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Author Topic: Nick's FatPadTrim, Medial plica/Distal patella excision, AIR x2, LMR 3in1 Diary  (Read 282942 times)

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Offline Clarkey

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Re: Nick's Medial Plica Excision & Fat Pad Trim 'Ongoing Saga'
« Reply #1125 on: March 18, 2014, 02:22:22 PM »
18/03/14: Four months Pre Op:

The countdown begins, in exactly 4 months time I will be having my 2nd exploratory scope on my right knee.

16/11/09 was my last surgery to remove the medial plica and trimming of the fat pad in my right knee.

I will do a monthly update on the 18th day of each month until the actual surgery date on Friday 18th July 2014. I have asked to have a copy sent of my MRI scan report. This will give me more in depth knowledge on what could be wrong once Mr Snow is inside my right knee with his mini camera.

I am feeling more pain daily in my right knee, I do know Mr Snow mentioned bruising of the actual bone inside my right knee as the main concern, he has not seen this come up very often in an MRI scan of the patients that he sees. ‘Bleeding inside the actual bone, inside the knee’

I am not sure what will happen once he is inside my right knee?

My future as a competitive runner could be a distance memory!

nickwclarke2014BhamUK
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 Trim 'Ongoing Saga'
« Reply #1126 on: March 20, 2014, 05:44:19 PM »
My 2014 MRI Scan Feedback on my right knee:

Diagnoses: Anterior knee pain right knee previous Botox injection facia lata.

This gentleman returns to clinic. He has not really had significant relief following Botox injections and IT band stretching and as such we went onto perform and MRI scan of the knee. This has shown medial femoral condyle bone oedema which I think probably represents cartilage degeneration.

He also has an abnormal signal within the fat pad but this is probably representative of his previous arthroscopy and scarring because he did suffer with stiffness.

It is always difficult to know exactly why people develop medial facet or medial trochlea disease as usually it is the lateral compartment of the patellofermoral joint which suffers from maltraking.

He does have a low TT-TG distance which may explain this and he is slightly varus. His IT band is still tender today but exquisitely painful and his popliteal angles were very good.

I think the only step forward I could go would be to undertake an arthroscopy to assess the medial trochlea, potentially there is scar tissue or band which is rubbing on this area which could explain the oedema but similarly it could well be a control lesion.

If it is small we could treat this at the same time with a microfracture but if it is larger we may need to return to use a different technique. He is fully aware of this.

Nicholas states that his pain is now impinging on his daily life and would like to consider intervention. I have listed him for a knee arthroscopy and will see him in due course.


There not much else I can do; I will leave it in the expert hands of Mr Snow that I have 100% confidence.

Mr Snow is there to help me that I fully appreciate, I will try best to remain positive Pre Op; it is just unfortunate that I have maltracking, bowed legged and a low lying patella that has started to wear the knee out, I may have to think wisely is it sensible to do run distance running in the future post op?

Mr Snow suggested cycling instead of running; I can see his point of view as it is the closest you can get to running with minimal impact on the knees.

It just hard to get use to the idea at the age of 35 that I may never run competitively again long distance that was something I was rather good at.

I can only blame myself as I ignored the knee pain while running and also ran at a too quick pace and now I am paying the consequences for my actions. 9 miles in just under an hour I have proof of, that is of some credit.

Also have an even better reason to help and support children with special needs instead of manual labour jobs like gardening and greenkeeping. It will just make my knees worse; doing a complete career change is a wise move and my dream job.

Bad things happen in life for a reason!

[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 Trim 'Ongoing Saga'
« Reply #1127 on: April 18, 2014, 10:00:46 AM »
18/04/14: Three months Pre Op:
 
Only 3 more months to wait until my exploratory scope and do not think that the surgery will be a waste of time and a mircofracture may be performed by Mr Snow. The right knee remains swollen and painful at the bottom of the kneecap that easily gets aggravated when using my knees while gardening and going up and down the stairs at the charity shop I volunteer at.
 
I have noticed that my right hip at times is delicate around the top and side of the hip, It happened twice now I get bruising on the side of the hip. Also certain movements cause a spasm effect with pain around the hip and already know I have tightness with my ITB. I did have a Botox injection into the tensor facia lata followed by PT and stretching before my MRI scan. It made no difference and do have tight and knotted leg muscles.
 
It am hoping it resolves by itself and just due to having problems with my right knee that is putting more strain onto my right hip joint. I hope the surgery is a success and if a microfrature was required it not as bad as I 1st thought as many patients younger then me have this type of surgery.

[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 Trim 'Ongoing Saga'
« Reply #1128 on: May 18, 2014, 02:36:44 PM »
18/05/14 Two months Pre Op:

Only 2 more months left until my exploratory scope that is fast approaching after seeing Mr Snow on 5th March.

My right hip is still an ongoing problem and will be seeing my GP 28/05/14 to book an appointment to see the sports physician I saw back in January 2013 before my fall and injury.

Diagnoses back then was tight and knotted quads & ITB tightness. Hip is delicate feeling the odd twinge around the groin & slight bruising around the hip at times.

Time to have another assessment at a separate hospital that I having my exploratory scope done that is closer to my home.

As Mr Snow specialises in knee & shoulder joints & not the hip might as well see my sports physician again. It should hopefully resolve by it self after surgery and physio on my right knee that having an impact on my right hip that often happens a domino reaction to other joints.

[email protected]
« Last Edit: May 19, 2014, 01:13:00 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 Clarkey

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Re: Nick's Medial Plica Excision & Fat Pad Trim 'Ongoing Saga'
« Reply #1129 on: June 18, 2014, 05:16:09 PM »
18/06/14 One month Pre Op:

Time has flown by and will only have to wait 1 month until Friday 18th July for my scheduled exploratory arthroscopy that should be going ahead still; I did have to reschedule it back to the agreed date after finishing my last exam on July 15th.

The hospital wanted me to come in for surgery on Monday 7th July and soon let them know that that day does not suit me as I was told I will have the surgery done on Friday 18th July. Thankfully they have put me back to the agreed surgery date.

It a very simple request to make in advance when I saw Mr Snow on Wednesday 5th March 2014 that I will be busy with my studies until July 15th. Mr Snow said that he can fit me in for 18th July and was even reconfirmed with his secretary.

I think they thought they was doing me a favour fitting me in earlier as it has gone passed the 18 weeks Government waiting list targets. The hospital know that I have Asperger’s and may have thought I would accept the date ok being less stressed out getting the surgery out of the way sooner.

I had the date 18th July set in my mind and pre planned up to that date and should get the confirmation letter from the arthroscopy department to have the surgery done on the 18th July; I have to be at the hospital for 7:15am.

I will try and give an update on the actual day of my exploratory right knee arthroscopy providing I can use my iPhone on the ward and feeling up to typing after the GA!

[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 keano100

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Re: Nick's Medial Plica Excision & Fat Pad Trim 'Ongoing Saga'
« Reply #1130 on: June 23, 2014, 08:40:16 PM »
I've been avidly reading your story as i've had a fat pad resection and an area of the medial plica removed about 3 months ago. To be honest the way it is at the moment its been a total waste of time. Physio said he cant do anymore so has sent me back to the surgeon. Ive got a appointment with him next week but im considering going back to my GP for a 2nd opinion. Anyway hope it all goes well next month with your 2nd scope.

Offline Clarkey

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Re: Nick's Medial Plica Excision & Fat Pad Trim 'Ongoing Saga'
« Reply #1131 on: June 24, 2014, 04:48:10 PM »
Hi There,

You will find that each individual knee problems is going to be different to the next person that may have had the same type of surgery as I had in November 2009. I am glad you gathered some information by reading through my post op diary from my 1st knee surgery. You may have read some similar symptoms to what I have been through or going through right now.

I had no option at the time but to go ahead and have an exploratory scope as my fat pad and medial plica iwas nflamed to an extent it was catching the bottom of my kneecap that went away after my 1st scope. Scar tissue was a problem for me post up and took 18 months of PT, friction massage, cortisone injection and dry needling sessions (IMS) until I was back to full fitness and running long distance again.

My 2nd exploratory scope that is due next month was caused by myself as I did overdo it running on a hard surface at a too fast pace doing a 9 mile circuit run 4 times a week plus 13 years of hard labour working on a golf course as a greenkeeper.

I also have a long history of knee problems with knee pain starting when I was still at primary school with PFS and maltracking in both knees and also know my right knee cap is on the lower end of normal. One can now see why my right knee is not happy and potentially may have partly warn out my kneecap!

If mircofracture surgery was done on July 18th it will save what cartilage is left in my right knee. My OS would drill a series of holes into the bottom of the kneecap that will generate new cartilage growth to form. It is not a guarantee that it will be a success and may not last for long if I overran again.

3 months is still early post op, it can take 6 to 18 months to know if the surgery has worked for you or not as a 2nd scope is a lot of trauma for the knee to take and could then have scar tissue problems to contend with as the knee has been opened up twice!

I am taking a gamble and risk as I am fed up not being able to run, feeling pain and discomfort in the knee; I have chosen an OS that specializes in soft tissue injuries to the knee. If you ever needed a 2nd opinion and live the UK and the Midlands region I suggest that you see Mr Martyn Snow. I am very satisfied with him and pleased he is doing the surgery, he is one of the best Knee specialist in the UK.

Good luck with what you decide to do next.

[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 keano100

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Re: Nick's Medial Plica Excision & Fat Pad Trim 'Ongoing Saga'
« Reply #1132 on: June 24, 2014, 08:46:00 PM »
Thank you for replying. Maybe i'm being a bit premature saying that it hasn't worked but it just seems to feel the same. Mine doesn't feel like a catching sensation but can vary from stiffness if kept in same position for a while, sometimes the leg would just go and i couldn't walk on it fo a while to just low grade irritation. Its as though you are pushing on a nerve. Its difficult to explain.

My problems started about 4 years ago from running on a treadmill. I wouldn't feel it until about 20 mins into each run. When it played up I'd give it a rest for a bit then start again. Eventually it just  became a more transient issue so I went to the dotors who referred me to a physio. The physio straight away said it was PFPS and to do some stretching and strengthening work. After over a year of this i asked for an MRI to take place which found some minor wear and tear but nothing else. By this time the knee seemed to be getting worse. Eventually i got referred to the surgeon and had a cortisone injection in Jan of this year. It didnt even touch it, apart from a feeling of carrying a brick in my leg for 2 weeks. How did you know you were suffering from scar tissue?

Offline kcknee

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Re: Nick's Medial Plica Excision & Fat Pad Trim 'Ongoing Saga'
« Reply #1133 on: June 25, 2014, 12:38:00 AM »
Hi Nick -

Great news that your surgery is getting closer. I hope that Mr. Snow is able to help you get back to running. Please post after surgery to let us know how you are doing.

Kristin
« Last Edit: June 25, 2014, 03:31:29 AM by kcknee »
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 Clarkey

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Re: Nick's Medial Plica Excision & Fat Pad Trim 'Ongoing Saga'
« Reply #1134 on: June 26, 2014, 05:54:14 PM »
Having a cortisone injection I found was just a temporary fix and numbed the pain slightly, so far have only had two injections into my right knee. I have been pre warned that it is not good for the knee to have too many cortisone injections.

Asking about how it felt having scar tissue after my 1st scope, for me I felt pain and tightness when bending and squatting as if someone was grabbing the side of my knee with pain around the portal areas where the OS makes the incision.

It did not help that I was forced to go back to work too early under a GP’s sick note as at the time my line manager was a bully. Going back too soon made my right knee even worse, I ended up having had to take 6 week off rather than 3 weeks.

My private sports physio did a great job doing friction massage around the portals to break down the scar tissue. I then had dry needling done on the NHS and had a cortisone injection at the pain clinic that did help get rid of the tightness.

18 months post op I was able to run long distance again for a further 18 months then had a fall on black ice and have not been able to run since the fall! Your scan showed up some minor wear and tear this happened during my 2nd MRI scan slight wear and tear and fluid around the fat pad that was nothing to be concerned about at the time.

1st MRI was all clear just spotted that the kneecap was on the lower end of normal 3rd MRI clearly shows the bottom of my knee is not how it should be with bone bruising, bleeding inside the bone. Mr Snow said he does not come across it to often on the MRI scan images. He even pre warned me that he may go in and my right knee will be ok, I think he has to say this to cover himself, realistically he will find a problem or would not go ahead with surgery.

If you are still concerned you are entitled to a second opinion or an alternative could see a sports physician as I did for dry needling sessions. They are higher than a PT, below an OS.

Thanks Kristin, I just want to get the surgery out of the way, I am now worried the hospital once again has got the date wrong as I have not yet had a confirmation letter and surgery is only 3 weeks away tomorrow. The letter they sent for earlier surgery was 5 weeks before saying to confirm within 10 days or be referred back to my GP.

Know in the email sent that Mr Snow’s Secretary has re booked me for the original agreed date on 18/07/14 and not on the 07/07/14. If it was botched up once again I will not be impressed!

nickwclarke2014BhamUK
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 Trim 'Ongoing Saga'
« Reply #1135 on: July 08, 2014, 02:56:41 PM »
08/07/14 10 days Pre Op:

Only 10 more days until my 2nd exploratory arthroscopy and still not received a letter this morning in the post so rang up the arthroscopy apartment, they have confirmed I am booked in for Friday July 18th under the care of Mr Snow and his medical team. I have been given a conformation reference number and now I am officially booked in for Friday 18th July.

I expect they had a cancellation when they wanted me booked in yesterday 7th July so sent out the letter dated 3rd June. I may still receive a standard admission letter in the post the next couple of days.

At least I have not got long to wait now to finally know what up with me right knee and hope it can be fixed so I can return back to long distance running. If my right knee is damaged to an extent that it best I no longer run I can continue swimming and with the recent Tour De France in the Yorkshire Dales can also take up cycling that Mr Snow already suggested I do pre op.

I am fine now about the surgery but when it comes to the actual day of the surgery nerves set in and have a horrible anxiety with a dry mouth and feeling nervous as I am getting ready to go into theatre as no matter how many times you have had surgery it is never nice feeling knowing that you are suddenly going to lose unconsciousness. Even dream about it at times and now it happening for real! 
 
[email protected]
« Last Edit: July 19, 2014, 11:15:25 AM 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 Vickster

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Re: Nick's Medial Plica Excision & Fat Pad Trim 'Ongoing Saga'
« Reply #1136 on: July 08, 2014, 04:56:08 PM »
Good luck for the op, Nick.  Once it's done, you hopefully shoudn't need the  services of the Droitwich Knee clinic as your other post  8)
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline Clarkey

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Re: Nick's Medial Plica Excision & Fat Pad Trim 'Ongoing Saga'
« Reply #1137 on: July 13, 2014, 10:38:13 AM »
13/07/14 5 days Pre Op

Thank you for the good luck message Vicky & let's hope you are right that my 2nd scope will hopefully resolve my knee issues! From past history & 2nd surgery in 5 years on right knee very doubtful with a possible microfracture. I will be 36 in 5 months time & think running long distance at a competitive level is now looking unrealistic & may have to cycle & swim instead of running.

Lots of professional sports women & men retire at around mid 30s as we more injury prone and our joints have taken a lot of impact compared to youngsters just starting their sporting career.

Still no confirmation letter for Fridays exploratory arthroscopy and was given a conformation reference number when I rang Tuesday so presume I am booked for Friday?

I could call the same number once again Monday morning just to make sure I am booked in as it is unusual not to receive a letter less then 1 week pre op. Thought it was standard procedure to send out a letter with time to come into Day Unit & precautions to take night before surgery.

[email protected]
« Last Edit: July 19, 2014, 11:16:21 AM 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 tez27

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Re: Nick's Medial Plica Excision & Fat Pad Trim 'Ongoing Saga'
« Reply #1138 on: July 13, 2014, 10:14:14 PM »
Nick maybe the fact that you have called and been given all the information about your upcoming scope means the hospital wont send you out the letter at all, as long as you have the conformation number I'm sure you will be fine and all booked in.
Good luck when the time comes I really hope everything goes well and Mr Snow can sort out your knee problem so you can get back to doing everything you are missing out on.
I don't come on here very often these days but I will check in and see how you get on
Take care Tez x 
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 Trim 'Ongoing Saga'
« Reply #1139 on: July 15, 2014, 03:58:40 PM »
15/07/14 3 days Pre Op

Thanks for the good luck message Tez, unfortunately you have been through numerous knee surgeries already. This will only be my 2nd right knee surgery in 5 years, so not done too bad considering all the running I did that led up to existing knee injury.

I agree with you that I do not require a letter from the hospital and fairly certain I am booked into the day unit on Friday. It was worth postponing as I just done my last day at college today. I did ok in the Functional Skills Maths level 1 exam today so hopefully I have got a pass. In September I can do my level 2 in FSM as I only started to gain confidence in maths since September 2013 as I have a fantastic maths teacher.

I just had a end of term year 9 gardening project at a school in Worcester I volunteer weekly, plus helped out yesterday at an adult disability disco. Autism Awareness and safeguarding training tonight in Birmingham to mentor young adults on the autistic spectrum aged 18 to 21. I will then sort out my right knee on Friday ready for September 2014/15 academic year.

6 certificates in one academic year, I shall be resting and recharging during the next 6 weeks, I just want to get Friday out of the way. I am not afraid to admit I will be petrified as it was bad enough my anxiety levels with the botox injection in September 2013.

[email protected]
« Last Edit: July 19, 2014, 11:17:03 AM 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















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