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Author Topic: re has anyone had a lateral release and OATS at same time? results? advice pleas  (Read 3937 times)

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Offline emilylauren

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Hi!

I just got my MRI results.  They say: the patella and its tendons demonstrate a focal area of abnormality noted involving the articular eminence extending to the medial articular facet of the patella.  This extends over approx 1.4 cm in transerse dimension x approx 1.3 cm in craniocaudad dimension.  This does not extend through the full thickness of the articular cartliage and is consistent with area of Grade II change.  There is a small jiont effsion.  There is some infiltrative edema noted within the infrapatella fat pad, consistent with a component of synovitis.  Laxity noted in the anterior cruciate ligament. 

Any thoughts on this? Has anyone else had this type of problem? Is 1.3/1.4 in cm big? I'm a fairly petite woman.

My ortho surgeon (suppose to be top doc in cartlidge repair) wants to do a lateral release and OATS procedure.  Any thoughts on this? Has anyone else had both at the same time?  My job and life revolve around biking and running so I really want/need to feel better.  I can bike on flats but struggle on uphillls (the downstroke hurts a great deal) and I hurt a great deal when trying to run.  Plus my knee seems to be stiff now after sitting for any length of time.  I'm very frightened about having any surgery.  I'm also of course afraid of all the down time.  I'm use to being very active each day.  Of course, if I knew this surgery would make my knee feel better I could hang in there during the recovery period.  Friends say they've heard horror stories and are afraid of my having the surgery and making things worst.  Also the ortho surgeon had orig talked about taking cartlidge from a cadaver.  This sounded good but now his nurse said that they would probably take it from my own knee. She said the waiting period if long for a cadaver.  How long did others have to wait? My knee is pretty small so I think I'd rather have it from a cadaver.  Any thoughts on this? Has anyone else had surgery using a cadaver? How long did you wait etc?

Any advice or words of wisdom are greatly appreciated.  Hope everyone is doing well. 

Offline JulieRose6

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Hey I understand your worries I was worrying a lot. I am a very petite girl as is so I had about a 1.5 cm taken out of my knee cap on my left last march. I did have a cadavar put in my knee, its a long wait period it kind of gets you upset and all. They told me to expect about 3 months to get it. So i waited and they moved up my surgery a few weeks earlier because of my doctor going on vacation, so the date approached and 4 days prior i got a call they did not recieve it, so I was totally screwed and upset, it turned out i think it was 2 weeks later that i had the surgery with the transplant, so that may be why the nurse told you. I think it was worth the wait in the end because its like a fresh start in the bad area. I have the pictures from the surgery if you want to see it.

I am about 7 or 8 months out and I have never been an active person but I can do a lot more than prior to surgery. I do not have full flexability I have about the last 15 degrees left but I haven't been working on it, so its most likely my fault. I don't know about biking and running I have heard people don't run after this or if they do its quite a few months out of recovery, so I am not sure. I do still have pain just lately it feels like i'm back to when i was 3 months out so it quite painful.

Your recovery is all your own and is different person to person so remember you will be fine in the end just let yourself recover on your own knee's terms. I moved into an apartment just my dad and I moving all the stuff a month to the date from my surgery, so you can see recovery goes fast.

Julz

PS When you do have the surgery get an ice machine that helped me a lot with recovery and pain from surgery
Arthoscopic (3/2002)
Fulkerson/Lateral Release/Arthoscopic (12/2002)
Arthoscopic/ Screw Removal (10/2003)
Arthoscopic (12/2006)
Oats Procedure (3/2008)
Partial Knee Replacement (11/09)
Partial Knee Replacement (6/10)

Offline emilylauren

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Re: re has anyone had a lateral rel/OATS-using cadaver?
« Reply #2 on: October 27, 2008, 01:23:06 PM »
thanks for the responses!  i really appreciated.  again if anyone who is athletic out there has had the OATS procedure (with cadaver) could response as well I'd love to hear from you.  i really want to bike and run again after the procedure.  wishful thinking? 
and if anyone has had surgery with riley williams - hosp for special surgery - would love to hear from you as well.

thanks, the people on this board are great.


Offline emelle

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Hi -

Did you end up having both a lateral release and OATS?  My doctor wants to do the same with me, but I am skeptical about the lateral release since I had one on my other knee many years ago and it didn't turn out so great.

Best Wishes~

Offline Riosilia

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Emilylauren and JulieRose6-

I'm really interested in both of your stories as I have a similar patellar cartilage lesion (mine is located on the distal medial aspect, measuring about 20mm in diameter grade III with a grade IV center that's about 10mm).  If you guys don't mind, could you please expand more on the type of graft you got (or are planning to get).  It sounds like you guys are talking about (cadaver) allografts but do you know if they are from the medial/lat condyles or patella? 

The reason why I'm wondering is because right now I've been on a list for a patellar allograft for over 5 months.  My doctor (and some of the most current research) seems to show that patellar to patellar allografts are better than a condyle allograft for a patellar defect (afterall the cartilage in the patellar is thicker than cartilage in the med/lat condyle). 

JulieRose I was also wondering if you clerify for me how you got scheduled for surgery in such a "planned" fasion.  From what I've been told, there's not much "scheduling" they can do.  Once they find a graft that matches my patella, I have to have the surgery within 7-10 days (since patellar cartilage starts to breakdown significantly after that).  Also, how are you doing now?  How has your pain changed since before the surgery?  Do you have any regrets?  Did any do any anteriolization of your tibial tubercle along with the osteochondral allograft?

I hope you don't mind all the questions. I haven't found too many people having patellar osteochondral graft so I'm really interested to see what you guys have to say.

Thanks!
98- first patelllar dislocation
99- LR + debridment
00- proximal (VMO advancement) + distal (TTT medialization) realignment
03- MPFL repair, lat retinaculum repair, patellar microfracture
09- Patellar osteochondral allograft + MPFL reconstruction
10- ant interval release + partial synovectomy

Offline JulieRose6

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Okay well let me explain on the planned part. My doctor told me on average it takes give or take 3 months until they can get a bone graft depending on your size and the amount needed. Remember they have to find someone with the exact thickness of yours because if its not like identical it will cause more damage. The first time i was supposed to have it we got a graft in 3 months but with my bad luck it disolved inside the sterile machine and had to wait another 3 months but I didn't have the transplant in the end. This one thats in my knee took about 3 months with a week or two later than planned.

Today I am almost a year out. Believe me it will hurt like you have never hurt before for the first few months but that is normal and it starts to fade. I still have pain in my knee and I went to see my doctor about it and I may have more surgeries on my knee. My surgery was completely successful I have felt better since then, I can walk more, I am actually going to travel in June which I have not been able to walk that much. The pain and surgery part is because of the other side of my kneecap is probably really damaged too so they may have to do the transplant on the otherside of the knee cap. Its really funny how half of my knee cap hurts and they other doesn't (the one that doesn't is from the transplant). Well now that I probably confused you, sorry I tend to do that sometimes. I have no regrets on this surgery or any other surgery because if you didn't take a chance on this surgery then I wouldn't have felt this good today. I suggest the transplant it was nice on me even though it hurt for a while, mine is totally healed.

I did have a lateral release awhile ago and I did dislocate my knee cap once afterwards and it hurt worst than the other ones so watch out. I have the pictures from the surgery if you want to see them.

Julz

PS Where are you located?
Arthoscopic (3/2002)
Fulkerson/Lateral Release/Arthoscopic (12/2002)
Arthoscopic/ Screw Removal (10/2003)
Arthoscopic (12/2006)
Oats Procedure (3/2008)
Partial Knee Replacement (11/09)
Partial Knee Replacement (6/10)

Offline emilylauren

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hi, sorry to be out of touch for so long.  how is everyone doing?

 i tried some experimental stuff which has not panned out.  so . . . i guess i'll now need to have major surgery - lateral release, OATS, tibial tuberculose (something like that).  it all sounds overwhelming to me.  but i'm in so much pain at this point.  if anyone has any good recommendations for ortho docs at the hospital for special surgery or in the washington dc area, please let me know.  i'm suppose to head back to grad school in january. so i'm not sure how i'm going to get around on crutches.  i'm beyond bummed.  thanks.
emilylauren

Offline emilylauren

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Hello,

I had some ''experimental stuff'' done to try and help my damaged articular cartliage in knee.  unfortunately it didn't seem to work  and in fact made things worse it seems. 

so back to having surgery i guess.  i've been off the board for awhile.  has anyone had the following - obi tru fit plugs, lateral release and a tibilalturburcle osteotomy (spelling may be off)? 

how did it go? who was your ortho surgeon if you don't mind saying/where done? 

your injury/your age etc?

would you recommend? 

i'm pretty scared and beyond bummed at this point.  i was a very good amateur athlete. 















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