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Author Topic: Bilateral MPFL Reconstruction-7/25  (Read 19575 times)

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Offline Teacher2Many

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #60 on: November 28, 2012, 02:44:18 AM »
So here's the latest scoop, for any that are interested:

Went to see another specialist yesterday, one that my OS highly trusts, and he, just like my OS I saw in MI, feel that the graft placement is wrong on both sides, sitting either too high or too anterior, which is what's causing all the pain and difficulty with flexion-the graft simply can't stretch that far due to off placement.  Treatment would be to completely redo the MPFLr-hate the fact that it's something that two well respected OS have mentioned as the cause but at the same time, love the fact that they mentioned it as an it's easy fix and more importantly, it's fixable.  My OS doesn't feel that's the case but doesn't know the answer either.  So I go back in about 6 weeks to see him, he'll do some thorough xrays, and then figure out what the plan of action is.  Either way, surgery is set for 1/23-if MPFLr is needed, it will have to wait until the summer as I refuse to subject my kiddies to a sub for at least four weeks.  Would be different if I could have timed it with winter break but no such luck.

This specialist also feels that I might need patella resurfacing due to the cartilage damage.  His recommendation is to cut off my icky part of the patella and then using a donor patella, cut off their healthy patella/cartilage and resurface mine with that.  Doesn't really sound fun to me!  When my OS does the diagnostic arthroscopic surgery on 1/23, he will be looking at any and all chondral damage to see if this recommendation is something to pursue or if there are other options.

The hip issue will have to wait-4 weeks on crutches (minimally) meant too much time off of work for now.  So it'll get postponed for the summer.  Ah, who needs to sit comfortably anyway; highly overrated!  :-)

Christmas is in less than a month (which will mark 5 months post-op as well)...man, how time flies when you're having fun!
6/07-L TTT & LR
6/08-R TTT & LR
6/09-Bilateral ACI
7/10-R derotational femoral & tibial osteotomies, LPFL reconstruction
6/11-L derotational femoral & tibial osteotomies, R hardware removal
1/12-L tibial hardware removed, R scapulectomy
4/12-L femoral hardware removed
7/12-L & R MPFL reconstruction

Offline YogaGirl

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    • my MPFL recovery + yoga blog
Re: Bilateral MPFL Reconstruction-7/25
« Reply #61 on: November 28, 2012, 01:23:58 PM »
I know it would be hard, but is there a way you could get the MPFLr done by the doctor in IN or MI? I mean, they seem to be on the same page, which is great... and your OS that may have placed the graft wrong isn't... I know the travel would be crappy, but if it meant getting it right and by people you trust, maybe you should look into it? Just a thought.

I can't imagine how frustrated you must be, but you've had a great positive attitude throughout this whole process! Keep it up! Its good to hear that they think its an easy fix!! Hopefully the patella and cartilage look better than expected in January! :)  My thoughts are with you, only a few more weeks til you get that holiday break!!
www.peaceloveknees.com <---- check out my MPFLr blog
www.brightskyyoga.com

Offline Teacher2Many

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #62 on: November 29, 2012, 03:35:50 AM »
Honestly, I didn't really care for the doc in IN.  I am eternally grateful as he's the one who noticed the rotational abnormalities two and a half years ago which sent me down the right path for that but those first impressions mean a lot.  Driving 3.5 hrs and I didn't even get his undivided attention, as he was checking in on other patients at that time.  The doc in MI would work but he is booking out a year in advance.  The travel would be bad for all-time off of work for my parents, hotel expenses, etc. but if needed, then it's something to consider.  For now, we are pushing harder in PT (and my burning eyes and extreme headache are proof from all the tears shed today) so that when I go back in January, I can say with 100% certainty that we're doing everything possible.  And I have no objection having it done again by my OS-he is wonderful and I trust him immensely.  Difficult right now only because it's hard to convey the magnitude of pain and limitations, etc. to someone else but only 6 weeks until my appt.-think I make it and WILL get answers by then!

Longing for the holiday break...so much on my to do list!
6/07-L TTT & LR
6/08-R TTT & LR
6/09-Bilateral ACI
7/10-R derotational femoral & tibial osteotomies, LPFL reconstruction
6/11-L derotational femoral & tibial osteotomies, R hardware removal
1/12-L tibial hardware removed, R scapulectomy
4/12-L femoral hardware removed
7/12-L & R MPFL reconstruction

Offline martussa

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #63 on: December 12, 2012, 09:33:41 AM »
Hi Teacher, I hope you're all okay!

I've got one question to you. As far as I remember you have good ROM and it isn't your problem. Now I'm around 110-110 at two months pst-op and my PT therapist gave me one exercise to improve it - and, to be honest, I really really hate it. I asked her about another one but she said it is the most effective and ended the topic. Maybe you know different exercises?
I'll explain mine: lay on the bed on a stomach with your healthy leg outside a bed. Put on your feet some belt and bend down to the buttock.

Offline Teacher2Many

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #64 on: January 03, 2013, 02:32:54 AM »
Haven't updated in a LONG time, mainly because there really hasn't been much to update and it gets pretty depressing to report the same 'sob story' of sorts.   :-[  I am undergoing bilateral surgery 3 weeks from today.  I was 'kicked out' of PT on 12/21 due to lack of progress with flexion, as the R has been stuck at 105-115 (active vs. passive) for the last 6 weeks without 1 degree of improvement either actively or passively.  Pain is still a huge factor as is tightness and limited flexion.  Flexion on the L is around 135 but it is definitely quite painful.  Both knees are catching and clunking quite a bit-subluxing vs. chondral defects; not sure but will get the definitive answer on 1/23 (I think more subluxing, doc thinks more of a chondral defect).  Surgical plan is to do a capsular release, clean out any scar tissue, and do a thorough scope to look at any and all chondral defects.  Nothing will get 'fixed' or 'repaired' until the summer when I am off to allow for a full recovery without wreaking havoc on my students' lives by taking extended time off now.

The L hip has been really bothering me lately and am regretting my decision to not have it fixed over Christmas break.  Doing so would have landed me on crutches for at least 4 weeks (doc was thinking more like 6 due to past surgical complications and bone healing issues), which meant at least 2 weeks off of work and I couldn't justify it.  My kiddos always have and always will come first and the thought of leaving them with a sub was absolutely horrifying, especially due to some of the challenges my particular group of kiddos have.  But at the same time, knowing that I will probably be having more knee surgery this summer, not sure when the hip will get done.  If this becomes reality vs. probability, hoping that they can do the knees and hip(s) at the same time.

Hope all enjoyed their holiday season and are starting the 2013 year on a great note!
6/07-L TTT & LR
6/08-R TTT & LR
6/09-Bilateral ACI
7/10-R derotational femoral & tibial osteotomies, LPFL reconstruction
6/11-L derotational femoral & tibial osteotomies, R hardware removal
1/12-L tibial hardware removed, R scapulectomy
4/12-L femoral hardware removed
7/12-L & R MPFL reconstruction

Offline Teacher2Many

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #65 on: January 14, 2013, 02:15:58 AM »
10 more days till surgery and more importantly, till we get some answers and a final plan in place!  So excited!!!!
6/07-L TTT & LR
6/08-R TTT & LR
6/09-Bilateral ACI
7/10-R derotational femoral & tibial osteotomies, LPFL reconstruction
6/11-L derotational femoral & tibial osteotomies, R hardware removal
1/12-L tibial hardware removed, R scapulectomy
4/12-L femoral hardware removed
7/12-L & R MPFL reconstruction

Offline Summer007

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #66 on: January 14, 2013, 08:25:25 PM »
Hiya Teacher2Many,

Good luck with your surgery when you have it! Hopefully you will get the answers that you want. I am also facing more surgery, just waiting on a date.

Please keep us updated with how it goes, my fingers are crossed for you!

Summer :)
October 2011-L LR
August 2012-L MPFL Recon
July 2013-L TTO & MPFL revision
March 2014-L Arthroscopy surgery

Offline Teacher2Many

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #67 on: January 17, 2013, 02:05:26 AM »
This time next week I will be recovering at home after surgery and doped up on pain meds AND will have the answers as to what's going on...the plan to fix it will come at my post-op appt. on 2/4 if not sooner!  Excited beyond belief, which I'm sure many think are weird to be 'excited' over surgery.

Hoping they'll do an injection in my hip and/or shoulder as well but might not get that lucky!
6/07-L TTT & LR
6/08-R TTT & LR
6/09-Bilateral ACI
7/10-R derotational femoral & tibial osteotomies, LPFL reconstruction
6/11-L derotational femoral & tibial osteotomies, R hardware removal
1/12-L tibial hardware removed, R scapulectomy
4/12-L femoral hardware removed
7/12-L & R MPFL reconstruction

Offline Summer007

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #68 on: January 27, 2013, 03:31:50 PM »
Hiya Teacher2Many,

Hope the surgery went well and that you have finally got some answers to what is going on! Fingers crossed for you on your post op appointment too!

Please keep us updated as and when you can. Summer :)
October 2011-L LR
August 2012-L MPFL Recon
July 2013-L TTO & MPFL revision
March 2014-L Arthroscopy surgery

Offline Teacher2Many

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #69 on: January 28, 2013, 12:22:51 AM »
Surgery was on the 23rd first thing in the AM and only took maybe 1-1.5 hrs. in the OR for both knees.  Bilateral LOA and MUA performed, along with a very thorough diagnostic scope to find any underlying issues that could be contributing to the other symptoms.  Post-op conversation with the doc is pretty foggy, which is a first for me as I usually remember everything quite clearly but think the pain med I took orally, in conjunction with those via IV, made me a little foggy in my recollection.

But from what I remember, the bilateral ACI sites looked good, which was a huge relief.  Not sure if there are other chondral defects that will need to be addressed as I can't remember clearly enough what he said.  I know going in that's what everyone was thinking (my OS, my OS in MI, and the one I consulted with in IN) was the main contributor to the painful crepitus, catching, and clunking, which is a million times worse now but I know in my head part of that is due to all the swelling.

Anyway, recovery is a breeze compared to the past 19 knee/hip surgeries I had done (yes, these two marked number 20 & 21 for the knees/hips, #26 and 27 for all surgeries).  I used the crutches just to get from the house to the car and then ditched them as soon as I got inside.  Took pain pills on the surgical day as prescribed, on Thursday I took one at 3 and one at bedtime (the knees were getting pretty sore around 3 from catching up on lesson plans, etc.), one at bedtime on Friday, and none since.  Surprisingly, the knees don't hurt at all!  My quads, however, are absolutely positively killing me!  Any kind of flexion or even resting something on my lap, such as my laptop or iPad is brutal.  Turns out that's a side effect of the manipulation-not one that always happens but not uncommon either.  Apparently my quads had gotten pretty tight from not being able to bend the knees fully and since he was able to get the heels to the butt with the MUA, that caused an excessive stretch on the quads and now I'm paying the price.  Hopefully that pain will let up over the next few days or hoping that I can at least find something to help.  Ice, nor the pain meds, nor heat seem to be doing the trick!

Swelling is ridiculous though, probably worse than the MPFLr; joint line is hardly visible and my kneecap well...let's just say it's lost in all the swelling!  Active flexion while supine is about 66 on the L and 54 on the R but I know a lot of that is due to the swelling and due to the quad pain, as I can get it further just letting it hang over the edge of a chair/bed when the quads don't need to work to get it to bend.

Post-op set for 2/4 and will get more answers to all my questions.  Should get the OP report sometime this week so I can 'review' everything and formulate more specific questions.  Not sure if more knee surgery will be done or not, as that depends on the findings.  But if not, I will be scheduling the hip surgery for sure for the summer and hopefully can get them both done either at the same time or a few weeks apart.  But the knees have to come first since the hips will leave me non weight bearing on the operative side putting all the stress/strain on the knee.  And since the L hip needs more attention and work than the R, that will get done first and the R knee is the one giving more problems so it has to get better before I can even contemplate getting the hip done.  But no worries...only 1 more week to go until I get a tentative plan in place and then back to PT on 2/5. 

Will be an interesting conversation with PT-they kicked me out on 12/21 due to lack of progress with flexion, as the R was holding steady at 115 with a ton of pushing and aggressive PT.  Was worried that the lack of them pushing 4x/week would cause the knee to regress but they refused that that would happen.  On the surgical day, R knee flexion was about 94 degrees.  I had lost 20 degrees of flexion in 4.5 weeks because they discontinued service.  So for those of you out there whose PTs seem to be giving up, fight for continued service.  It may not be making it better but who is to say it's not preventing it from getting worse.  In this case, I was clearly right (& will be sure to hold that over my PTs head every now and then too especially when I want to push harder and they are too 'afraid' of what will happen, like my request for doing shuttle jumps which will probably start up at about 3-4 weeks post.  But no fret, we have a great relationship so I can do and say things like that and we'll both laugh about it and then I usually end up winning, as I don't give up very easily!!)

Heading back to work tomorrow, as I took Wedn., Thurs., & Fri. off last week for surgery and two days of recovery.  Dreading the long walk from my classroom to get my kiddies off the bus and then back inside (long hallway with a super long playground to cross), especially as it is extremely icy here!  Did some shopping at the mall yesterday and then Target & groceries today and the knees held up well.  Some soreness and tightness from increased swelling but I hate sitting around all day and doing nothing-there is no worse mentality or medicine then succumbing to knee pain!  And I use my history of blood clots as a 'must' for getting moving ASAP, even on icy days like today; the darn Lovenox injections are making my belly look like you're playing connect the dots and the injections are twice daily for 2 weeks this time around!  Ugh!  Good thing it's not bikini season!  :-)

Will update after my post-op appointment with hopefully, marked improvement in this quad pain!
6/07-L TTT & LR
6/08-R TTT & LR
6/09-Bilateral ACI
7/10-R derotational femoral & tibial osteotomies, LPFL reconstruction
6/11-L derotational femoral & tibial osteotomies, R hardware removal
1/12-L tibial hardware removed, R scapulectomy
4/12-L femoral hardware removed
7/12-L & R MPFL reconstruction

Offline Teacher2Many

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #70 on: February 16, 2013, 03:33:04 AM »
Almost 3.5 weeks post bilateral LOA & MUA and figured I'd pop in and update.  Flexion is dramatically different-still quite painful but the fact that it's bending more is a good thing.  L is at 135 and R at 126.  We are measuring only weekly, as I was too afraid of measurements changing for the worse when done daily (due to stiffness, more swelling, etc. on any given day) and thought it would be too discouraging plus would cause unnecessary panic when numbers stop rising (after all, you'd probably see a jump of at least a few degrees every week vs. maybe 0-1 degrees every day).

Medial quads and hamstrings are a great cause of pain and PT feels that it is a big limiting factor with flexion as well.  So he's digging in there trying to loosen them up with some massage, ART, etc. and I just lay on the table and cry.  Thankfully, the new clinic I'm going to (same PT but he changed clinics) is nowhere near as busy so maybe there's only 1 or 2 other people there when I'm there so it's not as embarassing to sob like a baby.  But my surgeons words when I talked to him at 2 weeks post op where "have them push the hell out of it", which is what I told him to do and definitely what he's doing.

The popping sensation is ever so present-I still question if it's shifting, even slightly.  My OS wants me to duplicate this sensation at my next appt. on 4/1 so he can try to figure it out.  And if he can't figure it out and come up with a plan to fix it, he'll find someone who can.  He said he's not giving up and knowing my case is difficult with the past dx and surgeries, makes him want to work even harder to come up with a solution.

Hoping to have that on 4/1 because if there is no plan for the knees for the summer, I am booking surgery for the hips (and maybe the R shoulder as well).  There is some discussion on trying to obtain a flexionator as that extra push for the knees at home and also to work on dorsiflexion on the L foot as that is the one that got damaged with surgery in 2011 and still presents with limited dorsiflexion and immense weakness making walking, running, etc. difficult to say the least.  Need to do some more research on that though-was thinking a hinged AFO/night splint would be better as it's not me pulling it to work on flexion and hence inflicting pain (after all, how hard do we really push knowing how much it hurts).  Will revisit the conversation again with PT on Tuesday and then probably e-mail my OS afterwards to see what he has to say.

Hope all are enjoying the last month or so of winter-the bulbs are starting to grow and show through the mulch and just hope we don't get a bad enough freeze to kill them!
6/07-L TTT & LR
6/08-R TTT & LR
6/09-Bilateral ACI
7/10-R derotational femoral & tibial osteotomies, LPFL reconstruction
6/11-L derotational femoral & tibial osteotomies, R hardware removal
1/12-L tibial hardware removed, R scapulectomy
4/12-L femoral hardware removed
7/12-L & R MPFL reconstruction

Offline Summer007

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #71 on: May 31, 2013, 04:39:05 PM »
Hiya Teacher2Many,

Just thought I'd pop in and see how things are going now with your knees- I hope all is well.

Summer :)
October 2011-L LR
August 2012-L MPFL Recon
July 2013-L TTO & MPFL revision
March 2014-L Arthroscopy surgery

Offline Teacher2Many

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #72 on: July 10, 2013, 03:39:23 AM »
Thanks Summer!  Sorry for the late reply-things have been very busy with the end of the school year, moving into my condo, etc., etc.  I am undergoing more surgery on 7/24 for the L hip and R knee (trying for both knees but we'll see what he says).  The hip doc is going to fix the torn labrum and correct the impingement.  My knee guy is going to undo the MPFL in the R knee in hopes of getting rid of the pain and tightness with flexion.

This surgery was originally scheduled for 6/26 but on 6/24 it was decided that I needed emergency spine surgery on 6/26, which I had, and therefore the hip & knee got pushed back four weeks.

What's the latest update with your surgery?  Still planned for the 30th?  You should be able to resume classes in the fall so will keep my fingers crossed for you!
6/07-L TTT & LR
6/08-R TTT & LR
6/09-Bilateral ACI
7/10-R derotational femoral & tibial osteotomies, LPFL reconstruction
6/11-L derotational femoral & tibial osteotomies, R hardware removal
1/12-L tibial hardware removed, R scapulectomy
4/12-L femoral hardware removed
7/12-L & R MPFL reconstruction

Offline Summer007

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #73 on: July 10, 2013, 04:25:09 PM »
Hiya Teacher2Many,

It doesn't sound like your having a very good time of it at the moment! I'm sorry to hear about your back, it doesn't sound nice at all. I hope your making a speedy recovery! Good luck for your surgery on the 24th, I'll be thinking of you- I hope it all goes well.

Yes, its still the 30th for me- so just three weeks away. I'm hoping I'll be able to go back to classes but as it is only 5 weeks after my surgery, my surgeon isn't too keen on the idea of me going back straight away. I'm doing a course that is two days a week at college and then the other three days a week at a children's nursery so he doesn't want me going back to soon.

Again I wish you the best of luck, hopefully the surgery will improve your situation. Summer :)
October 2011-L LR
August 2012-L MPFL Recon
July 2013-L TTO & MPFL revision
March 2014-L Arthroscopy surgery

Offline Summer007

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #74 on: July 25, 2013, 08:29:00 PM »
Hiya Teacher2Many,

Thought I'd pop in and see how surgery went the other day. I hope you are making a speedy recover and that you aren't in too much pain.

Best wishes. Summer :)
October 2011-L LR
August 2012-L MPFL Recon
July 2013-L TTO & MPFL revision
March 2014-L Arthroscopy surgery















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