Lateral Release...Is it worth it??

[Tinkerbell11]

He seems to no what's he's talking about .... One thing I would advise is work on buliding ur quads so there as strong as possible that's been my problem sinice my lr good luck and all the best xx

[rob43]

your be fine in 4months time your be glad you had it done!

[aaa]

I had my surgeon tell me the same sort of thing, but the LR wrecked my knee.

It wasn't even the MRI, he told me I can severe tilt with a camera inside my leg ... how does a surgeon screw that up??

Anyway, on the one-hand I can't help but really hesitate to write this post since your surgeon is giving you confidence this will work.  On the otherhand, you need to be careful if your surgeon does this as a first-line treatment for patello-femoral maltracking. 

Could you ask him what type of surgeries he does for PF (patello-femoral) maltracking?  If it is only LR's and TTT's, that may be a bad sign.

I'm sorry, again I don't want to make you paranoid, but I've had a failed LR that needed reconstruction.  The LR is sometimes indicated, but quite rarely.  There is a study that among Surgeon's with a special interest in PF issues, the LR is done in less than 2% of their surgical treatments involving PF problems.

Another thing - if your knee was stable prior to your injury and became unstable afterward, a LR is much more likely to  fail.  The key thing to find out if your knee was stable prior to getting hurt is what damaged happened to your knee. 

[rob43]

there are plenty people out there, who has had a LR and its failed but 99% of them always right on forums lol
there are just as many that have it done and it works fine! so best bet is if the surgeon is sure then go with it, they know more about this stuff than we do!

[aaa]

Rob,

That is a false statement.  A failed LR is not that uncommon a scenario.

I have dealt with mine for over 2 years.  I went back to the OS who did mine after I cornered him with assessments from 2 world-renowned PF specialist.  At last, he admitted 50 percent of his LR's failed, and he's been practising for 30 years.  It became part of basis for my country to cover me out-of-country to get it fixed.

Basically, he admitted he was unaware of other treatments avaialble, and he simply didn't know.  He figured an LR was the only thing to try as a last ditch effort.  He gave me A LOT more confidence prior to the surgery but had to admit the truth later on.

[rob43]

no it isnt i know 5 people who have had a LR 4 have been a success myself being one of them!
ive had both knees done
i know plenty of people it doesnt work for but there are plenty it does,
is it down  to a bad surgeon if it doesnt work?

[aaa]

There are some long-term studies on the LR

Here is a study: http://ukhcforums.uky.edu/cartilage/articles/lateral.pdf

After 4 years, 63.5% of patients are happy with LR

Within 4 years it is a lot better - 80%.  But as you see, longer-term the results aren't good, 63.5% is pretty low.

IMHO the longer-term results matters more, and 4 years isnt' generally all that long in persons lifetime.

The worst part of it, is 35% of patients have another dislocation after their LR.  That is a huge number!  The reason is thought to be the lateral retinaculum provides medial stability.  That sounds counter-intuititve, but as the kneecap glides laterally, at some point the lateral reticulum tension will start holding it from dislocating.

I will have to find another study, but I believe after 8 or 10 years, patient's report they are unhappy with the LR in more than 50% of the cases.

The evidence seems to point at increased arthritic changes from removing a key stabilizing  structure in the knee.

[allyd]

If the OP is comfortable with her decision she made WITH HER OS. Who are we to question it?

Yb - Rob is simply trying to share a success story of himself (and others) to encourage the OP that it does not always turn out to be the extreme case w/ complications such as yours. A varying point of view of success is EXTREMELY important on this board. They help give a more balanced awareness to the procedures proposed. It is unfair to be dismissive of a person’s success because a study says it’s impossible. I’ll take a person in the flesh (both good & bad stories) over statistics collected w/ the intent to prove a specific hypothesis any day. 

I also know at least 4 people with a LR. They are all fine. I’ll share my sister’s story, who you will say proves your point – but I believe proves a more important point of life can go on just fine. At age 16 had LR after dislocation. (24 ys ago when in hot supply) continued to have dislocations intermittently over the years. 2 years ago had a scope to clean up some cartilage damage. Now, if we are collecting data for said mentioned studies: yup – it failed, arthritic changes, etc, etc, etc. Well let’s look at the individual: Over these 24 years, has been very active, continued playing varsity basketball in HS after, played volleyball, softball, etc in rec leagues continually over the years. Chases her 7 year old son all over the place. Moral: it didn’t fix the problem it set out to fix – but no regrets or short/long term complications from it, and did not make any lifestyle changes. Life went on just fine.

I will always agree that a LR is over performed and often done when not indicated or necessary. But people on a whole are not going to end up crippled.

[aaa]

Did I say she shouldn't go ahead with it?  No.

I suggested asking if her OS does this as a first-line treatment. 

Saying that 99% of people who have failed LR's is inaccurate, and I tried to provide some research on the success of LRs.

There are several cases on these boards of people asking about LR's prior to having them done who come back with a failure at some point in time.

Your case you mentioned - that would have qualified as a success by the terms of the study.  The study was based on patient feedback with their level of activity after the LR.  A large number were unhappy with the results.

[vickster]

Your case you mentioned - that would have qualified as a success by the terms of the study.  The study was based on patient feedback with their level of activity after the LR.  A large number were unhappy with the results.

I would hazard a guess that this would not be unusual for any knee surgery especially those performed in young, active populations (e.g. ACL, meniscus, PKR, ACI, perhaps not TKR)...? 

[Lottiefox]

I kind of think the LR debate could run for ever on every thread that asked about it. The OP has had some varied suggestions and advice on here. Clearly she has got herself extremely worried but has reached a decision that is now right for her. Not sure all this information is helping an already very concerned individual!!  We may feel we would do differently but I think sometimes despite conflicting evidence you just have to go with your OWN decision. I had a fusion in my big toe. MANY internet forums told me I'd never run, never be able to stand on the one leg, never find shoes that fitted, always walk with a limp. None of those have happened to me. Yes I have complications from nerve damage but thats the nature of surgery - things you don't plan for CAN go wrong and my surgeon's skill was 100% in the fusion surgery. Unfortunately the arthritis in the toe had damaged nerves and they didn't like the whole process. Nothing anyone could have known beforehand, and my body reacted badly to it. I guess I'm saying we reach a point where we HAVE to decide on something and when we have, this board should support. I have been guilty of banging on about LRs and yes, I honestly believe they are used too often and without proper investigations. But thats probably from seeing the bad outcomes on here!

Good luck with the surgery CountryGirl. Keep us posted.  

[aaa]

^ Yes agreed.

CountryGirl if you go ahead with the LR,  I wouldn't think you are crazy for doing it - not that it matters what I would think anyway

If you do it, I hope it works out 100%.  My advice was just some suggestions about things you may want to ask your OS if you didn't already, and consider your pre-injury vs. post-injury state of your knee and if the LR makes sense to you to correct an injury (I was making an assumption you pre-injury state you had a stable knee).

Best of luck.

[LKnees]

As long as you're aware of the success rates and risks, then you can make an informed decision. A lot of us weren't.

[Alicat]

i think a big problem with forums is those for whom the operation is a complete success have received all the support they require and silently disappear from the conversations, they don't see the need to stick around when all is going well after all you only usually need advice when something isn't going to well so you get a higher proportion of people with problems getting in on the discussion so its not well balanced. Its the same with reviews on shopping sites you often don't think to tell someone your new kettle is amazing but if there was a fault you think you need to tell the world. Luckily some people with success stories do stick around to balance the discussion and allow us both sides of the story its just usually less of them

[CountryGirl]

I didnt start this fourm to start fighting. i need support and advise. obviously iv seen that the LR isnt the greatest surgery to go thru with...but its like standing on a cliff where your about to be eaten by a bear or you could jump into the ocean an hope the waters deep enough to survive. i really dont know what else to do. and i told that same thing to my doctor. he point blank said that this is not something he recommends or tries to do to patients often infact he trys to steer away from LR bcuz of their bad rep. and failure to actually fix the problem. he said he wouldnt be putting me thru this if their was another choice. and i beleive him. their are people in this world who are generally good people and just try and help. then theres people who will do anything for money and i myself look at people and ask wich they are in my head. iv seen this doctor a few times and i really think he is the kind thats just trying to help out. i asked so many questions it was unreal...infact i had a list of things to ask him. so i was very aware of what i was getting myself into by going thru with this surgery. i can only hope for the best. knowing dang well this is my last option besides just living with the pain. iv done physio twice and nothing helped. everyone said i was too "inactive" so i took a job where i had to do alot of moving and it deff. didnt help. its not that i dont beleive you guys when you say LR is a crapshot but im staring at the rest of my life im not 40 and already into my career and all that good stuff im 19 yrs old still in school with dreams to the moon and back. i hafta beleive this will work. i just have to. and im not asking any of you guys to agree with my descision im just asking for your advice and support and i thank you all for all the info you have gave me good and bad.