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Author Topic: Nick's FatPadTrim, Medial plica/Distal patella excision, AIR x2, LMR 3in1 Diary  (Read 282460 times)

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Offline MyKnee2010

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Hang in there Nick!

I just had a scope on my right knee as the pain in it was getting worse & worse. The surgeon found a lot of scar tissue which was getting in the way as the knee implant moved (That knee has been replaced twice). He removed all that tissue & now even though I still have post surgical pain, the deep pain in that knee has pretty much disappeared. I'm hoping as it heals the pain will get less & less.

Just shows how much trouble scar tissue can cause! I don't believe I have AF & my ROM is equal to someone who has their real knees even though both my knees have been replaced. I think that scar tissue has accumulated from the 8 surgeries that knee had undergone in the last 8 years.

Anyways, I hope the exercises & ESWT help but if they don't I hope you are able to have another scope, & it helps as much as mine has! Now, I just have to get the other knee replaced again!

Phoebe

Offline Puffy the Knee Slayer

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Hi Nick

I'm sorry for all you've been through with regard to the charges against you and the staff provoking you. 7 types of meds is one hell of a cocktail and well known this can affect people negatively but easier for them to blame you than take responsibility for their errors. Really unfair that something that happened years ago and was not your fault should be held against you in this way, especially as you are clearly a gifted working with young people. I hope that you will be able to get justice about this and be able to pursue your career path, workers like you are what is needed, their are so many arseholes working in LDs, MH etc.

Hope your mum is doing ok too.
06/07 ankle sprain - collapsed arch
01/08 fall doing physio
06/09 MRI fat pad impingement
01/13 MRI medial meniscal tear
03/15 - decent orthotics
01/15 MRI - pes anseurine bursitis, SPL fat pad impingement, PFMaltracking
Cortisone 04/15; 03/16; 06/16; 08/15 Cortisone+Duralane; 10/16 Cortisone+Botox

Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
06/10/16 26 Months Day 812 Post Op

I have now had my 2nd ESWT session yesterday evening and saw the same sport physician as last week so far have not really made any difference. I am still experiencing anterior pain and discomfort with twinges of sharp pain going through the kneecap. The main pain is by the tibia where there is some noticeable hard knotting when pressing against the tibia while  moving my fingers up and down. A small pinpoint scab appeared shortly after 1st ESWT last week. I made it bleed the day before my 2nd ESWT or the shockwave probe would have been coated in blood.

The 2nd opinion OS did not seem concerned about the pain and knotting saying it perfectly normal! The knotting was not there when I last saw Prof Snow that suddenly appeared overnight. With a slightly bigger distal pole of the patella and a bone spur which may be affecting the fat pad this could be why I am experiencing knotting around the tibia. The pain and effusion is around the bottom of my kneecap with sharp spurts of pinching pain going through the kneecap.

It is starting to get frustrating being told patella tendonitis takes a while to get right again. It a rather long time from July 2014 to present just to be told it patellar tendonitis. A bone spur is a sign that the knee is not happy. The spur is protecting an internal injury inside the kneecap from further damage that is getting in the way which is why I get sudden spurts of pain.

I saw Prof Snow as he was leaving clinic to go home in the waiting room, he stopped to ask how my right knee is feeling with the ESWT sessions and PT. I said it is still not improving and mentioned the knotting around the tibia. I have been seeing him since 2013 so know each other at a more personal level as well as professional, it's important that OS's are natural and easy going with their patients rather than being up noxious thinking they are King's of the hospital which they showing it in a dignified manner.

My mumís left TKR surgery went ok apart from finding a bone fracture that was not spotted on the x-ray. Not sure if the fracture happened during the surgery or was a pre-existing condition? This has of course hindered her recovery by none weight bearing for 6 weeks. 

Phoebe, I am glad that your right knee surgery has finally given you some much needed relief after removal of excessive scar tissue. I know it's a battle for many OSís removing the scarring that seems to come back again unless you have it done by an OS specialised in scar tissue removal.

Puffy, Thanks for  the encouragement and support and understanding towards my wrongful convictions; I am determined to get it quashed despite being told it not possible to do so. There always a 1st for everything in life, I agree with you there are some terrible staff that should never be allowed to work with young people showing no commitment towards their job role. No love or passion in helping and supporting young people with autism and other additional needs that I have shown while volunteering.

[email protected]
« Last Edit: July 12, 2017, 11:26:05 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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13/10/16 26 Months Day 819 Post Op

I had my 3rd and final ESWT session yesterday evening at the sports injury clinic that was done by a young sports physician that had never used an ESWT machine around the patella tendon. Usually ESWT is used mainly for foot, ankle and heel pain with patella tendonitis not coming up regular. Why I was the 1st patient and apart from a few slips he did ok.

There were 2 members of the sports injury clinic accessing my progress of the effectiveness of ESWT so far. They told me that it can take up to 12 weeks to feel the benefits of ESWT that is meant to inflame the patella tendon to encourage healthy healing hopefully. The pain might get worse before it becomes better with my follow up appointment 07/12/16 @18:45.

The PT has benefited feeling less pain and discomfort for PFS, the anterior pain is still very much there if I take large strides or attempt to run. I would say the pain and discomfort level is the same as it was pre-op to scope #2 of AIR.  Dull aching pain with occasional sharp spurts of pain, this time round walking at a slower pace.

Here is a report after having my 1st ESWT session.

Dear Dr ***

We are reviewing Nicholas today in Sports Injury  Clinic for his first session of shockwave treatment for his patellar tendinopathy. Pre-Treatment check was conducted and he does not have any contraindications to shockwave treatment and he is on no blood thinners or anti-inflammatories.

Treatment was conducted at 1.8 bar at 1500 pulses with a frequency of 10. He will be due for his next treatment this time next week and I have therefore put him again in the Sports Injury Clinic for this. I have asked him not to take any anti-inflammatories immediately post treatment. We would therefore see him next week for his 2nd session.

Yours sincerely,

**** ****

Registrar in Sports and Exercise Medicine


I am getting used to being told that it takes a while to feel the full benefits of PT and the ESWT session. I still feel it will have no significant benefits. I can say how I feel at my next appointment when I attend the next Sports Injury Clinic appointment in December. Maybe it might work? I have my doubts with a long history of knee problems.

I can then ask for a referral to see Prof Snow again if the conservative methods of treatment have been exhausted, as they will have no other alternatives. This is clearly stated in my assessment letter from the Sports Medicine Team Head Physician that he will refer me back again to Prof Snow if the team are unable to sort out my patellar tendonitis.

[email protected]
« Last Edit: July 12, 2017, 11:25:49 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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18/10/16 27 Months Day 824 Post Op

My 2nd ESWT treatment report, the pulse frequency has gone up from 1500 to 2000 and the frequency from 10 to 15.

Dear Dr ***

Nicholas has attended today for his second course of shockwave treatment. This is performed energy 1.8, 2000 pulses and a frequency of 15. He did not have any complications after and he has been given the standard post-treatment advice. We will see him next week for his final course of treatment using the factory settings.

ours sincerely,

**** ****

Registrar in Sports and Exercise Medicine


Thursday is my PT appointment and will mention to the head physio that my right hip and left knee is more painful. I have been doing some gardening jobs around my region to get some income. Strange that the left knee and right hip is more painful at times than my right knee. It might be good to let him know, he can then add more PT for my left knee and right hip pain.

If anyone wants to watch my PowerPoint Presentation that I did last month with my sister Jinny the one that works as an Orthopaedic Nurse. It on Criminal Responsibility and Autism Awareness sharing my story of being wrongfully convicted with a lifelong criminal record for having a breakdown and late diagnoses of Asperger's. My Presentation starts just before 35 minutes into the video on the YouTube link below.

https://www.youtube.com/watch?v=8UmDZTx9v0Y&app=desktop


It is nice to put a face to myself and my sister after being a KG member for nearly 13 years. I am also on Twitter, I am not on Facebook for personal reasons.

https://twitter.com/nickwclarke1978

For 2016 it a completely unfair barring system to have in place for individual going through a breakdown and an episode of distress behaviour. I am aiming to clear my name and criminal record to inspire others to do the same with additional needs. Not to be unfairly labelled with a criminal record for actions that that could have been avoided if the authorities pulled their weight, if they did their job properly.

[email protected]
« Last Edit: July 12, 2017, 11:25:34 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
24/10/16 27 Months Day 830 Post Op

After seeing the physiotherapist last week Thursday what I expected has now materialised into reality. He said that after 3 sessions of ESWT and all the PT that by now the knee should be improving. I now need to push hard by adding more weights when doing squats of up to 10kg in weight to encourage the healing process that so far is not working.

I am seeing the physiotherapist again 10/11/16, looks like the PT sessions are not improving the patella tendonitis and will have to go back to see Prof Snow. I will see what Sports Physician says on 07/12/16 what the next option would be. I cannot accept what the physiotherapist said to me that I might have to live with the way my right knee is right now.

I always felt it is no just patella tendonitis that thatís the cause of the pain and discomfort with other problems inside that MRI scans do not always pick up on. It now looks likely what I expected to happen all along that surgery might be the only available option left. I know that patella decompression surgery was mentioned by Prof Snow in his last report before referring me to the Sport Injury Clinic as the last conservative option.

I am fully aware of the dangers of a 3rd surgery as I am prone to excessive scarring so are hesitating to go ahead as it could make my right knee problems worse rather than better. It is a risk and gamble. It would always be at the back of my mind if I will be 3rd time lucky with a successful outcome post-op.

Might sound crazy that I am still keen and eager to hopefully return back to long distance running once again. I enjoy long distance running. Find it upsetting to see family and friends taking part in marathons that I was once very good at doing a good time and average pace.

My last competitive running session in January 2013 14.5km/9miles in just under 1 hour with an average pace of 04:06 min/km, This is why I am want to try all I can to get back into long distance running once again.

https://www.runtastic.com/en/users/nick-clarke-3/sport-sessions/38296072

It might be self- inflicted that I caused the knee injury by overdoing it by running long distances at a quick pace as I take large strides as I run. This has an impact on my kneecaps as I am straining them with each heavy step onto mainly tarmac surfaces.

Is it a wise move taking a risk and gamble with a possible 3rd surgery? If it make no difference then I shall admit defeat accepting that I will never be able to run again during my lifetime.

[email protected]
« Last Edit: July 12, 2017, 11:25:18 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
26/10/16 27 Months Day 831 Post Op

After looking back when I was last able to run at a competitive level in January 2013, I am determined to return back to long distant running again in the not too distant future. I have previously mentioned Mr David P Johnson an OS based at Bristol Knee Clinic. He has good in depth knowledge towards Arthroscopic Decompression for Patellar Tendonitis both pre-op and post-op. Preventing scarring of the patella tendon from reoccurring.

His Rehabilitation Protocol is something that other OSís can also put into practice. Would it be ok to suggest to Prof Snow Mr Johnsonís rehabilitation programme? It is important post-op to follow Mr Johnson guidelines to Arthroscopic Decompression for Patellar Tendonitis. Scarring of the patella tendon has already established, his protocol seems to have a high success rate if you religiously followed Mr Johnson rehabilitation programme.

http://www.kneeandsportsinjuryclinic.co.uk/wp-content/uploads/2015/05/Rehabilitation-Guidelines-for-Decompression-of-Patellar-Tendonitis.pdf

I think it obvious to anyone that has been following my post-op diary that I will do all I can to hopefully get back into long distance running once again. I can then re-join my local athletics club. This would be a big achievement after being told that I may have to live with my right knee injury problems.

https://www.runtastic.com/en/users/nick-clarke-3/sport-sessions/38296072

http://www.droitwichac.co.uk/

[email protected]
« Last Edit: July 12, 2017, 11:24:59 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 #1447 on: November 10, 2016, 05:40:00 PM »
10/11/16 27 Months Day 845 Post Op

I have had my physiotherapy appointment this morning, at this stage I should be seeing improvements since starting PT exercises in July along with the 3 ESWT sessions. The head Physio said that there not any other options left where he can help to overcome the chronic patella tendonitis. It might be more than just patella tendonitis. I always had an incline that something is not right with the right knee internally. In comparison to how my right knee felt pre-op to scopes #1 and #2 it is a lot more restrictive, painful and a hindering my daily activities and job prospects supporting young people with addiational needs.

I do not want to come across in a negative manner all the time in my post-op diary; I would rather be posting in a positive manner. When I do one legged wall squats I can feel and hear a loud pop! There is some noticeable knotting around the top of the tibia where the kneecap joins. I pointed this out when I saw another OS for a 2nd opinion who told me it normal and nothing to worry about. The knotting only came on the last couple of months shortly after Prof Snowís consultation. It would be good to see him again in the New Year for another assessment.

The head PT has referred me back again to see the Sports Medicine Doctor that was the one that suggested trying  out ESWT sessions. I am booked in at the sports meds evening clinic @18:45 07/12/16 and will see the head PT the following day 08/12/16 @12:00 for what look like the last time before seeing Prof Snow in the New Year.

I am fully aware that a 3rd scope is a big risk and gamble given my history of excessive scarring that I am happy to risk in the hope I am 3rd time lucky with a successful surgical procedure and outcome. My mum said she happy to pay privately in order to get the aftercare to prevent scarring from building up using a CPM machine and keeping the knee cooled down. I could enquire if the NHS provides this sort of aftercare, I do not want my mum to use her savings account.

Here is my 3rd and final ESWT session report from my last appointment on 12/10/16.


Dear Dr ***

Nicholas attended today for his 3rd course of shockwave treatment to his right patellar tendon. This was performed energy 1.8, 2000 pulses and frequency of 15. He did not have any complications after and he has been given standard post-treatment advice. We will see him in two monthsí time to review how he is getting on with physio.

Yours Sincerely

*** ***

ST5 Sports and Excercise Medecine to Dr ***



It is now having an impact on my right hip and left knee and the colder weather conditions adds to the problems.  My mum is almost 6 weeks post op and seeing her OS this coming Saturday, she was not allowed to do certain PT exercises after having a crack at the bottom of her tibia that must have happened during the TKR! None weight bearing and a zimmer frame and maybe manipulation under GA to get her ROM back again thatís limited.

We are both looking forward to the end of 2016, role on 2017 that not too far away.

[email protected]
« Last Edit: July 12, 2017, 11:24:44 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 lucha86

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Re: Nick's RK Medial plica excision/fat pad op#1 Anterior interval release op#2
« Reply #1448 on: November 10, 2016, 08:32:44 PM »
Hey nick! :D
Hope you are well? My opinion, is Physios, dealt with joints everyday, they are fully aware of the motions, and the joint if something is not right, it may be a suggestion for your physio to write to your surgeon and sports medicine doctor to explain that things have been exhausted......

Secondly get a second opinion, every surgeon has different expertise, and some may pick up on other things that others surgeons don't just due to their vast rang of experiences, that each surgeon has.

Thirdly...Also there is an upright MRI which now takes pictures of joint standing as we know weight can effect a joint, and maybe something may show on that?

Another thing i was going to suggest is a lot of swimming therapy this is very good at reducing pain and muscle/ tendon pain and helps build up the muscle groups......

Im trying to give you a few more options to try, but also advice from what i have learnt if none of that works, i suppose it gets to a point where you just put your foot down.......
and say enough is enough... its your body and you need to have a certain quality of life

Offline Clarkey

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Re: Nick's RK Medial plica excision/fat pad op#1 Anterior interval release op#2
« Reply #1449 on: November 16, 2016, 06:12:11 PM »
16/11/16 27 Months Day 851 Post Op

Today marks my 7th anniversary for scope #1 of plica excision and fat pad trimming on my right knee. Pre-op to scope #1 in 2009 my right knee pain and discomfort was nowhere near as bad as it is right now. With knee problems you take one step forward then 2 steps back. I cannot help overdoing it at times with gardening and helping out at the clubs with kids on the autistic spectrum. The last few days I have started to walk at a much slower pace with more of a limp. I always knew something is not right and that PT, ESWT and cortisone injections will not benefit me in anyway. I was told by the Head PT to push the knee adding more weights when squatting that has agitated and flared up the knee pain.

The whole knee saga post-op to scope #2 seems to be dragging out too much. I could be offered full time employment as a Playworker for kidís autistic young people early 2017. I now worried that the knee will hinder my progress and that will require an exploratory/diagnostic arthroscopy at this stage to see what the cause to all my latest knee problems.   

Only 3 weeks away until I see the Sport Physician at the sports injury clinic on 07/12/16. I think they can only refer me back to Prof Snow again which means that surgical intervention is now highly likely to happen. If it was to go ahead I am hoping that I am 3rd time lucky and that the knee pain and immobility can be improved.

Lucha, Thanks for replying  I will see what Prof Snow suggests doing next before going for a 2nd opinion. Maybe could ask about the upright MRI as alternative to a standard MRI as the pain is mainly weight bearing pain. I could try going swimming more regular as well as the PT exercises, if they do not help then have a good reason to get a referral to Prof Snow, Is it cheeky to ask him to discuss my knee problem with the other OS's as what to do next and the treatment options?

http://www.londonkneeclinic.com/knee-problems/tendonitis

Surgical Treatment

Surgical treatment is rarely necessary but may be used to:

    Change the forces acting on the tendon by a realignment
    Excise the worst affected part of the tendon
    Insert new material to supplement the tendon
    Remove a bony prominence or spur causing friction
    Decompress the tendon by removal of scarred tissue allowing new in-growth of blood vessels.


The London Knee Clinic and mentions realignment that was briefly mentioned by Prof Snow Registrar doing an osteotomy who managed to locate the painful area during the examination. Both Prof Snow and the other OS I saw in June for a 2nd opinion did not pick up on the pain. The knotting by the tibia is very obvious along with the anterior knee pain and discomfort. 

Remove a bony prominence or spur causing friction is another possibility why the knee pain is increasing as in the last MRI scan back in December 2015 that mentioned a bone spur that could be flaring up the fat pad! If this is the case then it needs to be removed and smoothed over.

Decompress the tendon by removal of scarred tissue allowing new in-growth of blood vessels. is what Prof Snow has suggested as the next option if PT and ESWT have failed. Do I take a risk and gamble? Yes I am prepared to take a gamble as I cannot accept that I need to learn to live with the knee injury.

Lucha is right saying 'enough is enough' by being assertive saying that I can no longer live with the way my right knee is right now. I am sure something can be done to ease the pain and discomfort to a level where I can walk at a better pace again.

[email protected]
« Last Edit: July 12, 2017, 11:24:27 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 #1450 on: November 18, 2016, 05:42:33 PM »
18/11/16 28 Months Day 853 Post Op

I could walk at a reasonable pace a few weeks ago; it is obvious visually with my limping and slowed downed walking pace that something is wrong with my right knee. I am doing some paid gardening work for the Directors of the charity shop where I volunteer that impacting my right knee. They have kindly said they would give me a van to do gardening jobs to earn some money from spring 2017. The way my right knee is right now I would have to decline the kind offer as it's flaring up my right knee that is now impacting the left knee.

At the autism play group it is hard not to join in physical activities. It was a good ice breaker last week Saturday at club in north Birmingham that I attended for the first time to join in kicking a football. I was the goal keeper and did some good saving blocks not having to run, it has contributed to the knee becoming worse! I cannot just stand there doing nothing as it not in my nature to be like that.  A young person ran out of the building and could not keep up with him that could have ended up as a safeguarding issue, thankfully another play worker caught up with him.

If the NHS wants me to get back to full time employment again then they need to sort out my right knee so I can contribute once again to the National Insurance taxes. I did hold down a Job for nearly 13 years as a Golf Course Greenkeeper that was very hard manual labour on my joints. It might have contributed to the knee problems being out in the cold damp weather as well as the long distance running.

Remove a bony prominence or spur causing friction On further evaluation of the MRI one may appreciate a slightly bigger distal pole of the patella with a bone spur which may be affecting the fat padí. This could be the cause of the anterior pain and discomfort, not just inflammation of the patella tendon.

The above was mentioned on my December 2015 MRI scan, a diagnostic arthroscopy is something that could be done at this stage to evaluate the bone spur and taking a closer more detailed look around my paella tendon, or should I pay to have an upright MRI scan done on my right knee. A lot can happen over one year with a positive MRI scan this time round that would be more reassuring for Prof Snow knowing what surgical fix is required. Is it worth asking for another standard MRI scan by emailing Prof Snow's Secretary or go for an upright one instead?

[email protected]
« Last Edit: July 12, 2017, 11:24:10 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 Garywake6511

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Re: Nick's RK Medial plica excision/fat pad op#1 Anterior interval release op#2
« Reply #1451 on: November 20, 2016, 05:31:57 PM »
Hi.
I'm now 10 weeks post operative from the fat pad and olive removal.
This has been a disaster and not far off depressing.
I still have a lot of pain, mild swelling, stairs and walking are a struggle.
I am booked in for a steroid injection on Tuesday to bring the inflammation down.
What am I to expect after the injection and how can I get back to normal life......walking without pain!

Offline Vickster

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Re: Nick's RK Medial plica excision/fat pad op#1 Anterior interval release op#2
« Reply #1452 on: November 20, 2016, 06:00:42 PM »
Are you working with a physio to get all the muscles working again, having massage to break down scar tissue and trigger points etc?  What has the surgeon said? 

It could well be worth paying to see a sports physio with solid experience in treating post op knees.

Are you also icing and elevating several times a day?  Using anti-inflammatories and pain medication (something to discuss with your GP)?

I'm not sure what you mean by olive removal?

Might be worth starting your own post op diary or thread :)
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 RK Medial plica excision/fat pad op#1 Anterior interval release op#2
« Reply #1453 on: November 20, 2016, 07:00:14 PM »
Hi Gary,

I can briefly go through what I did after scope #1 of medial plica excision and fat pad trimming that is going to be different to the symptoms you are going through right now. We all react differently knee surgery. Some patients are more prone to excessive scar tissue. This can be reduced by doing friction massage around the portals to break down the scar tissue.

I was given a cortisone injection pre-op and post-op to scope #1 to reduce the pain and inflammation. Ultra sound and friction massage therapy was done around my portal/incisions by a private sports physiotherapist.
 
I also saw a Sports Physician for dry needling also known as Intramuscular Stimulation (IMS) to reduce the tightness around the trigger points where the leg muscles were knotted. It did help briefly after 18 months post-op I was back to full fitness doing long distance running. Then back to square 1 in January 2013. Scope #2 was to remove the scarring inside my right knee known as Anterior release surgery (AIR)

What Vicky has suggested is good advice and would also suggest seeing a Sports Physician as well as a Sports Physiotherapist before going back to the see your Orthopaedic Surgeon again. 10 weeks is still early days recovering from a knee surgery, I would not panic just yet after reading my post-op dairy.

Good luck with your recovery programme.

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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

Offline Clarkey

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Re: Nick's RK Medial plica excision/fat pad op#1 Anterior interval release op#2
« Reply #1454 on: December 08, 2016, 05:44:06 PM »
08/12/16 28 Months Day 873 Post Op

I managed to see the top Sports Physician yesterday evening who was very thorough and professional assessing both knees and hips. What he did find of a concern was problems with my right hip that was sore and tender during the examination. I am getting more pain and discomfort enough to have an x-ray and MRI scan done to make sure it structurally ok.

My right hip is sore and tender to touch with popping sounds! I read on his hand written notes possible dyspraxia of the right hip joint? The worst case scenario would be a referral to see an OS specialised purely on hip and groin pain in young patients, he is one of the top UK hip specialist. Hopefully it does not require any surgical procedure. Prof Snow specialises in knee and shoulder problems. 

I am also having another MRI scan done again on my right knee as the previous one was done a year ago in December 2015. I did mention to him if an upright MRI scan would be worth going through? It is weight bearing when I feel the most pain which is when I notice the anterior pain, he advised me not to part with my money of around £200. This is a good price that a special promotional price as it usually costs between £600 and £800.

Here the links to the upright MRI Scanning centre that just up the road from me that does a very competitive price.

http://www.bromsgroveopenuprightmri.com/services/mri-scanning/services-costmri-scanner-birmingham/

I am not going to question a top Sports Physician who is also the Sports Physician for the England Cricket Team, which is why I never saw him for the ESWT sessions. I can only praise him for being so upfront and honest by investigating my right hip that could be the culprit to the right anterior knee pain.

The hope this time round the MRI comes back positive, showing changes inside the right kneecap. I did mention to him that when I was doing one legged wall squats a few weeks ago that I heard a very loud popping sound! Since then I am limping more at a slower pace with noticeable swelling around the bottom of the kneecap.

I am booked in for all both MRI scans and x-ray in early January and will know the results when I see the Sports Physician for the results of the MRIís and x-ray of the right hip. Is this a common problem to happen that the hip is also affected by the right knee injury or is it a pre-existing condition?

I am not seeing Prof Snow again unless something shows up on the MRI scan that requires surgical intervention when I get the results on 31/01/17. Hopefully the right hip can be fixed with none invasive treatment. Having to have 2 surgeries would be very daunting! I have been told it important to have it investigated sooner rather than later, If there a delay it is harder to get right again.

Today I saw the Head Physiotherapist that has discharged me from the physiotherapy department, they can no longer help to improve my hip and knee pain. He thinks surgery is not required for my right knee and may have to cope with it for the rest of my life by going to the pain clinic. He does not have to live with a chronic knee condition! I am now hoping that the MRI scan shows something new rather than just patella tendonitis.

Will see what happens in the New Year, I am getting use to setbacks, nothing really shocks or fazes me if you have lived with an injury for so long, that I am sure many KG Members know too well.

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« Last Edit: July 12, 2017, 11:23:49 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