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Author Topic: Nick's FatPadTrim, Medial plica/Distal patella excision, AIR x2, LMR 3in1 Diary  (Read 282934 times)

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Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
11/10/14 Day 85 Post Op

Been in Liverpool all day with United Against Injustice Day. Met nice friendly people even met actress Melita Morgan and Maureen from TV documentary in the 90s Driving school.

Knee holding up ok with all the walking I have been doing today! Liverpool locals extremely friendly.

[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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  • Neil TheElephant knee packed up carrying his trunk
12/10/14 Day 86 Post Op

Cannot really give an update today been in bed all day after getting food poisoning that weakens your whole body so hard to tell with aching muscles. Was nothing to do with the venue went to a local fast food outlet and the chips did taste strange!

Think they been left out too long or not fully cooked properly that was covered with a weird spice that I thought was the the way it was meant to taste.

Seeing Mr Snow next week on Wednesday that gives me plenty of time to get over my food poisoning!

[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 Scubagrl4

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Oh Nick, how miserable! As if it isn't hard enough to properly rehab your knee, now you are sick too. Ugh! I really hope you get to feeling better soon and can quickly gain back your strength. Feel better soon!
4/14/14 L ACL rupture, grade 2+ MCL tear
6/6/14 ACLr allograft
9/4/14 MUA
10/6/14 LOA/AIR, synovectomy, lateral/medial retinacular release, partial lateral menisectomy, chondroplasty, deep tissue
biopsies.
11/20/14 insufflation, MUA
10/19/15: LOA/air, PLM, chondro, synovectomy, med/lat releases

Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
13/10/14 Day 87 Post Op

Thanks scubagrl4 for showing concern towards my food poisoning outbreak that I have now thankfully got over and anyone that's been through an outbreak of food poisoning will know how it feels! It was an unpleasant 24hrs to endure.

I do not often get really unwell that I spent 24hrs in bed and in future will look out for 5 star food hygiene standard ratings any lower will not buy food from the outlet. Even better bringing my own food.

I was tired and did not eat much all day that made it perfect to get food poising plus drinking a few pints made it worse as I did not realise I had a bad stomach until I was sick in the toilet and was not from drinking that I 1st thought as I had not eaten much that day.

My walking pace has improved to a point that I can walk at an ok pace and less noticeable my limping just kneeling and squatting I am struggle with still and running, I have been told it will take a while to run again!

The pain however is just as intense as it was back in the early stages post op if I try to speed up my walking and does not feel the right thing to do to try and kneel or squat right now.

No contact from My sports PT, I am not annoyed or surprised that he not responded as he was doing me a favour and family always come 1st.

[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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  • Neil TheElephant knee packed up carrying his trunk
14/10/14 Day 88 Post Op

Less than 24hrs until my 2nd post op appointment with Mr Snow and remaining open minded and optimistic still that I will get back to a competitive level in running again. It is hard to watch others taking part in half marathons and full marathons raising money for good worthy causes.

I have lost out not being able to rejoin Droitwich Running Club as I was only 6 weeks away from competing in my 1st ever half marathon at a competitive time with my average pace of under 7 minutes a mile. Best time I managed was a mile in 6 minutes and 1 second.

That time was a week before my fall on black ice in January 2013 and was hard to accept pulling out of my 1st ever half marathon. I will try and do all I can to run at the same pace again despite my knee problems.

Do you think it would be ok to get Mr Snow to check my left knee as well as seeing how my right knee is bearing up! I already do know that he and my regular PT both said can see maltracking issues. Know there was a mention of lateral release surgery that I know is a gamble type of surgery that could potentially make my left knee even worse!

If I am more prone to excessive scar tissue formation then I think it's best to stay clear from surgery only as a last resort if knee is really painful and restrictive. I have been pre warned by my regular PT and an NHS one I saw a while ago that if I run on a regular basis the left knee could become a problem.

10:40am tomorrow morning my appointment with Mr Snow and the hospital staff unfortunately know me well at the reception desk and volunteers unfortunately know me well. I am sure there are many regular patients with ongoing joint problems.

[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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  • Neil TheElephant knee packed up carrying his trunk
15/10/14 Day 89 Post Op

This morning appointment was not ideal from start to finish 1st the machine that meant to scan your bar code on the top of the appointment letter was not working and did it manually on the touch screen. Then the print out of your calling in number on the screen did not print out, thankfully one of the hospital volunteers sorted it out for me at the reception desk.

Then find out on the screen Mr Snow was not in clinic today that does happen more on the NHS as Mr Snow is entitled to take a holiday or doing training days and his Registrar must be good during consultation. When I did finally get to see Mr Snow Registrar was 40 minutes late with no apology from one of the nurses or the Registrar.

Felt the consultation was too rushed and told him it is still very painful around the medial portal to squat and knee with tightness and clicking. He stated the obvious that this is normal after AIR surgery and will be another 2 months before I see any significant  improvements.

My ROM is good and said I can start to cycle and go to the gym, he never really examined my right knee properly just a quick visual view and said to come back in 3 months time again and should then be discharged?

Ideally would have been better seeing Mr Snow as he knows my knee well and trust him 100%, it is still  too early to say still if the AIR surgery has been a success or not!

Hopefully in 3 months time I will get to see Mr Snow and if the knee improved and can be discharged fantastic if my right knee has not improved I want further investigation.

[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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  • Neil TheElephant knee packed up carrying his trunk
16/10/14 Day 90 Post Op

I am not at all happy with yesterday’s services and up until yesterdays appointment I was happy and satisfied so far with the services the hospital had provided so far. The Registrar could have shown more enthusiasm as he did not even introduce himself saying that he is Dr so and so and in place of Mr Snow today and sorry for the delay.

For all I know he could have been a member of the public impersonating a consultant that of course would never happen just felt like it! I had to ask him questions or would not have got any information out of him. At least after my 1st scope after my 2nd post op check up I was referred to the pain management clinic at the hospital.

I have experience in coping and managing with knee pain and this time round the pain around the medial portal is fairly intense pain if I try to kneel or squat right down or increase my walking pace or attempt to jog!

It is hindering me from be able to do paid work at my local catholic church as I cannot function properly to do gardening tasks and would have been nice to get something back from the appointment by at least putting my mind more at ease be booking me into the pain management clinic.

http://www.roh.nhs.uk/pain-management

I not sure what to do next deal and manage with the pain until I next see Mr Snow in January 2015, do I see my GP for a referral to a pain doctor. I think it would be better if I phoned up Mr Snow’s Secretary explaining my present situation and that I am still in pain and discomfort with my right knee and like to at least be booked into the pain clinic.

I just do not want to come across as a winger as I have complained a few times now already so must think I am fussy and difficult patient so reluctant to contact Mr Snow’s Secretary as I am more and less slating and complaining that I am unhappy with Mr Snow’s Registrar consultation.

I know the NHS has to save and cut back on their expenditure and not at fault for having a chronic knee condition and should do all they can to ease the pain around the medial portal of my right knee.

I am sorry to be moaning and sounding so negative I just expected a better service after going through AIR surgery as I had complication after scope #1 due to excessive scarring so needs to be monitored carefully.

[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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Hi Nick- sorry you had such a frustrating meeting.  I wish Mr. Snow could have been there to assure you.

Do remember that you are not cleared to run or jog yet, so at this point you have to be patient before you try either again. I hope you are still doing the patellar mobilizations and deep tissue massaging around the portals. If when you massage in deep around the medial portal, you are feeling hard scar tissue, you might want to see one of the providers that offer Graston treatment from the list below or get referred to a hands-on physio if possible.

http://www.grastontechnique.com/graston/search.php?zipcode=&f_name=&zip_radius=10&name=&address=&city=&state=0&canada_f_name=&canada_name=&canada_address=&canada_city=&canada_province=0&otherCountries=ENGLAND&method_country=Search

I'm not really sure how NHS works or if you could see one of these providers under the NHS. Graston is extremely painful at times, so be prepared if you try this option.
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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  • Neil TheElephant knee packed up carrying his trunk
17/10/14 Day 91 Post Op

Thanks Kristin for the link to Graston treatment that I have not come across before until you suggested. Rosanna Ellis is Physiotherapist based in Worcestershire that is an area I am around in the majority of the week. I know Hallow in Worcestershire that is not too far from the spa town of Droitwich were I have lots of connections at and hope to relocate there once I find employment after my studying.

You are right that I have not yet been cleared to run or jog yet, from being patient in the past saying that my last knee problem pre op that I have to be patient and carrying on doing PT and the knee should improve. However this time round no matter how patient I am, I could wait 18 months post op and still experience the same pain and tightness around the medial portal.

Since receiving poor advice and treatment from the PT’s with NHS PT I saw post op never wrote out what exercises to be doing then doing lots of 1 legged squats 2 weeks post op as I mistook his instructions. The private PT making me overdo it on the exercises and stretches 6 weeks post op. I felt at the time I was being pushed too early that could well have contributed again to excessive scar tissue formation, my right knee was feeling ok up until that point!

Patella mobilization I never did until after I saw Mr Snow 6 weeks post op and to be honest not done any friction massage just PM. When doing PM I can clearly feel something around the medial portal slight clicking that also noticeable when bending my knee that I am told is perfectly normal after AIR surgery. I am still feeling pain where the clicking is occurring around the medial portal.

I already know my next appointment with Mr Snow it on Wednesday January 14th 2015 @10:30am which incidentally was my original appointment with Mr Snow that I put forward as I felt I needed to see him sooner and only got to see his registrar that was not ideal as I needed Mr Snow’s expertise.

[email protected]

« Last Edit: October 17, 2014, 11:30:13 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 Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
18/10/14 3 Months Day 92 Op

I hope from now 3 months post op today until Wednesday 14th January 2015 when I see Mr Snow again hopefully this time and not his registrar, I am still surprised what a difference it makes when you have found a good OS you can fully trust but as soon as someone else is representing him thing go pear shaped!

Looking back now at Wednesday appointment I do not want to attend the next appointment unless I know that it Mr Snow on duty that day or will postpone the appointment. You can cancel your appointment within 48hrs before of your consultation as I see nothing wrong to insist that I only want to see Mr Snow that day.

I even had to instruct the registrar saying would you like me to take my trousers and socks of to examine knee or would not have really looked the state of my right knee. Could tell from his body language he did not show much interest towards my right knee! I am sure other patients that were in clinic that day must have felt the same way as I did not getting the service they deserve.

A good OS should make each patient feel valued and appreciated even if they are having an off day they should remain professional at all times with an annual salary of over £100,000+ a year depending on experience and if they work for both the NHS and privately. They deserve a high pay so should also be able to interact well with their patients.

My patience is wearing thin now, I know it still very early post op and takes a while to recover form AIR surgery, I just feel at present my right knee is now feeling more restrictive then it was pre op! Before the pain at the bottom of the knee was a dull pain that increased as soon as I tried to speed up my jogging pace.

Walking, kneeling and squatting causes intense pain and tightness around the medial portal, at least this time I am able to pinpoint the exact area of pain that happens to click and clunk when bending my kneecap. The pain has improved to a point that it is not giving out as much just feeling more restrictive and self conscious! 

Not being able to show respect at church for examples by not kneeling down as I could force myself through the pain and tightness around the medial portal but fear it could cause excessive scar tissue formation again!

I am now reducing my daily post op diary to weekly basis on a Friday now that I have reached 3 months post op which is the target I had in mind to go up to on a daily basis. Sorry to sound like Mr Victor Meldew a grumpy old man on a British 90s sitcom.

I am just fed up with the lack of understanding towards AF in general apart from Mr Snow that specialises in soft tissue problems of the knee. I could be at fault for maybe re-scarring again as fear I may have done too much in one go in the critical 6 week post op period that would mess up AIR surgery of a top World class AF specialist OS that I could of avoided if I did more research before hand of AF and AIR surgery post op recovery.

[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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Oh Nick, how very frustrating. I'm sorry you ended up with the registrar and that he didn't give you the time and attention that Dr. Snow would have done.

If the pain continues to be severe and limiting, I would go back to Dr. Snow's secretary and request an appointment sooner than January. It also doesn't sound like the registrar gave you any guidance on when to begin more demanding activities to minimize the risk of the scar tissue returning, which is very important - you don't want to be placing too much stress on the knee too soon.

You worked for many years and paid your contributions to the NHS, so you shouldn't feel bad if you have to ask for an extra appointment for peace of mind and better advice.
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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  • Neil TheElephant knee packed up carrying his trunk
24/10/14 3 Months Day 98 Post Op

Thanks for the reply Snowy and fully agree with you, it would be nice to see Mr Snow again earlier than 14/01/15. The only problem it is the NHS and know from the last time I called Mr Snow's secretary to see him earlier then the arranged appointment that the next available appointment was 2 months away so might just get in before Christmas if I am lucky to see him.

The other option would be more expensive seeing Mr Snow at one of the private hospitals he works at, I am usually around Droitwich Spa Hospital on a Tuesday when Mr Snow does consultations in the evenings after a day’s surgery at the hospital. I have seen him there twice before, once was private the other was done under the NHS system of paying for private care and was a free consultation.

IF the worse case scenario did occur and AF has returned inside the right knee again and another AIR surgery is required I would be ok about going through the whole procedure again under one condition that I am given proper 6 weeks post op aftercare with a team of PT’s and medical professionals doing regular friction massage therapy and patella mobilisation and gentle gradual PT exercises to fire up the quads again.

Hopefully it does not come to this and the scar tissue can still be broken down without the intervention of more right knee surgery. I know I am at a higher risk of scar tissue formation and that a 3rd scope could make my right knee even worse!

I will be putting my flat on the market this week as the flat is becoming too expensive to maintain and had nightmare tenants so will not rent again, I will get a job I want in the not too distant future. I would be happy to use some of the equality in my flat if it got to a stage I needed AIR surgery again to pay privately for the surgery and aftercare that is vital to get right to stop AF returning.

As I said hopefully does not come to this, find that it is always good to have a plan of action ahead for the worst case scenario.

[email protected]


« Last Edit: October 24, 2014, 08:22:15 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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  • Neil TheElephant knee packed up carrying his trunk
31/10/14 3 Months Day 105 Post Op

I have a copy of the consultation report to my GP I had with Mr Snow’s registrar from Wednesday 15th October and say’s the following;

I have seen this gentleman in Mr Snow’s clinic today who underwent anterior interval release of his right knee 3 months ago.

On examination today he has got full extension with full knee flexion. He still has some soreness around the portals and can straight leg raise but he still has some reduced quadriceps right side.

I have encouraged him to keep on doing his exercises and try to build up the quads in the gym for example with cycling exercises but to avoid high impact running for another 2 months. I would like to see him again in clinic in another 4 months time.


I seem to be exactly in the same position as I was after scope#1 full ROM but with pain and tightness still as soon as I kneel and squat around the medial portal in particular. I know that one can still have AF with full ROM and still have an excessive amount of scarring inside the knee.

I have to kneel on my left knee at the moment when helping out at the library and kneeling down to the level of my younger nephews and friends nieces or nephews. I am then putting all my weight and strain onto my left knee that already has maltracking issues and getting sudden spurts of sharp pain!

Right knee I am seeing no improvements at all and know from reading from other members that have had AIR surgery that are getting a good standard of aftercare post op are still at risk that AF has retuned again.

I did no proper aftercare till 6 weeks post op with patella mobilisation and friction massage, I do feel the one leg squat 2 weeks post op and intense PT for over 1 and a half hours has built up again excessive scar tissue, so could be back to square one again!

If only I was told this earlier when I left the day care ward that I had AIR surgery that the nurse in looking after me told me as she said she never come across the term AIR of the knee. Thankfully Mr Snow came out of theatre just as I was about to go into the main reception and told me he did AIR and found an excessive amount of scar tissue in my right knee.

If I did not know my right from my left I would have had surgery done on my left knee as it was somehow written on the pre op notes when I saw the registrar before I saw Mr Snow. When I squat I can actually hear the scar tissue if I try to squat on my right leg that I cannot really do as it too painful.

It is frustrating to have a never ending knee problem that's hard to get right again as I do miss the times I had with the running club I was a member for only a couple of months and was one of the top runners for the club. It is hard to accept that I may never run again during my lifetime, I am only 36 on December 2nd and was really into my long distance running before the start of my knee problems.

Even if my right knee is ok and is no longer AF just a slow recovery! I still have issues with maltracking in my left knee and have been pre warned long distance running could cause problem inside the left knee so cannot win both ways. I may just have to accept defeat that I may never be able to run again!

[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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  • Neil TheElephant knee packed up carrying his trunk
Re: Nick's RK Medial plica excision/fat pad op#1 Anterior interval release op#2
« Reply #1273 on: November 07, 2014, 03:50:29 PM »
07/11/14 3 Months Day 112 Post Op

I have now reached the same stage as I was pre op again with good ROM once again and walking with less of a limp now and at a quicker pace. I am still feeling pain and discomfort at the bottom of my kneecap with intense pain that is right inside the knee along the medial portal region.

I know when I was at my last post op consultation last month Mr Snow’s Registrar did say would be at least another 2 more months before I can start to do some light running again.

I have lived with dodgy knee most of my life and can feel that my right knee does not feel ok and the pain does concern me as it is intense pain as and does feel as if  scar tissue is what is causing the pain and discomfort.

Comparing my left knee to my right knee one can clearly see that there is swelling still at the bottom of my right knee that could also be fluid that always a sign the knee is not happy. I know I will always have slight swelling around the portals that not the case with my right knee if there is noticeable swelling around bottom.

I got use to the way my right knee functions that is a hindering me at times when I volunteer at Autism Children’s Charity Shop going up and down the stairs a lot and standing on my feet for hours sorting through donations my right knee starts to hurt and ache.

When I am with my nephews cannot do certain activities and seems like a no win situation as it seems once you have AF you stuck with it! One then has to adapt a lifestyle to cope with a chronic knee related condition that frustrating rather then annoying. 

Two years ago I was running at a good pace of under 7 minutes and mile that was getting towards 6 minutes and mile and now cannot run at all! I cannot see it coming back again the way my right knee is right now!

[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 Nettan

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Re: Nick's RK Medial plica excision/fat pad op#1 Anterior interval release op#2
« Reply #1274 on: November 08, 2014, 04:50:06 PM »
Hey Nick!
Ive followed you and your story though Ive not written for long.
I understand your frustration. Some conditions like AF that you have and CRPS that I have are really not easy to deal with. Try to set your goals lower for a while and see if that can stop the frustrated situation a bit for you. When I got in to my wheelchair due to my spinal injury I saw first all the downsides and set my goal very high to get back then I realized the most important first was to start function with the easisest tasks that I have in my Daily Life and work from there.
Hang in there.
/Nettan
Surgery 6 times left knee torn meniscus, RSDS,chondromalacia, nervdamage cause constant nervpain,chronic inflamm.
Spinaldamage wheeler 100%.
Right knee damaged aug-06, use brace surgery 4/9-07.LCL tear.















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