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Author Topic: Trochleoplasty advice please!  (Read 1312 times)

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Offline Summer007

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Trochleoplasty advice please!
« on: February 08, 2013, 07:43:02 PM »
Hiya all,

I'm a bit confused right now and I am looking for some advice please. I have been struggling with recurrent patella dislocations for a few years now. I have had two surgeries, but with no success. My first surgery was a Lateral Release in October 2011 and my second surgery was a MPFL reconstruction six months ago.

After getting no answers from my OS that did both my surgeries, I seeked a private second opinion. The OS that was my second opinion was very helpful and clearly outlined what my problems are. He told me that I have patella dysplasia, patella alta & grade III chondral damage (chondromalacia).
He then went on to suggest that I need a trochleoplasty and a distal realignment (TTTG), along with my MPFL being re-done. Because not many people around the country do trochleoplasties he had to send me on to Bristol to see someone that does. When I actually got there, I was told that he didnt want to do one because he said that although it is bad, it is not awful. However, he did say that he would still go ahead with the other parts of the suggested surgery.

I am now confused as what to do. Would it be worth going to maybe see someone else who specialises in this area, or just go ahead with the other surgery that has been suggested?
The problem I find is that I dont know how it all works, if I went ahead with the distal realignment, would it work without the trochleoplasty? Having already had two surgeries, I would quite like to get this one right!

I would love to hear from anyone that has had a trochleoplasty procedure that could help me out. Many thanks in advance!
October 2011-L LR
August 2012-L MPFL Recon
July 2013-L TTO & MPFL revision
March 2014-L Arthroscopy surgery

Offline anniehine

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Re: Trochleoplasty advice please!
« Reply #1 on: February 10, 2013, 03:01:19 PM »
Hi there, I had a Trochleoplasty done about 4 years ago now as i'd had a lifetime of dislocations. Who was it you saw at Bristol? As you know, it is a very specialised field and there are only a few surgeons who do this operation. I know that one of, if not THE most experienced Trochleoplasty surgeon is based in Bristol...soo if it is him you saw, and he advised against the op then i would settle for that as your answer. My knee was quite extreme apparently, which was why my OS (Mr Bell) decided to go ahead, but it is certainly considered only in the most extreme circumstances and where there is not other option. I assume this is because there can be so many complications after-and it is completely irreversible. I was also given a scope beforehand to factor in the decision-and my meniscus was in very good condition-which would aid my recovery and so they decided to go ahead. What I realised was key in all this knee business is to get opinions from the best. Do your research and find a list of the most experienced surgeons and specialists. Private doesn't always mean the best-Mine was also on the NHS but I got lucky (he is now just private incidentally). His name is jonathan Bell and he works in Wimbledon, SW London in case you want another opinion. Wish i could advise you on the other ops but I don't know much about them, sorry. If you want to contact me, please email me as i don't get on here much anymore. [email protected] . Good luck, and I hope you get your knee probs sorted!
Left knee started dislocating at 7 years old
Hypermobile
Arthroscopic scope April 2009
Trochleoplasty at 28 years old (10.2.10)
Did 1st SLR 1.4.10 WHOOP!!
Walked through house without crutches (12.4.10) very pleased with myself!!

Offline Summer007

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Re: Trochleoplasty advice please!
« Reply #2 on: February 10, 2013, 06:02:22 PM »
Hiya Annie,

Thank you for the reply! I saw Mr Jonathan Eldridge in Bristol, which is probably the man that you are thinking of as I believe that he is very, very experienced in this field. I was sent up to see him by another consultant as he felt that another input was warranted. I will email you with some more details.

Thank you again for your reply! Summer
October 2011-L LR
August 2012-L MPFL Recon
July 2013-L TTO & MPFL revision
March 2014-L Arthroscopy surgery

Offline LauraB

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Re: Trochleoplasty advice please!
« Reply #3 on: February 17, 2013, 01:42:39 PM »
Hello

I had a trochleoplasty and a TTO 2 months ago. I'm not sure if a TTTG is the same as a TTO - seems like there are lots of terms for this procedure... I didn't actually know whether I was going to have the TTO - they didn't decide until I was in the operating theatre.

Like lots of other people on this forum I had been having recurrent dislocations for many years, along with 2 previous surgeries which didn't fix the problem.  I looked online for a specialist and went for a private consultation with Mr Forster (in Cardiff). This led to an MRI scan - which clearly showed that instead of a trochelar groove I had a lump. He suggested the trocleoplasty. He explained that it was a major procedure, and that the main risk was that the cartilage might not take to the new shape. He also said he had done 37 of these operations. So I was pretty happy to go ahead with it.

I have a diary on this forum if you're interested to see what the recovery has been like http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=61220.0

I guess in the end we just have to trust that the specialists know what they are doing! I hope it works out for you.

Laura
1992 - First dislocation
1996 - Lateral Release
1999 - Roux-Goldthwait
2012 - Trochleoplasty/TTO















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