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Author Topic: 3 operations, 10 consultants and 3 years in physio....advice please  (Read 2487 times)

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Offline london_lass23

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Ok so have posted a couple of times before and everyone has always been really supportive and helpful. To cut a very long story short i injured my leg playing rugby in April 2009. Dislocated my patella which resulted in tearing ACL,PLC and damaging my PCL and MCL as well as fracturing the patella.

September 2009 went for an ACL reconstruction but the surgeon found too much damage and so referred me to one of the top knee surgeons in Scotland. Saw him in December 2009 and had my PLC reconstructed in April 2010. Then in September i went in for ACL and PCL double reconstruction but when he went in he felt that the PCL might repair on its own so he just did the ACL. That was the last surgery i had but since then i have had 2 falls. One where i landed on my injured knee bent underneath me (september 2011). Was on crutches for 2 weeks after that. Since then my last 2 physiotherapists have both said that on examination my PCL is either completely gone or severely torn. However when i went back to see my surgeon before the summer they didn't even examine it and said there was nothing they could do for me.

before my accident i was really sporty, studied it at university and was hoping to make a career in it but its just not possible with my knee. I am in pain every day and my knee is constantly swollen. It often feels unstable, i feel like i cant trust it (if that makes sense). My new physio thinks i should go and see a different consultant to see if they will operate but i am worried they wont (either because its the NHS or because i have already had 2 reconstructions on different ligaments) and that i will be stuck like this.

Has anyone been in a similar position or have any advice. I just don't know what to do anymore.

Online Vickster

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Re: 3 operations, 10 consultants and 3 years in physio....advice please
« Reply #1 on: January 14, 2013, 11:36:06 PM »
I would suggest you see another surgeon.  However, you'll need to find one who specialises in highly complex ligament work.  Perhaps your physio can advise. Are you still up in Scotland? Are you able to travel. I should think the orthopaedic centres are the best place to start - stanmore in Middlesex, Oswestry in Shropshire and Birmingham. Maybe you have to see them privately and then transfer to an NHS list - most surgeons do NHS work as well as private, just double check.  Also have a look at the list in the info hub.  Teaching hospitals are a good place to look too.

 Knee orthos are quite a close knit community, these guys tend to know each other.  If the one you see isn't able to help, they should be able to refer you to someone who can :)

Have a look in the ligament section for uk based posters. There was one guy who mashed his knee snowboarding I think. Posted after his first op...backflip king or similar? Was a while back, not posted since but may be worth a pm :)

Ok I found his thread... He was in Rochdale

http://www.kneeguru.co.uk/KNEEtalk/index.php?PHPSESSID=fa595c86086f730c18b35d2892542117&action=printpage;topic=55758.0

All the best. I am sure there is a surgeon out there who can help :)
« Last Edit: January 14, 2013, 11:41:16 PM by Vickster »
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline Brambledog

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Re: 3 operations, 10 consultants and 3 years in physio....advice please
« Reply #2 on: January 14, 2013, 11:50:20 PM »
Hi London Lass,

I'm sorry you're having such a crappy time at the moment, hope you can get some more helpful help very soon... ::)

Had to re-do this post as I was about to post pretty much the same as Vickster! She is quite right, get another opinion from a different surgeon, even if you have to pay to see one privately - they are worth every penny if they can give you a more positive experience than it sounds like you've had so far. You can request a second opinion through your GP and tell them who you want to see privately.

When I looked into this it seemed to cost about 2-300 for an initial visit of approx 1 hour to take history and talk it all through, then about 150 for any follow up appt, plus any tests on top. Not cheap. BUT even if you only go for an initial consult they will be able to give their opinion and feed that back to your own surgeon. Take any notes you have, plus any MRI images etc (you can request all this from your NHS trust for about 30) and go prepared with a list of questions so you get your money's worth.

Good luck with this, it's terrible to have to turn elsewhere because you don't feel right about the surgeon you have, but it is your right, and you are completely correct to do what is best for you, your knee and your future. Really hope you can hear something positive soon.

Take care of yourself,

Brams  ;)
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 Kaputt_Knee

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Re: 3 operations, 10 consultants and 3 years in physio....advice please
« Reply #3 on: January 15, 2013, 06:54:11 AM »
Get a referral to a specialist knee surgeon who also works with sportsmen and women. From your name I'm assuming you are in London now or can at least get there. A well known knee specialist who works with all levels of sports injuries is Jonathan Bell and he is based at the Wimbledon Clinic. He is listed here on this site in the list of surgeons for London and if you follow his links you can see when and where he has consultations. Get your GP to refer you to him, or go down the Choose & Book scheme. first class bloke who really knows his stuff and is a passionate sportsman himself. He is a reluctant cutter as he puts it, so if he suggests surgery, it means you really DO need it!

Sue  ;)
1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline london_lass23

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Re: 3 operations, 10 consultants and 3 years in physio....advice please
« Reply #4 on: January 17, 2013, 12:36:30 PM »
Thanx for all the replies guys. The things that really pisses me off is that the surgeon who did my 2 reconstructions is a knee specialist and works with professional footballers and other sports people. When i first saw him he seemed really interest in my case as this was his specialty, he eve said he had never seen anyone do that much damage from one tackle. But since my second surgery i have never seen him. At my follow up app i saw a senior physio and when my pyhsio referred me back becasue of the PCL laxity i saw one of his junior doctors when he was sitting in the next room. She barely even looked at my knee and said she had spoken with my surgeon and there was nothing to be done. But since then every physio i have seen has said either the PCL has gone or its baddly torn. Going to look in to seeing someone privately but i doubt i will be able to afford it. I am waiting on an appointment with a GP to get referred to a consultant, Everything just takes so long with the NHS. I am going to a lower limb class next week which my physio takes so will speak to her then.

I did some research into pcl injury symptoms and the tests they use to see if its damaged and i match up to all the tests/symptoms. The one thing my physio said which worries me is that they might not operate becasue i have already had 2 reconstructions, i hope this isnt true. I work as a chef so am on my feet 8 hours a day which doesnt help. Sorry for going on just so fed up with the pain and frustration. Thanx for all the advice  :)

Offline Kaputt_Knee

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Re: 3 operations, 10 consultants and 3 years in physio....advice please
« Reply #5 on: January 18, 2013, 12:36:03 PM »
Whereabouts exactly are you based and how far can you afford/are prepared to travel to see an alternative diagnostician? If you let us know then maybe we can suggest some specialists in those areas. I know for example that Jonathan Bell does some pretty complex stuff, but that is no good if you are up in the north of Scotland when he is down in Wimbledon and you cannot get there.

The PCL problem is pretty specialised and some NHS people avoid them like the plague because the outcomes are not always that good. Sadly it comes down to the costs and foreseeable outcomes in some Health Authorities.

BTW, the fact that you have already had 2 reconstructions on other ligaments should not play any part in the discussions about the PCL. 

Sue  ;)

1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline london_lass23

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Re: 3 operations, 10 consultants and 3 years in physio....advice please
« Reply #6 on: January 21, 2013, 01:33:40 PM »
I'm about 15 miles north of Edinburgh. I am pretty much up for traveling anywhere so long as it would be worthwhile. I've got the physio class on Thursday so i will hopefully speak to my physio then. She said she was hopefully going to speak to a consultant and orthopedic physio so i might get some more answers.

Im glad to know that having 2 previous reconstructions should make no difference. I have done some research and i know that there is often no significant improvement after PCL surgery but even the slightest improvement would make a difference.

Claire

Offline Kaputt_Knee

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Re: 3 operations, 10 consultants and 3 years in physio....advice please
« Reply #7 on: January 21, 2013, 03:42:05 PM »
It would be better if you can stay closer to home as it makes follow up visits easier and also finding an experienced physio is fairly important. If the surgeon has a physio they work with it makes life so much easier as they can and in some cases, do actually talk to each other!

Let us know if your physio knows of anyone locally before we start bandying names from all over the country  ;D There are so many good surgeons, you can be overwhelmed by recommendations, a lot of whom may be totally impractical in reality.

There is always an answer out there somewhere, it is getting to it that is the difficult part!  ;) Good luck with the physio's recommendations!

Sue  :)
1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline london_lass23

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Re: 3 operations, 10 consultants and 3 years in physio....advice please
« Reply #8 on: June 10, 2013, 09:47:31 PM »
Ok so i haven't been on here in a while. Since my last post i have gone through a course of physio through a lower limb class. My strength has really improved, my leg feels so much stronger but thats where the positive stuff ends. I have been waiting to see a consultant for 2 months and about 1 month ago my physio told me there was nothing else they could do. My knee still swells every day and is painful after being on my feet for a while. Also on some occasions when i turn round it feel like something rips inside my knee and its extremely painful. I am hoping to get an appointment soon but i am not holding my breadth. Anyone got any advice on stuff i can do in the meantime?

Claire  :)

Offline virtual_me

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Re: 3 operations, 10 consultants and 3 years in physio....advice please
« Reply #9 on: August 06, 2013, 12:27:54 AM »
Hi Claire,

IHMK referred me to this post.  I am based in Glasgow (study at Edinburgh uni though).  I recently had ACL surgery on my knee with a surgeon in Glasgow who I believe is really top notch when it comes to knee surgery.  I had it on the NHS - not sure if you'd be able to see him on the NHS if you're not in Glasgow, but he does do private work...  If you think I can help in anyway, send me a private message. 

I did go to Fasic when I originally injured my knee last year and saw Sandy there - she seemed pretty good.  And she knows my private physio I'm currently seeing in Glasgow, who in turn works with my surgeon (small knee world!), so it may be worth seeing her (and you'll get a discount if you're at Edinburgh uni).

(Also, if you're not happy with the surgeon you've seen on the NHS, I think you can request to see someone else... You might have already done this though...)