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Author Topic: How long is lateral release recovery? BAD pain at 12 wks. PLEASE. HELP needed  (Read 10577 times)

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Offline SarahMN

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 :'(
I had a LR on my left knee 12 wks ago.  I got better until about 7 wks when the knee cap slid medially while walking.  Since then horrible pain that hits 9 daily. 

I am having pain at the 9 level daily, and in need of strong narcotics.  Is this normal? 

My OS is useless.  He has his PA call me back.  At my post op visit of 4 weeks, the PA told me to buy the brace that my PT had suggested for my right knee off the internet, even though they had them in their clinic.  My brother age 46 had passed away unexpectedly the day before my appt, and I was in bad shape.  I did not even get to see the OS, just the PA, which it turns out is post op protocol, you don't see or get advice from the OS again.

But the OS is ready to schedule surgery for the chrondomalacia and patella maltracking of my other knee NOW.  I am hoping to see Steadman at the end of March, after finding out conflicting advice from other OS in the area about LR etc.

I am doing a PT program that is the protocol for TKR, which the PT said is the same for LR.  I take a major narcotic pre and post my PT.  My knee swells up horribly when I take a shower, even sitting down.  It hurts afterwards and around the surgery knee, I am getting mottled colored skin after the shower.

Anyway I am in too much pain to consider another surgery, of any kind now.  I have a family, and am now in a wheelchair when we go out anywhere because my knees can go out on me, or spasm up.

I am so fed up with the pain and being a burden on my family being so useless, I sometimes want to join my brother.  I have two kids and a husband who are burning out on me and my inabilitry to do anything.  I sometimes feel like I can't take it any more.  The guilt, pain, and griefing of losing my brother the week before Christmas is too much. My stepdad of 32 yrs is in hospice for cancer.  All of this fell on top of my post op recovery.  I am losing hope.   

Is THIS PAIN NORMAL for a Lateral release at 12 weeks? 

Anyone who knows something, please tell me. I have searched the posts, but could not find a LR story to help with this. 
PLEASE tell me if anyone knows what is normal for LR, w/chrondoplasty, plica excision, and synovectomy.

Thank you to anyone who will reply with any experience about this sort of recovery.  Sincerely, Sarah

It is night now and I am near tears from pain, like every night.  If I do no PT, no walking, and just be in a chair with ice, my pain drops.  But then my quads will weaken.  I do not know if I am supposed to keep working through the pain with PT and walking or not.  PA says gut it out, and get the LR done on my other knee.

« Last Edit: February 09, 2009, 06:18:36 AM by SarahMN »
3/25/09: R Knee: Arthofibrosis (LOA), chrondoplasty, excise plica, anterior interval release.
11/12/08:  L Knee: LR, Chrondoplasty of patella & MFC, Excise Plica, Synovectomy - 2005-2008: 12-16 weeks bi liateral knee injections with steroids. 
---& tried Synvisc, nothing but cost & 9-10 pain.

Offline ghost

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Sarah,

I haven't had lateral release, but it's in my not so distant future. I'm about 10 weeks post-op from a microfracture of the trochlear groove. Nonetheless it sounds to me that the incident at 7 weeks messed with something that was done during the surgery.

Have you talked to your pt person about it?  There's a difference between muscle and joint pain.  Although pt can cause some discomfort it shouldn't be causing the pain that you're describing.   I would call the OS back and demand an appointment with the OS.  Something isn't right and needs to be addressed.  Steadman is one of the best but it doesn't sound to me like you should be waiting until the end of March to see someone. 

You've had a tough few weeks, no doubt about it, but there is hope.  I'e found that we have to be advocate for ourselves.  Be aggressive and get yourself back to the os.  Demand xrays or an mri so see what is going on in there.

Keep talking there are others out on this site who have had this proceedure that you can connect with and get some advice from.

Sending you a cyber hug.

Sue
rt k med meniscus 1983
rt k lat meniscus 2001
lft k med meniscus 12/07
lft knee medial meniscus 6/08 with chondroplasty & debridement of the suprapatella pouch
lft knee trochlear groove MFX 12/2/08 with chondroplasty and debridement of the suprapatella pouch
7/31/09 trochlear groove resurfacing

Offline JustMeInNC

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I have had a few LR done on my knees. 1 on the left and 2 on the right. The most recent was done on my right knee 7 months ago. It defiantly sounds like you need to get an appt to see someone, if your OS wont see you then find another one and get copies of your records from the one that did your surgery.
My LR on this lovely right knee did not go well and at 7 months out I am still in alot of pain every day, although I try my best to not take meds. I'm sorry that you are in so much pain believe me I know how you feel being useless i still feel that way cause I cant do much around the house cause of the pain. I was in the constant severe pain before the surgery sine every time i would take a step my knee would crack loud (like you where cracking your knuckles) so i know how that feels.
Hope that you get to feeling better soon.
I'm so busy that I'm not sure if I lost my horse or just found my lead rope.

1989 - Right Knee - don't rember what they did
1997 - Right Knee - Orthoscopic clean up again
2000 - LR on left knee
2001 - LR on right knee
2008 -LR on right knee (again)
9-18-2009 - Maquet osteotomy right knee

Offline TwoBadKneesUSA

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Hi Sarah,

I'm so sorry you are in so much pain still.  One thing I have learned in my research on LR is that medial subluxtion (like you described) is not normal and is caused by the LR.  I would definately go to another OS.  I did read your other post and the list of other medical problems that complicate things.  Keep looking for someone to help you. 

Milly
'83 lt knee scope
'88 lt knee LR
'89 rt knee LR (6 mos. after left)
'05 rt knee scope (clean up)
7/5/07 - scope, LR left, right clean
3/19/08 - LR failed, Supartz failed
http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=47974.0
8/21/08 - new OS apt
8/5/09 - TTT, LR, PFJR sched.

Offline SarahMN

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This is SarahMN.  I have seen two other OS, they won't touch me because there was some 90 day rule about the first OS has to take care of you legally, and according to insurance in MN.  Both of the OS were able to bill my insurance on the right knee that has not had surgery yet, or so I am hoping.

One of the new post LR #1 OS said she didn't do lateral releases, and would not do anything to me ever.  Too complicated.  She said when my bones show enough deterioration for a TKR, then she would refer me to one of her partners.  She didn't even examine my knees.  Just looked at my history, said she would not do surgery.  I asked why, and she tapped my history paper.  She is a former Steadman fellow.  She works mostly with young women in HS and college age.  I think they are in better shape than me.

The other #2 post surgery OS also said she does not do LRs.  She would do a taping PT program, and then likely Tibia tubercle osteotomy.  She will not see, comment  or treat me though. Not until my current OS writes a letter to her, explaining why he did a lateral release in the first place.  I think this is because I show patella alta on my Xray and MRI reports. 
I read somewhere on this site, and a few others, that LR is not indicated for patella alta.  She clearly thought it was a mistake, as she lectured her residents while in the exam room.

I called my OS office and they would not guarantee that I would be able to see the OS.  Post op, he only sees you once briefly, and after that their protocol is to be handled by the PA. 

I can see Steadman in March.  I have gotten other names of OS here.  But I don't know if I can rely on any of them any more, after my experience, and reading the stories of other people here.  Plus a lot of the OS seem to protect each other when I do ask at church, retired OS, they say how great my OS is.  It is hard to get a true opinion from other local MDS.  Don't blame them though.  They have to work and refer to each other.

Thanks again for writing.  It made me feel better.  I have talked my other specialists and have upcoming appts and maybe they can be of help.


« Last Edit: February 11, 2009, 09:39:00 PM by SarahMN »
3/25/09: R Knee: Arthofibrosis (LOA), chrondoplasty, excise plica, anterior interval release.
11/12/08:  L Knee: LR, Chrondoplasty of patella & MFC, Excise Plica, Synovectomy - 2005-2008: 12-16 weeks bi liateral knee injections with steroids. 
---& tried Synvisc, nothing but cost & 9-10 pain.

Offline TwoBadKneesUSA

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Hi Sarah,

Glad I could help even a little.  You may not have to see the OS to get a letter.  Can you request a copy of your records and surgery notes?  Quite often the OS rationale will be in the notes somewhere.  That may be enough for the new OS.  If not, you can always leave a message with the PA or office person to have a letter faxed to the new OS.  Unfortunately LR is what most OS will do as a starting point.  I think it is now starting to come out of favor.  It does work for a very small percentage of folks with a specific problem, it is not a one size fits all procedure.  I also have patella alta, had it all my life and I've had 3 LR.  The first two did help somewhat, but I don't think they really solved the problem.  I know it' a bit to wait, but 90 days will go by fast enough and then the new OS can start taking a closer look at the left knee.

I know how you feel about OS and docs in general.  They try not to be too negative about collegues.  The best you can do is find an OS who listens and is willing to work with you.  He/she should also be willing to admit they have reached their limit of knowledge or expertise.  Thankfully my last OS was one of those.  He told me there was not anything more he could do for me until I was ready for a TKR.  So I went hunting for someone who could help.

Good luck with your appointment in March.

Milly
'83 lt knee scope
'88 lt knee LR
'89 rt knee LR (6 mos. after left)
'05 rt knee scope (clean up)
7/5/07 - scope, LR left, right clean
3/19/08 - LR failed, Supartz failed
http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=47974.0
8/21/08 - new OS apt
8/5/09 - TTT, LR, PFJR sched.

Offline rkneepain

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Hi Sarah,
              My name is Karen, I had a LR done last aug 14th.  My post op diary is in the +100 section.  UM......My journey has not been so easy.  I was sitting here crying over what I have to go through again next week, and I was reading your story and my heart broke for you.  I so understand what your going through.  I had it done 6mo ago and I am still on crutches.  I wish I had never had it done, and I won't do my other one.  But, I have to go back in on the 26th to go have scar tissue removed, and have an MUA done.  I can only bend it to 75 deg, and partial wtb.  I was in so much pain then they discovered I had RSD.  Nobody could get near my leg for the longest time, I had burning pain, and discoloration in my leg(signs of RSD.)  I know what it feels like to think your useless, but your not!  It's hard when your so independent, and used to doing things for yourself, and now we need others to help.  It still bothers me to ask for help, I feel like I am a big pain to my kids, but I tell them I used to do everything for them, and atleast they don't have to wipe my butt ha-ha not yet anyways!!! ha-ha-ha!!!!  Sorry for being a tad vulgar but I hope I made you laugh!  I try to do things first for myself so atleast I know I tried, then when I ask for help I don't feel so needy.  I am going to be asking for help again next week, and I hate that!  I am so sorry you lost your brother, and I am sorry about your step dad.  It's so hard to be strong when you have extremely heartbreaking things happing to you.  I know it's easy for me to say but you need to be strong for your kids, and yourself.
  For some strange reason when we think we can't do it any more we find away to hang on to something that gets us through another day, and when we make it through another day we get stronger.  (I need to take my own advice, I'm good at dishing it out)  I was thinking right before I pulled your page up that I don't know where I am going to find the strength to get through another surgery, to go through the pain, because I haven't forgot the last time!  The doc's and myself are all concerned that my RSD will hit me so much worse with another sx, but I can't sit here wasting away anymore with a knee that won't bend, I had to chance it.  I can't do my job like this, and I can't ride the motorcycle with my guy, can't chase after my teenagers :)  and I can't set a date to get married yet til I get fixed >:(  !!!!  Of course my cat misses the old me too, I swear she is going to kill me on these damn crutches!!  So I guess I just need to take a deep breath and do it....but I don't want to :-[  I swear the only ones who understand are the ones one this site!!!!  The people on here are wonderful!   Strangers reach out to one another and you will never feel alone.  You can rant, rave, complain, cry, laugh, and say anything you feel and there is someone on here who will reach out to you. 
   I wish you the best of luck in what ever you do, and keep us posted! 

  Sending sunshine your way!
    Karen from Boston, Mass

Offline SarahMN

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Hi Karen, You made me laugh about the cat.  I have two cats that are alternating loving me and punishing me!  You know cats.  If they try to lay or sit on my knee I have to push them off.  I think I have RSD, but my OS won't consider it. 

You did make me feel a lot better.  I too am grateful that I don't need help in the john.  I had one OS I saw pre the surgery, who wanted to do both the LRs at the same time.  And be non WB for 10 days.....I thought of that very thing and went with the surgeon who did one at a time so at least I could sit on the john and take care of myself! 

You are in my prayers and we will be in this together.  Write any time.  I have to figure out how to stop RSD.  It is mentioned a lot in the Steadman textbook on Crucial Principles of Knee Care (I think I got that right).  Maybe he can help me.

I need to have something done to the right knee, so I am keeping up on the PT, and getting ready for my trip to Vail in March.  Wish me luck.  I will keep you informed.

Thanks for writing and making me feel better.  I am sorry what you have gone through.  At least we are not alone.
Bless you, SarahMN
3/25/09: R Knee: Arthofibrosis (LOA), chrondoplasty, excise plica, anterior interval release.
11/12/08:  L Knee: LR, Chrondoplasty of patella & MFC, Excise Plica, Synovectomy - 2005-2008: 12-16 weeks bi liateral knee injections with steroids. 
---& tried Synvisc, nothing but cost & 9-10 pain.

Offline rkneepain

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Hey Sarah,
                I finally got the computer away from the kids ha-ha.  There on school vacation so I don't get much use of it unless I am up late, plus it's fri night and they stay up later than me sometimes.  It has been a gloomy day here, gray and very windy.  When I finally went to sleep last night I decided to try not to freak over my up comming sx...Well, the hospital has been calling to pre-register me, and then billing calls with a ridiculous co-payment that they want.  I said add it to the tab, been out of work for 6mo because of the last round of sillyness.  Grrrrrrrr!!!  This knee has taken over my life and I am soooo sick of it!!!  Someday I would love not to even have to worry about it.  What do you have to have done in march Sarah?  Did you say you have to go to Vail?  Is that colorado?  My goodness I can't imagine having both knees done at the same time!  I would have ended up in the looney bin!  Especially where I'm still on crutches 6mo later!  My left knee dislocates too but not as much as the right one did.  I can live with it ha-ha.  My knee issues started when I was 9, I jumped off the front steps of my house and the silly doctors won't leave my knees alone!  Iv'e noticed how crazy I am with guarding my knees.
   I felt somewhat productive today, folded some laundry that my son was nice enough to do for me, did the dishes, made the phone calls to let some people know about sx, and I have chicken defrosting for dinner.  Whew!  Gosh i'm wiped out already, any non-knee geek would say thats all you did and your tired?  Yup!  Thats me, feeling like I am 90yrs old, my heart is wanting to do so much and act like the 41yr old kid that I am, but the body.....well I mean the KNEE!!!!  ARGHHHHH!!!!!!! >:( >:( >:( >:(
   Let's change the subject for a minute to our cats :D  I only have one, Magic, she will be 9 in March.  Ooohhh she can be a stinker.  Of course she only comes near when "she" wants to.  I love her like crazy though!  She makes me nuts on the crutches ha-ha, darting in and out of them, my favorite is when she "stops, drops and rolls' when I am trying to walk by and she blocks my way!!!   She is so fresh to strangers, hissing and spitting at them, I can't help but love her though, especially at the end of the night when she decides it's time to come in and snuggle with me in bed.   Gosh the wind is howling like crazy I feel like the place is going to lift up and blow away!
   I miss my job like crazy, I was a vet tech before my sx, now I don't know what I am.  They keep asking when I'm comming back everytime I bring in another doc note.  I just say someday.  Well I sopose I should go put my laundry away....I hope you have a nice wknd, and have some relief from pain, I pray you don't have RSD, I don't wish that on anyone!!   

Sending sunshine!
 Karen


Chat soon

Offline SarahMN

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Hi Karen,
I had the left knee done.  My right knee is also in bad shape, but has had nothing done on it yet.  I would not do another LR.  The local Os here offer me either LR or a tiba tubercle osteotomy.

I have only talked to the OS's MA and nurse from Vail.  The possible surgeries mentioned for my right knee are a superior lateral release, or a patellar (anterior) release.  But I won't know until the OS looks at me, my MRIs, and maybe repeats them.  I also need a standing xray, for q-angle, which none of the 4 OS here have done.

From what I have read on this board post LR on the left knee, that is part of what needs to be done to determine q angle and appropriate treatment.  But I would be glad to have a competent knee specialist give me some input.

Thanks a million for the notes.  I hope to chat soon.  (The house is full now w/dh and both kids.  It is Saturday nite, so they will drift out of here eventually!)

Cheers, Sarah MN
3/25/09: R Knee: Arthofibrosis (LOA), chrondoplasty, excise plica, anterior interval release.
11/12/08:  L Knee: LR, Chrondoplasty of patella & MFC, Excise Plica, Synovectomy - 2005-2008: 12-16 weeks bi liateral knee injections with steroids. 
---& tried Synvisc, nothing but cost & 9-10 pain.

Offline rkneepain

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Hi Sarah,
             I hope you had a nice wknd.  I spent the day at the hosp getting the pre-registration over with, and I talked to the anesthesiologist about the sx.  I am starting to panic, and I don't want to do this.  I know it's for the best but I'm just so nervous.  They said if I am anxious to call the OS and he can call something in for me but I hate taking things,so I said I will try tylenol pm's ha-ha!  I had a nice wknd with the kids, then sun I went out with my guy (fiance') Kevin for my "last meal" ha-ha, had a nice steak dinner and a cosmopolitan!  The rest of the wk I need to get things in order again...make sure the laundry is done, groceries stocked, blah, blah, blah.  I know the kids will be ok because they will be with their dad, but I worry about Kevin and my cat ::)  If I am on good behavior I can come home monday.  Where does the time go?  Thursday will be here way too soon!!!
  Well my goodness you have been through alot too with your knees!  I hope all goes well with the decisions that everyone decides.  It is such a hard thing to go through.  I feel like once you mess with knees they are never the same.  I hope mine is sucsessfull this time!  I hope yours is too!  You will have to keep us posted on your journey!  Ok it's 1220 am time to try some sleep.  I will be in touch soon, definetley before my sx on thurs.

Sending Sunshine......
  Karen....

Offline Silkncardcrafts

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Hi Sarah,

I feel for you. Medial instability does exist. I developed it on both knees after having lateral releases on both knees. Initially my right knee responded really well, but 9 years after my lateral release I suffered medial instability. My lateral release on my left knee did not work and 3 months post-op I was still struggling. After much research and getting other opinions my OS did a medial patello femoral ligament reconstruction which made a massive difference.

Medial instability can be quite difficult to treat. In my case I had lateral and medial instability of my left knee. Last May I had a trochleoplasty and has made a massive difference to my quality of life. It no longer comes out, which I am very happy about. Waiting to get the other knee done.

I would encourage you to see a surgeon that specialises in patella problems. Good luck with your recovery.

Don't give up. They will be a way out of this. :)
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 kneessuck

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Hi Sarah,

I've had chronic knee pain for almost 3 years and seen 5 PTs and now 2 OSs over that period. My first OS from Steadman Hawkins in Denver gave me 3 rounds of cortisone over the years which helped but when the pain returned again he was leary of recommending a particular type of further treatment. I then went to Michelle Wolcott at CU Sports Medicine and she recommended a scope and potential LR. Once she got in there she did the LR, removed plica and scraped the rough edges off the back of my kneeecap. The surgery was in mid December and I'm back doing all normal daily activities, lifting, biking quite a bit but still struggling to run.

Ironically my PT who is still at Steadmans was really impressed with my surgery from Dr Wolcott given that there was little to now swelling and the recovery is going pretty well. So... although Steadman Hawkins is supposed to be a premier orthopedic clinic, it didnt work for me and I would definately recommend Dr Wolcott for another opinion.

Hope that helps...
Michelle


Offline TwoBadKneesUSA

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Hi Michelle,

Looks like you are about 3 months or so out.  It may take a couple more before running is at all comfortable.  It can take a good 6 - 18 months for a LR to completely heal.  I remember the first time I tried to crouch down to get a library book off a shelf and found myself sitting on the floor!  This was about 5 months after surgery.  The knee was not ready for that yet.  I eventually got there, it just took some time.

Milly

Sarah - How are you doing?  Hope things are getting at least less painful for you.

'83 lt knee scope
'88 lt knee LR
'89 rt knee LR (6 mos. after left)
'05 rt knee scope (clean up)
7/5/07 - scope, LR left, right clean
3/19/08 - LR failed, Supartz failed
http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=47974.0
8/21/08 - new OS apt
8/5/09 - TTT, LR, PFJR sched.

Offline chaos

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go see dr elizabeth arendt at fairview riverside.  she is the best female orthopedist in MN and probably in the country.
beauty always comes from within.  the outside doesn't matter.