Advertisement - Hide this advert





Author Topic: Patella stabilisation post op diary  (Read 110960 times)

0 Members and 1 Guest are viewing this topic.

Offline Sore knee

  • SuperKNEEgeek
  • *****
  • Posts: 1067
  • Liked: 0
Patella stabilisation post op diary
« on: May 27, 2008, 03:35:15 PM »
I am a bit late starting this but decided to do so.

I have had a year now of knee issues, well always had an irritable knee but last May 07 had a LR by a surgeon whom i will not name but found his post op care less than inspiring. 3 months on I was still on crutches with massive swelling - he told me to go to the gym.

Anyhow changed OS and had a scope Aug 07 to clear out any inflammation

Have been in PT for a year and still a very loose patella that I could almost play ping pong with.

So I saw my OS on April and he said my knee cap was loose and it was time for a patella stabilisation...May 16th was the date



Had travelled abroad to see my Dad and got home the night of the 15th, which worked well as I get really nervous before ops and it helped take my mind off tings.

I went in on the 16th and thankfully managed to speak to the anaesthetist before hand explaining how sick I had been last time and how afterwards I was still throwing up almost 18 hours later and nurses were giving me oral meds which was a nightmare as every time I was sick they had to check to see if I had kept pain killers. Yuch !

So the prep nurse was a man this time, oh joy I thought could things get any more embarassing, however fate was not to let me down.  Once the nurse  put on all the monitors on my chest and one on my side for some reason. The OS then came in and those of you who know about my OS well you will appreciate this moment.

 I felt the panic rise and thought seriously deep breath, hold your breath do something Joanne, think bad thoughts...no think good thoughts...no think nothing, dont breathe, no do breathe and a multitude of panicking thoughts to try and control my heart rate. ....All of them were triple underscroed with  but PLEASE dont make that machine bleep like mad.

The monitor was just starting to pick up speed, I could see it and like a movie scene you know where they go itno slow motion its about to just be a nightmare and then  the nurse (whom I told my concerns to about the aneasthetic) said ok now is the time to tell this man - the aneasthetist -  about your experiences so he can give you the right meds and turned down the volume. Oh I could have kissed him, I felt the relief sweep over me as I could see the swing doors to the op theatre open and the rest of the team all standing in there waiting on me. This was one grand entrance I was really kind of scared of making.

By this time I felt a bit more confident. My heart rate despite thundering through my chest was at least not heard even if visible to anyone who looked at the screen. However  at least I had a nice tan from being abroad and my hair was all blond from the sun. I figured if I ever had to meet anyone I was intimidated by at least this was the best time. Just home, no peeling from the sun (as yet) anda face that despite being petrified I knew looked fairly brown. Yes I was careful used sun protection but I am lucky, I have my dad's skin and in the sun I go brown. Great if only I lived in a  sunny country. Most of the time I look peely wally white here...for those who dont understand the local slang, I look all pale, tired and as if I am going to be ill I am so pale.

So despite being in a fetching hospital gown   (yeah right, I think the theory is they look bad enough you can only think yourself well faster in order to be able to wear your own clothes) which was being pulled down for the monitors my OS came up and stood beside the Aneasthetist. How are you he said.....(I thought do you want the truth but of course was not so bold as to say) and said I'm ok thanks, a bit nervous though. He said ohhh dear, well dont worry I'm nervous too does that help you. I said oh thats reassuring and we both laughed. I then told the Aneath about my previous issues with aneasthetics. He said he would ensure there was plenty local anesth put in so that it bought us some time after the op before I would need pain meds. (That bit didnt quite go to plan)

So he was great, him and the OS were there going through my file and the op notes from before to decide what to do. He gave me the stuff in my arm and the room started to swirl and then lay me flat and used the mask over my mouth which he said was just oxygen and to relax.....yeah yeah...and that was it. I could feel the panick rising by that time but didn't have time to feel any more.

The next I kew I was in the intensive care recovery. I had a mask over my mouth and was aware of noise but not quite there. I could hear the chat and what they were saying but couldn't quite bridge the gap and reach where they were. Then I was suddenly aware of huge throbbing pain. I started to make noise....you know where you hear noise but cant believe its you. A bit I assume like an out of body thing as people were shaking me gently asking me to wake up and I couldn't. I just kept saying pain, and they said are you in pain and I made some feeble gesture with my head. They gave me something in my arm..into the plastic thing they have in your wrist actually. It was cold and they said in a few seconds is that better. I was now becoming more aware and I knew it wasn't.
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

  • SuperKNEEgeek
  • *****
  • Posts: 1067
  • Liked: 0
Re: Patella stabilisation post op diary
« Reply #1 on: May 27, 2008, 03:46:45 PM »
They gave me 3 more shots of morphine.
Eventually they said if your pain is a 6 on the pain scale where are you now ...they gave me another shot. I said 5 so they gave me another shot. All in all I had about 10 shots of it over the period of time. They gave me morphine in about 2mg  or  ml  or whatever units they use at a time as I had already had so much local they said so I didnt have an excessive amount, just they gave it in small doses, I was still not with it at all but after 2 hours they took me to my room.

Nurses kept shining torches in my eye and saying wake up. I knew they were saying it to me it was weird but it was like I was just too sleepy. However it was peaceful, dreamy sleep with no discomfort and everything seemed an effort so I just lay there and even when I wanted to wake up its like I drifted away again. They got one of those body board things to move me into my bed and I kind of slipped along it or thats how it felt. Thinking back I really amnt that heavy and figured my husband could have lifted me in but as I found out later the chief nurse a matron like woman and who was scary as hell did everything as it should be. She scared the hell out of me, never smiled once. not a hair out of place and nippy with you. Not someone I would argue with thats for sure.

So in my room, pain now under control and I got a peak under the blankets to see the brace they had me in. I think I was finally able to speak about 3.30pm that afternoon from the op being at 8am. I never come round well after aneasthetics, my hubbie had to keep telling them that on the ward as they were getting in  a real tizz saying they hadnt seen anyone as sleepy as me afterwards and my pupils were still pin pricked or something like that. However that doesn't freak me out anymore as thats all 3 times, they just keep me on oxygen masks until I fully wake up. Apparently even then I did have some interesting conversations that I have no recollections of whatsoever.
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 arkitect06

  • SuperKNEEgeek
  • *****
  • Posts: 2822
  • Liked: 0
  • Medtronic = Life!
Re: Patella stabilisation post op diary
« Reply #2 on: May 27, 2008, 04:23:00 PM »
Good story Joanne!!  I can't believe how long it took to wake up! I didn't like the waking up part, but I eventually had to.  They just bothered me so much. 

Farrah
11/16/10 Fulkerson TTT, chondroplasty, LR (Left Knee)
11/17/09 SCS re-implant
7/29/09 I&D
5/7/09 SCS removal b/c of MRSA
12/15/08 & 2/6/09 SCS Revision
10/30/08 Spinal Cord Stimulator Implantation
6/27/08 diagnosed with RSD
1/8/08 Fulkerson TTT, chondroplasty, LR (Right Knee)

Offline Sore knee

  • SuperKNEEgeek
  • *****
  • Posts: 1067
  • Liked: 0
Re: Patella stabilisation post op diary
« Reply #3 on: May 27, 2008, 05:43:12 PM »
So fast forward 10 days now.

I went to see my OS yesterday who took my dressing off and told me all about things.

Apparently I have a shallow trochlea which doesnt help my situation. My patella is probably pre-disposed to sliding off but the LR didn;t help as it then lost all stabilising factors really and required this. As per my posts on my pre-op diary I said everything he done there.

However he has tightened the ligaments medial side along with the retinaculum ?.

I am in a splinted brace and cant bend. At present I am only allowed up to 40* bend although I am nowehere near that.

I got the post op rehab programme guidelines today which I will post later.
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 arkitect06

  • SuperKNEEgeek
  • *****
  • Posts: 2822
  • Liked: 0
  • Medtronic = Life!
Re: Patella stabilisation post op diary
« Reply #4 on: May 27, 2008, 05:57:35 PM »
Hello Joanne, I have a fairly flat trochlea too.  They showed me the images inside my knee and there wasn't much to hold my knee cap in place.  My OS was afraid that he may have to go back and do a trochleoplasty eventually, but I don't think that has to happen now. 

So are you in much pain now?  I hope it is being controlled well.  Pain sucks!  Are you walking only with crutches?  Or are you allowed to weight bear? 

You seem to be handling this very well!!  I admire your courage now!!!  Sounds painful!  Are you suppose to start PT at all?  When is your next OS apt?  Good luck!!! 

Farrah
11/16/10 Fulkerson TTT, chondroplasty, LR (Left Knee)
11/17/09 SCS re-implant
7/29/09 I&D
5/7/09 SCS removal b/c of MRSA
12/15/08 & 2/6/09 SCS Revision
10/30/08 Spinal Cord Stimulator Implantation
6/27/08 diagnosed with RSD
1/8/08 Fulkerson TTT, chondroplasty, LR (Right Knee)

Offline Silkncardcrafts

  • SuperKNEEgeek
  • *****
  • Posts: 3916
  • Liked: 6
Re: Patella stabilisation post op diary
« Reply #5 on: May 28, 2008, 03:24:02 AM »
Hi Joanne,

Your post-op diary is fantastic. I can't wait to read the next instalment !!!

I'm so glad that you changed OS's. This new guy sounds like he's really on the ball.

Like you I had a lateral release and patella stabilisation. My OS has been thinking of doing the trochleoplasty for a while and in the end decided it was my best option.

Farrah/Joanne, if you ever need a trochleoplasty as least I'll be able to tell you about it. The pain isn't actually too bad.

Look forward to reading the next installment.  ;)
11/1996 - RK LR
07/1997 - LK LR
11/1998 - LK MPFL Reco
12/2005 - RK LR Repair
07/2006 - LK MPFL Repair
11/2006 - LK LR Repair
22/05/08 - LK Trochleoplasty
11/02/10 - RK Trochleoplasty
07/03/11 - RK Chrondroplasty

Offline Sore knee

  • SuperKNEEgeek
  • *****
  • Posts: 1067
  • Liked: 0
Re: Patella stabilisation post op diary
« Reply #6 on: May 28, 2008, 10:25:00 AM »
why did you end up with a trocheoplasty Kirsty ? Did you still have patella issues after your previousnsurgeries, did the tightened tissue stretch ?

Just curious as it sounds like I have a similar history to yours and wondered how the stabilisation failed or what happened ?

Will post later
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 Silkncardcrafts

  • SuperKNEEgeek
  • *****
  • Posts: 3916
  • Liked: 6
Re: Patella stabilisation post op diary
« Reply #7 on: May 28, 2008, 10:52:25 AM »
Hi Joanne,

I developed one of the risks of a lateral release, medial instability. My CT scans also showed I had a tendency to have lateral instability as well. In the end my knee cap would come out laterally and medially. My OS said it's a really difficult problem to fix. He thought doing a trochleoplasty was my best chance of resolving my instability problems.

Last year I had a car accident where they think my knee hit the dashboard, which made my knee very unstable. I tried heaps of conservative treatment, but nothing worked.

So, that's why I had the trochleoplasty.

Look forward to your next instalment.  :D
11/1996 - RK LR
07/1997 - LK LR
11/1998 - LK MPFL Reco
12/2005 - RK LR Repair
07/2006 - LK MPFL Repair
11/2006 - LK LR Repair
22/05/08 - LK Trochleoplasty
11/02/10 - RK Trochleoplasty
07/03/11 - RK Chrondroplasty

Offline tanyap

  • SuperKNEEgeek
  • *****
  • *
  • *
  • Posts: 2902
  • Liked: 0
Re: Patella stabilisation post op diary
« Reply #8 on: May 28, 2008, 11:19:31 AM »
Hi Joanne,
GREAT diary!!! Very interesting.
I am the opposite after anasthetisia, not only do I come round pretty quick but I wake up FEROCIOUSLY hungry so I started begging for food within minutes :)
The only bad thing that happens me is the shivering, but I looked around and other people were shivering so I guess its normal.

Completely opposite to you guys also in that i do NOT have a flat trochear groove. My current OS wonders if they should have bothered doing the stabilisation on my at 14 years of age and perhaps should have just cleaned the joint out and done and LR but not the TTT - however we dont know the answer to that as it was done and thats that.

Joanne - I look forward to the next installment!!
xx
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 Sore knee

  • SuperKNEEgeek
  • *****
  • Posts: 1067
  • Liked: 0
Re: Patella stabilisation post op diary
« Reply #9 on: May 28, 2008, 12:24:31 PM »
ell I started this diary as I got my post op rehab protocol with at least a 12 week programme and figured this is a good place t see my progress.

I ended up at hospital yesterday as my wound has opened slightly but is now looking more than the little gap it was.

here are my piccies....hours after the op.

And photos today. Cant show you the full photos yet of my knee as I will take those when I have the brace off, my scope wounds have virtually disappeared.

ooops gotta resize them hang on
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

  • SuperKNEEgeek
  • *****
  • Posts: 1067
  • Liked: 0
Re: Patella stabilisation post op diary
« Reply #10 on: May 28, 2008, 12:30:17 PM »
oops no will have to do it on the computer and not off my phone will post them later
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

  • SuperKNEEgeek
  • *****
  • Posts: 1067
  • Liked: 0
Re: Patella stabilisation post op diary
« Reply #11 on: May 28, 2008, 12:42:22 PM »
I will try and post these photos now

1st day of op, my first look although not much to see
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

  • SuperKNEEgeek
  • *****
  • Posts: 1067
  • Liked: 0
Re: Patella stabilisation post op diary
« Reply #12 on: May 28, 2008, 12:44:12 PM »
2nd photo again just through brace, the wound opened.
At first it was just a dry line
Yesterday it was a wee bit swollen with red line starting along it but its ok
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

  • SuperKNEEgeek
  • *****
  • Posts: 1067
  • Liked: 0
Re: Patella stabilisation post op diary
« Reply #13 on: May 28, 2008, 12:45:30 PM »
and todays photo of the wound.

I will get one of my whole knee next time brace is off
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 arkitect06

  • SuperKNEEgeek
  • *****
  • Posts: 2822
  • Liked: 0
  • Medtronic = Life!
Re: Patella stabilisation post op diary
« Reply #14 on: May 29, 2008, 01:35:14 AM »
What did the hospital say about your incision opening up?  I hope you are okay.  Do you have screws or something in there?  Maybe you are allergic to them like Brianne was.  I hope you are feeling okay besides that.  How have you been?  Do you work?  If so, when do you go back?  How have your kids been through all of this for you?

Farrah
11/16/10 Fulkerson TTT, chondroplasty, LR (Left Knee)
11/17/09 SCS re-implant
7/29/09 I&D
5/7/09 SCS removal b/c of MRSA
12/15/08 & 2/6/09 SCS Revision
10/30/08 Spinal Cord Stimulator Implantation
6/27/08 diagnosed with RSD
1/8/08 Fulkerson TTT, chondroplasty, LR (Right Knee)















support