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Author Topic: Failed Lateral Release-Help!  (Read 1333 times)

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Offline noradaexplora

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Failed Lateral Release-Help!
« on: December 23, 2012, 05:42:16 AM »
This is my first time posting and I am just looking for a little insight and possibly advice/stories from others who have been down a similar road.

I am a 26 year old female living in Colorado and up until this summer was competing as a cyclist and riding a pretty high volume of intense miles for about the past 4-5 years.   
I had a lateral release done on my right knee in 2002, and my left knee was scoped later that same year (the surgeon went in with the intention of doing a LR on that knee as well but decided against it--thank god!!).  I've known for years that my right knee was never as good as my left, and just not quite "normal."  I didn't start doing intense exercise/training for years after the lateral release, and it was then that the difference in the two sides began to show up.
My left knee hasn't been exactly pain free, but my right knee has been the real trouble-maker most of the time.  My vastus lateralis never really developed as well on the right side, and I know that when biking my knee dips in on that side, quite noticeably.  I've gone to PT off and on for years and always been told that I just need to strengthen that side.  Problem is, my knee always gets so sore and painful after any real attempts at even modified strength training that it just doesn't work.
This summer the right knee began to get worse and worse, with pain predominantly behind the knee. Then, I started getting more frequent and intense pain underneath the front of my kneecap as well.
I got an MRI, did more PT, just kept getting worse.  The MRI showed a baker's cycst behind that knee as well as some moderate cartilage degeneration.
My orthopedist in Boulder didn't really seem to think there were many options, so on November 15th we opted to do a scope with the hope of cleaning it up a bit and maybe seeing if there was anything in there that didn't show up in the MRI.
She ended up just removing some scar tissue and telling me that my days of biking as much and as intensely as I wanted were over, as were any hopes of doing Ironmans in the future.
The recovery from the scope has been worse and longer than I anticipated--my knee still just hurts, hurts, hurts 5 weeks out.

Being as my husband is a professional cyclist, and I am an avid athlete and quite young, this was not an acceptable outcome for me.  So, this week I went to the Steadman Clinic in Vail and met with Dr. LaPrade.  His immediate assessment was that I am subluxing medially due to the lateral release, and my pain is caused by that (rather than the small fissure in my cartilage or anything else). 
He recommended trying reverse McConnell taping for 6-8 weeks.  If that helps, he recommends a Lateral Patellotibial Ligament Reconstruction.    He said he was fairly confident he could restore my ability to bike, but that I would always have some knee pain due to the amount of trauma that the knee has incurred due to multiple operations.  He also wasn't particularly hopeful about the possibility of me running much (his eyes bugged out of his head when I mentioned Ironmans!).

Soo....has anyone here had a similar experience or have any advice to offer?
Thanks!

Offline Lottiefox

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Re: Failed Lateral Release-Help!
« Reply #1 on: December 23, 2012, 02:36:38 PM »
Hi and welcome!

Sorry your knee is giving you such trouble. There is a long term KG member here called smilie who had LPFL done. Her diary is linked below. She is doing really well now, she doesn't post much but does check in and I am sure would be happy to answer questions. There is also another recent member who has had it done but I forget who - leave it with me or I am sure they will be along themselves! Really hope you can get your knee back to good function again.

http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=56141.0

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 allyd

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Re: Failed Lateral Release-Help!
« Reply #2 on: December 23, 2012, 04:01:24 PM »
I've heard good things about Dr LaPrade. There was a recent member who had the same sugery/similar situation as you with him. Like Lottie, the name escapes me. They posted a few times immediately following surgery, but not much there after... which I can only take to mean success! and moving on with their lives. ;) - if you put laprade in the search box, I bet the thread will pop up.

As for your concerns about returning to biking, ironmans(you get props for even WANTING to do that in my book!). Running is really hard on the knees of those of us with patella femoral problems.  You've probably created some early wear and tear on your knee from the instability. Overall, I suspect he cautions you to build some realistic expectations. This is alot better then him promising you the world in my book. He agrees you'll be active again... Which is great! Post surgical knees are just that though, post surgical knees. How much impact activity that will involve will come down to your tolerance.
04/09 RK - Dislocated Patella & Grade III MCL Tear
06/10 RK - Re-Dislocation Patella
09/11 RK - MPFLr + Lateral Lengthening

Offline Lottiefox

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Re: Failed Lateral Release-Help!
« Reply #3 on: December 23, 2012, 04:54:41 PM »
ally were you thinking of this one?

http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=59498.0

I think I was as I remember the pics! Also Driden is another member who had LPFL but alos had extensive derotational stuff done as well which probably means the experience isn't going to be comparable.

I agree with ally that it is far better to have a realistic doctor who is cautiously optimistic about being active and sporty but is honest about the long term prospects of some activities. Running is hard on the knees especially for us women, mine gave up when I was 39 and I was never a big runner at all, just general bits and pieces! I now do lots of other things that don't cause the impact. Some people do go back to running, and some people run even with aboslutely worn out knees - a guy at my old gym had been told he needed two total knees doing and he was trail running 3 times a week with minimal pain! It does depend on how you heal, how your knee copes....how you feel. Never give up on your dreams though, sometimes you need to find ways to work around them and take the dream in a slightly different direction.

Keep us posted, this is a situation with knees that I suspect doesn't always get picked up on. Many people on here scream against lateral releases - sometimes they work and for some people they don't. For those that experience problems afterwards then medial instability may be an issue and it will be useful for members to see how you get on. I hope to see you posting a pic of a giant cycling or Ironman medal one day!  ;D

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 allyd

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Re: Failed Lateral Release-Help!
« Reply #4 on: December 23, 2012, 05:43:10 PM »
yup, thats the one! :) There was also a second thread with a backstory as well:
http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=59189.msg575625#msg575625

Like Lottie says don't give up on your goals. Be realistic with your expectations - But the goals are what will drive you to acheive the best possible outcome.
04/09 RK - Dislocated Patella & Grade III MCL Tear
06/10 RK - Re-Dislocation Patella
09/11 RK - MPFLr + Lateral Lengthening

Offline captainruss

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Re: Failed Lateral Release-Help!
« Reply #5 on: December 23, 2012, 08:39:51 PM »
Nora,

As with Ally and Lottie, I have heard good things about the Clinic you are seeing in Colorado!  The doctor makes all the difference in the world.  I am the poster boy for what not to do with a knee.  I had shattered my knee cap at 17 playing football...had 5 surgeries and went 29 years with pain and swelling, but was able to do anything I wanted (working, scuba diving, etc).

I had a TKR (#1) just about three years ago and have paid ever since.  Scar tissue and bone growth has really disabled me and causes me huge pain just to walk.

Fortunately, my pain and failures with eight (8) surgeries and three surgeons caused me to really look into knee issues here on KG.  The people here saved me from making the wrong decision with my daughter......my OS #3 and two (2) OS's from All Children's Hospital (Johns Hopkins) wanted to do a LR on my 14 year old daughter.  She had a growth plate fracture 6 years ago, and her knee has rotated so that her knee cap groove is many degrees twisted inward. 

I thank God and KG for their help as I feel in my heart that if I had agreed to the LR, she would have suffered for the rest of her life.  I see you are suffering from the same sort of decision.  It is one thing for me to make mistakes at 47 and become disabled, but if my daughter had lost her dreams do to an ill advised LR......all I can say is I hear voices telling me what I would have done if that would have happened.  I keep hearing the voices....make the voices stop!!  You are all my witnesses.....the insanity is there!! 

Anyway....all insanity defenses aside, I am sorry you are suffering with the pain due to the LR you received a decade ago.  I actually laughed....I had my knee joint removed more than have a dozen times due to "infection" yet was never infected.  Just so you know, that is not malpractice!  A bad outcome is not malpractice.  Ripping out a "healthy" knee joint is not malpractice.

Anyway, we are on the path to surgery for my daughter.  I fortunately know how to research her condition and what questions to ask.  The very knowledgeable people here have helped me find a very (2-4) surgeons in the entire United States who I would allow to operate on my daughter and we are moving towards future surgery.

My daughter Kiani (kee' ah knee) wants to be the first U.S. Navy Blue Angel female pilot in history!!  She is very dedicated....graduated High School at 14...is in her second full semester of College at 15, and working towards applying to the U.S. Navy Academy in 2-3 years!  So, she has a great future and big dreams if the doc's can repair her knee! 

I make jokes about hearing voices, but I just can't imagine what a father would do if three (3) knowledgeable OS's made a mistake like an LR on her and ruined her chances at a future.  I am not psycho or demented, but I do really care for my daughter and just don't understand what they are thinking when they prescribe some of these procedures.  You might want to read your surgical reports from your first surgery.....I found very interesting notes from my three previous surgeons when I asked for the surgical reports from the hospitals.  My last OS moved to TN in the middle of the night two months ago due to a nasty divorce.  I could not get my records as I did not know where he went.  He had two thriving clinics here in Florida, but just loaded up the girlfriend and all our records and split!

The really hard part is I almost fell for the LR.  He (and the other two) suggested an LR.....calling it minimally invasive surgery....a good start with such a young girl.  He stated if they were in there with the scope and found any other issues, the could deal with them at that time.  What that means......translated is he can do any further procedure and will tell you all about it (maybe) after she is in recovery and you have no ability to decide or seek more information. 

I do understand young females have rotational and patella issues quite a large amount of the time.  There are very smart people (not me) here who can really help you.  If you get time, do some of the games...send 20 small posts so that people can PM (private message) you with doctors names and private advice.  I am very appreciative of the information provided to me here on KG!  It saved me from making a tragic mistake with my beautiful (looks like her mama) daughter!

Good luck...Merry Christmas and keep us up to date!

Russ
80 Shattered patella 5 surg
09  TKR 
09  MUA
09  MUA
09  Knee infected??
10  TKR  Scar Tissue
10  2nd OS  Diagnosis Infection
10  TKR with antibiotic spacer, no joint
4/11  TKR
11  TKR PT
11  TKR
11  TKR  AF diagosis
12/11  HO diagnosed
2012  Intractable Pain
2012  OS split
amputation possible?

Offline noradaexplora

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Re: Failed Lateral Release-Help!
« Reply #6 on: December 24, 2012, 05:11:46 AM »
Thanks everyone so much for the encouragement!  I am actually in contact with Clare to hear more about her experience, so that will be very useful I suspect! 
I'll be sure to let everyone know what happens if I decide to go the surgery route!  I am trying the taping now and because I am lucky enough to be spending January and February in Tucson I will be seeing if I can get back to some of my normal activity level.

Thank you!

Offline captainruss

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Re: Failed Lateral Release-Help!
« Reply #7 on: December 26, 2012, 04:48:30 AM »
Nora,

If you have any questions, please feel free to ask.  You need to go to the games section and post 20 times before you can send private messages (PM).  At that time, you can ask anyone on this blog specific questions about doctors they have utilized, procedures they have had.

I would be happy to answer any questions you might have....just send them over.

Merry Christmas!

Russ
80 Shattered patella 5 surg
09  TKR 
09  MUA
09  MUA
09  Knee infected??
10  TKR  Scar Tissue
10  2nd OS  Diagnosis Infection
10  TKR with antibiotic spacer, no joint
4/11  TKR
11  TKR PT
11  TKR
11  TKR  AF diagosis
12/11  HO diagnosed
2012  Intractable Pain
2012  OS split
amputation possible?