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Author Topic: Vail Surgery December 15th.....  (Read 28154 times)

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Offline willp

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Vail Surgery December 15th.....
« on: November 29, 2006, 06:18:20 PM »
Hi Everyone,

Is anyone is going to be in Vail in December. I got a second opinion from Dr Noyes yesterday which essentially confirmed almost everything that Dr S had said about my knee.

So I'm going ahead with my surgery in Vail on 12/15 and will be staying to do PT for a month or so afterwards. If anyone's there, it'd be great to say hi in person.

Am very nervous, but now just want to get it over with and start on the long road to (hopeful) recovery. Dr Noyes said that unless I had my anterior interval scarring removed asap I would almost certainly end up with a shortened tendon and patella inferra.

On a more personal note, thanks to you all for giving advice to someone newly diagnosed with AF. Reading your stories made me aware of the urgency of treatment. If I am able to recover, it'll be partly thanks to you all.

And if anyone is reading this who is still wondering whether to take the advice of so many people on this board and seek out an opinion from and AF specialist (Steadman, Noyes etc) rather than stick with their local OS.......all I can say is that I'd still be meddling around with various NY based surgeons, none of whom have the faintest idea of what scar tissue is or what it involves. The quality of care with both Dr S and with Dr Noyes is impeccable. They both are able to see things that other surgeons simply can't. If you can, do yourself a favour and see a specialist asap.

Happy holidays......hope you're all doing well.

Will
Medial plica removal 4/12/06. Not referred to PT. Increasing pain and quad weakness. Diagnosed with scar tissue by Dr Steadman 10/12/06, LOA and AIR in Vail 12/15/06. Returned to high level activities 4 14 years.
2020 - flare up with medial joint line pain and occasional collapse. Currently baffled

Offline hottubpam

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Re: Vail Surgery December 15th.....
« Reply #1 on: December 01, 2006, 04:52:44 PM »
Hi Will,

I won't be in Vail, but as a fellow AF patient, I wanted to wish you the very best with your upcoming surgery and rehab.  And congrats to you for taking the initiative to see TWO of the leading AF specialists. 

Looks like you will have a White Christmas in Vail.

Take care,
Pam
ACLR, Menisectomy 3/04; ACL resection, Cyclops lesion removal, LOA & MUA 10/04; LOA, LR & AIR 12/29/04;#4&5 surgery on 2/9/05 & 3/2/05 debridement, irrigation & lavage, portal closure; #6  LOA, AIR, LR & other releases 12/9/05; #7 surgery 1/18/06 portal closure, lavage, debrid etc #8 skin graft 3/06

Offline Jaci

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Re: Vail Surgery December 15th.....
« Reply #2 on: December 01, 2006, 10:08:59 PM »
Hello Will,

I'm glad everything has come together for your surgery. You'll be in very good hands with Dr. Steadman and his team.

I hope all goes well with surgery and recovery.

Best wishes,

Jaci
10/03 Twist injury
12/03 Menisectomy- tears ACL, MCL, & LCL missed by OS
Arthrofibrosis ROM 38-68
3/04- 4/08 Multiple scar tissue procedures:
6 scopes w/LOA, AIR, LR, chondroplasty, synovectomy, bone spur & plica removal
3 insufflations, many injections
Chronic AF, patella infera, IPCS

Offline willp

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Re: Vail Surgery December 15th.....
« Reply #3 on: December 02, 2006, 03:07:01 PM »
Hi Pam and Jaci,

Thanks for all your good wishes....and your support. I'll be posting here with my rehab diary and keeping my fingers crossed. I know that I'm in the best of hands....and, as I've said, I'm really grateful for the advice you gave which led me to take this so seriously.

Happy holidays to you both.

Will
Medial plica removal 4/12/06. Not referred to PT. Increasing pain and quad weakness. Diagnosed with scar tissue by Dr Steadman 10/12/06, LOA and AIR in Vail 12/15/06. Returned to high level activities 4 14 years.
2020 - flare up with medial joint line pain and occasional collapse. Currently baffled

Offline TracyS

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Re: Vail Surgery December 15th.....
« Reply #4 on: December 05, 2006, 04:57:14 PM »
Will,

Best of luck to you on your uncoming surgery.  You'll find Steadman Hawkins and VV Medical Center to be a very well oiled machine.  They'll take great care of you there.  And Vail in December is beautiful.  There are certainly a lot worse places to be stuck doing rehab, that's for sure!

I'll be thinking of you on the 15th. 

Tracy

left knee: '90-ACL recon, '91-tibial screw removal
right knee: 12/00-ACL recon, lateral meniscus repair, 3/01-LOA, 10/02-patella tendon LOA, bone spur removal, tibial screw removal, 4/04-joint, patella tendon, pes anserinus tendon LOAs, 5/05-LOA, AIR, synovectomy, chondroplasty, loose body removal

Offline jbartlett

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Re: Vail Surgery December 15th.....
« Reply #5 on: December 05, 2006, 08:00:36 PM »
Will,

Best of luck, I hope that it all works perfectly for you. Looking forward to your POST afterwards. I am just starting on the road to see these other surgens. How long have you been dealing with the AF? It has been 16months since my last surgery, do you think I have waited to long?

Anyway good luck!!

John

Offline Jaci

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Re: Vail Surgery December 15th.....
« Reply #6 on: December 15, 2006, 12:04:24 AM »
Will,

Good luck with your surgery tomorrow! Looking forward to your updates.

Take care,

Jaci
10/03 Twist injury
12/03 Menisectomy- tears ACL, MCL, & LCL missed by OS
Arthrofibrosis ROM 38-68
3/04- 4/08 Multiple scar tissue procedures:
6 scopes w/LOA, AIR, LR, chondroplasty, synovectomy, bone spur & plica removal
3 insufflations, many injections
Chronic AF, patella infera, IPCS

Offline willp

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Re: Vail Surgery December 15th.....
« Reply #7 on: December 17, 2006, 12:21:03 AM »
Hey everyone,

Thanks so much for the good wishes.....the surgery took place yesterday, and I'm sitting in my CPM machine after  my first two PT sessions.

Firstly, what a difference from my previous surgery, where my OS washed his hands of me as I started to develop what turned out to be AF. I can't say enough in praise of Steadman Hawkins. The standard of care is superb. I was very nervous meeting Dr Steadman (and I suspect asked far too many dumb questions), but it was the last thing I needed to be. I stayed overnight in the hospital, and was in PT first thing this morning. They got me on the bike and doing quad sets and wall slides.....and I managed to get my flexion up to 140, with almost no pain. It was a wonderful feeling. The PT set up here is truly amazing.

Dr S came round this morning and said that he felt everything had gone well, but that he'd discovered some scar tissue on the top of my knee which hadn't shown up on my mri and which was making one of my capsules smaller. So there was more scarring than he'd anticipated. He said that there was a 20% chance that it could grow back, so I'm not out of the woods yet. And i know from reading this board how tricky AF can be, so I'm going to stick religiously to my PT regime.

I'd recommend Steadman - Hawkins to anyone, and consider myself very lucky to have been able to come here. It's (very) early days yet, but I'm feeling positive.

John - you asked me a couple of questions, and I'm going to send you a private message.

Hope you're all doing well.....happy holidays!

Will

Medial plica removal 4/12/06. Not referred to PT. Increasing pain and quad weakness. Diagnosed with scar tissue by Dr Steadman 10/12/06, LOA and AIR in Vail 12/15/06. Returned to high level activities 4 14 years.
2020 - flare up with medial joint line pain and occasional collapse. Currently baffled

Offline QBknee

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Re: Vail Surgery December 15th.....
« Reply #8 on: December 17, 2006, 01:16:03 AM »
Will,

Let's toast to sitting in the CPM together! It's just great at 3 am when you are trying to get comfortable but you can't!

Good luck with your recovery! Amazing you are bending so well so early.  Did you have any releases performed?  My leg is quite swollen from my releases and I have not started any flexion yet other than 30 degress in the CPM to keep the leg moving a little.

DAn
5/90 - Microfracture, 11/02 - ACI harvesting scope, 09/03 - Bone graft-Scar Resection -10/27/03 - Manip w scope 2/2/05- Posterior Capsular Release, Anterior Interval Release/staph infection, 3/14/05 wash out scope 12/11/06- Scar resection, lat/med releases

Offline jbartlett

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Re: Vail Surgery December 15th.....
« Reply #9 on: December 17, 2006, 01:20:33 AM »
Will,

You sound in really good spirits, I am really hope that it continues to go well with your PT. Remember no matter how bad it feels at times it will be worth it in the end. So continue with the possitive atitude and thank-you for the email.

BEND< BEND< BEND

John

Offline willp

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Re: Vail Surgery December 15th.....
« Reply #10 on: December 17, 2006, 11:26:17 PM »
Hey John and Dan,

Thanks for the messages and good wishes. Today was a bit more painful (probably the last of the op drugs wearing off), and my flexion decreased a couple of degrees, but the PT's are still pleased. And I'm wondering how I;m ever going to get in the 8-10 hours a day in the CPM! But overall, I'm still very happy.

Dan, I know I had an anterior interval release performed, but I'm not sure if I was given a lateral or medial retinacular release as well. I was worried about a lateral release, but Dr S said that he didn't think he'd need to do one. I'm hoping to get my op report soon. I never had a severe flexion or extension deficit - my problems came from my patella being scarred down and causing pain and stiffness.  30 degree flexion sounds like it must be very difficult to deal with.....

Bye for now,

Will

Medial plica removal 4/12/06. Not referred to PT. Increasing pain and quad weakness. Diagnosed with scar tissue by Dr Steadman 10/12/06, LOA and AIR in Vail 12/15/06. Returned to high level activities 4 14 years.
2020 - flare up with medial joint line pain and occasional collapse. Currently baffled

Offline willp

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Re: Vail Surgery December 15th.....
« Reply #11 on: December 27, 2006, 06:38:05 AM »
Hi everyone,

I'm now 10 days post op, and thought I'd post an update on my Vail rehab. I got my op report from Dr Steadman's office, and my diagnosis was as follows:

1) Severely compartmentalized suprapatellar pouch

2) Chrondomalacia of the medial femoral condyle (grade 2) measuring approx 8mm by 8mm

3) Anterior interval scarring.

He released both areas of scarring and tidied up the cartilage. I'm a little bit confused as my MRI mentioned scarring on the antero-medial joint line and on the medial retinaculum, neither of which are referred to in my op report, but I'm guessing that just as the MRI can miss things (it didn't see my suprapatellar pouch problems) it can also see things that aren't there. It would seem that I didn't have any sort of medial or lateral patellar release.

Anyway, the good news is that my ROM seems back to near normal. I was only ever missing 10 degrees of flexion and a couple of degrees hyperextension, which I know is minor compared to some here, but it feels great to have such a tangible difference post surgery.

I'm doing two sessions of PT a day, and am also working on my own out of session. I'm still in the cpm machine, and am sleeping in it.

I still have some sharp pains around my patella when releasing my knee from a long flexion stretch, or when extending it against resistance in PT.

My biggest issue pre- surgery was that my patella continually felt as if it was 'slipping out of the groove' when I walked, and I was nervously awaiting the day I walked any distance off crutches to see if that sensation returned. Well, today was the day, and  - frustratingly - I'm still getting that sensation. It's certainly less pronounced, but it seems to still be there. I'm working like crazy on those patella mobilisations, but it's motion still seems very different to my good leg and there are a few signs that my previous stiffness around the kneecap might be returning.

Overall though, there have been definite improvements. My initial excitement has worn off a bit and some of the worries are coming back, but there's no question that I needed to have the surgery. I'm just hoping that my patella stays mobile and on the right track (excuse the terrible pun!)

Happy holidays to you all,

Will






Medial plica removal 4/12/06. Not referred to PT. Increasing pain and quad weakness. Diagnosed with scar tissue by Dr Steadman 10/12/06, LOA and AIR in Vail 12/15/06. Returned to high level activities 4 14 years.
2020 - flare up with medial joint line pain and occasional collapse. Currently baffled

Offline Jaci

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Re: Vail Surgery December 15th.....
« Reply #12 on: December 28, 2006, 04:47:14 AM »
Hello Will,

I'm happy things are going so well for you.

I wouldn't be too concerned about the difference between the MRI and the op report. As you probably know MRI is not 100% accurate and then it's subject to interpretation. Dr. S uses one of the best radiologists out there to read his MRI's but I think there is still some margin of error. I wonder if the area of chondromalacia on the medial femoral condyle was interpreted by the radiologist as scarring of the antero-medial joint line, could be one possible explanation. I don't remember if it was Dr. Folk (my first OS at SH) or Dr. S that told me that the suprapatellar pouch does not show up well on MRI, so they don't really know until they take a look.

Be sure to mention the slipping feeling to your PT. I've had problems with my kneecap catching. I finally had a PT check my gait, posture, muscle strength and some other things that I don't remember right now. (I'll have to look around for my old posts on it) We figured out the things that could be contributing to the catching and worked out exercises to possibly resolve it. It's taken a while, but I have significantly less catching now than I did before and immediately after my last surgery.

It sounds like you're coming down from 'the hopeful high' of surgery. I think it happens to most of us around this point post op. Hang in there. Keep working hard in PT, you'll get through this and things will be better on the other side.

Take care,

Jaci

10/03 Twist injury
12/03 Menisectomy- tears ACL, MCL, & LCL missed by OS
Arthrofibrosis ROM 38-68
3/04- 4/08 Multiple scar tissue procedures:
6 scopes w/LOA, AIR, LR, chondroplasty, synovectomy, bone spur & plica removal
3 insufflations, many injections
Chronic AF, patella infera, IPCS

Offline willp

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Re: Vail Surgery December 15th.....
« Reply #13 on: December 29, 2006, 01:18:58 AM »
Hi Jaci,

Thanks for all the encouragement - I've read enough posts from others on here to not be surprised by this post surgery dip, though I wish I wasn't experiencing it.

But overall I'm definitely doing well. I needed to have the operation, and think that I now I just have to work very hard in PT and be careful to manage my expectation.

I mentioned my slipping kneecap to my PT today. He didn't think there was much to be concerned about yet. He said that my knee is still adjusting post surgery, and that I need to build my quads up again. Howard Head have seen a lot of AF cases, so I'm sure they know what they're talking about.

As for my questions about the surgery itself, I'll ask Dr S when he does his rounds next and see what he has to say.

Hope you're doing well.....

Will
Medial plica removal 4/12/06. Not referred to PT. Increasing pain and quad weakness. Diagnosed with scar tissue by Dr Steadman 10/12/06, LOA and AIR in Vail 12/15/06. Returned to high level activities 4 14 years.
2020 - flare up with medial joint line pain and occasional collapse. Currently baffled

Offline joew

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Re: Vail Surgery December 15th.....
« Reply #14 on: January 02, 2007, 01:09:56 AM »
Will,

I'm glad I came across your posts.  Good luck with the rehab.  After reading your posts, I'm considering going to SH for an eval.  After my ACL reconstruction four years ago I had anterior knee pain and could not return to my regular sports of basketball, skiing, running, etc.  I did all the required rehab and continue to work out at the gym.  I only lost hyperextension (I'm at o degrees straight) and 10 degrees of flexion and my OS said chondromalacia of the patella was the cause of my pain. 

A year ago I had a second surgery (scope) with my original OS to find out what was causing the pain and to debride a bone spur near by new ACL.  The OS found I am now bone on bone between patella and trochlear groove (trochlear groove was in pristine condition at time of ACLR and I had an 8mm X 12mm Grade 2-3 chondromalacia on patella at time of ACLR).  I asked how after only three years I could degrade to this condition and he did not have a definitive answer.  I am 46 and work out regularly.  I am now wondering if I have AF since my patella has never been as mobile as it was before ACLR surgery.  My pain has increased since the second surgery and I recently started PT and lots of joint supplements, which has helped some.  I went to PT after ACLR, but not after the second scope a year ago.   

Any thoughts from you would be appreciated.  Maybe I am over reacting.  I was considering seeing Dr. Grelsamer in NYC since he is a patellofemoral expert.  I assume you never went to see him?

Joe
7/02: ACL and medial meniscus tear playing basketball
9/02: ACLR; meniscus repair (local OS)
2003-2005: Patella grinding and pain after surgery.
12/05: Scope. Patella and trochlear groove debridement (kissing lesion).  Partial medial meniscectomy. (local OS)
5/07:  LOA/AIR, plica removal (Vail)