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Author Topic: What do I ask at Pre OP?  (Read 1221 times)

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Offline AllieG

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What do I ask at Pre OP?
« on: July 01, 2012, 06:36:16 PM »
Yesterday I met the Orthopaedic consultant who is doing an arthroscopy to find out what is wrong with my knee.  He sent me for x-rays and it was even obvious to me that my kneecap has slipped out of the groove and is tilted and it looks like it is rubbing on the bone.  He told me is going to do a lateral release to try to fix it.  I have a pre op assessment in 10 days and wondered what questions to ask them.   I have never had surgery before and am a bit worried about it and wonder as well why it didn't show up on the MRI, which according to the radiologist only showed fluid between my kneecap and the skin.

Offline aaa

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Re: What do I ask at Pre OP?
« Reply #1 on: July 01, 2012, 07:32:18 PM »
You may want to look at: http://www.facebook.com/pages/Lateral-Release-Friend-OR-FOE/408880595820810

I am biased. I had a lateral release and it failed terribly (medial instability).  I had to get it reconstructed, which believe me is no fun at all.

I eventually saw a surgeon specializing in patellofemoral surgeries, he is a pioneer in the field, and has corrected hundreds of failed lateral releases.  He no longer does *any* lateral releases himself, he uses other surgical methods to treat PF problems.  I think its a useless surgery.

end rant :)

If you are going to go ahead with this procedure anyway, I've been through it.  It is typically quite painful, and can take weeks or months for the pain to settle down.  You may want to ask about how long it would be before you can return to work.  Usually PT starts pretty early, and to my knowledge, most surgeons allow immediate ROM and movement after the surgery as tolerated, you may want to ask about what to expect in the few weeks after the surgery at least.

The quadricep muscles typically will get a bit weak initially, the goal is to regain strength and control.  Check out the 'post-op' diaries on this site, and it will give you a picture of how peoples recovry has gone with this procedure as well.

You will find some cases where after about 6 months - 1 year, people tend to do better, and get there limb control back.  There are others which seem to never get better.

The lateral release is to cut some stabilizing lateral structures, which loosens the kneecap with the hope it glides more centrally. 

Good luck
« Last Edit: July 01, 2012, 07:35:35 PM by yb »

Offline AllieG

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Re: What do I ask at Pre OP?
« Reply #2 on: July 01, 2012, 08:28:08 PM »
Thanks for the info.  He did say he would do a lateral release but he might do something else when he operates and looks into my knee.  I just hope it isn't as bad as I think it is.

Offline Lottiefox

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Re: What do I ask at Pre OP?
« Reply #3 on: July 01, 2012, 10:12:07 PM »
Your pre op will probably be fairly generic to make sure you are healthy enough to have surgery...blood pressure, etc etc....If you have specific questions about what the surgeon plans to do you'll need to target him directly...

Personally I would be asking:
Why is he planning a lateral release? NB you describe a tilted patella - do you have any instability issues with your kneecap?
What is his proposed rate of success and what of failure? In the case of failure what does he say could happen?
What is the "something else" he is proposing? NB Don't let anyone cut on you unless you know what they're doing. Would you take your car to a garage and just let them do what they feel like or make it up as they go along? No, you'd want an estimate of works - and your knee is a whole lot bigger and more important than a car!
What is the rehabilitation protocol? e.g. crutches? non weight bearing? physio? when? how many sessions? restrictions?
What are your symptoms....I'd be asking him why he thinks what he proposes will help them..and how...and why?

Good luck - remember this is your health and asking questions is GOOD thing!

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 AllieG

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Re: What do I ask at Pre OP?
« Reply #4 on: July 01, 2012, 10:28:07 PM »
He is going to examine the knee and and clean out what is in there and then cut something to make the kneecap fit properly then it will be physio for a few months.  He said my knee will be swollen for a while, which I can cope with I just hate the constant pain.  He said other things but because I am still so shocked about my knee being tilted (which I didn't know about until yesterday since I haven't had an x-ray for years) I forgot what it was.  I will know more when I get the letter from him telling me what he is doing.  I am just worried about it because I have never had surgery before apart from a few stitches when I cut my lip when I was small.

Offline aaa

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Re: What do I ask at Pre OP?
« Reply #5 on: July 01, 2012, 11:02:33 PM »
Getting diagnosis of knee problems / tilt is definitely a bit of a shock, i've been there.  If you can, don't worry too much and give yourself some time - take a look at the resources on this site to learn more about PF problems.  Do not shy away from learning - it is best to understand the problem, rather than leave unanswered questions  heading into surgery.  You will be surprised that understanding PF problems at a high level is not all that complicated, of course the detailed knowledge of a surgeon is something different but you do not need that from a patients perspective.

There is a ton of good information here, that typically you would not hear from most orthopedic surgeons.  This information may help you to formulate more questions for your OS.  If you would like, I can post some other links which I found useful?

I don't want to turn this into an 'anti-lateral release' thread.  The link posted earlier has a lot of information worth looking at, and there are a lot of threads / post-op diaries that should give a better picture of what you would be getting into with this surgery.  About the LR, I will just say the lateral release is not the only surgery that can treat what is perceived as tilt, it is not absolutely necessary to do a LR for the tilt. 

Post any further questions here, and best of luck.

















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