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Author Topic: More Knee Surgery Suggested :o(  (Read 2202 times)

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Offline JoniF

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More Knee Surgery Suggested :o(
« on: December 24, 2007, 03:59:50 AM »
Hello,

I am new to this forum and not sure if this is the right place to post this, but here it goes.  Back in 1989 I had my first knee surgery (lateral release, cartilidge removal and arthroscopic).  My knee was no better.  In 1996, I had a TTT, debridment, lateral release, a few other proceedures.  Again, no relief.  I was told that if this did not resolve my issues, there was nothing else that coud be tried.  1997 hardware removal and a "clean up" of the joint.  I gave up and waited until October of 2006 and had more surgery (2 meniscus tears, acl tear and yet another lateral release).  I ended up with nerve damage and left with severe chronic pain.  I have been to several OS's and finally settled on one who I am hoping can help me.  He wants to do an osteotomy on my hip and knee as he believes my issue to be mechanical.  I am leary to have additional surgey after the result of my previous surgeries.  I feel as though I am getting worse not better.  Any advise would be appreciated.

Joni
« Last Edit: December 24, 2007, 04:28:01 AM by JoniF »
1989 Lateral Release, debridement, and arthroscopic surgery - lk
1996 TTT, Elmslie-trillat procedure, lateral release and debridement - lk
1997 Debridement and hardware removal - lk
2006 Lateral Release, 2 meniscus tears repaired, & acl repair - lk
2008 Sev Patella Effusion - rt knee

Offline GemmaLeigh

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Re: More Knee Surgery Suggested :o(
« Reply #1 on: December 28, 2007, 07:46:54 PM »
I am so sorry that your surgeries so far have been unsuccessful!

I think that going in for more surgeryis a huge decision and need to be thoroughly thought over. When i was faced with the option of surgery i thought i had no choice if the doctor was suggesting it, but he made it very clear that it was entirely my decision. I have opted for the surgery as my knee is getting worse and worse.

However, in your position I think i would be jubious about having yet more surgery. Can you put yourself through the rehabilitation again just to be back at square one?

Sorry that this has been completely unhelpful but i must stress that it depends on how you feel about it.
1995 - first trip to the doctor with 'growing pains'
1998 - xrays show left patella is out of place
1999 - first dislocation
1999-2006 - Physio therapy every week
Jan2007 - Traumatic dislocation
feb 2007 - OS suggests surgery
Jan 2008 - date for surgery 30th jan

Offline JoniF

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Re: More Knee Surgery Suggested :o(
« Reply #2 on: December 29, 2007, 02:40:27 AM »
Gemma,

Thank you for the advice and support.  I must admit the thought of more surgery is frustrating; but then I keep going back to the thought of what if it helps...When is your surgery and what will you be having done?

Take care,
Joni
1989 Lateral Release, debridement, and arthroscopic surgery - lk
1996 TTT, Elmslie-trillat procedure, lateral release and debridement - lk
1997 Debridement and hardware removal - lk
2006 Lateral Release, 2 meniscus tears repaired, & acl repair - lk
2008 Sev Patella Effusion - rt knee

Offline GemmaLeigh

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Re: More Knee Surgery Suggested :o(
« Reply #3 on: December 29, 2007, 12:52:08 PM »
My surgery is scheduled for the 30th January and i'm having a knee realignment. I'm not sire of the proper name but it involves putting the knee cap in the right place and bolting it down with 2 bolts :/ I'm terrified but as you so, what if it helps? I'm at the end of my tether with all the pain and dislocations.

I took a lot of time to deicide though, my mum was very against it and said i was too young to be having such a big operation, but i thought to myself, it really has to be my decision because she can't feel the pain that i am in.

Hopefully this time next year i'll be active again and able to walk my dogs :)
1995 - first trip to the doctor with 'growing pains'
1998 - xrays show left patella is out of place
1999 - first dislocation
1999-2006 - Physio therapy every week
Jan2007 - Traumatic dislocation
feb 2007 - OS suggests surgery
Jan 2008 - date for surgery 30th jan

Offline kathat

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Re: More Knee Surgery Suggested :o(
« Reply #4 on: December 29, 2007, 09:49:37 PM »
It's a difficult decision. When you are in a lot of pain with restricted mobility you can justify surgery by saying "it can't be any worse" but when you feel that it COULD be worse if surgery fails, then it makes for a very hard decision. I am in a slightly different boat in that I know I will need surgery and I accept that the surgical options I have are appropriate for my problems, but I have to decide when is the right time, without putting things off so long that some surgical options are no longer possible. I don't want to do it until I have to, because of the possibility of failed surgery making me worse off.

How did you decide upon your current OS? What other options have been put forward? Or did the other OSs just fob you off and tell you there was nothing they could do?! I can understand you being put off more surgery considering how unsuccessful surgery has been in the past. Is there anyway they can simulate the effect of the surgery beforehand, to see if it's likely to be a success? I know that an unloader brace can simulate the effect of a tibial osteotomy and is often tried before surgery to see if it is likely to work. Sorry I can't be of more help. I can certainly wish you lots of luck though! GOOD LUCK!! I hope you find a way of coming to a decision.

Kathy

Offline JoniF

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Re: More Knee Surgery Suggested :o(
« Reply #5 on: December 30, 2007, 01:57:05 AM »
Hi Gemma,
I will be thinking of you on the 30th.  I had a similar procedure and did not have a good result, but my issue is also with my hips.  I was told that the surgery would have worked had it not been for the alignment of my hip.  I know you will do awesome though.  How did you come to your decision?  If you need a friend while you are rehabbing, just let em know and we can chat as often as you'd like ;D.  I go to the OS on the 7th to see what the options are.

Hi Kathy,
Thanks for your response and advice.  The OS that I am currently seeing consults with some of the local sports teams in the area and seems to be very compassionate.  He is about the 5th one that I have seen.  A friend of mine had his surgery performed by him and had nothing but good things to say about him, so I feel really lucky to have been referred to him.  What type of brace is an unloader?  Is it like a sleeve type brace?  10 years ago after my reconstruction procedure I was told that there was no other options available to me.  Now it seems that everyone's answer is just to medicate you and hope that you go away!  After my last operation in 2006, I was left with what feels like permanent nerve damage.  I would not have had the surgery knowing this would be the result.  I feel as though I am worse off than before.  It is soo awesome to be able to chat with such caring understanding people.

Take care,
Joni
« Last Edit: December 30, 2007, 02:00:30 AM by JoniF »
1989 Lateral Release, debridement, and arthroscopic surgery - lk
1996 TTT, Elmslie-trillat procedure, lateral release and debridement - lk
1997 Debridement and hardware removal - lk
2006 Lateral Release, 2 meniscus tears repaired, & acl repair - lk
2008 Sev Patella Effusion - rt knee

Offline Robin M.

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Re: More Knee Surgery Suggested :o(
« Reply #6 on: December 30, 2007, 03:05:16 AM »
Hi Joni,

Welcome to the forum! I've been a member since November and have found so many nice, supportive people. I'm sorry that you have had so many surgeries with such few results. When your life is effected by pain and immobility you will do anything to improve it. I know cause I've been there.

What type of osteotomy is the Os talking about, femoral or High tibial osteotomy? I had a high tibial osteotomy(HTO) 9 months ago for degeneration in the medial knee compartment and to correct malalignment.I hope it lasts 10-15yrs. then I'll have to have a TKA. Did your OS do an x-ray (i think it's called a long view) It's from the hips to the feet and if it's computerized the OS can measure right in the exam room to determine how off your alignment is. I also wore an unloader brace prior to the HTO since the brace helped with the pain my OS and I felt fairly confident that the surgery would help. It's a big surgery with a long recovery period. I was in the hospital for 5 days and non-weight bearing for 10 weeks.Make sure that you have exhausted all treatments before having this surgery. I'm 9 months post-op and doing very well. I have very little pain just some general achiness when I've over done it or haven't stretched, gone to the gym, or rode my stationary bike.

I understand about the apprehension of having another surgery. I have had 5 knee surgeries. The left knee has become problematic. Two yrs. ago I had a mosaicplasty which has been great. I now have donor site failure though the mosicplasty site looks great and degeneration in the other two knee compartments. The OS was going to do  a HTO but with degeneration in the lateral compartment the HTO will be unsuccessfull. I have been referred to his associate for evaluation for a TKA. Also did you have a recent MRI ? You may want to talk to your OS about it. MY os had me get one which showed that the knee was much worse then the x-ray indicated. At 43 yrs. old I hate to think that I may need a TKA but my OS says that I have done everything that can possibly be done to improve the knee.

I hope you get the advice you're seeking. Come and talk any time you need to. Good luck!

Robin
Lt. knee- 6/04 scope and chondroplasty of MFC,11/04 Synvisc injections, 11/05 mosaicplasty, 3/06 scope,LOA and MUA, 1/08 degeneration entire knee, 5/12/08 TKA, 7/21/08 MUA
Rt.knee- 10/06 scope,,plica removal-OA, 3/07 HTO, 9/09 hardware removal  12/7/09 TKA 1/10,3/10 MUA, 11/10 LOA,partial revision

Offline GemmaLeigh

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Re: More Knee Surgery Suggested :o(
« Reply #7 on: December 30, 2007, 03:06:27 PM »
Thank Joni it's much appreciated, i am also in hospital on the 7th!! Having my pre op assessment. Good luck and I hope you that you find some answers from your OS and get the advice you need to make this decision.
1995 - first trip to the doctor with 'growing pains'
1998 - xrays show left patella is out of place
1999 - first dislocation
1999-2006 - Physio therapy every week
Jan2007 - Traumatic dislocation
feb 2007 - OS suggests surgery
Jan 2008 - date for surgery 30th jan

Offline JoniF

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Re: More Knee Surgery Suggested :o(
« Reply #8 on: January 02, 2008, 12:09:37 AM »
Hi Robin,

I have my OS appointment on the 7th and then I will know what the options are.  He mentioned to me that in order to fix my knee, I would need hip surgery as well.  From what it sounds like he believes alot of my issues to be stemming from the malalignment of my hips causing wear on my knee.  My last MRI was in Feb. 2007 and my previous OS was mostly concerned with foreign bodies in the joint.  After my last surgery in 2006, I ended up with nerve damage.  Also, during the surgery he found severe OA with multiple bone spurs, 3 tears and patellar tilt.  The patellar tilt seems to still be there. 

I am not sure what type of osteotomy he will want to perform as he wants to address the issue with my hip as well.  I was told that I am not a candidate for a tkr due to alignemnt issues.  The only x-rays taken were the standard ones they take when you become a new patient.  All of the research I did on the internet mentions alot of pain and recooperation time (OUCH!!!  :()  I'm just not sure if I am up for that.

How are you feeling now?  I am happy to hear that you are not in alot of pain .  How is your mobility?  Were you off work for a long period of time? also, how soon were you able to drive after surgey?  (sorry for the twenty questions ;), but I live alone and I am not sure how much help I will have.

Gemma,

Thanks for the kind words and good luck with your pre-op :).  How long will you be in the hospital for your realignment procedure?

Take care and Happy New Year,
Joni
1989 Lateral Release, debridement, and arthroscopic surgery - lk
1996 TTT, Elmslie-trillat procedure, lateral release and debridement - lk
1997 Debridement and hardware removal - lk
2006 Lateral Release, 2 meniscus tears repaired, & acl repair - lk
2008 Sev Patella Effusion - rt knee

Offline cat

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Re: More Knee Surgery Suggested :o(
« Reply #9 on: January 02, 2008, 03:44:15 AM »
Hey Joni,
I underwent a derotational osteotomy of my femur, near my hip, in Oct for my malalignment issues. I will be interested in hearing what type of osteotomy your OS has in mind for you. So keep us posted.
 ;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 Robin M.

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Re: More Knee Surgery Suggested :o(
« Reply #10 on: January 02, 2008, 04:58:44 AM »
Hi Joni,

I am now almost 10 months post-op from the HTO. With this type of osteotomy my  OS cut a wedge of bone out of the tibia(lower inside leg bone) realigned my leg so that more weight would be redistributed to the healthy portions of the knee. He then packed the open wedge with cadaver bone and some of mine and placed a plate with 4 screws over the area. Originally he was going to do a mosaicplasty but after the scope I had 5 months before I had too much medial compartment degeneration and cartilage restoration wouldn't be successful. I spent 5 days in the hospital and was 10 weeks NWB. Yes it is a painful surgery and as my OS said it "I'm keeping you in the hospital for pain control." I had a femoral and a sciatic nerve block plus IV pain medication. The first night in the hospital was pretty bad pain wise- the sciatic nerve block wore off and the pain was horrible. The anesthesia team did a great job getting the pain under control and by that afternoon I was sitting out in a chair doing some gentle ROM exercises. My knee wasn't bending real far about 45 degrees but by the time I left the hospital my ROM was 65-70 degrees. I started PT at 2 weeks post-op 3 days a week for the next 5 months.

As far as returning to work, I could have returned at 6 months post-op. I'm an RN and work in rehab./long-term care in a per-diem position. I'm a fill in nurse for the full and part-time RNs. I'm not eligible for light-duty so when I return I must be able to work on the floor and be on my feet for an 8 hr. shift. If you're job isn't real streneous, you can probably return earlier. Swelling in the knee as well as the rest of the leg was an issue for me for quite a few months. My OS said off and on swelling can occur for up to a year. Total recuperation time can take up to a year. I was pretty much back to normal activities by 6.5 months.What takes a while is to get full strength in the leg.

At this point I'm happy with the results of the surgery. I occasionally have some stiffness in the knee but nothing that a little stretching or ride on the stationary bike doesn't cure. I'm not having any pain. I didn't drive for about 4.5 months. Since the surgery was on my right leg I was concerned about my reaction time also I had a wonderful mother-in-law who took me to PT and my mom as well as other family or friends who helped out while my husband was at work. I've had several surgeries on the left knee, one of them a mosaicplasty. I have donor site failure (mosaicplasty) and degeneration in the other 2 compartments. I have an appt. Feb. 5th to be evaluated for a TKA. Also my OS told me the results of the HTO should last 10-15 yrs. then I'll do a TKA.

I believe the rehab. protocal as well as weight-bearing status vary depending on the type of osteotomy. Also everyone heals and recovers differently. I hope this info. is helpful. Good luck with your appt.

Happy New Year!

Robin
Lt. knee- 6/04 scope and chondroplasty of MFC,11/04 Synvisc injections, 11/05 mosaicplasty, 3/06 scope,LOA and MUA, 1/08 degeneration entire knee, 5/12/08 TKA, 7/21/08 MUA
Rt.knee- 10/06 scope,,plica removal-OA, 3/07 HTO, 9/09 hardware removal  12/7/09 TKA 1/10,3/10 MUA, 11/10 LOA,partial revision

Offline GemmaLeigh

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Re: More Knee Surgery Suggested :o(
« Reply #11 on: January 02, 2008, 01:32:47 PM »
Hi Joni,

I'm supposed to be in for 2 nights but they say it very much depends on my pain levels. They won't let you out until you can get out of bed and have the strength to get about on crutches.. or so i've been told. They'll probably need the bed and kick me out as soon as i wake up!!!
1995 - first trip to the doctor with 'growing pains'
1998 - xrays show left patella is out of place
1999 - first dislocation
1999-2006 - Physio therapy every week
Jan2007 - Traumatic dislocation
feb 2007 - OS suggests surgery
Jan 2008 - date for surgery 30th jan

Offline JoniF

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Re: More Knee Surgery Suggested :o(
« Reply #12 on: January 02, 2008, 09:06:51 PM »
Hi Gemma,

I hope not.... ;)  Tell them I said to be nice to you or else.....

Joni
1989 Lateral Release, debridement, and arthroscopic surgery - lk
1996 TTT, Elmslie-trillat procedure, lateral release and debridement - lk
1997 Debridement and hardware removal - lk
2006 Lateral Release, 2 meniscus tears repaired, & acl repair - lk
2008 Sev Patella Effusion - rt knee















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