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Author Topic: which op to go for!!  (Read 1274 times)

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Offline tessie

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which op to go for!!
« on: October 19, 2010, 02:02:00 PM »
Hi all,

I'm new to this so hope I've posted on the right board?!!

Basically I have flat trochlear groves and very small, tilted patella's in both knees which didn't give me an issue until I was 37!! (no trauma involved)

I'm in a real dilema over which op I should go for on my left knee, a LR or TTT? My surgeon has given me next to no info on the TTT only to say it's x6 more complicated than the LR and he wont give an opinion only that he could perform either.

I have had a real horror story on my right knee, basically I recieved no PT after a LR back in Dec and am no way near recovery (limited ROM, atrophy and a new complication of sudden giving way - to the point of hitting the floor!)

I still don't know if ithe LR was a success or not but I can't progress any more with rehab (I now have a great PT) because my left knee won't support it.

According to the surgeon I had an abnormal reaction to the LR and my PT also said it was the worst reaction she has ever seen however no one can tell me if it is likely to happen again on the left side or if it was due to the fact I recieved no rehab after (despite camping out in the ortho dept on Xmas eve!!)

I would be really interested to hear from anyone who has had a similar experience as I am finding making a decision really hard, my surgeon now won't see me until I've made up my mind and I've been told to phone his secetary once I know which procedure I want him to perform. My PT is also really worried my right leg won't support my left leg after the op but I seem to be stuck between a rock and a hard place!!! Any help or advise will be great as I really can't go on with the constant pain!!

 Cheers all!!




Offline TwoBadKneesUSA

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Re: which op to go for!!
« Reply #1 on: October 19, 2010, 03:13:27 PM »
I would get another opinion if possible.  With flat troclear grooves I don't think either surgery would benefit you.  A trocleoplasty can be done to deepen the groove and help stabize the kneecap.  A LR is only going to make the kneecap more unstable and is really only good for a very small number of kneecap issues.  I am not a doc, but if it were me, I would look at another OS.
'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 crankerchick

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Re: which op to go for!!
« Reply #2 on: October 19, 2010, 06:11:27 PM »
I second getting another opinion!

Why have a surgery on one knee that already didn't work on the other knee, by a doctor that won't even see you anymore to answer any questions?

Lateral release is only really called for in very specific instances of patella tilt caused by tight lateral structures in a knee with no instability. It is entirely overused and a dangerous procedure in the wrong hands. What your OS and PT have said about an "abnormal reaction" to the LR just sounds like some straight BS to be honest. Have you read some of the stories on here about lateral release? Seen all the signatures of folks that have had LR only to have even more surgeries following it?

Not saying lateral release is the devil, but definitely tread very carefully. A second opinion never hurt anybody.
Mar '07 - plica excision
Oct '09 - femoral + tibial derotational osteotomy & TTT
Aug '10 - hardware removal
"You control your leg. Don't let it control you." -Smart trainer
"Get your a$$ in gear and go for it! Nothing will happen until you make it!" -Smart doctor

Offline duckie857

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Re: which op to go for!!
« Reply #3 on: October 20, 2010, 12:02:49 AM »
*looks up* What she said!

Be careful with the lateral release. Very few people actually need one and end up in a world of hurt because of it! Clearly, you've already had a bad experience...why do it to your other leg?
'04 - '10: Years of dislocations & subluxations

01/13/2010 - LR, MR, VMO Advancement
10/06/2010 - Fulkerson Osteotomy (TTT)
09/02/2011 - Scheduled MPFLr

Offline tessie

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Re: which op to go for!!
« Reply #4 on: October 20, 2010, 12:29:23 AM »
Thanks all for the replies, I guess I'm living in hope that the LR on the right was caused by no aftercare and that won't happen this time around on the left?!!

I would dearly love a 2nd opinion but not sure how to go about getting one? Any help again would be gratefully recieved!! As I live in Scotland I'm not sure how many surgeons there are in this field, my OS seems to be really over worked and work's for a few hospitals (private and NHS) as well as lecture at the medical school. He see's over 150 people on average every day in clinic (they publish this amount on the waiting list wall!!)

It's funny but after my diagnoses I did a wee bit of research on the net and thought it strange that a LR and TTT would be appropriate for my condition but as I was not the expert I put myself in the hands of my surgeon........

Unfortunatly my left knee is so bad now that every footstep is sore and performing basic tasks such as house work impossible, I'm on hefty meds for it (doesn't even touch the sides) and haven't slept through the night for over 18 months!!

I'm so scared to make the wrong decision and make matters even worse!! My gut instinct is that I'm being offered the wrong ops but it's so hard to make a rational decision when you are in so much pain that you tend to trust the so called proffessionals!!

Offline duckie857

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Re: which op to go for!!
« Reply #5 on: October 20, 2010, 12:58:59 AM »
Tessie,

I'm sorry, but I'm in the US so I don't know what sort of steps you need to go through to get a second opinion. Maybe start by calling your GP's office and seeing what they say?

Stay strong, it sounds like you've had a rough road. I know it's tough, but try not to make decisions based on the pain alone. It can be really easy to go with anything if it means that the pain might go away...but if it didn't work the first time, what's to say it will work now?

Good luck, keep us posted!
'04 - '10: Years of dislocations & subluxations

01/13/2010 - LR, MR, VMO Advancement
10/06/2010 - Fulkerson Osteotomy (TTT)
09/02/2011 - Scheduled MPFLr

Offline tez27

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Re: which op to go for!!
« Reply #6 on: October 20, 2010, 08:15:23 AM »
Tessie
sorry your going through all this but I must agree with the others and really think a second opinion is the way to go, I am also in Scotland and know the hassels with the nhs and the long waits etc but I would think that the next step should be to go back to your g.p, and explaine the whole situation and ask for a referral to another o.s, not sure where abouts in Scotland you are but if its possible to get to it the Golden Jubilee in Clydebank have a good orthapedic dept plus I know they have a hotel as part of the hospital where you can stay free of charge the night before your op if you stay too far away to get there for first thing if needed.
Good luck with everything
Take care Tez   
L K injured 25th June 2008
scope Jan 5th 10
diagnosis ACL rupture
fiberous band excised from acl
ACLr July 19th 2010  scope on 24th Sept 2011
ACL has failed incorrect tunnel placement
23rd July 2012 1st stage of a 2 stage ACL revision
10th May 2013 2nd stage ACL revision

Offline tessie

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Re: which op to go for!!
« Reply #7 on: October 20, 2010, 10:49:16 PM »
Thanks again all for such prompt and reassuring replies, I've got an appointment tomorrow at my G.P, so finger's crossed he'll be able to refer me on for a second opinion. I'm based in Edinburgh Tez, so fairly central for most parts of Scotland, thanks for the hospital recommendation!!

I got my PT to write down the medical term for my dodgy knees, apparently I have " patellofemoral dysplasia with lateral patellar tilt in the femoral trochlea grove and hypoplasia of the patellar facet" !!!!!! Does that change anything???















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