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Author Topic: Patella stabilisation post op diary  (Read 113144 times)

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Offline Sore knee

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Re: Patella stabilisation post op diary
« Reply #555 on: March 06, 2009, 06:26:11 PM »
 :-* :-* :-* :-* :-* :-*  Thanks so much

Thought I would get back on but hubbie and both kids have a sick bug so its been a bit manic

Back on when finished washing bed clothes :(
11/5/07 LR right knee and cartilage tidied up
6/8/07 Knee aspiration, steroid injection- more physio
22/8/07 Knee to be scoped for answers
16/5/08 Patella stabilisation for  subluxations
24/6/08 Infection -hospitalised for a week. Debridement surgery
21/11/08 Repeat patella stabilisation performed

Offline tanyap

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Re: Patella stabilisation post op diary
« Reply #556 on: March 06, 2009, 10:18:24 PM »
Happy Birthday Joanne!!!
So glad the family are making it so special for you!!!
xxx
1986 - recurrent dislocations of right patella began
1988 - Modified Hauser Procedure
1991 - dislocations started again
2005 to 2007 - 150 dislocations in 2 years - OUCH!!!
June 2007 - new OS, new physio
Oct 2007 - VMO woke up
Mar 2008 - big quads, still dislocating
Apr 2008 - next OS app

Offline kathat

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Re: Patella stabilisation post op diary
« Reply #557 on: March 07, 2009, 01:35:54 PM »
Oh dear, I hope you don't get the bug!! I had a gastro bug once, and couldn't even take the time to be sick, as my son got it shortly after and I had to clean up after him because hubby can't deal with vomit :P At least if you get it then the rest of the family will have already had it and you can be sick in peace, knowing they won't get sick too ;)

Take care,

Kathy xx

Offline Sore knee

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Re: Patella stabilisation post op diary
« Reply #558 on: March 07, 2009, 01:50:05 PM »
I'm in stealth mode :D   I give the kids kind of a quick hug or else a bear hug where they just rest their head on my shoulder. They are easier than hubbie.......you know what man flu is like, not a great patient LOL

Hope you are all ok. Going to try and catch up on your news now.
11/5/07 LR right knee and cartilage tidied up
6/8/07 Knee aspiration, steroid injection- more physio
22/8/07 Knee to be scoped for answers
16/5/08 Patella stabilisation for  subluxations
24/6/08 Infection -hospitalised for a week. Debridement surgery
21/11/08 Repeat patella stabilisation performed

Offline Sore knee

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Re: Patella stabilisation post op diary
« Reply #559 on: March 09, 2009, 04:04:41 PM »
Warning - this will be a moaning post!!!! Leave now if preferred LOL


Now I saw my os today and as you know needed my PT to refer me. I knew from the first 30secs it was not going to go well. I saw the os and said I am sorry but I am back and he said that's ok come for a chat. ( having seen him so many times now I knew when he said that that my pt had probably not given me the referral. He is not a come for a chat person)

So I sit down he pulls a chair beside me ( again not usual manner, I know this sounds daft but the whole apt felt very condescending ). Now he says I hear your pt has managed to get all the swelling under control. I said yes but now I am left with my patella being loose, catching, grinding and the knee giving way. He said there is NO way that patella can be loose, I belted and braced that patella , it can't be loose.

I said well it feels looser. So he said let me see. So no exam couch, just told me roll upyour trouser leg and sat there in his office chair and he pushes it and says well ok it is a bit looser but it will have an end point, it won't come right off.

I said maybe not like that but it moves, slips and grinds.

So the usual response if we could just get muscle control, you know I think you have regional pain syndrome. Have you any numbness ? Have I everscanned your back? Isaid noand seriously this is not myback, I do t have chronic pain, I don't have this syndrome  my knee is just loose.

He said well your vmo has wasted til we are down to bone that side. I said well it's not for lack of trying, 2 yearsatphysio. I said my knee keeps pulling laterally and grinds over and he said well yes your patella sits here and shows me the knee model and how my patella sits laterally on the bone. I said that muscle has never got the chance.

So he says I know I will send you to a neuro consultant for neuromuscular testing, it's just lime accupuncture. He decided my knee should be perfect after the surgery so it is obviously a muscle fault. I said well if it comes back clear ( and I will put money on itdoes) he said oh no it won't, it can't.

A pt told me last year with the strength of the lateral pull I have the vmo was never going to compensate and there was talk of redoing the lr. Obviously I am the only one who remembers this.

He never even felt my knee and the grind and I was with him for under 8 minutes. I left angry with myself as much as anything. I am too shy to push and didn't want to see
 cheeky and say are you not even goi g to view how bay this tracks and the grind I have.

I just feel like walking away from all this. I believe if I could just get my patella to sit in groove and have it there that maybe my vmo could pull against it. However I am a lay person and may be so wrong.

I want to give up, the bottom line is they just don't know and I can't bear anymore.

I feel if and when the test comes back my muscle functions - just very weak then they willsay it must be something I am doing. Having been in their care 2 years and having had this problem since surgery 1 first of all why do this now and not back then ? Second really it's not going to change this knee and what can they do that I have not done in the 2 years.

*sigh* they just don't know and are now doing guess work 

I am cross that I get the chat pain holds me back - I could bring in my gp / chiro / medical friends who can all vouch for the fact that with 2 youn g kids and my nature to not give up then I don't let pain hold me back.

However the constant telling my pt this is now getting to me and I don't think anyone is listening. None of this is new, I seem to have few options and an os who now wants to make this neurological when I know from everything here on kg that I don't have that.

So fed up so frustrated and so at a loss I just want to run away from it all. I think this is the first time in my life I have walked away from something and give up
11/5/07 LR right knee and cartilage tidied up
6/8/07 Knee aspiration, steroid injection- more physio
22/8/07 Knee to be scoped for answers
16/5/08 Patella stabilisation for  subluxations
24/6/08 Infection -hospitalised for a week. Debridement surgery
21/11/08 Repeat patella stabilisation performed

Offline Sore knee

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Re: Patella stabilisation post op diary
« Reply #560 on: March 09, 2009, 04:13:04 PM »
Sorry for all typos was doing that on my phone waiting for kids after school. Just to clarify my pt and os are friends and work in same building so they chat on informal basis all the time
11/5/07 LR right knee and cartilage tidied up
6/8/07 Knee aspiration, steroid injection- more physio
22/8/07 Knee to be scoped for answers
16/5/08 Patella stabilisation for  subluxations
24/6/08 Infection -hospitalised for a week. Debridement surgery
21/11/08 Repeat patella stabilisation performed

Offline lenorem9

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Re: Patella stabilisation post op diary
« Reply #561 on: March 09, 2009, 07:52:44 PM »
Don't give up,  Don't let them tell you they don't know what's wrong, and don't let them use you as a guinea pig!!!  OOOOOOH  I'm getting mad all over again at these darn OS's and PT's.  If only they could feel your pain and live your life right now.

I too have a hard time standing up to these OS's and have had very similar exams like you describe where they barely touch your knee, talk down to you, and push you out the door as fast as they can.  I've had 4 different OS's misdiagnose me for different issues and PT's that had no clue what to do with me. 

I don't remember your whole story and history Joanne but I really hope you can find someone that knows what is wrong with you and how to fix it.  Please don't give up.  Take a few days to mourn this OS visit and have a huge pity party because you certainly deserve it after that jerk. 

After a few days of that crap put your fighting hat back on and go get em!!!  It just takes finding the right person to treat you and one that will listen!  I'm cheering for you and hoping for something positive very soon.   
« Last Edit: March 09, 2009, 08:18:01 PM by lenorem9 »
07/07  Injured @ Taekwondo
11/07  ACL allograft, Posterolateral corner recon
01/09  Scope for scar tissue, notchplasty
02/09  Diagnosed w/arthrofibrosis/IPCS
04/09  Scope for scar tissue, lateral/medial release
05/09  MUA
11/09  Scope for scar tissue, chondroplasty
Learning to "live with it"

Offline Sore knee

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Re: Patella stabilisation post op diary
« Reply #562 on: March 10, 2009, 01:30:07 PM »
Thanks Lenore I was so upset last night that I started to remember things how some kind of muscle testing was done before. Not with the needles though, but he didn;t even remember. I am convinced that noone is actually reading my case history in all this. I cant believe I paid for an apt where he was asking me what he had done before. I like this OS very much, but I really felt that he took this very casually and didnt even have the courtesy of reading my notes before I came in. *sigh*

I have made another apt to see him with a list of things I want clarified. I will take hubbie and if he cant come I will take my brother as he is good in these situations.

Here is what I have written down that I want to reorganise and take with me so it does not sound inflammatory or accusatory - apologies for the obvious in it but I e-mailed this to my bro so he understands it all.

History
 
Knee pain since earliest childhood memories - pre-school
In adolescence they diagnosed chondromalasia patella (roughening of back of knee cap)   {although to be fair does not look rough from recent op pictures so not sure if that was ever correct]
Told to stop sports etc
No improvement - they wanted to operate then in an op that involves breaking some bone and reattaching it. We said No
 
Knee persisted to irritate but not be OTT until I started at the gym and dancing again, exercising 5 times a week.
 
 
 
RECENT YEARS
Went to the first OS (orthopaedic consultant) who said my knee cap was tilted to the outside and pulled that way and a lateral release cuts some of the retinaculum  on the lateral side which is the soft tissue over the knee cap running down either side of your knee. This is supposed to lessen the tilt and allow the knee cap to sit in its groove.
 
Huge inflammation afterwards and swelling for 3 months, on crutches for around 9 weeks...quads died.
 
AT around 12 weeks after surgery I went to see new OS  for a 2nd opinion. He injected steroids into the knee which didn;t help.
 
He said he would scope it , so Aug 2007 he scoped it but could see no damage. They gave me things for my shoes...tried them for months, nothing altered.
 
I carried on with swelling of the knee and around Oct 08   - physio did tests sticking electrodes on my leg to see if they could measure any muscle function. It was weak and fatigued easily...but it was there.
 
Then they decided to put me in a knee brace
 
I carried on painstakingly until around March 2008 when I said I had enough, PT referred me back to OS who said there was no stability in my patella and it would simply slide off. So op booked for May - patella stabilisation where on the medial side sutures and anchors are put in to tighten medial side and prevent sliding out to lateral side or subluxation they call it when the knee cap sits partially out of groove, fully out of groove is dislocation.
 
5 weeks after that back in hosp for a week with huge swelling leading to internal stith getting infected. Operated to clear out infection but was told after that op that "repair" as they call it (patella stabilisation op) looked fine.
 
August 2008 still swelling and whenever contracted my quads my patella would move laterally and click over bone. PT calls OS through with his assistant during one PT visit and they look and OS says the lateral pull is very strong and wonders if they should increase the LR to reduce the pull allowing the VMO muscle to try and kick in. Its just being completely overpowered he said. I was sent out an op date of around Sep 18th but I cancelled it.
 
In late Sep I went back to see OS saying my knee felt loose and he said it was, I must have stretchy tissues and that perhaps using a tendon graft from the hamstring would be better. Op booked for Nov. No mention of LR(lateral release).
 
Go in Nov and during theatre they re-do tightening but don't use tendon graft for whatever reason. He says to me during post op visit the infection could have stretched it all out.
 
Back in PT HUGE swelling again, eventually get swelling down and here we go lateral movement of patella and clicking over bone. Again PT says its cause I have no VMO  ( well I havent since op number 1 so this is NOT new). I said the grinding is increasing and I am worried. PT now decides its because I have a soft core and don't work my glutes or lock my leg straight through these years and need to try and strengthen those to help with gait. We do this and my knee seems to get worse with the grinding and clicking which seriously drives you mad. The pain is not always unbearable but at times is gnawing. At this point PT now tells me to walk with a slightly bent leg and not lock it straight so as to avoid the clicking - complete reversal of all we had been working towards in previous year
 
I said to pt I am concerned that last time the infection stretched things out and it could happen again. PT says no the infection didn't stretch things out, its maybe just your tissues are flexibile. SO I say well whats to stop this recurring again  ? Last time I was in this position you all suggested a LR to be extended ?
 
I am going round in circles. To which PT gives me his usual answer which I could now scream at, well pain can hold you back and I say ITS NOT THE PAIN !!!!! I have 2 kids I don't have the luxury of sitting with my feet up. I said I do my exercises what more do you want me to do.

SO last PT visit my usual pt  was off and I said to the girl I had that I felt I had been here before I wondered if it was time to speak to OS again. She said she would get my pt to refer me.
I don't think he did, no written letter etc, I think OS spoke informally to him due to the tone of our last apt and that the usual crap was said as PT himself says to me he has never met a knee like mine and is trying anything with no idea if it will work. (He did say that)
 
So see OS yesterday and felt the whole thing was condescending beginning with  -  lets have a chat.
 
He obviously has not read up on notes and asks me has he scanned my back, I forgot about the wee sticky pad testing they done on the computer over a year ago so feel this coming test is both a waste of time and money.
 
I wish some clarification:
 
One says you need the LR...then the LR suddenly disappears off the horizon because I cancelled it
One says infection stretched it out, the other says no that's not what happened
Constantly told by PT if I could work through the pain - to which I have said I appreciate you don't know me personally but if need be I will bring in 10 people with professional backgrounds who know me to give you a character reference. With young kids and running my own business being like this is not in my best interest.
I am also prepared to say if its you think I am not workinf hard enough tell me and I will take that on board, this is not time to worry about hurt feelings, this si time for straight talking. I will try harder but equally must say in2 years never once have I been told I am doing exercises incorrectly at any PT visit where I am supervised 85% of the time. I am happy for input here, but I want everyone to be fully knowledgable of my history as it seems much has been discussed informally and then forgetten when convenient.
 
 
Same situation now as has always been there, total muscle imbalance. Why was the LR mentioned , arranged and then never required ? Was it done as part of the last op and I don't realise it ?
IF they don't know what to do anymore or I have to just live with this, then tell me don't waste money and my time. I think having 5 surgeries in 2 years is enough for anyone to go through. Plsu the hours and hours of physio I have put myself through, steroid injections, knee aspirations
 
I am just a number to them but it appears that they forget so much of what has happened and that I need to go in and go through all these things and say you know what I am totally confused here. A lot seems contradictory and I really just want everyone singing off the same hymn sheet as I am concerned everyone is using guess work and noone is truly sitting down going through details and offering constructive suggestion. Both the OS and PT now seem very causual about things and especially yesterday as it was very obvious notes have not been shared.

Can you please give me your opinion. Now that I have put all this down in black and white for the first time I dont like what I am reading.

Please for good or bad do tell me.
 
« Last Edit: March 10, 2009, 02:26:28 PM by *joanne* »
11/5/07 LR right knee and cartilage tidied up
6/8/07 Knee aspiration, steroid injection- more physio
22/8/07 Knee to be scoped for answers
16/5/08 Patella stabilisation for  subluxations
24/6/08 Infection -hospitalised for a week. Debridement surgery
21/11/08 Repeat patella stabilisation performed

Offline lenorem9

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Re: Patella stabilisation post op diary
« Reply #563 on: March 10, 2009, 01:52:33 PM »
5 surgeries in 2 years is more than anyone should have to go through Joanne.  Thanks for the history rundown.  Wow, talk about confusion.  I wouldn't even know where to start.  Sounds like they don't have a clue.  Are you seeing patellar experts or just your run of the mill local OS?  Maybe it's time to find the best patellar guy you can and get this straightenend out once and for all.  Have you been talking to other KG's with similar problems?  What treatment have they received and who do they recommend?  I don't think I would waste my time going back to the same people you've already seen.  Maybe it's time for a new set of eyes and ears.  You really need someone who cares and someone who understands the problems you are having.  Someone you don't have to coach along and someone that will give you a thorough exam and tell you what's wrong instead of you telling them. 

I haven't had anywhere near the amount of problems or surgeries you have but I will say driving 10 hrs to see Noyes was the best decision I ever could have made.  I finally got a proper exam, finally found someone who cares and will finally get the treatment I need.  I hope you can find someone like that too.  It shouldn't be this much of a battle to get proper treatment but unfortunately it is. 

I really feel for you Joanne and I hope you don't give up yet. 
07/07  Injured @ Taekwondo
11/07  ACL allograft, Posterolateral corner recon
01/09  Scope for scar tissue, notchplasty
02/09  Diagnosed w/arthrofibrosis/IPCS
04/09  Scope for scar tissue, lateral/medial release
05/09  MUA
11/09  Scope for scar tissue, chondroplasty
Learning to "live with it"

Offline Sore knee

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Re: Patella stabilisation post op diary
« Reply #564 on: March 10, 2009, 02:24:22 PM »
Here is the really sad part Lenore - he is meant to be the best and highly recommended. He is a knee specialist and sports surgeon for knee injuries etc.

I have not heard of anyone else better than him and I am scared tomove as here - well the system here is not as customer orinetated as in the US. If you keep moving around for opinions you are seen as a problem patient......even if you go private.

I feel totally dejected.

Thanks for listening to me moan, I do appreciate it and to everyone elses thread forgive me for not replying to your posts. I am just in a bad place today but hopefully I will feel better tomorrow.
11/5/07 LR right knee and cartilage tidied up
6/8/07 Knee aspiration, steroid injection- more physio
22/8/07 Knee to be scoped for answers
16/5/08 Patella stabilisation for  subluxations
24/6/08 Infection -hospitalised for a week. Debridement surgery
21/11/08 Repeat patella stabilisation performed

Offline lenorem9

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Re: Patella stabilisation post op diary
« Reply #565 on: March 10, 2009, 02:37:52 PM »
Oh boy, that really complicates things.  Wow, I don't even know what to say.  I can certainly see why you feel dejected.  Feel free to moan any time.  I just left a pretty good moan of my own on my thread.  Sometimes that's the only way to get it out.

I'm hoping some of the other UK KG's will jump on here and make some great suggestions for you.  There has to be a way to get you better.  Meanwhile don't worry about posting on everyone else's threads.  You've got a lot to handle right now. 
07/07  Injured @ Taekwondo
11/07  ACL allograft, Posterolateral corner recon
01/09  Scope for scar tissue, notchplasty
02/09  Diagnosed w/arthrofibrosis/IPCS
04/09  Scope for scar tissue, lateral/medial release
05/09  MUA
11/09  Scope for scar tissue, chondroplasty
Learning to "live with it"

Offline Sore knee

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Re: Patella stabilisation post op diary
« Reply #566 on: March 10, 2009, 02:59:42 PM »
The thing is here it's not as easy to find drs who specialise in particular things. He is a well known sports injury surgeon. Recommended by the rugby team and football teams and all injuries that accompany that. Maybe it's because I am not built like an athlete they don't know what to do.

I don't know of any docs in Scotland that are purely patella femoral experts so he is the best that has been recommended to me within reach.
11/5/07 LR right knee and cartilage tidied up
6/8/07 Knee aspiration, steroid injection- more physio
22/8/07 Knee to be scoped for answers
16/5/08 Patella stabilisation for  subluxations
24/6/08 Infection -hospitalised for a week. Debridement surgery
21/11/08 Repeat patella stabilisation performed

Offline lenorem9

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Re: Patella stabilisation post op diary
« Reply #567 on: March 10, 2009, 04:08:13 PM »
It could be that you just have a rare condition he has never seen before and doesn't know how to treat it.  Working sports injuries doesn't mean he has seen every possible injury.  He's probably used to those rock hard muscular athletes and doesn't know how to handle the average person like you and I.  In a perfect world we would all be rock hard athletes before and after surgery but you and I know that's not always feasible.  We just don't train like a professional athlete does.

Have you considered e-mailing a patellofemoral specialist somewhere else for opinions?  I know of at least one on here,  Dr. Ronald Grelsamer in NYC.  Somewhere in the information hub is a link to his site.  At least maybe they could tell you where to go from here.  Some may not want to give any info without seeing you but it wouldn't hurt to ask.  There has to be many of them online.
07/07  Injured @ Taekwondo
11/07  ACL allograft, Posterolateral corner recon
01/09  Scope for scar tissue, notchplasty
02/09  Diagnosed w/arthrofibrosis/IPCS
04/09  Scope for scar tissue, lateral/medial release
05/09  MUA
11/09  Scope for scar tissue, chondroplasty
Learning to "live with it"

Offline Sore knee

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Re: Patella stabilisation post op diary
« Reply #568 on: March 10, 2009, 06:39:39 PM »
Lenore

 :-* :-* :-* :-* :-* Thank You SO MUCH !!!!!!!!!!!!!!!!!!!!!!!!!!!

I so appreciate al your research and am off to read it all now  :-*

You have a heart of gold but I want you to know I am so grateful and appreciate the time, effort and trouble you have gone to for me.

Thank you for all the links you e-mailed me  :-* :-* :-* :-*
11/5/07 LR right knee and cartilage tidied up
6/8/07 Knee aspiration, steroid injection- more physio
22/8/07 Knee to be scoped for answers
16/5/08 Patella stabilisation for  subluxations
24/6/08 Infection -hospitalised for a week. Debridement surgery
21/11/08 Repeat patella stabilisation performed

Offline Sore knee

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Re: Patella stabilisation post op diary
« Reply #569 on: March 10, 2009, 06:58:53 PM »
I took your advice and posted a help thread in patella femoral section to see if anyone can help.

So I hope someone can give me hope or option.

Thank you again
11/5/07 LR right knee and cartilage tidied up
6/8/07 Knee aspiration, steroid injection- more physio
22/8/07 Knee to be scoped for answers
16/5/08 Patella stabilisation for  subluxations
24/6/08 Infection -hospitalised for a week. Debridement surgery
21/11/08 Repeat patella stabilisation performed















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