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Author Topic: Considering Trochleoplasty Surgery - Pro's and Con's  (Read 3641 times)

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Offline twilli931

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Considering Trochleoplasty Surgery - Pro's and Con's
« on: February 22, 2010, 05:37:17 PM »
Hello!

I am new to this forum and very glad to have found it.  I recently injured my knees (yes plural :)) and would like some insight from your experiences.

Background
When I was 4 years old, I experienced my first subluxation in my kneecaps.  For the next 24 years, I continued to experience them quite frequently in both knees.  I altered my life to avoid situations where this would happen.  So I was never able to play sports, or run like a normal child, etc.

3 weeks ago, I experienced my first full dislocation as I was walking on the treadmill.  I ended up on the ground in horrible pain.  I looked down and both of my kneecaps were dislocated laterally.  The EMS took me to the ER, the ER team "popped" my knees back in, put me in straight braces and on crutches, and gave me a referral to see an OS.

The OS sent me for an MRI and CT.  In the meanwhile, I started physical therapy.  I went today for the results and they told me that I had a shallow trochlear groove and have recommended me for trochleooplasty.

Trochleoplasty
I go to see the trochleoplasty surgeon, on Friday.  Here is some of the information that you all may be able to help me with.
  • What questions should I be sure to ask the surgeon?
  • Logistically, I may not be able to have this surgery until late this year or early next year.  Have any of you ever waited a long time before having surgery?  Do you regret choosing to wait?
  • What did you do about your job for those of you in the US?  Did you use short term or long term disability?
  • How long did it take to recover?  What were the stages of recovery? (ex. Bed rest, Standing, Walking, Off Crutches, Back to Normal, etc.)
  • I have flat feet.  They seem to pull my legs more inward in an ackward fashion.  Should this be a consideration?
  • Did any of you decide not to have surgery?  What is your quality of life now?
  • Genetically speaking, I have a good chance of having to have knee replacements in the future.  Is trochleoplasty even worth it?
  • Do any of you see a physiatrist rather than an OS?  What successes or challenges have you had there?
  •  


Any insight you can share would be absolutely wonderful.  Good luck to all of you on the forum.

Offline crumblingknee

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Re: Considering Trochleoplasty Surgery - Pro's and Con's
« Reply #1 on: February 24, 2010, 03:08:09 AM »
Hi Twilli, I have had multiple knee surgeries though not your particular issue. Thus, I can only offer you some general advice which I place in [brackets] below.

Hello!

I am new to this forum and very glad to have found it.  I recently injured my knees (yes plural :)) and would like some insight from your experiences.

Background
When I was 4 years old, I experienced my first subluxation in my kneecaps.  For the next 24 years, I continued to experience them quite frequently in both knees.  I altered my life to avoid situations where this would happen.  So I was never able to play sports, or run like a normal child, etc.

3 weeks ago, I experienced my first full dislocation as I was walking on the treadmill.  I ended up on the ground in horrible pain.  I looked down and both of my kneecaps were dislocated laterally.  The EMS took me to the ER, the ER team "popped" my knees back in, put me in straight braces and on crutches, and gave me a referral to see an OS.

The OS sent me for an MRI and CT.  In the meanwhile, I started physical therapy.  I went today for the results and they told me that I had a shallow trochlear groove and have recommended me for trochleooplasty.

Trochleoplasty
I go to see the trochleoplasty surgeon, on Friday.  Here is some of the information that you all may be able to help me with.
  • What questions should I be sure to ask the surgeon?
[What level of disability can I expect after the operation? When can I return to work or care for family members? How long before I can drive or use public transport or fly? How long will I need to take painkillers?]
[li]Logistically, I may not be able to have this surgery until late this year or early next year.  Have any of you ever waited a long time before having surgery?  Do you regret choosing to wait?[/li] [I rushed getting my last knee surgery in some respects. However my knee cartilage was literally falling apart & I needed to take quick action. You have to weigh out what you gain & lose by your choices. Waiting for a surgeon who performs a particular fancy procedure - what I would have preferred - would have resulted in an additional 6 months of pain & my knee falling wholly apart. Then I still would have faced a heavy year of rehab. Take a close look at where each of each of your options will lead you].
[li]What did you do about your job for those of you in the US?  Did you use short term or long term disability?[/li] [I took 6 weeks off of work without pay. I was a contractor at the time].
[li]How long did it take to recover?  What were the stages of recovery? (ex. Bed rest, Standing, Walking, Off Crutches, Back to Normal, etc.)[/li]
[li]I have flat feet.  They seem to pull my legs more inward in an ackward fashion.  Should this be a consideration?[/li] [Flat feet  are always a concern to my mind if you have touchy knees. You should see a poditirst & get the best possible orthotics ASAP if you have not done so yet.]
[li]Did any of you decide not to have surgery?  What is your quality of life now?[/li]
[li]Genetically speaking, I have a good chance of having to have knee replacements in the future.  Is trochleoplasty even worth it?[/li] [I would always recommend keeping your natural tissue as long as possible. A knee replacement for a young person means a whole lot of limits in your life going forward. Science will likely offer a lot more options in 20 years if you keep your natural tissue.]
[li]Do any of you see a physiatrist rather than an OS?  What successes or challenges have you had there?[/li] 
[/list] [Physiotrist was not helpful for my issue, which is osteoarthritis]

[Best of luck. Please let me know what you decide.]
Any insight you can share would be absolutely wonderful.  Good luck to all of you on the forum.

Offline Silkncardcrafts

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Re: Considering Trochleoplasty Surgery - Pro's and Con's
« Reply #2 on: February 25, 2010, 09:06:40 AM »
Hi there,

I have had trochleoplasties on both knees and was the best thing I did. The left one I had about a year and a half ago. My right knee was done 2 weeks today. For me they have made a massive difference to my quality of my life. I no longer wonder whether my knee cap is going to come out in bed, which was a frequent occurrence.

Here are some answers to your questions:

- You need to ask your surgeon how much time you will need off work, how long you will be in hospital, about PT and also how many trochleoplasties has the OS done. It is a technically difficult operation to do. So, is really important that they specialise in this procedure.
- Personally I would try and have the surgery as soon as you can. I waited 3 months for my right knee to be done and was really hard waiting.
- My OS said I would need 4 weeks off work if I did a desk job or 6 to 8 weeks if it was a manual job. I work as a sports trainer and Allied Health Assistant so I fall in the second category.
- The recovery can be broken in to a few stages. 1st stage is being on crutches and can't really do much in that time. I have just been doing quad sets, leg raises and some bending exercises to get the bend back. 2nd stage is just getting used to walking again and getting back into activities of daily living. The first 3 months my OS didn't want me going to the gym or doing any exercise to give time for the bone to heal. Then at around 6 months I started a gym program and pilates. It is really important to note that the rehab needs to be done slowly and not taken aggressively.

So, I guess apart from the first month the recovery isn't too bad.

You do need to be aware that it is a long recovery and something not to be taken lightly.

I had cartilage damage under both knee caps and by having both knees done I shouldn't have further problems with the cartilage.

Let me know if you have any further questions. I am only too happy to answer them.
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 nickhunt

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Re: Considering Trochleoplasty Surgery - Pro's and Con's
« Reply #3 on: May 02, 2012, 09:50:03 AM »
Hi Everyone.
I have had chronic patella instability and knee pain my entire life. I have had lateral releases and TTTs on both knees with no success. I am 32 and now desperate as walking is becoming an issue. I have now discovered that a Trochleoplasty might be my saving grace, however my surgeon has only performed this operation 4 times and the last was in 2008.
If i have this surgery, I need to have a competent surgeon. I live in Perth Australia I am struggling to find any surgeons that perform this operation regularly. Does anyone know any surgeons (Australia wide) that you could recommend?? I would love to hear from someone who has had a successful Trochleoplasty experience with an Australian surgeon. Thanks!
Nick 0413609903 [email protected]















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