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Author Topic: What to do now ?  (Read 1587 times)

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Offline nokneed

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What to do now ?
« on: February 11, 2010, 02:00:41 PM »
Hi Everyone

Here's my story so far. I injured my left knee in 2006 whislt skiing and was sent to Selly Oak Hospital for an arthroscopy and medial menisectomy. When I came out of surgery the nurse said the inside of my knee was 'carnage'. When I got to see the surgeon later, he said there was a ruptured ACL, and 'damage' ?? to the PCL, LCL and Postero Lateral Corner which at the time didn't really mean a lot to me. The most significant thing I was told was that if the ACL alone was reconstructed it would fail due to the other damage around the knee.

As I live in Devon I was booked in to a hospital nearer my home and had a non conclusive MRI and a visit to the consultant which resulted in him basically giving my leg the once over for perhaps a minute or two saying it was just the ACL and he didn't rate the previous surgeons findings. I had my first reconstruction/medial menisectomy in the Autumn of 2006 and 12 weeks later it was evident the surgery hadn't been successful. I went through a period of rehab and physio for a while and underwent another reconstruction and menisectomy in early 2007. Although the surgery hasn't failed as such (there is an end feel but an awful lot of movement) my knee is very unstable and swells at the drop of a hat, leaving me unable to build any quads. I was recommended to wear a brace to try to stabilise the knee whilst training (the consultant did not agree with this recommendation, and doesn't believe in braces at all) . My knee still regularly gives way but also hyperextends to the point where my left knee is around 3-4 cm further back than my right one when standing upright.

The surgeon has basically told me I am possibly one of the few people who don't react well to surgery and should concentrate on finding a more sedentary job and however much more surgery I have it will probably not improve my situation. I disagree. When I saw the trauma physio recently they said basically there was a lot more complex going on in my knee than meets the eye, and not to give up. I've asked for a second opinion and was offered another surgeon at the same hospital, but now wondering if I should try a different hospital altogether with a clean slate.

I am still a young(ish) bloke who used to be very active and won't let up until I feel enough is enough. I've even considered amputation but thats a long way off.

Thanks for reading my endless drivel, hope to hear something back.

Many Thanks

Realistically I'm looking for a recommendation for a surgeon in the south west who can tell me once and for all what is wrong with my knee and has experience with the postero-lateral corner.

Offline Kaputt_Knee

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Re: What to do now ?
« Reply #1 on: February 11, 2010, 02:20:45 PM »
How far are you from Bristol? I think that might well be your nearest Centre of Excellence. Otherwise, definitely go for a second opinion at another Health Authority not just another hospital. For example, if you are being treated currently at Derriford in Plymouth, try the Royal Devon & Exeter in Exeter.

I can recommend Jonathan Webb, not from recent personal experience, but from reputation he is now one of the best. When he was involved in my treatment he was a lowly SHO in the team of Mr Christopher Ackroyd at the Bristol Royal Infirmary and the Avon Orthopaedic Centre. He was the only person in the team who recognised what had been done to my knee in an Austrian hospital, despite being one of the most junior in the team. He was supportive and backed me every time I pushed for answers or treatment which would allow me to return to my job as a PE teacher. He has since made knees a speciality:

http://www.jwclinic.com/

You could also try these guys: http://www.bristol-knee-clinic.co.uk/boc/v2home.asp

Good luck

Sue ;)

1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline nokneed

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Re: What to do now ?
« Reply #2 on: February 11, 2010, 05:48:22 PM »
Thanks for the quick reply Sue. I'm based in Plymouth so Bristol isn't too far. I was amazed when I looked at Jonathan Webb's site and realised it's actually the ex-England rugby full back. Unfortunately I can't afford to go private as I had to leave work with the knee, so a different Health Authority it is.

I'll see who I can track down in the various Devon/Somerset hospitals.

Thanks Again

Offline Lottiefox

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Re: What to do now ?
« Reply #3 on: February 11, 2010, 07:27:46 PM »
You can be referred to a private hospital through the NHS under something called the Extended Choice Network - google has some useful information. The hospital you ask to be referred to must have "opted in" to the ECN scheme, but there are about 150 of them that have. So, if you found a reputable knee person at one of the listed hospitals (again google should list them) you can ask your GP to make the ECN referral. It doesn't have to be in your area either. Just a thought - many of the surgeons at the private hospitals have NHS lists as well, so it might not be worth it, but remember YOU have the choice in your hands, don't be fobbed off by a GP who just sends you to any old OS. You need a knee one! You can't choose the actual OS but usually at the private hospitals it finds its way to the knee person by default if that is what on the referral.....

Good luck,

Lottie  :)
Bilateral patella OA since 2009, no surgeries.
Euflexxa working well x3 to current
Right forefoot CRPS post fusion surgery 2011
Refusing to let the ailing parts stop me....

Offline nokneed

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Re: What to do now ?
« Reply #4 on: February 11, 2010, 09:57:06 PM »
Hi Lottie
Thanks for this info. It's amazing what's out there, and how little of it you know about until things get to this stage. I'm so glad I posted on here today, it's given me the focus back after a pretty negative day at the hospital.

Thanks Again , Will

Offline Lottiefox

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Re: What to do now ?
« Reply #5 on: February 11, 2010, 10:42:14 PM »
Hi Will

Just an additional positive add-on - my friend's husband has significantly damaged both of his knees playing football (I don't think he was a born footballer!). On his second injury the OS said he really had done everything in style. Torn and ripped and destroyed virtually everything ligament wise and mashed up a fair bit of meniscus etc. He had two operations on it. It took over a year to get back to a normal knee but he is now playing cricket at a decent level, skis, hikes and generally is very active. He can't play football, well he could - but he has been told he risks doing damage that wouldn't be salvage this time. Plus he'd be divorced by my friend.  :P ;D

You need to seek further opinions and not be fobbed off by a doctor telling you to get a sedentary job. That is just shocking. Surgery isn't the cure all but if you're willing to work hard (which you clearly are) you should be offered options.

Good luck and keep us posted

Lottie  :)
Bilateral patella OA since 2009, no surgeries.
Euflexxa working well x3 to current
Right forefoot CRPS post fusion surgery 2011
Refusing to let the ailing parts stop me....

Offline Kaputt_Knee

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Re: What to do now ?
« Reply #6 on: February 12, 2010, 07:59:18 AM »
Hi Will

another Knee Geek called Vicky is also based in your neck of the woods and has had similar problems. I think she was also being treated at Derriford I think and has now moved to a Cornish consultant. She is busy with exams right now but I will PM her and get her to contact you with the name of her new consultant.

You need 20 posts by the way in order to get Private Message rights


Sue  ;)

1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline nokneed

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Re: What to do now ?
« Reply #7 on: February 14, 2010, 10:53:23 AM »
Lottie, I know where your coming from when you mention divorce. I know my poor wife has put up with a hell of a lot over the past 4 years. I'm surprised I'm still married after watching my wife digging our new garden pond in last week.

Sue, nice to hear there's someone down my neck of the woods having problems, hopefully we'll be able to swap some useful information that'll benefit us both.

Thanks, Will

Offline Kaputt_Knee

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Re: What to do now ?
« Reply #8 on: February 14, 2010, 01:33:09 PM »
Hi Will

check out the posts of Clarkey_VL - that's Vicky's User ID.

I'll PM her now and see if she can let you know who she has been seeing. She can send you her details in a PM and if you can get 20 posts (answer some of the fun & games threads in the Games Room section), you can correspond in that manner. Naming names is a precarious thing on open forums and is better done by means of the PM system.

I hope she proves helpful for you.

Sue

1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline nokneed

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Re: What to do now ?
« Reply #9 on: February 17, 2010, 11:26:52 PM »
Thanks Sue
I've been in touch with Clarkey VL, and swapped stories. Looks like I'll be venturing into deepest darkest Cornwall for the next leg of my ongoing adventure.

Many thanks again for your help ;)

Offline Kaputt_Knee

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Re: What to do now ?
« Reply #10 on: February 17, 2010, 11:49:45 PM »
You're welcome Will :D

If I can help out in any other way just buzz me via the Cruciates Board. Remember I'm the dumb 5 times champ ;) I must have picked up something in the way of knowledge, even if it is only what NOT to do!  ;D

When you have 20 posts you can PM me and Vicky yourself.

It is better to keep names etc off the public areas as it could put the owner of the site into trouble. One surgeon who was never actually named has already threatened to sue for damages to his (over-inflated?  ;) ) professional reputation  :o As far as I know it was all p*ss and wind (so far). But it is a worry to the Knee Guru for sure.

Sue  ;)
1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline karen smith

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Re: What to do now ?
« Reply #11 on: February 18, 2010, 08:57:56 PM »
Wow! You have been through it.

I can't believe you sugeon said you maybe one who doesn;t take to surgery.  It sounds to me like he is making excuses.  Everyone is suitable if they get the correct operation done.

My local NHS did various arthroscopies etc and meniscus repairs etc. eventually telling me similar to you.  I was told nothibg else could be done.  What they meant was there was nothing else theuy could do and the surgeon wasn't man enough to admit there was someone out there better than him.  With the help of my physio, we tracked down a brilliant surgeon who not only sorted me ou, but 7 years later I have had no problems.  It took some work but it is wort it if you have someone to help you who is independent of your NHS treatment cycle.

Never accept nothing can be done.  a surgeon's ego is usually too big for Charles Atlas to carry.  If they can't do it doesn't mean someone else can't.  It sounds like you need an orthopod who does knees only and nothibng else all the time.  They are out there.  I found one and so can you!

But don't forget, you are entyitled to a second opinion.  I would look up private doctors(specialist knee surgeons) in an area you are prepared to travel to.  When looking up their cv and subspecialities within knee surgeries, you will also see where they practice on the NHS.  If you see one you feel you would be confident with, go armed with details to your GP.  It is your right, so make use of it!

I hope you get it sorted soon, you deserve this when there are people out there who will sort you out.

You can enail me direct if you wish.  My personal email is on the personal deytail sheet behind my login name.

Speak soon

Karen Smith

Offline nokneed

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Re: What to do now ?
« Reply #12 on: February 22, 2010, 07:51:48 PM »
Hi Karen

Sorry for late reply, I've been on the Tramadol for  a few days and it does my typing no favours, so I thought I'd wait until I had a clear head until I got back. ( Does anyone else take it and get really groggy ?)

Thanks for the post, it's a really positive one. You should be a union rep  ;D

I've been to see my GP since you posted and I've been referred to another surgeon I was recommended by another KG. So fingers crossed....

Nice to see you've had a good outcome, even though it took a lot of doing.

Many Thanks, Will















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