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Offline aclgator

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lateral release
« on: January 19, 2004, 07:47:58 PM »
I am brand new to this board and would appreciate any help anyone can provide.
I had acl recon via hamstring graft on may 1st 2003, rehab has been a struggle but i finally was close to getting released about a month ago. I was 75% bad knee to good knee on the biodex and had started jogging. Suddenly my VMO shut down and i started having knee cap pain to the extent where i couldnt do the knee extension machine. My VMO is back to strength but the pain is still there. Went to the doctor today and he suggested a lateral release. I have heard bad things and good things about this procedure.

Any articles or first hand knowledge of this situation would be greatly appreciated.

P.S.  I injured the knee playing competitive basketball and had hoped to return by now. Also, tore my mcl, medial meniscus, thigh fracture and patellar fracture
2-10-03 injury torn acl, mcl, med men, fract pat 5-01-03 acl recon surg

Offline runann

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Re: lateral release
« Reply #1 on: January 20, 2004, 12:06:51 AM »
Hi

If you haven't done it already then I recommend that you go to the Steps to Enlightenment bit of this site and read up about kneecaps. It covers quite a bit about lateral releases.

My personal experience of a lateral release is positive. I had my right knee done in May 2002 and have found it a great improvement (get my left one done next month). But I think I'm in a minority on this site so I think it's important to hear other points of view.

It does strike me that your OS seems to be rushing things here. The usual advice is to only contemplate surgery when more conservative approaches have failed. I had months and months of PT trying lots of different things before the OS even discussed surgery with me. And he has been very open with me about the success level of the operation. Interestingly he is much more confident for the second knee. He says in his experience if the surgery worked for the one knee then it's likely to work for the other one as well.

If the VMO is back to strength I confess I don't understand how surgery could help with the pain - but I'm no expert and very new to all of this. No doubt others can explain!

Ann

Offline ATsoccergirl

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Re: lateral release
« Reply #2 on: January 20, 2004, 04:22:31 AM »
ACLgator-

I would seek a second opinion before undergoing any more surgery.  Due to the more complex nature of your problem is would be unwise to undergo such a course of treatment without a proper understanding of why the knee cap has suddenly become symptomatic.

Lateral retinacular releases are great when done for the right reasons, but can cause further problems when done for the wrong reasons.  I have been involved in a study documenting the post-op success of lateral releases.  We had a very strict screening process to determine if the lateral release would be successful.  We found that the highest rate of success was found in those with either lateral tracking or lateral tilt due to tightened retinacular structures.  The high failure rate that is often reported is due to the surgery being done for the wrong reasons.  I would encourage you to have an x-ray done to determine patellar orientation.  I would also recommend further physical therapy focusing on VMO activation patterns and patellar mobilizations.

1999 LR, 2002 ACL/PLC recon, reversal of LR, 2004 ACL revision, 2006 Car accident torn PCL and small fractures resulting in bone chips in my knee.  Torn MCL 3 times.  Wicked screws under IT band and Pes Anserine.  June 2008-Hip Arthroscopy.

Offline aclgator

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Re: lateral release
« Reply #3 on: January 20, 2004, 01:51:27 PM »
I appreciate your help and support. I intend to dig deeper into my options before having the surgery. I am just very frustrated at this point, because january was my goal to start back playing basketball and everything seemed on tract and now its gone haywire. I will continue to go to therapy 2x week and continue to do everything in my power to avoid surgery. The mcconnell(sp) taping seemed to help for a while but now it seems less effective

thanks,

Tim
2-10-03 injury torn acl, mcl, med men, fract pat 5-01-03 acl recon surg

Offline ATsoccergirl

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Re: lateral release
« Reply #4 on: January 20, 2004, 05:06:48 PM »
Tim-

Are you using the McConnel tape just during exercise/PT or all the time?
1999 LR, 2002 ACL/PLC recon, reversal of LR, 2004 ACL revision, 2006 Car accident torn PCL and small fractures resulting in bone chips in my knee.  Torn MCL 3 times.  Wicked screws under IT band and Pes Anserine.  June 2008-Hip Arthroscopy.

Offline Linds

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Re: lateral release
« Reply #5 on: January 20, 2004, 08:07:04 PM »
Personal experience. Well I am still on the search for a knee that does what I want it to...HOwever I had a LR almost 22 months ago. My Right knee...the kneecap no longer subluxes there is still pain but not the same intensity I had before.
It's important to make sure the surgery is being done for the right reasons. I had Lateral tilt in my patella, it solved that and not the lateral tracking.
Does that help...check out the enlightenment..it's a good source of info.
Good luck
Linds
1997 Scope RK
2002 LR RK
2002 Scope and hematoma evac RK
2004 LR LK
May 06 Fall from Horse, partial ACL tear and meniscus injury, Tibial plateau injury
2007 Scope, Plica Excision and Debride LK
2009/2010- Possibly Ankylosing Spondylitis?

Offline Leentje

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Re: lateral release
« Reply #6 on: January 20, 2004, 09:44:19 PM »
I can only say what most people over here will say, be sure you have it for the right reasons!!! If there's no tilt, don't have the LR! Do a research and try PT and patellar tracking orthesis before jumping into LR surgery!
I had a lateral release 3 years ago, which failed. Nevertheless I would have it again.

Good luck and start a research now!

H
Bilat patellar malalignment/PFdysplasia
00/06/83 L wrist #
11/12/00 L knee LR + chondroplasty
21/08/02 L knee TTT
02/03/04 L knee stretched PCL
11/09/07 L ankle dislocation/medial avulsion #
25/05/09 L ankle medial avulsion # AGAIN!
05/06/13 R ankle dislocation

Offline aclgator

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Re: lateral release
« Reply #7 on: January 20, 2004, 11:06:07 PM »
Once again I appreciate everybodys input!!!! I have visited the steps to enlightenment and foud it very helpful, thanks for suggesting that as well.

To answer the question regarding the mconell taping, i have therapy 2x week and its used durring all exercises and i leave it on for the rest of the day. I also could tape it everyday if you thought that would help. Also, I am wearing a Palumbo brace since i saw the doctor on tuesday and it seems to be making the knee even more sore than before. Arghhhhhhhh!!!!!!!! Any exercises I can do on my own time that would help please let me know.

I go to therapy on wednesday and i have already asked the therapist to talk to my doctor just to make sure we are all on the same page. I will keep everybody posted.

Tim
2-10-03 injury torn acl, mcl, med men, fract pat 5-01-03 acl recon surg

Offline Linds

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Re: lateral release
« Reply #8 on: January 21, 2004, 02:58:35 AM »
The best Tracking brace I have ever found, because like you with the brace you are wearing now...I found the other's all really caused alot of problems... The best one that I have for both knees now is the Breg PTO brace.  It works really well, suplies you with alot of stablitity and  I find doens't put too much pressure on the joint. If you go to the products you coudln't do without you will find alot of posts about PTO braces.
Take care
HUGS and hope
Linds
you can take a look at the PTO brace if you would like..at
www.breg.com under patello femoral bracing.
1997 Scope RK
2002 LR RK
2002 Scope and hematoma evac RK
2004 LR LK
May 06 Fall from Horse, partial ACL tear and meniscus injury, Tibial plateau injury
2007 Scope, Plica Excision and Debride LK
2009/2010- Possibly Ankylosing Spondylitis?

Offline ATsoccergirl

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Re: lateral release
« Reply #9 on: January 21, 2004, 03:38:38 AM »
McConnel taping is actually only effective for a short amount of time due to failure of the adhesive base which results in loosening of the tape.  Combining the tape with other VMO targeting activities is the most effective.  I would also look into incorporating biofeedback into your physical therapy routine.
1999 LR, 2002 ACL/PLC recon, reversal of LR, 2004 ACL revision, 2006 Car accident torn PCL and small fractures resulting in bone chips in my knee.  Torn MCL 3 times.  Wicked screws under IT band and Pes Anserine.  June 2008-Hip Arthroscopy.

Offline aclgator

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Re: lateral release
« Reply #10 on: January 21, 2004, 06:38:47 PM »
I just got back from pt and he had talked to my doctor and they discussed what was going on in my knee. This is what was said:

The doc noticed severe chondrlamacia(sp) durring my acl recon. also had a patellar and thigh bone fracture and bruising. they are now in agreement that we are going to give pt another month and then go back in for surgery. Once in, he will determine what needs to be done, which could range from scope to a lateral release. After talking with the pt i am a little more comfortable with the plan of attack, but im still in a fact and opinion gathering mode

Tim
2-10-03 injury torn acl, mcl, med men, fract pat 5-01-03 acl recon surg

Offline KM

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Re: lateral release
« Reply #11 on: January 22, 2004, 08:04:47 PM »
Hi Tim,
I had similar problems, but hope you will have better luck than I did...
I had a lateral release 6 months after my ACL reconstruction- the kneecap pain and swelling prevented me from completing the ACL PT, but the OS wouldn't go back into the knee til 6 months after the original surgery.
Unfortunately my lateral release was not   a success, but the TTT I had one year after that was, and now that knee is great.
Best of luck to you!
:D
Left knee: scope '90, ACL reconstruction '98, LR'98,  TTT '99, screw removal '01
Right knee: LR '02, TTT 12-03
Baby Boys '01, '03 !