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Author Topic: Nick's FatPadTrim, Medial plica/Distal patella excision, AIR x2, LMR 3in1 Diary  (Read 282693 times)

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Offline Clarkey

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BHM
« Reply #1050 on: March 20, 2013, 05:46:28 PM »
Hi All,

My consultation went better than expected with Mr Snow yesterday evening at Droitwich Spa Hospital. I did have to wait till 7:30pm till I saw him and did not mind as he had a busy day in Theatre and then had to see a few Patients in front of me and was happy to be his last Patient of the day as he would then have more time to spend with me.

Mr Snow looks young for an OS and do not mind this as he has many more years ahead of him and we got on really well and he read through my knee history and asked me a few questions and then examined both knees.

I was having a bad day as I was asked to leave a Childcare Course I had been attending for 4 weeks due to one incident during my breakdown when I had a meltdown and now trying to remove these underserved convictions has cost me a place as a Volunteer at a Pre-School so and can no longer continue the course so did not take in all of what Mr Snow said after examination.

Basically I have biomechanical problems and some fluid at the bottom of my right knee as well as a tilted patella? and said 1st to try out PT and is happy to see me again on the NHS the Royal Orthopaedic Hospital in Birmingham where I had my last scope in November 2009. I will be seen by a PT at the ROH and will also see Mr Snow again in a few months time and if my right knee is still not improving will be given a cortisone injection.

Mr Snow said have I tried running and told him as soon as I try to run bottom of my knee hurts and said give it another go. I have tried running today and as soon as I gather pace the bottom of my right knee hurts and still swollen at the bottom of the kneecap. I do not want to run through the pain and cannot run at a good pace so best not to run at all.

It looks like I be out of action running for Droitwich AC this year and been through all this before with my last knee injury and my guess is if PT and injection fails then will need an MRI or exploratory scope and will not think that far yet just take one step at a time.

I was very satisfied with Mr Snow and have found an OS that I will stick to for future knee problems and is £150 well spent money.

[email protected]
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline Clarkey

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Re: Nick's Medial Plica Excision & Fat Pad!
« Reply #1051 on: March 28, 2013, 12:32:14 AM »
Hi All,

I still unable to run at a steady pace and think I will have to sit out of running for Droitwich Athletics Club for this year or start running again in the autum if I am lucky and very disappointed and have to say this year has to be my 2nd worse year, 2005 was a bad year and this knee injury could have come at a worse time and some members will know what I am talking about who are my FB Friends and have joined my Asperger  Syndrome closed FB Group Page and a family member not very well that I will not go into too much detail as I find it upsetting to talk about right now.

Will a 3rd cortisone injection really help as too many cortisone injections in my right knee I have been told is not good and feel I have many more years left of running and this fall was very unlucky as I was being sensible at the time back in Januaryís cold spell and now we had a extremely cold March and Spring. I did not run for 2 weeks as the pavements were icy and slippery and be crazy to run on the ice and snow. I was walking with my walking boots and slipped on black ice yards from my Mumís House and my right knee never healed again.

I get really annoyed when I see runners out there in the snow and ice and are lucky as they never have a fall as still disappointed to miss out on the Droitwich Half Marathon and have noticed the Club are keeping there distance from me by excluding me from their FB Page as they are lucky that they can run and do not have a knee injury like mine so will not understand how hard it is to accept an injury and get left out of the weekly running meet up that I really enjoyed participating in. They are not responding to my comment on FB that I have seen an OS and looks like I be out of action for the running club this year and could have said hope you are able to join us running for the club region soon  rather then saying nothing at all.

I was one of the top runners for the club and who knows maybe they are glad I am injured as I did tend to show off at times by leading up at the front as a Newbie and smaller Towns like to stick together and make new members feel like outsiders to the regions and have to prove your status before you get accepted and respected by the club for being a Brummie born and bred. I may be very touchy and totally wrong as I am feel a little down right now for not being able to run for the club.

Sorry to moan just had to get it off my chest and share it with you guys as you know how hard it is to accept a knee injury.

My FB Group Page AspieAreCool

https://www.facebook.com/groups/380254262010904/members/

[email protected]

RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline Clarkey

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Re: Nick's Medial Plica Excision & Fat Pad!
« Reply #1052 on: April 04, 2013, 02:14:43 PM »
Hi All,

My right knee is still the same and not improving yet and still waiting back for an appointment to see Mr Snow again and PT on the NHS at the Birmingham Royal Orthopaedic Hospital that I am now very familiar with as I had my last scope done there and was there pre op and post op and then had IMS sessions done up until last year July and now they got me once again as a Patient and did not want to go back again so quickly after only being discharged finally less then a year ago. I can have a laugh and joke at Reception as I am a familiar face and the staff thought they finally seen the last of me.

[email protected]
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline Clarkey

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Re: Nick's Medial Plica Excision & Fat Pad!
« Reply #1053 on: April 24, 2013, 05:38:42 PM »
Hi All,

I am still waiting back to see Mr Snow on the NHS and now have got a copy of the report from my consultation last month and will share a paragraph that highlights my knee problems.

Nicholas is of a slim build with slight varus alignment of both lower limbs. There was a very small effusion affecting the right knee and also the left. The right knee had a slight fixed flexion at approximately 5ío  but full active passive flexion. There are tenderness over the antero-medial joint line, but the knee was stable. Patella height was normal, but there did appear to be moderate rotational abnormality of the lower limb at approximately 30-40ío. The quadriceps were tight and similarly the hamstrings were tight causing him to lift the pelvis off the bed when straightening the leg. There appeared to be no flexion deformity at the level of the hips. The IT band was normal.

Then goes onto to say that it is a pre-existing condition and the fall just quickened the whole process. I will have PT 1st and if that does not help a cortisone injection and then an MRI scan. The pain could be caused by PFS or Patella tendon problems.

I still cannot run at the moment as straight away get pain at the bottom of my right knee if I try too and also get pain at times in my left and Mr Snow has spotted swelling and fluid in both knees and now know I have got problems with both knees, going to get back into long distance running despite these setbacks.

In simple terms what is up with both my knees and will it always be a problem in the future if I carry on long distance running.

[email protected]
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline Clarkey

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Re: Nick's Medial Plica Excision & Fat Pad!
« Reply #1054 on: May 02, 2013, 04:16:41 PM »
Hi All,

Once again can someone simplify what's basically wrong with my right knee in the report that Mr Snow produced and now waiting to see him again under the NHS and know it can take some time and has been 7 weeks now since I saw him for my consultation and should have had a date by now to see a Physio at the Hospital and the main reason I paid to see him privately is to speed up the waiting time to see Mr Snow at the Birmingham Royal Orthopedic Hospital.

My GP only got the report back from Mr Snow last week and did ask at the Droitwich Spa Hospital last week when will I get to see Mr Snow on the NHS and said will get a letter within the next few days and now it has been over a week and still no letter. I am not blaming Mr Snow for the delay as it his Secretaries job to arrange my appointment. I will wait till Tuesday after the Bank Holiday Weekend and give the Hospital a call about why it taking so long to get an appointment.

I am now doing volunteering work at charity shop raising money for families that have children on the Autistic spectrum by providing funds for sensory and vital equipment in the West Midlands region to families that cannot afford the essential equipment needed for children that have been diagnosed with Autism and Asperger syndrome.

I have to go up and down a steep flight of stairs to a storage room and also do lots of kneeling and heavy lifting and feeling pain and discomfort in my right knee that still swollen and still unable to run and already had shop lifters and could not give chase and also missing not being able to run for Droitwich Athletics Club.

I could really do with getting my right knee sorted out before finding a full time job as a Support Worker for children and young adults with Autism and challenging behavior full time as I need to be flexible in that line of work and my right knee injury is a hindrance to me once again so needs sorting out properly while out of paid work.

[email protected]
« Last Edit: May 02, 2013, 04:18:53 PM by Clarkey »
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline Snowy

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Re: Nick's Medial Plica Excision & Fat Pad!
« Reply #1055 on: May 08, 2013, 07:32:14 AM »
I'm afraid this is a really tricky one for a layperson to help you with. It really depends how severe the rotational abnormality is, and only the surgeon can judge this.

If the pain is primarily down to PFS or patella tendon issues, PT is by far your best bet - but you need to find someone who really understands these issues. I know from personal experience how debilitating PFS can be, and I do know that a lot of the pain and symptoms you describe match severe PFS very closely.

I went through years of pointless physio in the UK with therapists who didn't really understand the problem. PFS is a symptom - to fix it, you need to deal with the cause (in my case, maltracking kneecaps due to a combination of overpronation and very tight IT bands and quads.) My UK PTs focused on the symptoms, and never even mentioned what could be causing them. Consequently, nothing worked.

When I started working with my current PT in Canada, he took a huge step back and rebuilt the way I handled my knees. He dialed back all the exercise exponentially for a full month to allow the inflammation to settle, got me in orthotics to address the overpronation, used regular IMS to release all the tight muscles, and then very gradually built my exercise program up again to gain strength in the right areas while not overstressing others. The results were dramatic. I went from not being able to walk down stairs or run at all to comfortably running down stairs.

If the rotational abnormality is severe enough, nothing short of surgery to correct the rotation is going to help. I'm not a professional, but my suspicion is that this is not the case for you - you wouldn't have been able to run the distances you were doing previously as consistently if it were. Of course, you may have suffered a soft tissue or bony injury from the fall that is throwing a spanner in the works, and this is definitely worth more investigation. But overall, finding a PT who really understands PFS issues and what causes them is probably a very good option at this point, given the likelihood of this being the source of your pain.
« Last Edit: May 08, 2013, 04:59:56 PM by Snowy »
Mar 11: R Biceps femoris tear (skiing)
Jul 10: ACLr (hamstring autograft)
Mar 10: L ACL rupture (skiing)
Feb 06: L partial ACL tear (kickboxing)
Dec 03: R bone edema (motorbike)
Jan 01: R patellar chip (motorbike)
May 93: R ACL sprain (hockey)
Ongoing: bilateral PFS and OA

Offline Clarkey

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Re: Nick's Medial Plica Excision & Fat Pad!
« Reply #1056 on: May 08, 2013, 06:38:20 PM »
Thanks Snowy,

I agree that PFS and maltracking can be hard to get right again and will try out PT 1st and see how it goes and did ask my OS about orthotics and said I did not really need them and would not get too many benefits while my PT said it would really help so confused what to do now.

I did see the guys at the running club yesterday evening outside the leisure centre after a swim and got the impression that they think I am being too cautious as one member had a really swollen knee and carries on running despite being told not to.

I have attempted to run and can only go at a slow pace and do get knee pain and discomfort and feel a bit rejected by the running club as it was not my fault I slipped on black ice and already had 1 scope on my right knee and would be very foolish of me to carry on running through the pain as I could end up doing permanent damage and will never be able to run again.

Still not had any letter from the Hospital to see a member of the Physio Team and been 7 weeks now and did pay privately to speed up the NHS waiting time and usually be good in the past by sending a letter a 8 weeks plus in advance so will call them on Monday morning if I have still not got a letter from them.

I need to be patient and see what my OS says and PT when I see them again as it best that I do not damage my right knee even further.

[email protected]

RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline Clarkey

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Re: Nick's Medial Plica Excision & Fat Pad!
« Reply #1057 on: May 22, 2013, 05:00:21 PM »
Hi All,

I have finally got a date to see Mr Snow on the NHS on the 12th June in the afternoon after a cock up with my referral letter that was only sent last week after asking twice to send over the referral and finally they managed after 8 weeks that is nothing to do with Mr Snow. It mix up with the private hospital and the NHS that somehow never received my letter of referral and was told that the last time I was referred was in 2010 when I was having a slow recovering from my surgery back in November 2009 when I called the hospital myself last week.

I am still getting pain and tightness at the bottom of my right knee and have tried my best to run that does make the pain worse and cannot really go at a good pace. They do say no pain, no gain and worried I may damage my knee further by running on a painful knee and as I said before my running pace is too slow so it is pointless going for a slow jog.

My right hip is now more painful and did fall onto my right hip and knee onto my side, should I get it checked over next month or is it due to having an injury to my right knee that is like a chain reaction and is now putting a strain onto my right hip which is why it has become more painful.

[email protected]
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline Clarkey

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Re: Nick's Medial Plica Excision & Fat Pad!
« Reply #1058 on: May 30, 2013, 06:18:46 PM »
Hi All,

Not too long now before I see Mr Snow again and have tried running and still getting pain at the bottom of my right knee and hope Mr Snow will at least give me a cortisone injection as it might help reduce the pain and swelling at the bottom of my right knee. I did ask Mr Snow if the plica could have grown back again that could be inflamed again and causing the same problems as I had before my 1st scope and said it unlikely in his opinion.

My left knee also starting to cause some problems with a little bit of swelling on the lateral side and have had maltracking issues since I was in my teens and suppose having a reoccurring injury to my right knee is bound to put strain onto my left knee so will get it checked over as well as my right knee.

I do really miss running and would love to be able to compete and be a member of Droitwich AC again and have frozen my membership till my knees are feeling ok again and think I can rule out 2013 going back to running and 2014 is more realistic as even if the knee did get sorted out before the end of this year I need to slowly build up my stamina and gradually increase my long distance running so I can compete in runs for Droitwich AC.

For now just have to be patient and wait and see what happens when I see Mr Snow on June 12th.

[email protected]

RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline Clarkey

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Re: Nick's Medial Plica Excision & Fat Pad!
« Reply #1059 on: June 06, 2013, 05:12:07 PM »
Hi All,

Only another 6 days till I see Mr Snow again this time on the NHS so could take some time to get my knee sorted out properly. I been told by a number of people to give it a go doing a short slow jog and can tolerate pain it just that I physically unable to run at the moment and when I attempt to run I feel pain and discomfort straight away with each step I take. The pace I am going I can walk better at a fast pace and does not hurt the bottom of my knee.

My right knee is not overly swollen accept for the bottom of the knee and Mr Snow did mention fluid at he bottom of my right knee. Is it too risky to have the fluid removed as it may be a form of protection for the knee to prevent any further damage.

I cannot see at this stage PT fixing my knee problems and maybe would benefit from a 3rd cortisone shot that was mentioned by Mr Snow and had a cortisone injection pre op and post op that might reduce the pain and swelling so I can do a bit of running rather then none at all which is happening right now.

I am doing long distance walking instead for now thatís still a good form of physical exercise to be doing and is healthy and getting fresh air. I know once my right knee is ok again will very quickly get back into my running rhythm again as it did not take me long to get to a good competitive level after my scope back in 2009 that took 18 months to fully recover and run again which only lasted 18 months and then fell on black ice again in January 2013.

I was at my peak before my fall average speed under 7 minutes a mile and was getting quicker and hope to get back to this level again once my right knee gets sorted out properly. I do miss running and only ran in one competitive race and was about to do the Droitwich Half Marathon and feel like the Michael Owen always getting a new knee injury and can never get the opportunity to show my full potential.

[email protected]
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline kcknee

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Re: Nick's Medial Plica Excision & Fat Pad!
« Reply #1060 on: June 10, 2013, 10:27:42 PM »
Hi Nick-

Good luck at your appointment on Wednesday.

If Mr. Snow recommended physio and you were never contacted to set up the appointments, he might still want you to try that first. Hopefully you have been doing all the physio exercises and stretching at home that Russ and the NHS Physio at the Queen Elizabeth Hospital gave you for your quad and calf muscles. I'm not sure if you ever went back to that physio for a follow-up but bring notes from there if you did. Try to put together a schedule of the stretching, exercises and massaging (deep rolling) that you do on your leg each day to show him that you are doing physio at home on a regular basis. He can then decide if he thinks more formal physio could help. I would also suggest bringing your running trainers (sneakers) in with you so he can see how they are wearing out.  Maybe that could help you get the orthotics on the NHS.

Good luck and let us know how your appointment goes.

Kristin
12/31/08 - Skiing injury L knee
6/1/09 - ACL stump removed from joint
8/31/09 - ACLr - Hamstring Graft
12/21/09 - Ant Fasciotomy 
8/26/10 - Anterior Interval Release
12/6/10, 5/5/11, 12/22/11 - Fasciotomy
12/7/12 - Nerve Decompression
6/3/13(m), 7/29/13(l), 12/13/13(m & foot) 2/3/14(l) Fasciotomy

Offline tez27

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Re: Nick's Medial Plica Excision & Fat Pad!
« Reply #1061 on: June 12, 2013, 09:39:41 AM »
Good luck with your appointment with Mr Snow today I hope all goes well and he has a plan to get you running again, let us know how it goes,,
Take care Tez
L K injured 25th June 2008
scope Jan 5th 10
diagnosis ACL rupture
fiberous band excised from acl
ACLr July 19th 2010  scope on 24th Sept 2011
ACL has failed incorrect tunnel placement
23rd July 2012 1st stage of a 2 stage ACL revision
10th May 2013 2nd stage ACL revision

Offline Clarkey

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Re: Nick's Medial Plica Excision & Fat Pad!
« Reply #1062 on: June 12, 2013, 01:08:17 PM »
Thanks Kristin and Tez, wishing me good luck for todayís appointment that is now not happening anymore.

I received a phone call yesterday and was told that my appointment has been cancelled for today and will get a phone call within the next couple of days to arrange another appointment. I am not at all happy as I had to ask twice to get a referral to see Mr Snow on the NHS and now there is a further delay.

I paid £150 to speed up the waiting time to see him that's now a complete waste of money and not having a go at Mr Snow itís the Admin Team at fault for not communicating properly and will not hesitate to go back to The Droitwich Spa Hospital and will ask in a polite way if I could have a follow up consultation done privately at Droitwich.

The lady at The Droitwich Spa Hospital already knows that I had to ask twice to make sure the referral had gone through and now there is a further delay again and the NHS will have to pay the bill as this is the least they can do for messing it up for the 3rd time.

[email protected]
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline Clarkey

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Re: Nick's Medial Plica Excision & Fat Pad!
« Reply #1063 on: June 20, 2013, 05:04:44 PM »
Hi All,

I never received a phone call from the Birmingham Royal Orthopaedic Hospital after cancelling the appointment with Mr Snow last week Wednesday. I did go back to the Droitwich Spa Hospital and asked if they can add me as one of the hospitals NHS choice programmes so I can see Mr Snow privately and get treatment at the Hospital all paid by the NHS as they messed up my referral twice and then do not bother to call me back to arrange another appointment so entitled to go through the NHS Choice as I have been messed around a lot and been waiting a long time for a follow up consultation to see Mr Snow.

I now have to wait till Tuesday to find out when I can see Mr Snow again and been told I could see him within a week of getting a referral from my GP. Why I had to see my GP again for a follow up consultation is a bit bizarre as I am already a registered patient at The Droitwich Spa Hospital.

I could have done without this hassle to be honest as I have got other things to worry about right now and will be glad to see the last 6 months of 2013. I hope to see Mr Snow soon as my knee is not improving that's still sore and swollen and unable to run and just want to get my knee sorted out now so I can go back to what I was good at since childhood, long distance running.

[email protected]
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline Clarkey

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Re: Nick's Medial Plica Excision & Fat Pad!
« Reply #1064 on: June 26, 2013, 03:36:20 PM »
Hi All.

I am finally making some progress and have now got an appointment on Tuesday 2nd July at 7pm at the Droitwich Spa Hospital in Worcestershire. It will be funded by the NHS as they did botch up my appointments a few times. I am now seeing Mr Snow privately through whatís called The NHS Choice Scheme. 

I could do with getting my right knee checked out as I walked with my friend over the Malvern Hills in Worcestershire yesterday and my right knee was hurting and felt it more going up the hill rather than down it. My right knee feels ok on a flat surface but soon hurts when I try to increase the speed or try to jog or run with pain at the bottom of my knee thatís still swollen in that particular area.

I like have it sorted out sooner rather than later as I am still eager to find a job doing Support Work for Autistic Children and would then have to ask for sick leave if the worst case scenario was to happen and needed a 2nd scope on my right knee. I would rather be physically fit again before starting a new job if accepted.

I read through all my medical records the other day and Mr Turner use to work at Droitwich Knee Clinic in 2003 when I saw him and has retired since. Back then he worked out it was the plica causing me the pain and discomfort and was removed 6 years later along with a fat pad trim

http://www.nhs.uk/Services/hospitals/Overview/DefaultView.aspx?id=295

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RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming















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