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Offline squibler

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I have some questions about a lateral release
« on: October 15, 2008, 09:08:09 PM »
I'll give you the abridged version of my knee problems:
      I am currently 17 but my problems started when I was 14.  Three years ago, while playing soccer, my left knee started to bother me.  Over the course of a month, the pain got so bad that I couldn't lift my leg up to go up a curb.  I went to ortho #1 who gave me x-rays, an MRI, and a CT scan (all came back clear).  He prescribed me PT for 6 weeks (twice a week).  After the PT was finished, I went back to him and told him that my knee still didn't feel right.  His solution was another 6 week round of PT (this time, the PT gave me a lateral j brace and showed me how to tape my knee, both of which really relieved the pain).  After it was finished, I again went back to him and told him that my knee still was hurting me.  He told me that should probably get a Lateral Release.  I didn't want to jump into surgery so I went to get a second opinion.  Ortho #2 told me that I may just be having growing pains and to wait a while before thinking about surgery. 
      So I waited for 2 years, wearing my knee brace or taping it almost every day.  I recently got fed up with my whole situation and got an appointment with an excellent ortho (Ortho #3).  He told me that the ligaments in my knee are very tight and that I would benefit from a Lateral Release.  Since I will be starting college next fall, I figure that I might as well get this taken care of now.  I am getting an MRI this weekend (to see if there is any cartilage damage under my patella) and will probably set a date for surgery soon after.  This being said, I have a few questions about the surgery and recovery:
  • How much pain were you in immediately after surgery?
  • How long did it take for your knee to fully recover?
  • How long did the swelling last?
  • Were there any complications from the surgery?
  • Did you have to wear a brace after surgery (if so, for how long)?
  • Did you have to use crutches (if so, for how long)?
  • How soon after the surgery did you start PT?
  • How many weeks/months did you have to attend PT?
  • For those who had their left knee done, how long until you could drive again?
  • How long did you have to wait until you could return to school/work?
Thank you for reading this, and thank you to anyone who can answer any of my questions!  :)

Offline hugo

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Re: I have some questions about a lateral release
« Reply #1 on: October 15, 2008, 10:16:03 PM »
I understand your frustration, but the lateral release route can be tricky one. Seriously!

I mean if all your previous exams came back with nothing... it sounds iffy to me. Just saying.

I'd say wait around for those MRI results to see what kind of state your cartilage is in or maybe any other issues you could have going on. Ask your docs to explain things you don't understand and do your own research.

Any surgery has to be done for the right reasons. It doesn't seem that your doc or exams are giving any strong reasons why your knee is a candidate for a LR
« Last Edit: October 15, 2008, 10:29:27 PM by hugo »

Offline scooter5

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Re: I have some questions about a lateral release
« Reply #2 on: October 16, 2008, 12:57:42 AM »
Recovery is different for every person.  I have had 8 surgeries on my right knee (3 lateral Releases - 1993, 2005, and 2008) and each one varied.  The one in 2005 I was up and about that next day.  On a CPM for a few weeks but was able to walk right away.  Couldn't drive for 3-4 weeks.  I was in little pain.  I was in PT 4 days later for 4 weeks as I have a tendincy to develop a decent amount of scar tissue and this was a correction from an earlier cartilage plug transfer.  The one in 2008 was an open LR.  I walked out of the facility but had severe pain (had a leak in my pool the day of surgery and tried to figure out where it was coming from the next day) the next day and was on crutches for 2 weeks.  No PT needed after this one and wasn't allowed to drive for almost 5 weeks.  No complications from either surgery.

Listen to your doctor and most importantly, your PT.  They will know what is best for your recovery.  Don't over do it and when your knee feels like it has had enough, listen to it.

Good Luck

Offline squibler

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Re: I have some questions about a lateral release
« Reply #3 on: October 16, 2008, 01:43:21 AM »
I understand your frustration, but the lateral release route can be tricky one. Seriously!

I mean if all your previous exams came back with nothing... it sounds iffy to me. Just saying.

I'd say wait around for those MRI results to see what kind of state your cartilage is in or maybe any other issues you could have going on. Ask your docs to explain things you don't understand and do your own research.

Any surgery has to be done for the right reasons. It doesn't seem that your doc or exams are giving any strong reasons why your knee is a candidate for a LR

I get where you're coming from, Hugo.  The doctor is going to call me as soon as he reads the MRI results so I guess I'll have a chat with him then.  When orthos #1 and #2 mentioned the lateral release, I was iffy about it too because they were just regular pediatric orthos.  But the ortho I'm seeing now is ranked as one of the best orthos in the country and is even in the American Orthopaedic Society for Sports Medicine Hall of Fame.   I feel confident in his judgement  and don't think he will preform the surgery if it isn't necessary.

Thank you for your concerns though, I will do as you said and question him about my whole situation  :)

Offline squibler

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Re: I have some questions about a lateral release
« Reply #4 on: October 16, 2008, 01:45:33 AM »
Recovery is different for every person.  I have had 8 surgeries on my right knee (3 lateral Releases - 1993, 2005, and 2008) and each one varied.  The one in 2005 I was up and about that next day.  On a CPM for a few weeks but was able to walk right away.  Couldn't drive for 3-4 weeks.  I was in little pain.  I was in PT 4 days later for 4 weeks as I have a tendincy to develop a decent amount of scar tissue and this was a correction from an earlier cartilage plug transfer.  The one in 2008 was an open LR.  I walked out of the facility but had severe pain (had a leak in my pool the day of surgery and tried to figure out where it was coming from the next day) the next day and was on crutches for 2 weeks.  No PT needed after this one and wasn't allowed to drive for almost 5 weeks.  No complications from either surgery.

Listen to your doctor and most importantly, your PT.  They will know what is best for your recovery.  Don't over do it and when your knee feels like it has had enough, listen to it.

Good Luck

Thank you for your response, Scooter.  I've been reading up on the surgery but nothing is better than hearing about it from someone who already went through it.  Thank you again!

Offline FormerlyActive

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Re: I have some questions about a lateral release
« Reply #5 on: October 16, 2008, 05:39:25 AM »
Agree with other posters. I would definitely wait and gather more information. The international patella femoral doctor group I thought I heard had recommended against isolated lateral releases. There are specific conditions under which it is done, I would research those, one I think is excessive tilt and the other is tracking to the outside (you should check, I can't recall exactly). I had a release on both knees at same time and was in a wheelchair. For me, the surgery was very successful, although recently I had a doctor tell me he thought it was the 2 years I took off exercise (I was formerly an aerobic instructor) not the lateral release which cured me.

Here are my answers :
How much pain were you in immediately after surgery? - Lot of pain that night, stayed overnight in hospital. After that never took much of the percocet as it made me nauseous. For me the pain was very manageable.
How long did it take for your knee to fully recover? - 1 year to 18 months to be better than before.
How long did the swelling last? - a few months off and on probably
Were there any complications from the surgery? - no
Did you have to wear a brace after surgery (if so, for how long)? -no
Did you have to use crutches (if so, for how long)? - wheelchair outside of the home first week or two, but crutches off and on probably at least 8 weeks, maybe 12
How soon after the surgery did you start PT? - next day or two after surgery I had simple exercises at home
How many weeks/months did you have to attend PT? - it wasn't much, I don't think I had a good PT program, they mostly just gave me a list. It should be much better now.
For those who had their left knee done, how long until you could drive again? I can't remember but I'm sure it was less than 6 weeks.
How long did you have to wait until you could return to school/work? - I took 2 weeks off work but then couldn't return to my floor (2nd floor no elevator) so I had to sit downstairs for a long time. I should have taken longer though to have been stronger when I returned.

I hope this is helpful. Many people on the site have had one you could do a search. Best wishes let us know.
3/82 - Medial Synovial Plica removal both knees
9/89 - Lateral Release both knees
3/08 - Reinjury left knee hiking Asia Pac
5/08 - Miserable Malalignment diagnosis
4/08 - 9/08 Five doctors diff. opinions
7/08 - 02/09 - In PT, no chg.
4/09 - Dr. 6 opinion femur & tibia derotation together

Offline Leentje

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Re: I have some questions about a lateral release
« Reply #6 on: October 16, 2008, 02:02:53 PM »
How much pain were you in immediately after surgery?
no real pain

How long did it take for your knee to fully recover?
I never fully recovered, becuase the LR wasn't enough. correcting the patellar tilt alone didn't do the trick

How long did the swelling last?
a few months

Were there any complications from the surgery?
No

Did you have to wear a brace after surgery (if so, for how long)?
No

Did you have to use crutches (if so, for how long)?
No crutches, was walking around on surgery day

How soon after the surgery did you start PT?
A week after

How many weeks/months did you have to attend PT?
I went 9 times

For those who had their left knee done, how long until you could drive again?
2 weeks

How long did you have to wait until you could return to school/work?
5 weeks (am a nurse)

Hope this helps!
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 squibler

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Re: I have some questions about a lateral release
« Reply #7 on: October 16, 2008, 05:58:00 PM »
Agree with other posters. I would definitely wait and gather more information. The international patella femoral doctor group I thought I heard had recommended against isolated lateral releases. There are specific conditions under which it is done, I would research those, one I think is excessive tilt and the other is tracking to the outside (you should check, I can't recall exactly). I had a release on both knees at same time and was in a wheelchair. For me, the surgery was very successful, although recently I had a doctor tell me he thought it was the 2 years I took off exercise (I was formerly an aerobic instructor) not the lateral release which cured me.

Here are my answers :
How much pain were you in immediately after surgery? - Lot of pain that night, stayed overnight in hospital. After that never took much of the percocet as it made me nauseous. For me the pain was very manageable.
How long did it take for your knee to fully recover? - 1 year to 18 months to be better than before.
How long did the swelling last? - a few months off and on probably
Were there any complications from the surgery? - no
Did you have to wear a brace after surgery (if so, for how long)? -no
Did you have to use crutches (if so, for how long)? - wheelchair outside of the home first week or two, but crutches off and on probably at least 8 weeks, maybe 12
How soon after the surgery did you start PT? - next day or two after surgery I had simple exercises at home
How many weeks/months did you have to attend PT? - it wasn't much, I don't think I had a good PT program, they mostly just gave me a list. It should be much better now.
For those who had their left knee done, how long until you could drive again? I can't remember but I'm sure it was less than 6 weeks.
How long did you have to wait until you could return to school/work? - I took 2 weeks off work but then couldn't return to my floor (2nd floor no elevator) so I had to sit downstairs for a long time. I should have taken longer though to have been stronger when I returned.

I hope this is helpful. Many people on the site have had one you could do a search. Best wishes let us know.


Thanks for the response.  I'll definitely do some more research and question my Ortho when he calls.  It's just so frustrating that I've been going through this for 3 years with no relief.  Thanks again.

Offline squibler

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Re: I have some questions about a lateral release
« Reply #8 on: October 16, 2008, 06:01:00 PM »
How much pain were you in immediately after surgery?
no real pain

How long did it take for your knee to fully recover?
I never fully recovered, becuase the LR wasn't enough. correcting the patellar tilt alone didn't do the trick

How long did the swelling last?
a few months

Were there any complications from the surgery?
No

Did you have to wear a brace after surgery (if so, for how long)?
No

Did you have to use crutches (if so, for how long)?
No crutches, was walking around on surgery day

How soon after the surgery did you start PT?
A week after

How many weeks/months did you have to attend PT?
I went 9 times

For those who had their left knee done, how long until you could drive again?
2 weeks

How long did you have to wait until you could return to school/work?
5 weeks (am a nurse)

Hope this helps!

Thank you for answering, Helena.  I'm an EMT so if do get the surgery, I hope I won't have to take a lot of time off  :-\

Offline hs06nnh

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Re: I have some questions about a lateral release
« Reply #9 on: October 16, 2008, 06:46:11 PM »
Hi,

I was also told i needed a lateral release.. i had a problem for 3years (im now 21) however when i had surgery they found that the maltracking and pain was caused by alot of damaged cartlidge on the back of the knee cap which had accumilated over the 3yrs after a bad fall on my left knee. I had surgery on saturday and am now alot better with the pain gone (only surgery pain at the moment) and being able to walk normally without pain. My muscles are/were also tight and you may find that they only need stretching instead of the release and just any other damage removed.

My PT diagnosed me the first time he saw me with the problem (a month ago) though he wanted to try and calm the knee down first. He works with the olympics high up so he knew alot about what he saw in my knee etc. You may want to ask if it could be just damaged cartlidge as you may not need the release... i also had PT for 3months which made the knee pain worse and left me unable to walk etc. Also MRI's dont/cant see damage behind the kneecap as at the start of my treatment i had one done and it only showed a lil soft cartlidge, when actually i had alot of ripped up cartlidge and soft cartlidge which i still have some as there was too much to get rid of it all.

Hope that helps a little
« Last Edit: October 16, 2008, 06:53:00 PM by hs06nnh »
11/05-Fall on left knee
12/05-PT/settled down
08/08-PT
11/10/08-Arthroscopy left knee = chrondoplasty/chrondomalacia found
22/06/09-Arthroscopy left knee = chrondoplasty/lateral release
08/08 to now (23/12/09) = PT continueing

Offline squibler

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Re: I have some questions about a lateral release
« Reply #10 on: October 16, 2008, 08:25:53 PM »
Hi,

I was also told i needed a lateral release.. i had a problem for 3years (im now 21) however when i had surgery they found that the maltracking and pain was caused by alot of damaged cartlidge on the back of the knee cap which had accumilated over the 3yrs after a bad fall on my left knee. I had surgery on saturday and am now alot better with the pain gone (only surgery pain at the moment) and being able to walk normally without pain. My muscles are/were also tight and you may find that they only need stretching instead of the release and just any other damage removed.

My PT diagnosed me the first time he saw me with the problem (a month ago) though he wanted to try and calm the knee down first. He works with the olympics high up so he knew alot about what he saw in my knee etc. You may want to ask if it could be just damaged cartlidge as you may not need the release... i also had PT for 3months which made the knee pain worse and left me unable to walk etc. Also MRI's dont/cant see damage behind the kneecap as at the start of my treatment i had one done and it only showed a lil soft cartlidge, when actually i had alot of ripped up cartlidge and soft cartlidge which i still have some as there was too much to get rid of it all.

Hope that helps a little

Our situations sound very similar.  I'm definately going to ask my Ortho about streatching instead of surgery.  I'm just so disgusted with PT because it was supposed to build up the muscles on the other side of my patella to correct the maltracking and didn't.  Also, in PT they made me do squats and put me on a machine (it's like a leg lift machine but you're sitting while you do it) and when I told my ortho about all of the things I did in PT, he said that those 2 exercises probably just made things worse.  I want a new knee lol

Offline hugo

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Re: I have some questions about a lateral release
« Reply #11 on: October 16, 2008, 08:43:15 PM »
Don't want to repeat myself, but don't jump into to an LR without certainty it's needed. Only knee or patellofemoral specialists have the know how to tell you what will address your issues.

Even though you're young I don't think those previous pediatric orthopedic doctors could address your issues because they might not specialize in knee/patellofemoral issues (surgery if needed to address tracking or cartilage issues is delicate surgery, and can't be trusted to an average orthopedic doc).

It's good you've been seen by a doc that's highly ranked. I'm guessing he specializes in knee/patellofemoral issues too?

Good luck to you
« Last Edit: October 16, 2008, 08:45:08 PM by hugo »

Offline Leentje

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Re: I have some questions about a lateral release
« Reply #12 on: October 16, 2008, 09:13:50 PM »
An EMT huh? Well hi collegue! Sort of... Work now as an ER nurse, on MICA (Mobila Intensive Care ambulance) and ambulance. Nice job hey? I just love it!!
When I had my LR I was working on ortho and still 5 weeks was long, but I am happy because I didn't want to retunr too soon so I again had to take time off.

What exactly do you do as an EMT? as working in UK/USA is very different as here in Belgium. With MICA I am always going to a call along with a dr, with ambulance I can do whatever I want, but I want to work in the 100system here but I still haven't got my badge for that (I can finally go get my special ER/ICU diploma on thursday oct 23th jippee!)

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 squibler

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Re: I have some questions about a lateral release
« Reply #13 on: October 16, 2008, 09:43:33 PM »
Don't want to repeat myself, but don't jump into to an LR without certainty it's needed. Only knee or patellofemoral specialists have the know how to tell you what will address your issues.

Even though you're young I don't think those previous pediatric orthopedic doctors could address your issues because they might not specialize in knee/patellofemoral issues (surgery if needed to address tracking or cartilage issues is delicate surgery, and can't be trusted to an average orthopedic doc).

It's good you've been seen by a doc that's highly ranked. I'm guessing he specializes in knee/patellofemoral issues too?

Good luck to you

Hugo,
I completely understand where you're comming from.  I'll see what my ortho's opinions is on another round of PT.  I believe he specializes in knees and shoulders.  Thanks!

Offline squibler

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Re: I have some questions about a lateral release
« Reply #14 on: October 16, 2008, 10:02:50 PM »
An EMT huh? Well hi collegue! Sort of... Work now as an ER nurse, on MICA (Mobila Intensive Care ambulance) and ambulance. Nice job hey? I just love it!!
When I had my LR I was working on ortho and still 5 weeks was long, but I am happy because I didn't want to retunr too soon so I again had to take time off.

What exactly do you do as an EMT? as working in UK/USA is very different as here in Belgium. With MICA I am always going to a call along with a dr, with ambulance I can do whatever I want, but I want to work in the 100system here but I still haven't got my badge for that (I can finally go get my special ER/ICU diploma on thursday oct 23th jippee!)

Helena
    I absolutely love being an EMT.  Even though getting a 'thank you' is rare, the whole experience is just so rewarding.  In the US, we can do all the basics, like administer certain medications (EPI Pens, Nirto, inhalers, oxygen, and oral glucose), control bleeding, take c-spine precautions, insert OPAs and NPAs, use suction, CPR, splint, deliver babies...  The biggest thing is that as an EMT, you are NEVER allowed to diagnose anyone.  We never have a doctor on board, only paramedics if we need them (like for a CPR, difficulty breathing, chest pains call).  We also get the honor or carting drunks to the ER lol.  Since I'm only 17, my EMT license still says 'preliminary' but I just have to wait 4 more months until I get my official one. 
    My EMT friends went on a call two days ago where they were trying to revive the father of the bride at a wedding.  He didn't make it and the crew was a bit disterbed by the whole call.  They said that the bride was in the front seat crying hysterically while they were rushing to the hospital.  It was really sad.
    That's wonderful about you're diploma!  You should get a nice frame for it and put it where everyone can see it! 















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