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Author Topic: 2nd opinion - UK private costs? Advice appreciated...  (Read 13283 times)

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Offline anna82marie

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Re: 2nd opinion - UK private costs? Advice appreciated...
« Reply #15 on: September 04, 2011, 02:01:34 PM »
I see Mr Wilson in Basingstoke and North Hampshire hospital. I trust him to deal with my knee and would happily recommend him to anyone!

http://www.kneeguru.co.uk/KNEEsurgeon/wilson02/index.php?memberid=1112

Have a little read up and see if you think he could help you.


Offline Brambledog

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Re: 2nd opinion - UK private costs? Advice appreciated...
« Reply #16 on: September 04, 2011, 03:05:09 PM »
Hi Anna,

I've had a read up on him, like the fact he seems so enthusiastic and forward-thinking. Doesn't mention patellofemoral arthritis at all, but seems to know a lot about problems with the patella. When I get that 2nd opinion I'll maybe see him... I'm going to wait until I see my guy again in feb before deciding what to do.

H x.  ;)
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 vickster

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Re: 2nd opinion - UK private costs? Advice appreciated...
« Reply #17 on: September 04, 2011, 04:23:49 PM »
Interesting to read feedback on Mr Wilson.  I had looked at his profile and website when it was mentioned after my last scope that I may need a DFO to deal with my dodgy valgus alignment and protect my tatty lateral cartilage.  I was treated by one of the OS's from the RNOH (second OS, referred as insurance company wouldn't play ball), no doubts whatsoever about his skill, very expert especially in cartilage repair, but I would certainly want a further opinion before anyone goes near my thigh bone with a saw!  :o   Mr Wilson looks to be very expert in matters of osteotomy (has written the section on here for starters).

Fortunately, all is pretty calm on the knee front for me - I put it down to stronger leg muscles due to a lot of cycling (oh and not trying to run or kneel with any force)!

To add on the cost front - although I have insurance through work, I did see all of the bills (I think if you self pay the rates tend to be better than those charged to the insurers, but as an outline).  These are in line with what Lottie said earlier

Initial OS appointment - around £250, each follow up appointment, £120-150ish.  MRI with discs, report etc, around £600 at the hospital locally to me, X-rays around £100.   Scope - for surgeon and anesthetist, around £1000-1200, hospital bill around £2500 (day op); physio privately usually around £40-60 a session (my new physio was £50 for first 1hr appointment, £42 for 30-45 min follow ups). 

Depending on what you have done, the cost can add up very quickly - over the 18 months I was receiving active specialist treatment (2 scopes, 2 MRIs, countless OS & physio appointments), I reckon it has cost the insurers close to £15k  :o (we have just switched providers, they'll be glad to be shot of me I reckon).  IF I had been eligible for the MACI in December, would have been another £10k I reckon (I think an osteotomy is relatively cost effective in comparison)!

After my second scope, I had my stitches removed on the NHS by GP nurse - for free (wasn't prepared to make a 3 hour round trip to the hospital for a 2 minute appointment!)

Good luck Brambledog :)
« Last Edit: September 04, 2011, 05:03:04 PM by Vickster »
Came off bike onto concrete 9/9/09 (lat meniscus, lat condyle defect)
LK scopes 8/2/10 & 16/12/10
RK scope 5/2/15 (menisectomy, Hoffa’s fat pad trim)
LK scope 10.1.19 medial meniscectomy, trochlea MFX
LK scope 19.4.21 MFX to both condyles & trochlea, patella cartilage shaved, viscoseal, depo-medrone

Offline kneesurgeonvictim

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Re: 2nd opinion - UK private costs? Advice appreciated...
« Reply #18 on: September 04, 2011, 04:39:38 PM »
Be very careful. is my advice. I had some advice that I accepted on face value because I initially respected the knee surgeon and now I have worse problems than before plus a £10,000 hole in my life savings. Don't feel that questioning advice given by a surgeon is to disrespect that surgeon. Sometimes surgeons can think that every problem can be resolved with one solution. Don't disregard the value of physiotherapy. I was extremely fortunate to come across a physio who was outstandingly good - Clare Robertson - who managed to get me from a state of agonising pain and unable to walk properly after my surgical experience to a state in which I could walk without pain by selectively strengthening the various muscle groups that support the knee. What I learned from the brilliant physio experience was that sometimes rugby players and footballers have knees that are completely shot, but they keep going because their leg and knee muscles are extraordinarily strong. Some 'forward thinking' surgeons may scoff at physio - or not even mention it when considering alternatives - but in my opinion a surgeon who does not mention physio as a first course of action is simply no good, probably in the knee business as a means of accumulating wealth, and is best avoided. After my first knee experience when physio was not recommended as a first course of action I went to two clinics who did, and experience shows that the two clinics that did recommend physio were by far the best in terms of being patient centered.

One of the really important things to realise is if your knee has been painful for a while, it is likely your muscles may have weakened - possibly more than you know, and weakened knee muscles may be giving rise to more pain in a vicious circle. If you try a course of physio, try to find a physio who is exceptional as this is likely to give you the best chance of success. If I had had physio as a first course of action, perhaps I may have saved myself £10,000 and still be playing my favourite sport, but unfortunately this was not to be as I opted for surgery based on the surgeon's recommendation.

Only try surgery once you have exhausted every other option. Knee surgery is not a cure all, and it is possible knee surgery may leave you in more pain than before - especially if you have had no prior surgery. Avoid 'new' surgical developments and solutions that promise to restore your knee to new. I believe there is a very enlightening blog on the internet from someone who went for one of these new treatments and ended up on powerful painkillers and crying themselves to sleep at night with pain. That is the risk you may be taking. Don't sleepwalk into surgery.

Offline Brambledog

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Re: 2nd opinion - UK private costs? Advice appreciated...
« Reply #19 on: September 04, 2011, 05:09:24 PM »
Thanks for your posts Vickster and kneesurgeonvictim,

I am very aware that my leg muscles have wasted quite significantly, and that their strength will do for more for my knee than surgery will. My OS said to concentrate on strengthening exercises as the most helpful long-term solution. I certainly don't want any surgery unless I have to! That's the whole point in getting a second opinion of an expert in my particular arthritis at some point... Knowledge is power, both the surgeon's and mine.

As I've written on my post-op diary, I think I have an excellent straight-talking physio at the hydro pool, and I'm hopeful that my usual physio will be able to help a lot now that she knows my diagnosis.

No-one's coming near me with a saw!

 ;)
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 vickster

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Re: 2nd opinion - UK private costs? Advice appreciated...
« Reply #20 on: September 04, 2011, 05:14:05 PM »


No-one's coming near me with a saw!

 ;)


That is my current stance too, hence cycling 50-100 miles a week in all weathers!  :P  Just looking at Mr Wilson's stuff on the DFO is enough to make me skip-limp-run a mile at speed hobble pace!  You're lucky it isn't indicated for wonky patellas as far as I know!

PS I modified my post with some costs from my experience too
Came off bike onto concrete 9/9/09 (lat meniscus, lat condyle defect)
LK scopes 8/2/10 & 16/12/10
RK scope 5/2/15 (menisectomy, Hoffa’s fat pad trim)
LK scope 10.1.19 medial meniscectomy, trochlea MFX
LK scope 19.4.21 MFX to both condyles & trochlea, patella cartilage shaved, viscoseal, depo-medrone

Offline Brambledog

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Re: 2nd opinion - UK private costs? Advice appreciated...
« Reply #21 on: September 04, 2011, 05:23:04 PM »
Thanks Vickster, I saw you'd put all the costs in - very helpful if scary!

I don't have insurance (and no point applying for it now  ::) ), but if I start running out of options, or good advice, then I might just have to go for it and get that private opinion.

Hope I don't need to!

 ;)
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 #22 on: September 04, 2011, 05:46:24 PM »
Your life isn't truly complete until you've had a nice, personable man stroke your bones, then put you to sleep and attack a limb with a rapidly rotating little saw and smoother, and then screw in some funky titanium screws and a plate for good luck, stitch you up and send you on your merry (limping) way. And send you a bill for the whole charming experience. And then pull the stitches out a fortnight or so later. By hand. Without warning.  ;D

Personally I'd prefer an osteotomy over something like MACI. At least there is a clear cut aim and reason behind it, and plus bones are generally designed to heal if they are broken. Whacking new cartilage onto divots and hoping it grows is still such a long shot!!

Bramble I think you're right to wait. See how recovery goes, work on your muscles and take a call in Feb. But stay around here and keep us posted. We like you!!  :D

Lottie xx
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 #23 on: September 04, 2011, 06:27:51 PM »
Hi Lottie,

Loved the 'stroke your bones...' description!  :D. Strangely, I've never fancied any one, no matter how qualified, taking a rotating saw to any part of me...! Long may it stay that way.

Oh I'm not going anywhere for now, far too early on to think I've got all the answers yet. Besides, I quite like it here. Might stay for a bit.  8)

Hx.  ;)
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 vickster

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Re: 2nd opinion - UK private costs? Advice appreciated...
« Reply #24 on: September 04, 2011, 06:34:20 PM »
I think Lottie's toe-tale has now really put me off - weirdly, it is the metalwork that freaks me out more than the sawing - I guess as I'd be asleep for that one!    Obviously the pain associated with having my thigh bone broken (albeit in a controlled surgical way) isn't something to relish!

I do agree on the MACI front - glad I didn't have it, especially as with my knock-wonky knees more than likely it wouldn't have taken and as Mr S said in the understatement of the year, a DFO and a MACI is a lot of surgery in one go!  I of course have my super-duper diy fibrocartilage filling my femoral divot!  ;D

At least I wouldn't get the bill, but probably a small consolation!  I shall keep pedalling and running the traffic gauntlet, all good (even though my knee still doesn't like hills much).

Brambledog - as Lottie says, work on those muscles, cycling is pretty good as long as you keep the resistance low and don't annoy the patella (mine is broadly ok having been tidied but it is still around the kneecap where the complaints come from), also swimming (crawl better for knees than breast stroke frog kick) and when ready, the crosstrainer is pretty ok on the knees for most (personally as dull as ditchwater for me but hey).  My knee doesn't like rowing (which I do miss) or the treadmill - I am just cycling now, when the weather turns really nasty, I'll unfreeze my gym membership and get back to the boring indoors stuff.

Sounds like you have a good physio - so use her as much as possible for advice - there are a bunch of admittedly dull physio exercises which can help saggy muscles as well as the more active cardio stuff :)  

And definitely don't rush into surgery - I have recovered well from my second scope, but there is always a risk.  It may be worth considering a visco jab if the knee doesn't settle - Lottie loves her Euflexaa and I was stabbed with Durolane while under the knife and certainly had no ill effects.  My OS reckoned it would help the knee heal more quickly, may well have done, hard to say, but the recovery has been fairly smooth fortunately.
Came off bike onto concrete 9/9/09 (lat meniscus, lat condyle defect)
LK scopes 8/2/10 & 16/12/10
RK scope 5/2/15 (menisectomy, Hoffa’s fat pad trim)
LK scope 10.1.19 medial meniscectomy, trochlea MFX
LK scope 19.4.21 MFX to both condyles & trochlea, patella cartilage shaved, viscoseal, depo-medrone

Offline anna82marie

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Re: 2nd opinion - UK private costs? Advice appreciated...
« Reply #25 on: September 05, 2011, 08:54:09 AM »
You guys make me chuckle!  :D

I had my ACL and bony block removed under spinal and heard Mr Wilson's registrar talking about the chisel they were using inside my knee; yummy! It was so surreal that I actually wanted to watch what he was doing!

I think I have now avoided an osteotomy as I am at 5° extension following the chisel's destruction! I was at 20° before; go chisel, go!!  ;D

Happy Monday! x

Offline Brambledog

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Re: 2nd opinion - UK private costs? Advice appreciated...
« Reply #26 on: September 05, 2011, 09:28:53 AM »
Thanks Vickster, good advice. I've been holding off on the bike until I saw my physio again, particularly as the hydro physio said to leave the bike and weight-bearing exercises for now, and concentrate on getting the pain under control and the motion better. She gave me some different exercises to do for my quads that put least stress on my patellas, and we're working up from there.

Oh Anna - you make me chuckle too, but that one defintely had a small shudder in it! Saws are bad enough, now you bring chisels into it! What next? No, don't answer that...  :-X

Hx.  ;)
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 #27 on: September 05, 2011, 10:16:14 AM »
I think my lovely foot man had been to the whole of the tool section in B & Q.

As evidenced below....

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 Rknees4

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Re: 2nd opinion - UK private costs? Advice appreciated...
« Reply #28 on: September 05, 2011, 10:37:48 AM »
Man Lottie,
That is a lot of hardware for one little toe. :o
No wonder when you bonked it you felt the tears coming.
Rk4
Knee pain since teens
06/09 Patella mal-alignment grade 3/4 chondromalasia both knees, PFS
09/11/09 patella realignment,Trillat/LR/scope cleanupRK
10/02/11 patella realignment,Trillat/LR/scope cleanupLK
Cortisone LK 04/06/11
Scope LK,/RK HW removed 28/06/12
Chin up keep hobbling!

Offline Lottiefox

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Re: 2nd opinion - UK private costs? Advice appreciated...
« Reply #29 on: September 05, 2011, 10:55:54 AM »
The top view is quite funky too...

Rk4 - yep, smacking that lot did bring tears! Its astounding and testament to his skill that I cannot feel ANYTHING of that lot when I weight bear, walk, jump, pivot etc. I even jumped off a gate yesterday and landed on that foot as I didn't want to lane on left leg as thats the weakest kneecap...not a flicker of hardware sensation. My only pain/problems have come from the danged CRPS. Seeing that lot in there it isn't surprising that I got significant nerve upset and damage, so hopefully things will calm down. Having a calm day today, that DMSO (Does melt skin off) works a treat used after a shower, Epsom salts sock wrap and a coffee! (Coffee for me not toe..)  ;D

Here he is from the top down..

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....















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