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Author Topic: Nick's FatPadTrim, Medial plica/Distal patella excision, AIR x2, LMR 3in1 Diary  (Read 282711 times)

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Offline Clarkey

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Re: Nick's RK Medial plica excision/fat pad op#1 Anterior interval release op#2
« Reply #1230 on: September 16, 2014, 10:39:02 PM »
16/09/15 Day 60 Post Op

A later post then usual been a busy day gaining extra qualifications doing Functional Skills Maths Level 2 & GCSE English as well as mentoring two boys with Aspergers & ADD that's all tiring if you on the go 12hrs.

Make a quick post op as I feeling tried went for a swim bit took it easy this time mentoring a 12 year old with ADD and think it ok lifting and donking him in the pool! Tends to have mood swings while getting changed after swim due to a kid bullying him at school that he can't help doing.

Goes to a special school and teachers cannot always keep an eye constantly such as in the changing rooms or toilets. As long as I do not get a kick on my right knee things will be fine.

Been way too busy to do regular PT and patella mobilisation all day apart from 1st thing this morning and been told need to look after myself and not always with others. It in my nature to help others which is why I want to become a support worker.

Right knee still about the same and do feel pain more in left knee when driving that I do between Birmingham & Worcester as well as local driving in the Worcestershire County clocking about 80 to 100 miles.

[email protected]

 
« Last Edit: September 17, 2014, 04:09:57 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 RK Medial plica excision/fat pad op#1 Anterior interval release op#2
« Reply #1231 on: September 17, 2014, 04:09:29 PM »
17/09/14 Day 61 Post Op

I know it is going to be a slow and frustrating recovery to be going through as there will be setbacks just be nice to get back to the things that I enjoy doing for leisure, running, swimming and gardening, that all really help me to reduce my stress and anxiety levels. I know if the knee is showing signs of pain and discomfort then the last thing to be doing is forcing it through the pain.

I am seeing my psychologist tomorrow morning who I known for several years about some unfair legal issues to sort through, he is also an author who has written a book about asperger's that is also on the autistic spectrum who is 100% supporting me.

I may have to give up running completely and can no longer walk at a fast pace that has slowed right down that is another reason why I am seeing him tomorrow.

[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 RK Medial plica excision/fat pad op#1 Anterior interval release op#2
« Reply #1232 on: September 18, 2014, 05:50:12 PM »
18/09/14 2 Months Day 62 Op

Two months post op today and my right knee remains the same with no vast improvements that has now become a hinderance!

My psychologist counseling session went really well and if the worse case scenario did occur and will have to live and manage with excessive amounts of scar tissue inside the right knee, being told to do a manual labour job is out of the equation.

I do love working outdoors in the fresh air and did 13 years working as Golf Course Greenkeeper full time. I now look back and realise that I could have sued the golf club and my line manager for forcing me to come into work when I had a sick note from my GP. My right knee got a lot worse going back to work too soon that started AF in my right knee. 

Having Asperger syndrome on a milder scale makes me the ideal support worker for both children and adults with autism and other additional needs that will gradually become a reality that I am already doing voluntary helping to run autism support groups and families with children on the autistic spectrum.

I know it can put strain on the knees the lifting and bending that you are doing less as you would do in a manual job. The good old British weather is unpredictable with 4 seasons in one day! It is great working in the spring and summer months but not so great in the autumn and winter months in the cold damp conditions that is a nightmare if you have chronic knee problems.

[email protected]
« Last Edit: September 19, 2014, 04:08:06 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 RK Medial plica excision/fat pad op#1 Anterior interval release op#2
« Reply #1233 on: September 19, 2014, 06:40:57 AM »
Quote
I did not realise that AF is serious knee condition to manage with that seems to be on the increase. Surely there must be a way to cure excessive amounts scar tissue forming after knee surgery and AIR surgery. With modern day medical science would think there are methods to eradicate arthrofibrosis!

Strange though it seems, AF is an exceptionally hard thing to stop once it starts. Doctors don't really know why some people start this excessive production of scar tissue when others don't. That's why it's so important to follow the protocols that will stop your knee from becoming overly inflamed and getting back into the scar tissue cycle this time around.

The AIR cleaned out the scar tissue that resulted from your last surgery, but now that you know you're prone to this it's critical to do the right things and pace your recovery properly. If you don't, you'll just end up in the same position again a little further down the line.

Don't give up on running - if you manage your recovery well and avoid another build-up of scar tissue, it's not an unreasonable goal in the longer term. The tough thing will be scaling back what you want to do in the short term and building up slowly to make sure that you recuperate successfully from the latest surgery.
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 RK Medial plica excision/fat pad op#1 Anterior interval release op#2
« Reply #1234 on: September 19, 2014, 04:22:27 PM »
19/09/14 Day 63 Post Op

Thanks Snowy for a constructive and good guidance to my question of curing or preventing AF from reoccurring again. I will not give up the idea of running just yet, find it annoying the long recovery process and protocol after AIR surgery!

9 weeks post op today and I am finding it hard not to overdo it as I am too helpful and kind to admit to others that I still have issues with my right knee and still need to take things easy for a couple of months. I do not like to say no when I am have been asked by the Directors of the autism charity shop for children and their families that I cannot help them to take boxes of heavy books and other items up a steep flight of stairs at their shop.

This happened today and do not like to feel restricted as I am very much a hands on type of person so feel that it is rude to say I am sorry I cannot do any lifting till my knee is more settled again.

[email protected]
« Last Edit: September 26, 2014, 04:03:58 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 RK Medial plica excision/fat pad op#1 Anterior interval release op#2
« Reply #1235 on: September 20, 2014, 04:18:46 PM »
20/09/14 Day 64 Post Op

Now I am into the early part of week 9 post op I would like to be able to walk longer distances again that I cannot do right now as the right knee starts to play up more if I have walked further distances.

I really like walking long distance that I could do it without any problems pre op just could not run or walk at a fast pace. Now pace is average and sluggish that was not too bad pre op, knee still tends to give out after walking for over 30 minutes plus.

I am not the type of person that can just stand there and take things easy and do not want to be hindered from doing everyday tasks that I could once do without any problems. I am still doing patella mobilisation, I still have swelling around the medial portal as well as doing squats and leg raises.

Finding that there are far to many precautions and strict guidelines to follow after AIR that is a hit and miss surgical procedure and maybe did too much after 2 week post op 1 legged squats that I did not realise was the wrong thing to do as the NHS PT did not write down what PT exercises to be doing at home.

Then find that my well trusted Sports PT is overseas for 9 weeks and see a new Private PT that I was told is good at his job! He made me do a gym workout and PT that was too painful for my right knee. Since then my knee has not felt right again as I can still can hear and feel the clicking around the medial portal!

[email protected]
« Last Edit: September 20, 2014, 04:20:40 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 RK Medial plica excision/fat pad op#1 Anterior interval release op#2
« Reply #1236 on: September 21, 2014, 08:00:46 PM »
21/09/14 Day 65 Post Op

If was unfortunate and scar tissue had returned after my AIR surgery the scar tissue would return within the 1st 6 weeks post op. If the scar tissue was already there then using the knee more again will not make the scarring worse that cannot be reversed.

It hard to take things easy as I am not the type that to take things easy as I like to be as physically active as possible. If it was not for the medial portal giving me all the problems I would be further ahead with my recovery. I am still finding pain and tightness when trying to squat down as the pain level is fairly intense.

[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 RK Medial plica excision/fat pad op#1 Anterior interval release op#2
« Reply #1237 on: September 22, 2014, 02:53:05 PM »
Nick- Read over the advice you have posted here from your surgeon and physio. Call your surgeon if you have questions. Eight weeks is still in the early stage of recovery from a scar tissue removal surgery. No one likes to have to limit their activity especially as their body starts feeling like it can handle more and you start getting the urge to push your recovery faster, but the surgeon is saying to hold back. Keep reminding yourself why you had the surgery - you wanted your knee pain to stop and to be able to run again. You ultimately are in charge of your recovery, your surgeon can only give you his advice on what be believes you need do to have the best chance at a good recovery.

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 Clarkey

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Re: Nick's RK Medial plica excision/fat pad op#1 Anterior interval release op#2
« Reply #1238 on: September 22, 2014, 04:20:06 PM »
22/09/14 Day 66 Post Op

Kristin you are right that it always best to listen to your OS and physio and agree totally with Mr Snow's advice and guidance so far however I am not happy at all with my new private physio's advice as he was the one I am pointing the figure at for making me do too much PT in one session!

The intense PT too soon has made my right knee medial pain worse that has not been the same since! He may have 25 years of expert knowledge with common types of post op surgeries but not so knowledgably about the protocols after AIR surgery.

It has been a while ago now that my most trusted and usual sports physio has been overseas who should be due back in the UK soon or sometime in October. I am happy to see him for advice and guidance of what I should be doing and what I should avoid doing during physio as I trust him 100% who known me since January 2010.

[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 Snowy

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Re: Nick's RK Medial plica excision/fat pad op#1 Anterior interval release op#2
« Reply #1239 on: September 22, 2014, 07:01:27 PM »
Quote
I am not the type of person that can just stand there and take things easy and do not want to be hindered from doing everyday tasks that I could once do without any problems.

I know it's hard to make yourself do this, but it's so important right now. Keep reminding yourself that this is temporary, and that you will get back to those every day tasks - but right now the priority has to be making sure that you recover without causing overdevelopment of scar tissue in your knee again.

Quote
If the scar tissue was already there then using the knee more again will not make the scarring worse

Unfortunately this may not be true in your case. This is the difference between normal scarring and arthrofibrosis: obviously some formation of scar tissue is inevitable after surgery, but what characterizes AF is that formation of scar tissue becomes excessive and doesn't stop when it should. As Kristin says, that's why your surgeon placed so much emphasis on taking it easy following this surgery.

When there's a possibility of AF, recovery isn't as straightforward and you can't rely on the timeline from a standard surgical recovery to know what you should and shouldn't be doing. It's a much slower, longer, more cautious process. Just remember that frustration at slow progress now will be well worth it in the long run if it means you recover successfully this time around and can begin running again.
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 RK Medial plica excision/fat pad op#1 Anterior interval release op#2
« Reply #1240 on: September 23, 2014, 11:00:25 PM »
23/09/14 Day 67 Post Op

Thanks once again Snowy for giving me so useful and helpful advice, I just have to be patient for now as you have pointed already. Slow and gradual process is the key to hopefully getting back into running long distance again.

Worse case scenarios did occur and AF returns again I would accept not being able to run and a 2nd AIR would just make my right knee worse. If it did happen might have to get into cycling and running that a good form of exercise giving the body a good workout.

Hopefully will recover eventually and get back into long distance running! I have been pre warned by my family that running makes their knees ache and do not have any knee problems and 2 scopes like I have had.

They are saying it would be unwise if I did return back to long distance running as I am more at risk of wear and tear of the knee and road running will speed up the process.

I notice lots of adults my age in their 30s or as young as their 20s limping or using walking aids as they already have problems with their joints.

[email protected]
« Last Edit: September 23, 2014, 11:04:15 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 RK Medial plica excision/fat pad op#1 Anterior interval release op#2
« Reply #1241 on: September 24, 2014, 04:16:18 PM »
24/09/14 Day 68 Post Op

3 weeks today I will be seeing Mr Snow for my 2nd post op checkup, I so far done what he has suggested by doing patella mobilisation on a daily basis with lots of squats! It has benefited my right knee as it does not give out as often. It still does give out at times but not as bad after I seeing the new private physio so could say it is easing slightly as my quads are getting a lot stronger.

If there was not pain and swelling at the bottom of my right knee and the pain was not so intense around the medial portal then my right knee would be ok to slowly increase my physical activities. Swimming breaststroke by not going to quick and kicking back legs gently puts less strain on my right knee and only do 30 minutes with regular breaks. Before did 45 minutes solid swimming with just 2 short breaks.

[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 RK Medial plica excision/fat pad op#1 Anterior interval release op#2
« Reply #1242 on: September 25, 2014, 05:00:18 PM »
25/09/14 Day 69 Post Op

Would now be a good time to start going to the gym again, doing some lighter exercises or would it be best to wait till I see Mr Snow on October 15th 2014. I know that is a slow and gradual process to recover fully from AIR as scar tissue build up can easily return if you do not stick to the strict guidelines of how to prevent AF from returning.

It is frustrating to see others running long distance and raising money for good causes! I never had the opportunity yet to run in a long distance race being injury prone. I do know there are other ways to compete competitively that's not just long distance running.

Cycling, swimming and walking for a charity organisation is an alternative option to replace running but for me is not the same as running that I enjoy the most. If the knee pain is still there by spring 2015 I may as well give running a try again even if it hurts my right knee by putting up with the pain. My pain tolerance is higher then some runners comfort zone.

[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 RK Medial plica excision/fat pad op#1 Anterior interval release op#2
« Reply #1243 on: September 26, 2014, 04:18:41 PM »
26/09/14 Day 70 Post Op

10 weeks post op today that has gone quickly, hopefully no significant amount of scar tissue has built up inside the right knee that might go away with patella mobilisation and deep tissue massage.   

It would be nice by the time the spring 2015 arrives that I am able to do some light short distance running that I can slowly increase to full running distances that I could do ok until my slip on black ice. 

The knee swelling has subsided apart from the bottom of the knee and can clearly see swelling around the portals. The incisions have healed up nicely that are not so obvious anymore that was the same after scope #1! One cannot spot the scar tissue inside the knee even after an MRI scan has been done.

[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 RK Medial plica excision/fat pad op#1 Anterior interval release op#2
« Reply #1244 on: September 27, 2014, 03:54:15 PM »
27/09/14 Day 71 Post Op

I know that there will always be some slight swelling around the portals, I can clearly see that the medial portal is more swollen and not subsided or gone down yet compared to the lateral portal that also not as painful as the medial. The upper portal poses no problems what so ever and is now only the bottom of the right knee causing me pain and discomfort.

At least my right knee is no longer giving out just know the pain is deep down and more of a chronic type of pain as I can tell the difference coping with knee problems on and off throughout most of my life. The bottom right knee pain at the moment is more intense then it was pre op. The main reason for the exploratory scope was to hopefully get back into long distance running again.

It may still happen as the recovery is slower for AIR surgery, for me the bottom of my right knee pain feels fairly intense as I always had a higher pain tollerance towards pain.

[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