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Author Topic: AF after fat pad debridement - should I have surgery to fix?  (Read 11981 times)

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Offline josowiam

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Re: AF after fat pad debridement - should I have surgery to fix?
« Reply #15 on: April 14, 2011, 08:12:08 PM »
Hi all,

Appreciate the responses.  I have scheduled surgery with Dr. Steadman for Wed. 6/1/11.  I think I am going to try to stay in Vail for four weeks if possible.  Does anybody else have experience with LOA from Steadman and staying in Vail for an extended period?  Does four weeks sound reasonable, excessive, not enough?

Any recommendations as to places to stay, etc?  Hopefully a good surgeon plus an extended rehab in Vail only means that one more surgery will fix this problem!



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Re: AF after fat pad debridement - should I have surgery to fix?
« Reply #16 on: April 15, 2011, 05:28:47 AM »
I have come across a number of posts by Jaci that provided very useful information about accommodations in Vail. Here are links to a couple of posts that also contain functioning links to accommodation sites.

You might want to also call the clinic and talk to somebody there if they have any updates on recommendations for staying there.

I don't know if four weeks sounds reasonable, you might want to check with Sr. Steadman's assistant on that as well, they would have a better idea. But it's probably not a bad idea to err on excessive and to be flexible if needed. It looks like Vail has a 11% bed tax if you rent something for less than 30 days so renting it for the whole month might be cheaper. If they tell you at the clinic, that you don't need to stay there for four weeks but you can do it, you might want to book it anyway because you will take time to re-hab one way or another and it might be easiest and the safest for a good outcome to do it on location. The Steadman clinic has an awesome PT department from what I have read.

Good luck!

Offline mleung41

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Re: AF after fat pad debridement - should I have surgery to fix?
« Reply #17 on: March 19, 2020, 07:49:18 AM »
I am pretty new to AF as well, just having found out that I had AF a few weeks ago when an OS in Seattle diagnosed me and suggested arthroscopic scar tissue removal

when you had AF pre-op, what were some things you couldn't do physically

Offline mleung41

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Re: AF after fat pad debridement - should I have surgery to fix?
« Reply #18 on: March 19, 2020, 09:19:13 AM »
Hi all,

I hope some of you who have gone through similar experiences as me can help me make some tough decisions.

In November, 2010 I had a "routine" exploratory scope to try to determine cause of sharp, antero-lateral pain that I would experience only while running.  Other than this pain during running, my knee was fine and strong.  During my consultation prior to surgery, I explained to the ortho that autoimmune diseases run in my family and asked if that should be considered before surgery.  He did not indicate any reasons to avoid the routine scope.  The scope lasted 10 minutes and involved debridement of my fat pad which was slightly hypertrophic.

Beginning days after surgery, things began to go wrong.  My knee swelled up like a grapefruit for several weeks, I was not able to walk at all for 2 weeks and was not able to walk down stairs properly for up to 2 months.  I began doing PT the week after surgery and nobody suspected that I could be forming scar tissue in my knee.  In fact, I was able to gain virtually full ROM in both extension and flexion.  However, as time went on, I noticed large lumps around my patellar tendon, extreme knee stiffness, and an inability to do any quad strengthening exercises.  For the first 2 months following surgery, my ortho was completely unavailable and would tell me to speak with his PA who would just tell me that everything is fine and to be patient.

Fast forward to today and my knee has continued to worsen.  I am beginning to lose some ROM in flexion and the knee is extremely painful when pushed to full extension or when attempting a quad set.  When attempting a sitting knee extension I can not bring the leg back to a resting position without extreme pain and loud popping/crackling throughout the knee.  I can not do a squat without a great deal of pain and certainly can not run, etc.  In the weeks following surgery I was able to do a stationary bike but even a bike now seems to cause a lot of kneecap pain.  I do however still have virtually full ROM, granted this comes along with pain.  I have some patellar mobility but it is very limited as compared to the good knee.

I recently had an MRI that showed "extensive fibrosis" in both my lateral and medial fat pads and the fat pad fibrosis has become fused to my patellar tendon.  After discovering this website, I recently sought an opinion from Dr. Noyes in Cincinnati who immediately recommended an open debridement with proximal Z-plasty.

As I do still have nearly full ROM, I am wary to rush into another surgery.  I can currently walk, still work full time, etc. and I am very scared that an additional surgery may result in new scar tissue being formed making my situation even worse!!  Without surgery, can I expect my knee pain, ROM, etc. to get worse and worse or are there any non-surgical things that I can do at least for the next few months to see if I can avoid another surgery?  My ortho who conducted the surgery seems to have very limited experience with AF and has been little help.  Is surgery really my only option?  Has anybody had luck with other non-surgical treatments/PT to improve AF?

Any feedback would be greatly appreciated!!

Hi OP, man am I happy to find your post. I've had quite the journey and saw my life turn upside down.

I also had a fat pad debridement with severe complications. I regretted the surgery immediately, but have been managing the fallout 7 months ago ever since.

I'm 7 months out and I still have several issues:

-sunken area of skin on the lateral scope of my knee is depressed inwards. when i extend my knee it is pronounced that something is missing
-trouble loading my patellar tendon
-trouble getting out of a chair where I put too much weight on my bad knee
-impossible to do a pistol squat on my bad knee
-impossible to run, always limping when walking
**have you had any of these issues too?

-what did you end up doing with your AF? how are you doing now?
-Do you know how much fat pad they debrided?
-do you have any problems with deep squats or kneeling now?