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Author Topic: 2nd opinion - UK private costs? Advice appreciated...  (Read 13282 times)

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Offline Brambledog

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2nd opinion - UK private costs? Advice appreciated...
« on: August 31, 2011, 04:52:01 PM »
Hi,

I've been reading around KGs quite a bit and gleaning some of the accumulated wisdom and experience here. I have severe patellofemoral arthritis and I need to find an OS who has a particular interest in it to make sure I get the best advice on what is best to do. I'm only 40 so I want to make sure any surgery I have is the right one.

Obviously as I've already seen an NHS OS, I'll have to pay to see a different one. Can anyone who has done this give me some idea of the kind of costs involved? I know a 2nd opinion initial consultation is around 250, but that's a bare minimum and I'd like to be prepared for the sort of costs I'd be looking at if I had a surgery privately. We are not in a great position financially and i need to be going into this with my eyes open.

Thanks in advance.
 ;)
2009 - diagnosed coeliac
Aug 2011 - L knee arthroscopy
Aug 2011 - diagnosed PF arthritis L knee
Nov 2011 - diagnosed CRPS L knee
Dec 2011 - MRI R knee, PFOA is worse than L!
June 2012 - no surgery 'til TKR's
Nov 2012 - CRPS spread to L foot/thigh, increasing pain
- Worsening pain/symptoms R knee
;-)

Offline Lottiefox

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Re: 2nd opinion - UK private costs? Advice appreciated...
« Reply #1 on: August 31, 2011, 09:28:23 PM »
I have sought a couple of private opinions, so can only give you the costs I have paid. I have also gone through private foot surgery...

Initial consults - depends on area but between 150 amd 250 seems to be the norm. Then every follow up will be between 90 and 150 from my experience.

X-rays - I paid around 50 per image/angle - so my foot had standing and lateral and was 99.00.
MRI scans - ouch - depends on the type but I had a T2 image scan done and CT tracking and they took pity on my credit card and charged me 900 instead of 1200....
Surgery - for a private scope I was quoted around 3500 plus surgeon's fee and anaethetist. I have managed to avoid surgery on the knees so far! For my foot surgery the surgeon's fee was 1200, the sleepy man was a bargain at 250 and the hospital costs were the killer at 3300 for the surgery and one overnight stay. I did get some free drugs when I left. And Sky. And loads of nurses, loads of drugs, a nice dinner, and it was spotless.

If you start looking at funding anything more extensive than scopes it gets really scary. I happened to glance at rough costs that my London OS was describing and a TKR was around 12,000 with a partial around 8,000 or more. Things like MACI just get really costly.

It is always worth seeking more views. You may find a consultant who is then willing to place you back into the NHS system, that has happened to me for something unrelated to knees/feet but I am not sure how common that is.

Where in the UK are you based?

Hope this helps, even if it is scary.

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 UK Girl !

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Re: 2nd opinion - UK private costs? Advice appreciated...
« Reply #2 on: August 31, 2011, 09:47:43 PM »
would your gp not be able to reccommend a particular consultant and then you could see that person - we do now have the right to see who we want !


When my 'good' knee got to the point of needing a consultant I requested to see the same person that had done my knee replacement but because he is in such high demand I had to wait longer than normal to see him but it is so worth it to get the right man !
1978 - ruptured acl and all cartalidge removed.
several debridements over years
TKR 10TH JULY 2006 http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=28257.0  Aug 07 patellar maltracking - more physio! Still pain - but so much better !
BIOMET AGC  TKR  (with 10 yr warranty !)

Offline Brambledog

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Re: 2nd opinion - UK private costs? Advice appreciated...
« Reply #3 on: August 31, 2011, 10:41:14 PM »
Thanks Lottie (again!) and UK Girl,

Have I got this all wrong then?! I thought that as my GP sent me to my OS (who did my scope) through the NHS that I had to stay with him and do as he recommended, and that if I wanted a second opinion and any treatment I had to pay for it privately.

If I've got this wrong then that's great. I'm in Gloucestershire. Could I ask to see an OS in another county like Oxfordshire or Bristol?

Lottie - that's fantastic detail, thank you, although I can see the charges amounting to scary levels...

 ;)
2009 - diagnosed coeliac
Aug 2011 - L knee arthroscopy
Aug 2011 - diagnosed PF arthritis L knee
Nov 2011 - diagnosed CRPS L knee
Dec 2011 - MRI R knee, PFOA is worse than L!
June 2012 - no surgery 'til TKR's
Nov 2012 - CRPS spread to L foot/thigh, increasing pain
- Worsening pain/symptoms R knee
;-)

Offline Lottiefox

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Re: 2nd opinion - UK private costs? Advice appreciated...
« Reply #4 on: August 31, 2011, 10:49:32 PM »
You are entitled to seek a second opinion through your GP. They will probably put up many reasons why you can't! You can ask to be referred to a different place, through the Extended Choice Network that even covers many surgeons working in private hospitals that the NHS contract with, or through Choose & Book. The problem is this - the request goes before the PCT in your home county. They look at what you're asking for, consider why, and decide if you have to be seen outside their area but with them still funding you. Hopefully they say Yes. If they say No you can challenge it.

If you do ask for this through your GP make sure you are certain on who you want to see and why. Don't just go a new orthopaedic surgeon as they'll probably say the same thing. Unfortunately choices are limited by both funds and the spectrum of knowledge of many knee surgeons. So many still do pointless things like lateral releases as a catch all "cure" or don't understand patella issues.

My one thing to highlight would be to find someone who can tell you WHY you have severe patella OA at your age. No point trying to fix something if the root cause is still there. Has anyone talked to you about what is going on in your knees/kneecaps from a structural point of view.

Gosh I have verbal gushing tonight - its my bedtime. I am a transfer window widow, that is why!

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 Brambledog

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Re: 2nd opinion - UK private costs? Advice appreciated...
« Reply #5 on: August 31, 2011, 11:06:18 PM »
Lottie you do make me chuckle  ;D , thanks yet again.

That is good news. I'll make sure I do my research before going to my GP.  I like my OS, but having looked at his profile info and interests, he doesn't list patella arthritis as an interest, and some of his comments were very general when I was asking questions. No reasons why or structural info. I certainly had none of the physical tests that I now know would have been helpful before they did my scope and found the PFA.

I've found 3 OS who list PFA as a special interest, Max Gibbons in Oxford, Jonothan Eldridge in Bristol and Bath, and Shivanand Geeranavar in Birmingham area.

Can I ask whereabouts you are and anyone you would recommend?

;)

Sleep well - transfer window has closed now, so you should be ok...!

2009 - diagnosed coeliac
Aug 2011 - L knee arthroscopy
Aug 2011 - diagnosed PF arthritis L knee
Nov 2011 - diagnosed CRPS L knee
Dec 2011 - MRI R knee, PFOA is worse than L!
June 2012 - no surgery 'til TKR's
Nov 2012 - CRPS spread to L foot/thigh, increasing pain
- Worsening pain/symptoms R knee
;-)

Offline Lottiefox

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Re: 2nd opinion - UK private costs? Advice appreciated...
« Reply #6 on: September 01, 2011, 07:28:28 AM »
Hi Bramble

I am in Warwickshire, I have seen three different people (I don't like to leave things to chance!!)

I have my Euflexxa injections through Glyn Evans at the London Knee Clinic at the London Bridge Hospital. He is a decent bloke. Very informative and down to earth. I know he is doing a fair few PFJRs so I guess he must understand patella arthritis. He is quite old school and conservative, but that isn't always a bad thing. He has never pushed me to surgery. He does a great knee injection! His secretary is always helpful so you could always drop him an email and see what he thinks before you book. Check out the website and send Carole Segger a query.

I have also seen Anan Shetty in Chatham, Kent. This was borne out of the Cartifill work. He is the pioneer of this in the UK. It is a new repair technique that will be helpful even for patella lesions from OA so long as they are under 3cm squared in size. Hence the T2 mapping to establish if mine were. (Yes - just!!). He is a lovely man, totally immersed in his research and development and very forward thinking. A little chaotic but there are several people on here who have had surgery with him - two with Cartifill and they seem to be doing well. Tough to get it on the NHS as officially it isn't funded or approved by NICE but he has ways and means.....

I also saw a guy in Solihull who did my friend's double ACLr and various other football injuries but I didn't like him and wouldn't recommend! He made me cry!!

The Wellington in London also has a good knee unit - Mr Rahul Patel has done work on one of the KG members here and is well respected. There is the RNOH in Stanmore who do a lot of knee work. Tim Spalding in Leamington Spa has a good reputation too, and has worked on another KG member Rennschenke who had MACI with complications. Never met him though! Finally there is an excellent patella man in Norwich if I recall correctly. I need to dig about in my brain for his name.

Obviously this is only my personal views. I am not endorsing any particular surgeon especially as I have never had surgery on my knee! Ask me for a foot surgeon and I'd stake my life on my one. he is wonderful. But, he doesn't do knees....

Lottie x

PS Transfer window closed....only another what....8 months of football now??  ::)
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 Brambledog

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Re: 2nd opinion - UK private costs? Advice appreciated...
« Reply #7 on: September 01, 2011, 08:50:59 AM »
Hi Lottie,

Yes I had Tim Spalding's name with a '?' as he mentions patella interests but didn't mention PFA. Definitely don't want to pay to have your friend's OS make me cry! I can do that all by myself...

I'll keep researching...

;)

ps - my husband supports Liverpool and they are top for a change so he's a happy bunny - it won't last though, they'll play someone soon that they should beat easily, and play like muppets. Might get a week or two off then...  ::)
2009 - diagnosed coeliac
Aug 2011 - L knee arthroscopy
Aug 2011 - diagnosed PF arthritis L knee
Nov 2011 - diagnosed CRPS L knee
Dec 2011 - MRI R knee, PFOA is worse than L!
June 2012 - no surgery 'til TKR's
Nov 2012 - CRPS spread to L foot/thigh, increasing pain
- Worsening pain/symptoms R knee
;-)

Offline Lottiefox

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Re: 2nd opinion - UK private costs? Advice appreciated...
« Reply #8 on: September 01, 2011, 08:59:05 AM »
My husband is also a Liverpool supporter. As you say, it won't last. But the good fortune at the moment means it is a happy house! (Actually it is always a generally happy house, he just laughs when they loose to someone like....Exeter...or....Scunthorpe....

 ;D

Keep smiling,

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 Brambledog

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Re: 2nd opinion - UK private costs? Advice appreciated...
« Reply #9 on: September 01, 2011, 09:23:45 AM »
 ;D exactly!  ;D

What were the chances of that then? Plus of course you're a Garfield too...

;)
2009 - diagnosed coeliac
Aug 2011 - L knee arthroscopy
Aug 2011 - diagnosed PF arthritis L knee
Nov 2011 - diagnosed CRPS L knee
Dec 2011 - MRI R knee, PFOA is worse than L!
June 2012 - no surgery 'til TKR's
Nov 2012 - CRPS spread to L foot/thigh, increasing pain
- Worsening pain/symptoms R knee
;-)

Offline Lottiefox

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Re: 2nd opinion - UK private costs? Advice appreciated...
« Reply #10 on: September 01, 2011, 10:18:22 AM »
All the best people are Garfields.  8)

Lottie x
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 Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
Re: 2nd opinion - UK private costs? Advice appreciated...
« Reply #11 on: September 01, 2011, 05:59:11 PM »
Hi Brambledog,

I would suggest going to Droitwich Knee Clinic that just up the M5 junction 5 and would be seeing the top knee surgeons in the UK. You say you live in Gloucestershire and Worcestershire is the next county and is worth going there for a consultation.

http://www.kneeclinics.co.uk/

Also Mr Oliver Schindler is an excellent OS to go and see and says he works in the BMI Droitwich Spa Hospital so could see him for a consultation and would be my 1st choice!

http://www.oliverschindler.co.uk/

Nick  :) {2011} :)
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline Brambledog

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Re: 2nd opinion - UK private costs? Advice appreciated...
« Reply #12 on: September 01, 2011, 06:07:22 PM »
Thanks Nick! I'll read up on them...

 ;)
2009 - diagnosed coeliac
Aug 2011 - L knee arthroscopy
Aug 2011 - diagnosed PF arthritis L knee
Nov 2011 - diagnosed CRPS L knee
Dec 2011 - MRI R knee, PFOA is worse than L!
June 2012 - no surgery 'til TKR's
Nov 2012 - CRPS spread to L foot/thigh, increasing pain
- Worsening pain/symptoms R knee
;-)

Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
Re: 2nd opinion - UK private costs? Advice appreciated...
« Reply #13 on: September 03, 2011, 11:54:13 AM »
Hi Brambledog,
 
Glad my link has come in useful for you and hope you find the right OS for your knee condition. Another OS that treated me is Mr Marcus Green who came across as a really nice guy and has a dry sense of humor and a very down to earth guy who you can have a laugh and joke with.

http://www.bmihealthcare.co.uk/consultant/consultantdetails?p_name=Marcus-Green&p_id=41250

I know Birmimgham is a bit further north for you to travel and it is only about 4 miles off junction 3 of the M5 so on the south west side of Birmingham and works both private and NHS. Mr Green works at The Birmingham Knee & Shoulder Clinic that based at the Edgbaston Hospital and has treated some Warwickshire cricket players and other professional sports men and women. My PT said he the best OS you can see in the West Midlands region.

I saw him in April 2009 at the Edgbaston Hospital and think it cost around 230 for one consultation and think it was around 90 for a follow up. He managed to locate the knee pain and gave me a cortisone injection. I then saw him on the NHS at the Birmingham Royal Orthopaedic Hospital where I had my right knee scoped and his Registrar did the surgery.

http://www.bhamknee-shoulder.co.uk/

Nick :) {2011} :)
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline Brambledog

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Re: 2nd opinion - UK private costs? Advice appreciated...
« Reply #14 on: September 03, 2011, 01:08:12 PM »
Hi Nick,

Thanks again. That's really useful - I'll read up on him. I'm going to get to the end of my 3-month post-op healing time and then give the hydro and physio a real go until I see my OS again at 6 months post-op. Then I'll see what he thinks and get a 2nd opinion after that.

Seems an awfully long time away!

 :)
2009 - diagnosed coeliac
Aug 2011 - L knee arthroscopy
Aug 2011 - diagnosed PF arthritis L knee
Nov 2011 - diagnosed CRPS L knee
Dec 2011 - MRI R knee, PFOA is worse than L!
June 2012 - no surgery 'til TKR's
Nov 2012 - CRPS spread to L foot/thigh, increasing pain
- Worsening pain/symptoms R knee
;-)















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