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Offline missxr

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trochleoplasty
« on: September 08, 2008, 09:14:48 PM »
hello
 I'm new to this but am looking for advice, i have just returned home from a meeting with my surgeon and he has told me i have to go into hospital for a trochleoplasty just before christmas. i have had 2 lateral thigh releases as the first one went wrong. but they have now found out that i have no groove in my femur for my knee to run in. Has anyone had this if so please could they advise me what to expect as i am a little worried. i have suffered with knee problems for 25 years so i am hoping this op will sort it
 Thankyou

Offline Silkncardcrafts

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Re: trochleoplasty
« Reply #1 on: September 09, 2008, 09:56:25 AM »
Hi there,

I had this operation on my left knee about 4 months ago and has made a huge difference. It is a long recovery and quite difficult as you need the bone to heal before you can do much exercise.

At 4 months post-op I am doing pilates about twice a week, walking twice a week and going to the hydro pool a couple of times a week. Not able to go to the gym yet until my bone pain settles down.

It is worth noting that everyone is different in their recovery and you may recover a bit quicker.

Who is your surgeon and where are you based ?

I hope this helps.  :D
11/1996 - RK LR
07/1997 - LK LR
11/1998 - LK MPFL Reco
12/2005 - RK LR Repair
07/2006 - LK MPFL Repair
11/2006 - LK LR Repair
22/05/08 - LK Trochleoplasty
11/02/10 - RK Trochleoplasty
07/03/11 - RK Chrondroplasty

Offline miners

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Re: trochleoplasty
« Reply #2 on: September 09, 2008, 04:07:31 PM »

Hi I have the same problem, I started having knee disolcations at 11. I am 33 now. I underwent the lateral releases several times, but what I found was that the one knee is the worst for dislocating whilst the other was much more painfull and was having problems walking due to it. I had a new surgeon who suggested this op and said I should under go the Tibia Transfer first. He agreed to do the knee with the most pain because of my mobility trouble and eventually I bit the bullted in April 07 and did it. I was petrified. He said that if this didn't work I would need to have the groves cut into the knee. We tried this first. Everyone said about the pain levels after but I had nothing apart from the odd ache when I over did it on my brace. I had my brace off in 6 weeks and was back driving. The pain levels are almost zero now, but I was not told about the problems with the screws. I cannot kneel and have massive problems getting up off the floor. However, I would seriously recommend thinking about surgery. I do have problems now walking own hills, because the mechanic's of my knee are diffrent even 18 months on it feels strange sometimes. I am not brave enough to have the other leg done, because I am relying on that one now to get up and down should I have screws in the other leg then I would not be ale to cope. However, so far touch wood I am doing grate considering the level of surgery I went through. He did tell me that when he opened up the knee I had stage 3 arthritis due to the knee rubbing back and for over the end of the femur as my knee caps are also very highly placed .

Don't be put off by the level of surgery, I would recomend it if only to help, but my surgeon does say it best left alone if not playing up. So I am guided by him. I see on October 8 and I hope that all the bone grafts are still in place.

Best of luck
miners

Offline missxr

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Re: trochleoplasty
« Reply #3 on: September 09, 2008, 07:43:34 PM »
Hi
 Thankyou for your replies i am based in Suffolk but i'm having my surgery done by Simon Donell at the Norfolk and Norwich hospital. i was referred from my previous surgeon as he cannot do the op. i am pinning my hopes on this op as i work with children and need my mobility i have not been able to run for 3 years or kneel without pain. I am worried about the op because i suffer badly when i have aneasthetic and i cannot take many pain killers so the surgeon has said he will put an epidural in to manage the pain. Someone has told me i may have to have a catheter fitted as i will be immobile, not sure if this correct please advise.
I'm glad your ops have been successful and hope mine will be too thankyou again

Offline miners

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Re: trochleoplasty
« Reply #4 on: September 10, 2008, 04:55:14 PM »
I am based in south wales and my original surgeon wasn't able to do the op. I was then told that the only surgeon that he could refer me to was in Norwich and he does have an excellent reputation. However, I was luck enough to be in the same area as Mr Pemberton who is the knee surgeon for the welsh rugby team and he had developed an expertise in this surgery and I got say he was fab! he took the time the week before the op to let me gate crash his out patients clinic and he went through everything with me. Even the day of sugery he was considerate
I didn't have to be catherterise I was in bed for 3 days as they were afraid to fit the brace and let me out of bed because I had trouble with my blood pressure after the op and they were afraid I would faint. I used the bed pans, it was really hard work and effort, but that is much better that catherter, yuck! The nurses will help you deal with it. I did wonder what the hell I had let my self in for after the op thinking about how long I was stuck in bed and then when I saw the brace, but I would say Noriwich is good and go for it!
miners

Offline Silkncardcrafts

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Re: trochleoplasty
« Reply #5 on: September 11, 2008, 09:59:04 AM »
Hi missxr,

You are definitely in good hands. He's done some research in this area and considered one of the best.

I am seeing my OS in mid November and am dreading that I will need the other knee done. In the last few months I have been under a lot of stress so my knee has been affected by that quite badly.

Like you I often have a bad reaction to the anaesthetic. Fortunately I didn't have a very bad reaction when I had my op in late May. The pain afterwards actually wasn't too bad. It was actually several weeks after the op when I started doing more that I had a problem. Don't worry I am sure it will be fine.

When are you scheduled for the operation ?
11/1996 - RK LR
07/1997 - LK LR
11/1998 - LK MPFL Reco
12/2005 - RK LR Repair
07/2006 - LK MPFL Repair
11/2006 - LK LR Repair
22/05/08 - LK Trochleoplasty
11/02/10 - RK Trochleoplasty
07/03/11 - RK Chrondroplasty

Offline missxr

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Re: trochleoplasty
« Reply #6 on: September 12, 2008, 05:19:18 PM »
Hi
thankyou that puts my mind at rest, i'm booked in for the op on the 17th december so i can rest over xmas my hubby will have a busy time. I am going to ask about my other knee when i go for pre assessment in november.
As i have suffered that one aswell so i will see what he has to say, did you have an epidural after you op, and how long before you could weight bare on it? its all fear of the unknown. good luck when you go for your assessment.

Offline Leentje

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Re: trochleoplasty
« Reply #7 on: September 12, 2008, 08:11:27 PM »
I was supposed to have a trocheoplasty, but my OS decided jsut to do the TTT and see how it turned out, trocheoplasty could still be considered if it failed. Have to say, the TTT so far did the trick, wonderfull results, no more dislocations but it still subluxes, not as bad as it did before. I play sports everyday and have a very busy job, however the knees hold fine so far (fingers crossed). Maybe one day I'll go ahead with the trocheoplasty if the patella decides to lead it's own life again, hope it'll be a long time yet!

Good luck with the surgery!

Helena
Bilat patellar malalignment/PFdysplasia
00/06/83 L wrist #
11/12/00 L knee LR + chondroplasty
21/08/02 L knee TTT
02/03/04 L knee stretched PCL
11/09/07 L ankle dislocation/medial avulsion #
25/05/09 L ankle medial avulsion # AGAIN!
05/06/13 R ankle dislocation

Offline Silkncardcrafts

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Re: trochleoplasty
« Reply #8 on: September 13, 2008, 09:04:17 AM »
Hi there,

Definitely ask about your other knee but I would wait till you are completely out of the woods with the knee that is being operated on in December. Can you have the op done any earlier ?

My OS doesn't want to touch my right knee till I'm out of the woods with my left knee. It makes sense.

I'm not sure whether the anaesthetist did an epidural. I think he did a femoral block which lasts a long time. Maybe you could ask about that. I was weight bearing with crutches straight away and didn't have to wear a brace at all. My surgeon prefers not to use them if possible. I was on crutches for about 11 weeks but some of that was complicated by the fact that I had a car accident 3 weeks after my operation. Thanks to an incompetent Asian driver !!!! The pain after the operation was bearable but was on strong painkillers. I still have bone pain 4 months post-op but have heard it can take a while to fully recover from bony operations. As for physio I started that 3 weeks post-op after I had seen my surgeon to get the all clear. I have been able to do most of my physio at home for the sheer fact that I've done rehab before and know what I have to do.

Good luck. Let me know if you have any more questions.  :)
11/1996 - RK LR
07/1997 - LK LR
11/1998 - LK MPFL Reco
12/2005 - RK LR Repair
07/2006 - LK MPFL Repair
11/2006 - LK LR Repair
22/05/08 - LK Trochleoplasty
11/02/10 - RK Trochleoplasty
07/03/11 - RK Chrondroplasty

Offline missxr

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Re: trochleoplasty
« Reply #9 on: September 13, 2008, 05:56:01 PM »
Hi
Thankyou again for your kind words i could have had the op done when i wanted but i'm of to New York at the end of November and didn't want it done till after. I know its going to be a long slow process but it has to be done i've 6 knee ops so far but none have worked.  :-\
I hope your knee surgery is a complete sucess after all the pain you have been through. My surgeon doesn't use a brace after either, i will be put on a machine to get the knee moving the very next day.
I also hope your TTT op is sucessful and you don't have to have the trochleoplasty it doesn't sound the nicest of op but we do what we have to, to make our lives better.
 :)

Offline Silkncardcrafts

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Re: trochleoplasty
« Reply #10 on: September 14, 2008, 11:47:29 AM »
Hi again,

It's nice you are having a bit of a holiday before your op. I did that in March when I went to Japan. It was great to just get away. I am contemplating getting the other knee done, but am going to make sure I get a break before I go. I will probably go to northern Queensland in late October.

What knee operations have you had so far ? It sounds like you've been through a lot like I have.

It's interesting that your OS is going to put you in a CPM machine. I didn't use one after my op. My OS thought I'd get my bend back pretty quickly so didn't worry about that.
11/1996 - RK LR
07/1997 - LK LR
11/1998 - LK MPFL Reco
12/2005 - RK LR Repair
07/2006 - LK MPFL Repair
11/2006 - LK LR Repair
22/05/08 - LK Trochleoplasty
11/02/10 - RK Trochleoplasty
07/03/11 - RK Chrondroplasty

Offline missxr

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Re: trochleoplasty
« Reply #11 on: September 14, 2008, 04:28:12 PM »
Hi
 Its nice to talk to people who know what your going through and who have had the same procedures. Yes i'm looking forward to my trip its a present from my husband for my 40th birthday but i wanted to go when it was christmassy,
I had my first op when i was 20 it was done by key hole it was just an exploritory one but they found out a piece of bone had chipped off so they had to open it up to remove it, since then i had 3 more key hole procedures. Then in May 06 i had my first lateral thigh release but the day after the op the physiotherapist dropped my leg of the bed whilst he was changing the splint he dislocated it you have never seen nurses move so quick >:(. I then had the procedure repeated in february 07 this time it was successful for about 6 months, but then the problems re -occurred. I pesterd my surgeon for a second opinion and he finally he sent me to Mr Donell, he knew straight away what was wrong he took lots of xrays. He said he would use the CPM because he wanted to get it moving as my thight muscle has wasted away from all the ops.
How many operations have you had? and which ones?

Offline Silkncardcrafts

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Re: trochleoplasty
« Reply #12 on: September 15, 2008, 08:54:01 AM »
Hi there,

I can't believe what the physio did. They should have fitted the splint on the bed !!!! A lateral release should only be done one. It can cause other problems if done more than once from what I understand. Glad you got referred to Mr Donnell.

In total I've had 7 knee operations, 5 on my left and two on my right. Initially I had a lateral release on my right knee and then a lateral release on the left one. The lateral release worked on my right, but not on my left so ended up having a MPFL reco which worked really well. At about the 9 year mark post-op I developed medial instability of my knee caps. My OS did a lateral release repair of my right knee which worked well. Then, had the same on my left but didn't work. So, he lengthened the extra ligament he put in when he did my MPFL. My knee was really stable again but had a car accident last year and my knee cap became very unstable again. So, my OS decided to do the trochleoplasty. My right knee is really playing up at the moment but hope it settles down soon. Otherwise, I will probably have that operated on too.

Just sick of the operations and rehab. Fortunately I have a fantastic knee surgeon, sports physician and knee physio.

It is great you have a holiday booked before your surgery. I am trying to organise a holiday in late October, but my boss can't tell me for a one or two whether I can take holidays then. It sucks as I really need the break.
11/1996 - RK LR
07/1997 - LK LR
11/1998 - LK MPFL Reco
12/2005 - RK LR Repair
07/2006 - LK MPFL Repair
11/2006 - LK LR Repair
22/05/08 - LK Trochleoplasty
11/02/10 - RK Trochleoplasty
07/03/11 - RK Chrondroplasty

Offline missxr

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Re: trochleoplasty
« Reply #13 on: October 01, 2008, 09:55:15 PM »
hi
  Sorry its been so long have a had a really busy few weeks and just celebrated my 40th birthday was thoroughly spoilt. Have you had any luck with getting a holiday booked? i have been looking for info about my op but there is very little info out there, it sounds like they don't do these ops very often, not sure if thats a good thing does it mean they don't work very successfully? i have been reading other peoples remarks and they don't seem very positive, i suppose i'm just getting nervous as the time gets closer xx

Offline Silkncardcrafts

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Re: trochleoplasty
« Reply #14 on: October 02, 2008, 10:53:35 AM »
Hi there,

Happy belated 40th birthday !!! Did you have fun in New York ?

No luck in booking my holiday yet. Hope to find out about whether I can take leave tomorrow when I meet with my boss.

This operation is not done very often, but my OS says he's had a lot of success with it. My left knee has done so well and have no more instability and pain to follow. It has made a massive difference to me. It is a very invasive operation so often do it as the last resort. I think Mr Donnell does quite a few of them.

A lot of comments are around what their OS's say about the operation, but it can have wonderful results. I think a lot of this is due to not knowing a lot about it, but my OS specialises in patella problems and really trust him on this one.

The hardest thing about this operation and the recovery is not knowing what to expect. It can be a long recovery as the bone has to heal before you can do a lot of exercise. I am 5 months post-op and am not back in the gym yet. Hope to start back in the gym soon. 
11/1996 - RK LR
07/1997 - LK LR
11/1998 - LK MPFL Reco
12/2005 - RK LR Repair
07/2006 - LK MPFL Repair
11/2006 - LK LR Repair
22/05/08 - LK Trochleoplasty
11/02/10 - RK Trochleoplasty
07/03/11 - RK Chrondroplasty















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