the cast and even suggested a brace, but no.   I told him there is no way im doing a second MUA at this stage as it will cause more trauma.   And I'M DEFINITELY NOT having a cast. 

I'll see what this OS says on Thursday.  At least my insurance company are happy for me to have a second opinion.

I'll keep you updated....

ACL April 05
Infection May 05
Manipulation June 05
Still on Crutches
?RSD

Offline Nick_Knack

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Re: ARTHOFIBROSIS specialisted recommended in Australia
« Reply #5 on: July 11, 2005, 04:31:20 PM »
listen you may want to:

1) post this in the arthrofibrosis section of this web site.

2) email or call some of the "arthrofibrosis gurus" in the U.S. or elsewhere who might be able to recommend someone in Australia.  The top OS's all know each other: around the world I mean.  They go to international knee conferences, read each other's articles, etc....
Age: 35
1989 rt ACL (+25 degrees ext loss)
1994 rt ACL resection (+ 10 deg)
2001 rt ACL revision (+ 10 deg)
2003 rt med meniscus repair (+10 deg)
2004 rt LOA and post capsulotmy (zero degrees)
2005 rt LOA and tib bone plug removal (even w/ other leg)
2006 rt Fulkerson TTT & ACI Carticel

Offline favouritesearcher

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Re: ARTHOFIBROSIS specialisted recommended in Australia
« Reply #6 on: October 11, 2005, 09:40:07 AM »
Just to follow up on this, in case anyone does a search later on, I had a problem with arthrofibrosis (see below signature) and last week went to see a surgeon who specialises in patella baja/infera (and who had a reasonable knowledge of arthrofibrosis, in my opinion) and he examined my knee and put forward a couple of names of surgeons to see if you have this problem: Merv Cross and Leo Pinczewski in Sydney, and David Young (I think, couldn't quite remember this name) in Melbourne.  I can't personally vouch for anyone, but they would be people to think about seeing.

Some things that I think differentiate between arthrofibrosis specialists and less capable surgeons are: arthrofibrosis specialists usually want to cut scar tissue out (LOA) before doing a forced manipulation (MUA); they will examine the mobility of the kneecap; they will check how supple the patellar tendon is; they will test your ability to tense your quads; they will compare the two knees; they will have an organised rehab program; rehab will start immediately; they will usually organise a CPM machine for a decent period of time; they will be definite about what is expected in rehab (see other posts on rehab routines); they will consider cortisone; they may offer an opinion about where the scar tissue is (eg fat pad, suprapatellar pouch, blocked extension).  The two easy questions to ask the doctor about are the CPM machine, the rehab, and the surgical plan (the use of an MUA).

John
Mar 04 - Tibial spine avulsion fracture (skiing). Open surgery to fix, 1 screw.  Max passive ROM 20-75, active ROM 30-45
Aug 04 - Diag. severe arthro. Scar tissue clean up (LOA, removal of scar tissue).
Feb 05 - Discharged from surgeon's care. ROM 3-125.
Apr 05 - Discharged from physio. Same ROM

Offline Boydy

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Re: ARTHOFIBROSIS specialisted recommended in Australia
« Reply #7 on: October 11, 2005, 10:20:41 AM »
I'm also trying to find someboydy who specialises in 'difficult knees' in Australia. Not nesseccarily scar tissue expert, but just somebody who doesn't just give up and say ," I don't know what else I can do for you ,sorry!"  I have been given a few recommended specialist in Sydney from one of our fellow knee geeks ' SPK ' . Actually Merv Cross is one of them. If you want more I will be happy to pass them on to you.   I'm from Queensland,  Dr Malisino in Brisbane is supposed to be very good, (sports doc who works on the Broncos)  but getting into him is the hard part.  Anyone who has any other names in Brisbane I would be glad to hear from.  Its a bit of a worry that you guys have done all this research in search of a good specialist and aren't having much luck.  :-\   Hope we get lucky soon.
Boydy
Arthroscope to repair meniscus tear, 10/04
Arthroscope for Lateral Release & repair another medial meniscal tear, 2/05
"Time heals all wounds"
Gosh I sure hope so !!

Offline sienna

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Re: ARTHOFIBROSIS specialisted recommended in Australia
« Reply #8 on: October 11, 2005, 12:45:46 PM »
Hi All,
Having been through the wc ring circus myself, I know how hard it can be.
Arthrofibrosis is quite uncommon and most docs never see it in their working career.  I had a couple tell me that I didn't have scar tissue even though I had plenty of symptoms.  And with workcover breathing down your neck, it just makes things harder.

I'm from Brisbane and was referred to my os by my gp who pulled his name on a computer list of sugeons that I'm guessing are in Brisbane.  He has a good reputation.  Unfortunately, things go wrong to the best of them.  I will say that he did try to help me but it was just outside his expertise.  I do know of someone not to go to but for obvious reasons will not say publicly. 

Persist and perservere.  Keep going til you get the care you deserve.  Thankfully in Aust, our wc system allows us to see whichever doc we want.  Other countries are not so accommodating.  That being said, you may have to fight tooth and nail for that right. 

Have you tried calling the office again (the one with the rude receptionist)?  perhaps she is part time and there is someone else a little more approachable there.  Ask to speak to the os personally and let him decide.  don't mention wc to the phone girl.  After all its none of her business.

Good luck.

PS I would be very against a mua and cast, too.  Heather M is very knowledgeable in this area.  Check out the scar tissue section for more info.
rk posterior meniscus tear. Successfully repaired 10 Sep,03. Now have nerve damage and cps which goes with it.  I want to slap the person who said 'It just takes time....'

Offline SPK

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Re: ARTHOFIBROSIS specialisted recommended in Australia
« Reply #9 on: October 11, 2005, 04:47:06 PM »
Merv Cross is almost impossible to get into unless you feel like waiting 3 months, can get a referral from another OS, or play in the NRL.

Sporty I'm also from Sydney and if you wanted I'd be more then willing to give you a list of names and numbers of Knee Specialists here in Sydney. Some are on the Listing on this site, but some aren't. I wouldn't have a clue as to how qualified they are with Arthrofibrosis but they are all Knee specialists and I know that at least 2 of them work with a lot of the League and Union guys for their Ortho stuff so they have very good reputations.


May 05 - Injury playing Rugby League; Torn Lateral Meniscus, High Grade partial tear to ACL
August 05 - Partial Lateral Meniscectomy
ACL Reconstruction - November 28th 2006

"I don't know how to put this but... I'm kind of a big deal."

Offline DuffyMum

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Re: ARTHOFIBROSIS specialisted recommended in Australia
« Reply #10 on: February 28, 2022, 12:51:40 AM »
Specifically for favouritesearcher ....

From another Canberran. Presumably the surgeon you saw for the arthrofibrosis is still practising in Canberra, yes?  Would you be willing to recommend him/her? 

I'm at the end of my tether and need to see someone that will actually do something to treat this for me. I had BTKR three years ago and have struggled with "the bends" (or lack of) since then. The only treatment I've had since is an MUA and Pie Crusting AKA Quad Tendon Release, neither of which did anything. I am pushing for something more to be done but it's close to radio silence at his end. So I'm tossing around the idea of finding someone that will do something.

Would you be willing to share a recommendation?

Thanks so much for your time.

Offline vickster

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Re: ARTHOFIBROSIS specialisted recommended in Australia
« Reply #11 on: February 28, 2022, 11:44:32 AM »
There’s a list here, just one name in Australia (but he may know others)
https://www.kneeguru.co.uk/KNEEnotes/primers/whos-who-knee-surgery/whos-who-arthrofibrosis-surgery

Unfortunately (or fortunately if better), favouriteresearcher hasn’t been active in the forum for 10 years
Came off bike onto concrete 9/9/09 (lat meniscus, lat condyle defect)
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