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Author Topic: Patella stabilisation post op diary  (Read 116859 times)

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Offline Sore knee

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Re: Patella stabilisation post op diary
« Reply #330 on: September 22, 2008, 02:03:01 PM »
Well thanks for all the well wishes-  very much appreciated !

It went a b it like this:

I went in and said I had spoken with Ian my PT and he said he now thought it best to speak to you (OS) but I thought it too hard to explain. He said you look as if you have more mobilty and I said I do, I am mobile but my knee gives way constantly, I have no confidence in it at all and I feel the patella is very loose again. He said loose ? !!! ?? (Can't really show suprised voice LOL )

I said look I dont want to keep jumping surgery to surgery and I have scheduled an op date in November already and thought that it best to tell you now rather than on the day as I cant explain this well enough. he said is it sore when it moves...I laughed and said it aches all the time but its so loose that I can move it side to side at will and I am sure it is much looser than when I came out of the top in May.

So he said hop up on the bed and he went to move my patella and said WOW ! I totally agree with you and am amazed. I can get my thumb right under your patella and this is rreally loose. He said you know looking at my first OS notes, he said I know you have had work done laterally (by first OS) but I believe your problem is all medial. We need to keep this medial side tight to allow your VMO to kick in and I actually bleieve we could get the quads firing early and get the VMO initiated which I think would then give you good tracking.

He said your tissues are very flexible and can get lax very easily...he said really easily - given I only had them tightened in May. He said he felt my soft tissues round there would just continue to stretch and get worse and although something he didn;t like doing he felt he would need to look at taking a graft I think from my hamstring tendon somehow (think thats what he said) and re doing the soft tissue tightening. He said he wanted to think over this as it was not a run of the mill problem and he wanted to think how he felt best he would fix it. He said I beat most of the odds on flexible tissues and mine are very stretchy so using mine again that are there just now is not an option, we need to look at grafts.

I said look I am too young to be so immobile, I cant keep taking the painkillers, anyway they have no effect and I just want a quality of life back. He said he totally agreed and that no matter what he was in this with me and he wouldn't abandon me. He would find a resolve.

ANyhow I then went along to physio and Ian wasn't there but another PT was there whom I knew and I spoke to her. I said I didn;t quite take it all in and she said dont worry they would speak to the OS and someone would phone me and explain. I said give it a few days as the OS said he would need to think on which way he would do it and they said ok.
So if anyone can shed any light or give me Qs to ask do let me know. I am stunned and a bit sad that I am going to face another big op again. Definitely in overnight at least, also open surgery again, splint, brace and LOADS of PT....again :(

So thats my update....bit shell shocked right now. Worried about gettign Ben, I have my heart set on him and will be devastated if I cant but by then he will be 3 months and I hope I will have him in a routine by then....wishful thinking maybe but the thought of not getting him  :'( :'( :'( :'( :'( :'( :'(

Surely with my family's help I could cope. My hubbie says no he has his work etc etc and is stressed but I am so hoping we can chat tonight and I will try so hard to be on my feet as best I can to help. I think I would crumple up right now and shrink if I couldn'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 tanyap

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Re: Patella stabilisation post op diary
« Reply #331 on: September 22, 2008, 04:29:13 PM »
Hi Joanne,
First of all - you'll cope with Ben. He is a puppy, theyre adaptable and youre not meant to walk them much too young anyway, and other than that - what coping? Put food down, put water down, let him in and out to do his nature calls and make your hubby clean the garden once a week - thats it for a couple of months of new puppy. AND - if I were you Id just get him cos youre hubby WILL take responsibility if he has to. Its easier to ask forgiveness than permission so just do it!!

Now about your knee. Yikes!!! Nasty flexible soft tissues. It didnt sound right how much push you had on it. Im glad the OS has seen it. So he didnt mean a TTT anyway, just more soft tissue work - which is still a big deal but at least its not bone work eh? Dont be sad over it - if they get it right youll have such a better quality of life, you cant live with it giving way on you all the time. And your OS sounds like he really wants to help you too so thats great.
I know you have a pain in your nether regions at the prospects of more surgery and rehab but hey, Ill be rehabbing for the next 2 years so I will encourage you when you get sick of it and gently remind you that it has to be done!! You dont mind doing it when youre improving anyway - its doing it and getting nowhere thats soul destroying!!

I hope your chat with hubby goes well, i am sure he will understand, its not like its your fault!!!
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

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Re: Patella stabilisation post op diary
« Reply #332 on: September 22, 2008, 05:27:45 PM »
Thanks Tanya :-*

I know, if this works it will be greatbut I am almost scared to hope that way after all the surgeries now and I am willing this one to work !

He said this will be more painful and afterwards can create a feeling of pressure on the patell as if pushing down slightly but it does restrict the lateral glide. However I am in pain now so living with pain that is productive and would give me a quality unctional life would be better.

But THANK YOU !!!!!!

My hubbie isn't into Ben as much as me and the kids so he needs to be worked on so fingers crossed.
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

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Re: Patella stabilisation post op diary
« Reply #333 on: September 22, 2008, 06:28:31 PM »
Joanne, I am so sorry about your soft tissue stuff!!  I know you were already planning surgery, so this just means you have a better chance for success!  So congrats on that!!!  Go with the puppy no matter what!   IT will make you so happy.  Your husband will fall in love once he sees Ben.  I am about to start a meeting now, so I have to go.  I Just wanted to let you know that I am so sorry for you with your stress.  I am glad that the OS knows what's next though and is thinking of the best way to make it right!!!  Gotta go, but thinking about 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)

Offline MartinsGirl

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Re: Patella stabilisation post op diary
« Reply #334 on: September 23, 2008, 12:09:35 AM »
Hi Joanne,

I just found your journal so am going to comment on the stuff you wrote today.  I'm sorry about your soft tissue problems and needing more surgery. I'll have to read back in your journal during the week to catch up on exactly what you had done and how you've been coping. 

I know you're worrying about getting a puppy now that you're getting more surgery. I agree with what others wrote. GET THE PUPPY!! My doggie is almost 10 yrs old and i remember when I got him as a puppy. Some puppies get house trained so quickly. It really isn't as stressful and tiring as some might claim. tanyatap is right. it's not that hard to put down food and water and let the dog out. and also your hubby WILL fall in love with Ben right away. what kind of dog is he?? Puppies are just adorable!!! And he will bring you so much joy. Just read Farrah's posts about the sheer joy her doggies bring her :D Ben will come lay with you and lick you, etc. at all the right moments.  Dogs just know. 

i'll catch up on your thread during the week, ok? it was so cute how you wrote on Lenore's journal that reading what her and I write to each other cheers you up. i'm glad to help :D  you're awesome! ttys!
~Nevella :D
-July '07-soccer injury
- microfracture of the tibial plateau
- arthroscopy in Oct. '07 (remove torn cartilage and repair microfracture)
-developed AF but beat it (avoided surgery)
[img width=200 height=136]http://dl6.glitter-graphics.net/pub/504/504056crsfyif

Offline Silkncardcrafts

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Re: Patella stabilisation post op diary
« Reply #335 on: September 23, 2008, 12:29:05 AM »
Hi Joanne,

I know you are probably really upset right now, but I just want to reassure you that things will be ok.

If it's any consolation I have the exact same problem. That's why a number of my operations have not worked. If your OS uses a hamstring graft he is most likely talking about a medial patellofemoral ligament (MPFL) reconstruction which is also known as patella stabilisation. They essentially insert in another ligament to stabilise your kneecap. I had this operation on my left knee after my lateral release failed and worked really well. The recovery is similiar to an ACL reconstruction.

I am suprised that your OS hadn't worked out that you had problems with soft tissue especially considering your results after the lateral release. It's probably a lot to take in right now but I would seriously think about getting a second opinion. Mr Simon Donnell who is based in Norwich specialises in patella problems and meant to be one of the best in the country. It is really important you get the right advice and the right sort of treatment for your knee.

Don't worry about Ben, I'm sure it will work out fine.

You really need to have a good talk with your hubbie about your knee and how much it's impacting you. Having support around you is so important right now.

I am thinking about you a lot at this difficult time. You'll get through it.  8)
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 Mookie11

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Re: Patella stabilisation post op diary
« Reply #336 on: September 23, 2008, 09:32:37 AM »
Hi Joanne,
I just found you over on Lenore's thread so I thought I'd read up on your diary too. You have really been through the ringer!! It is just so hard to think of you having had so many procedures already. Is there nothing that will be a more permanent option?  Sheesh, you are tough.

I wish you well and will continue to check up on you now!

Candace
Who knew knees were so complicated!

Offline Sore knee

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Re: Patella stabilisation post op diary
« Reply #337 on: September 23, 2008, 10:29:31 AM »
awww thank you ALL so much for your support  ;D I suddenly felt lifted rasding all your replies knowing that firstly you understand ( and those with families or other hectic lifestyles) know how quickly you go down the list as you try and sort everyone else first and secondly you all get this knee stuff. I read on here and keep thinking well there are those with much worse situations than me so onwards and upwards !!!

I so appreciate the support and know I am going to get through this.

Kirsty I think my OS feels the LR was the wrong choice for me, he said to me yesterday that he believes much of my problem is medial and that if he was going to scope it he was going to see what the first OS had actually done with the LR, to see if it had scarred badly and the muscle pulling wrong. I actually think I have worked too hard on my rehab and with such an imbalance my quads pull heavily laterally and think that has stretched out the medial side.

Anyhow can you tell me what your recovery was like Kirsty ? Its consoling to know someone else who has had it done. Ok really stupid Q here....this is an open surgery right ? I'm sure he said it was but I didn;t take evrything in yesterday.

Secondly where exactly does the graft come from ? Hamstring is on back of leg....is that right ? Can they do it all via same incision.

i think I will need to phone up and ask but if I can get the basis in my head it gives me something to work with.

Thanks for the heads up on Norwich Kirsty...unfortunately its still ages away from me and the commuting with young kids would not be an option as I would need to go down there for any consults or surgery.

I have defied every prediction ever made......so my mother tells me. I was born at 30 weeks ...way back then and all they could do was set me in an incubator. They told my folks I had a very limited chance of survival, but hey I did. They do Q whether some of my joints were fully formed though as apparently much of it s cartilage based and although I thought it all done in the first 12 weeks that does not cover all the cartilage ....and someone once queried was the patella one of the last to form ???? Never checked that out but doesn't make any difference now as I am where I am.

THANK YOU ALL so much, you have lifted me out of a cloud of despair today and I have more focus now :)

TY !!
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

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Re: Patella stabilisation post op diary
« Reply #338 on: September 23, 2008, 10:59:27 AM »
Hi Joanne,

We are here to support you.

To be honest my recovery was pretty tough. By the time I had my op my quads were pretty much non existent so it was a tough road to strenghten them again. It took a good 3 years to get back to where I was. My case was probably extreme as my muscles had weakened really badly. This is definitely an open surgery and so takes a lot longer to recover from.

For the first 3 months I was in a zimmer splint, which a straight leg knee brace. What did your OS say about this ? I guess there was a lot to take in and probably not what you were expecting.

The graft comes from the hamstring, which is at the back of the leg. They usually just take a few strands of it for the graft.

I would perhaps make another appointment to see your OS or email him a list of questions. It's important to get your head around this and know what to expect.

I know you say Norwich is ages away, but would strongly suggest you get another opinion. It doesn't mean that you would need to go with that surgeon. It's just an opinion. From others that have been to him he doesn't do a lot of follow up with patients post-op. Trace doesn't need to see him for 11 months. Please seriously think about it. You have got to live with your knee for the rest of your life and need to treat it with respect. You only get one set of knees and need to look after them.

Chin up, things will be ok. Ben will cheer you up and get through this. It's nice you have a holiday to look forward to as well.  ;)

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

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Re: Patella stabilisation post op diary
« Reply #339 on: September 23, 2008, 01:18:53 PM »
Thanks Kirsty, he did mention splint then brace.

I have textd my PT ans asked him to call me once he knows as he will be able to give me all the info  - he is very good that way.

Thanks so much for your replies  :-*
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

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Re: Patella stabilisation post op diary
« Reply #340 on: September 23, 2008, 01:46:13 PM »
Hi Joanne,

Sounds like you have a great PT.

Let us know what he says.

Good luck. Thinking of you.
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 lenorem9

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Re: Patella stabilisation post op diary
« Reply #341 on: September 23, 2008, 02:11:08 PM »
Hey Joanne,  Just read up on your diary.  Wow!  You have been through so much and are facing so much more to come.  I love that you're not giving up and want that knee to be right again.  Good for you to continue the struggle.  You're young and active and it will be worth it in the long run.

Sounds like the puppy will be a much needed positive in your life.  Sometimes you just need that extra push to keep you mentally sane.  Pets are the best and they know exactly how to make you smile when you are crying. 

I'll be following you now and pray that this op will be the last one. 
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"

brianne

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Re: Patella stabilisation post op diary
« Reply #342 on: September 23, 2008, 02:40:33 PM »
Joanne,

I agree with Kirsty in that a second opinion could be so valuable to you.  I know it might seem like a horrible trouble to travel and such to see a second opinion, but it is so important.  An MPFL recon is a tricky procedure and if it is done incorrectly you can be left with too much medial pull and a whole bunch of problems relating to that.  Surely a few days of extra travel will be worth it if it fixes your knee. 

Ask your OS how many MPFL recons he has preformed.  He might be right that you need an MPFL recon, but that does not mean he is necessarily the most qualified or the one who should do it.

Brianne

Offline Sore knee

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Re: Patella stabilisation post op diary
« Reply #343 on: September 23, 2008, 03:18:00 PM »
thanks brianne, kirsty and lenorem9 I know what you are saying and can find that out through my pt as all my os referrals will go via my pt. So I can get an idea as even with the last op my os had written rehab notes that were printed and used as a pack so it was obviously quite a popular op........ Not by choice obviously, so I can get all that info via my pt which is good. I would go seek a 2nd opinion but my insurance will not cover anymore outpatient apt of anykind. Not physio or follow ups or anything like that and certainly not xrays or scans. My allowance is all used up and won't renew until into next year.
Also everyone I ask here seems to recommend him for knee issues although I know my history may not look that way. Financialy we just can't, we are hoping my husband won't face redundancy and god forbid he does we lose all private health insurance thus we think better to make decisions sooner rather than later. As if we lose it I lose my current OS also  because we simply could not afford it and then we would not have a choice really .

So I will check up on his history and am not being flippant about this in anywAy but my husband has had enough of my knee. He wants to blame someone and that would be satisfying  but  have accepted that you can't take these things as standard. I have had knee issues for ages and they are complex. It's too easy for me to go down his road of being negative and wanting to blame, it's too negative for me when I have to live it. So I feel I need to be upbeat for both of us. O don't take him to meetings with my OS as I know he would be too aggressive and rude and he is not interested in finding out the issues and complexities of my knee. I am not a silly girl but sometimes he makes me feel it.
He is super stressed at work now and has said he can't be available for me of the kids during the day after my op and o will need to find the money to get help in to get kids out to school and nursery and collected. He just doesn't have the time to help let alone how he will feel with a puppy there too or me complaining of pain.
So you can imagine if I said I needed to go to Norwich possibly for one overnight and have to pay for that plus an apt with this dr.

My husband is great in many ways but right now he is super stressed- unfortunately.
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 #344 on: September 23, 2008, 03:29:30 PM »
I should point out on a positive note that all my inpatient care is covered. So OS, op, hospital etc are all ok provided I am an inpatient. So that's a silver lining...... Sort of!

Well you have to smile, if I didn't I would cry and I hate panda eyes which I alwYs get if I cry.
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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