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Offline al365

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patella stabilization
« on: September 08, 2005, 02:25:45 PM »
Hi all

My left kneecap dislocated for the third time a couple of months ago and I've just had surgery on my knee to hopefully prevent future dislocations; - from what the surgeon said I've had a release of the outer section of my knee and on the medial side the ligament has been 'tightened' up, all work being on soft tissue around the knee.. surgeon said it's a very routine operation and essentially the first thing to try to correct a dislocating knee.  When I asked the surgeon of the procedure he only said 'stabilisation', but from what I can gather it would appear to be a medial reefing and lateral release.  My question really is what are the success rates of this kind of surgery against needing further 'invasive' surgery?   

i've come out with a 4-5cm vertical cut down the right-hand side of my left kneecap and a small incision mark on the opposite side.  This was 3 weeks ago, pain has subsided but the knee is still very swollen..


best regards

Al

Offline cat

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Re: patella stabilization
« Reply #1 on: September 08, 2005, 02:50:41 PM »
Hey Al,
Can't address the sucess rate of your surgery. I had a proximal realignment but had it in conjunction with a TTT. Have you started therapy? Your knee will remain swollen until you can 'work' the fluid out- not something to be rushed though. Just wanted to wish you well with your recovery.
 ;D cat  ;D
"Miserable malalignment"
 Lateral release, medial reefing, VMO advancement, and TTT-  3/2/04
Screw removal- 5/24/05
Cortisone injection to pes anserine- 7/27/05
Femoral derotation osteotomy, TTT revision- 10/18/07

Offline al365

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Re: patella stabilization
« Reply #2 on: September 08, 2005, 03:38:10 PM »
Thanks very much cat!  I haven't started therapy yet, my knee is in a splint to stop me bending my knee for a period of 6 wks after surgery, I am able to put weight on my leg though, and I have been doing leg-raising exercises from the hip (if you know what I mean). Quads and calf muscles have really depleted since the injury which was beginning July, so there's plenty to be done there!! Thanks for your reply

Al

Offline cat

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Re: patella stabilization
« Reply #3 on: September 09, 2005, 12:10:37 AM »
So 3 more weeks to go. Then you can start working on ROM. Fun, fun. ;)
 ;D cat  ;D
"Miserable malalignment"
 Lateral release, medial reefing, VMO advancement, and TTT-  3/2/04
Screw removal- 5/24/05
Cortisone injection to pes anserine- 7/27/05
Femoral derotation osteotomy, TTT revision- 10/18/07

Offline mhsflute07

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Re: patella stabilization
« Reply #4 on: September 09, 2005, 03:13:24 AM »
Hi Al,

Sounds like you're recovering well. That's great!

The success of a proximal realignment depends on the individual knee. My surgeon told me that in my case, a proximal realignment would probably prevent dislocations because the Medial Reefing provides a restraint on that side of the patella to hold it in place. However, because of my alignment and stuff, I had a TTT/LR. Your sugeon is correct...as far as I know....a proximal realignment would the first "step" to correct a dislocating patella.

Best of luck with your recovery!

~Erin~
June 2, 2005 TTT/LR  R.
July 26, 2005 TTT/LR  L.
June 6, 2006 Microfracture R.
June 5, 2007 Microfracture & Screw Removal R.
March 12, 2009 Scope and ACI Biopsy R.
May 12, 2009 TTT, Trochleoplasty R.
December 15, 2009 ACI (patella) & bilateral hardware removal
December 21, 2010 LOA and LR

Offline purplestars1881

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Re: patella stabilization
« Reply #5 on: September 09, 2005, 03:32:42 AM »
Hi Al,

I had a Lateral Release roughly 3 and a half weeks ago as well, on August 15th. However, I am not imbolized as it sounds you are...perhaps because of the medial reefing??

I know a lot of people have not had great experiences with LR's, but mine (knock on wood!) so far has been great. I am completely weight bearing, have started PT (yesterday), and am walking around with just a bit of a limp. I am still  having a great deal of stiffness and difficulty going down stairs, but other that all 'seems' to be well. I just wanted to give you a good story so you know that it can work, but there is never a definite. Do EXACTLY what your doctor tells you to and ask LOTS of questions. I would come right out and ask your Dr. if you had a LR done. You have a right to know this info so you can do your research and be informed.

If you need anything, let me know! Keep going with those quad exercises, they will be very important when you start PT.

Heather
Lateral Release & Torn Meniscus...August 2005

Offline al365

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Re: patella stabilization
« Reply #6 on: September 09, 2005, 09:53:31 AM »
Thank you all for taking time to reply..I'll let you know how my recovery goes,- cat - sorry for sounding daft but what's 'ROM' that I can look forward to?

Erin- When the surgeon was outlining the risks involved he said that there is a risk of dislocation on the opposite (medial) side if they over-compensate..  and also that future 'lateral' dislocations could recur as time could simply loosen the effect of surgery.. guess there's some element of trial and error on the surgeon's part in finding the right balance either side of the patella. fingers x'd!

Offline al365

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Re: patella stabilization
« Reply #7 on: September 09, 2005, 10:06:01 AM »
Hi Al,

I had a Lateral Release roughly 3 and a half weeks ago as well, on August 15th. However, I am not imbolized as it sounds you are...perhaps because of the medial reefing??


Guess that could be it, I was advised to keep my leg straight at all costs as bending my knee would undo their work! It would be pointless taking a risk and there's not long to go until I can go splint-free..

Thanks for your reply Heather & good luck with the rest of your recovery!

Al

Offline BridgetJones_uk

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Re: patella stabilization
« Reply #8 on: September 09, 2005, 10:16:32 AM »
Hmmmm.... Had something similar and the success rates are quite high, but most of the studies look at children, with their follow-up being inbetween 10-15yrs, after the procedure. It also depends on why ur kneecap was dislocating in the first place.

Oh and as for swelling...........ur have a melon like knee for a while! sorry but thats from past experiences. A LR is a messy procedure in the fact that by its definition tissue has to be damaged to be divided, which is traumatic. It will go down tho.

Good luck and keep lovin' that brace!

M
xxxxx
Trauma - Dislocation '96
Chondromalacia, PFS '01
Shallow trochlear groove, Patella Alta & tight ITB dx '03
Right Modified Galeazzi, LR and scope 2004
Left Modified Galeazzi, LR  2005
Redo Modified Galeazzi, LR and scope and medial reefing 2007
Right redislocation 2014

Offline cat

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Re: patella stabilization
« Reply #9 on: September 09, 2005, 02:46:16 PM »
Al,
I had a 'medial reefing +'   but only had one week of no knee bending. Guess my OS used better super glue than yours did. ;)

As for ROM, that's an acronym for range of motion. Your knee will be pretty stiff after being immobilized. It will take some work to get that baby to bend again. ;D

 ;D cat  ;D
"Miserable malalignment"
 Lateral release, medial reefing, VMO advancement, and TTT-  3/2/04
Screw removal- 5/24/05
Cortisone injection to pes anserine- 7/27/05
Femoral derotation osteotomy, TTT revision- 10/18/07

Offline ralemap

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Re: patella stabilization
« Reply #10 on: September 09, 2005, 03:47:05 PM »
Hi Al. I had a  LR around the same time as you, too! (08/16/05) I didn't have the medical reefing, though... so my knee swelling is really just about gone (I had this done arthroscopically... so no big scars, either!).

I'm also concerned about future invasive surgery. My OS told me we wouldn't know if this did the trick for at least 6 months. I have started PT though (I'm actually 1/2 way through the 8 sessions my insurance company authorized) and I've noticed a tremendous improvement. I never had an immobilized at all... just the post-surgery bandages.

It's interesting that there are so many different protocols! (Although we did have different things done, I realize!)

Here's to a speedy recovery when you get that darn splint off!

Pam

Offline al365

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Re: patella stabilization
« Reply #11 on: September 09, 2005, 05:11:23 PM »
Thanks for all your replies -   

I've had the brace on my left leg since 5 July, apart from the night in hospital before the op when movement of my knee was very stiff indeed, so after surgery and another 6 weeks in a brace it will call for plenty of PT!

Al

Offline mhsflute07

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Re: patella stabilization
« Reply #12 on: September 09, 2005, 09:45:47 PM »
Al,

Yeah, that makes sense. My OS didn't want to do a medial reefing on me because the groove that my kneecap sits in is shallow, so it would be an even great risk for medial dislocations. Sounds like you have a good surgeon. Have a good weekend!

~Erin~
June 2, 2005 TTT/LR  R.
July 26, 2005 TTT/LR  L.
June 6, 2006 Microfracture R.
June 5, 2007 Microfracture & Screw Removal R.
March 12, 2009 Scope and ACI Biopsy R.
May 12, 2009 TTT, Trochleoplasty R.
December 15, 2009 ACI (patella) & bilateral hardware removal
December 21, 2010 LOA and LR

Offline cat

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Re: patella stabilization
« Reply #13 on: September 09, 2005, 10:22:34 PM »
Quote
I've had the brace on my left leg since 5 July
Al, that must have been some 4th of July weekend you had! LOL!  ;D

 ;D cat  ;D[/color][/b]
"Miserable malalignment"
 Lateral release, medial reefing, VMO advancement, and TTT-  3/2/04
Screw removal- 5/24/05
Cortisone injection to pes anserine- 7/27/05
Femoral derotation osteotomy, TTT revision- 10/18/07

Offline al365

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Re: patella stabilization
« Reply #14 on: September 11, 2005, 09:22:39 PM »
Quote
I've had the brace on my left leg since 5 July
Al, that must have been some 4th of July weekend you had! LOL!  ;D

 ;D cat  ;D[/color][/b]

One to remember!  ::)