Banner - Hide this banner





Author Topic: An athletes mpfl reconstruction diary  (Read 97207 times)

0 Members and 1 Guest are viewing this topic.

Offline Clarkey

  • SuperKNEEgeek
  • *****
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • Posts: 4190
  • Liked: 75
  • Neil TheElephant knee packed up carrying his trunk
Re: An athletes mpfl reconstruction diary
« Reply #630 on: July 12, 2016, 05:12:21 PM »
Hi Lucha,

Surely it would be a tribunal case as unfair dismissal in a working environment to get warned that you job could be at risk of being dismissed from your job. You can take sick leave for long periods until you are deemed fit to return back to work by your OS. I feel they are being very harsh, if you was getting treated for cancer they wouldn't dare say anything negative towards being on regular sick leave. 

I also had problems with my previous employers, they made me come into work 2 weeks post-op when I had a sicknote from my GP. It was a manual labour job, the Manager took advantage straining my knee too much by making me do heavy lifting when I told him I need to be on light duties. Walked out of the job 4 years ago, I was not going to be bullied by him for any longer!

Good luck with PT and pre-op preparation.

[email protected]
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline lucha86

  • SuperKNEEgeek
  • *****
  • Posts: 676
  • Liked: 40
Re: An athletes mpfl reconstruction diary
« Reply #631 on: July 16, 2016, 01:07:21 PM »
So now I'm just flabbergasted lol my date for surgery in August got cancelled and I lost 250 pound on a hotel I prebooked for the night before..........the next one they gave me was late September..............
So now that I have an mcl sprain on my left knee due to my right knee instability and also having damaged eyesight because of a fall down stairs due to the right knee instability and the thing I have got with my eye only happens with trauma or people over 50 I'm not over 59 lol  and being on a final strike at work if I do another non planned sickness ... I wrote a letter to the team leader of the appointments explaining all of this and I was covering my self to explain how if I have another major collapse I could lose my job damage my sight further and my left knee further ....
So now I'm on two type of list one the day before cancellations and on the day cancellations for the next 5 weeks.....so I have to fast on each same day cancellation for 6 hours in case they ring me and tell me to go to the hospital I just can't fathom this who situation on a clinical or even ethical scale
« Last Edit: July 16, 2016, 05:09:17 PM by lucha86 »

Offline lucha86

  • SuperKNEEgeek
  • *****
  • Posts: 676
  • Liked: 40
Re: An athletes mpfl reconstruction diary
« Reply #632 on: July 19, 2016, 10:30:18 PM »
So ACL reconstructions get even more complicated when you have an MPFL reconstruction,
so there are several types of grafts which are patella graft and quadricep graft, which if you have had MPFL
reconstruction you cant have as the patella (knee cap) is weakened from the MPFL and you could risk damaging the kneecap further.....
Then if you have had a hamstring graft already most surgeons wont take another hamstring graft to not cause imbalance to the hamstring as there is not enough research or evidence to say that they grow back in all cases...
So basically then your left with either

Artifical Ligament a.k.a Lars ligaments - man made fibre ligaments.... which again have not a lot of research in longevity and are known to have high rupture rates in very high fitness people

Allograft ligament - Donor tissue from a deceased person, its as strong as ligament from a live patient then you have a one in 2 million chance of getting a disease or from Hepatitis to mad cow disease (But there have been no cases in last decade or so for Mad cow disease.)

So if you have had an MPFL forget the following for ACL Reconstructions
-Quadriceps autograft (own tissue)
-Patella tendon autograft (own tissue)
-Hamstring Autograft (own tissue)

and your left with.........
allograft ligament - donor tissue of a deceased person with a 1 in 2million risk of getting a disease...
artifical ligament - man made material like LARS, has been know to have rupture rates, but some surgeons
                          say it is dependent on case and level on fitness... and return to sport,...no risk of disease

so now im thinking what is the best graft.................?? any ideas lol


Offline lucha86

  • SuperKNEEgeek
  • *****
  • Posts: 676
  • Liked: 40
Re: An athletes mpfl reconstruction diary
« Reply #633 on: July 25, 2016, 08:01:54 PM »
so what have i learnt about doctors regarding the whole process it made me think.....

why do some doctors feel intimidated when we use medical terminology but some respect us for it surely there should be a respect for the patient that has taken the time to learn the information or find the research?
i have met some doctors where i talk to them they respect me then sometimes some are just intimidated and turn it into a negative with closed psychology hands arms etc......

i think some doctors need to accept that every case is unique and not be so adamant that everything is correct and law by what they say its case is unique so one thing might not work for one person but might work for another case.....

medicine has only advanced by trying to see if something works, and some doctors i think forget this.....

we should all have a right for quality of life and we should all fight for it no matter who says what, when an error has been made by a previous surgeon then that new surgeon must understand the frustrations of the patient and of course any patient would check everything to see what us going to be done to them after a previous not so good experience........

when its been going on for years for the patient it can only become an emotional rollercoaster for them and they just want it to be fixed, i myself taught doctors language skills abroad, and i always said to them the amount of respect you show you will get the same back the least respect you show will only give you no respect and no reputation....... we all all human and we all feel emotions.........

my knee..... is so so both swollen just awaiting to see if i get a cancellation before september so fasting every tuesday for next four weeks in case they ring me as a day cancellation....

but i have decided going forward i would like to train to be a personal trainer to help those who have had the same issues as mine and give them so hope that anything is possible




« Last Edit: July 25, 2016, 09:24:54 PM by lucha86 »

Offline lucha86

  • SuperKNEEgeek
  • *****
  • Posts: 676
  • Liked: 40
Re: An athletes mpfl reconstruction diary
« Reply #634 on: July 26, 2016, 09:52:40 PM »
Knee workout  prepping for surgery knees are sweating it out due to ongoing  collspses

Offline lucha86

  • SuperKNEEgeek
  • *****
  • Posts: 676
  • Liked: 40
Re: An athletes mpfl reconstruction diary
« Reply #635 on: July 30, 2016, 11:16:07 PM »
So there are many thinks i have asked and sought answers to i suppose anyone in my situation would believe that  after the experiences i have had you have questioned everything, and not what to expect....

I have spoken with some other surgeons in the orthopaedic field who have said to me

 "so you had an MPFL reconstruction, now you having a ACL reconstruction and an ALL ligament reconstruction( Anterolateral Ligament).... this research does not exist? Did your surgeon sound hesitant in regards to this as this is a unique case where even the most experienced surgeon may be hesitant, because there is no scientific evidence to say it would work?.."

"The only evidence to say that the ALL ligament and the ACL Pivot shift issues was only found around 2013, and its still in it's early days.........there is very little research to prove that it works...."

I then thought about this and thought everything in medicine is changing and without trying things how can we create a sense of quality of life? Help others in the future by learning from it and at least be given the chance to try it without not trying it and questioning "what if?"

Time is a quality we all want quality of life is a pre defined thing that everyone wants to have in life and if there is any chance of retrieving that time or having just a little better quality of life the complications or unknown seem less fearful, in life there is always hope and determination with the drive to get yourself on the road to recovery.......

The patient is the one that takes the risk signs the surgery off and decide on what is the best road for them be surgery or no surgery, it is their quality of life.... for me i have to consider the way my knees are collapsing i could end up with a double knee replacement the way it is going, so the unknown to try to prevent this from happening seems a lot easier in the long run....

I think in these situations some surgeons should show a sense of respect as a patient is trying the unknown to create a better quality of life for themselves and in order to help other patients in the future, as many advances in medicines have only come through trials and also through errors too......

The ligaments which i have injuries to such as the ALL and the MPFL, are new areas. Im sure if i said to a surgeon yea i have an injured MPFL, ACL and ALL, i would more than likely be shoved back outside their office, due to lack of knowledge of these ligaments in my sport we always got told "Never look back, keep going forwards and follow the sunrise, because at the end of all the trails there can be only hope because we cannot see what is our future."

sometimes the hardest decisions we have to make can be the best decisions we make,

i remain on the cancellation list for the next three weeks if i dont get a cancellation ( which im praying for as my knees are dodgey right now.) if not i will have the surgery early September.....








Offline Snowy

  • SuperKNEEgeek
  • *****
  • *
  • *
  • *
  • Posts: 2555
  • Liked: 93
Re: An athletes mpfl reconstruction diary
« Reply #636 on: August 07, 2016, 04:01:14 AM »
Quote
allograft ligament - donor tissue of a deceased person with a 1 in 2million risk of getting a disease...
artifical ligament - man made material like LARS, has been know to have rupture rates, but some surgeons
                          say it is dependent on case and level on fitness... and return to sport,...no risk of disease

so now im thinking what is the best graft.................?? any ideas lol

If it were my knee, I would have no hesitation at all in choosing the allograft. I researched artificial ligaments very extensively when I had my ACL reconstruction, as LARS in particular was getting a lot of press at the time because of the much shorter rehab period compared to other graft types. They were a popular option for professional athletes who needed to get back to sports fast, which appealed to me a great deal as that was also my main goal.

However, what I learned (and research is part of my profession, so I was thorough) was that there's insufficient evidence to trust the current generation of artificial ligaments in the longer term. They just haven't been around long enough. Previous generations suffered catastrophic long-term failures, with serious consequences for the people who had them. The new generation, which includes LARS, hasn't been around for long enough to know whether the same thing is going to happen at a certain point. They're supposed to be much better, but no-one anticipated the failures of the earlier generations until they happened. That, for me, was a risk I wasn't willing to take - it's a big gamble on something that isn't known yet. It's true that there's also a risk of infection from an allograft, but it's miniscule.

Ultimately it's your choice, but those are my thoughts from the time when I was considering the same options. I wasn't a candidate for the patellar or quad tendon grafts because of a pre-existing condition, so my choices were hamstring autograft, allograft or LARS (I had the hamstring graft). Keep in mind that a contralateral hamstring graft (where it's taken from the other leg) could still be a possibility.
Mar 11: R Biceps femoris tear (skiing)
Jul 10: ACLr (hamstring autograft)
Mar 10: L ACL rupture (skiing)
Feb 06: L partial ACL tear (kickboxing)
Dec 03: R bone edema (motorbike)
Jan 01: R patellar chip (motorbike)
May 93: R ACL sprain (hockey)
Ongoing: bilateral PFS and OA

Offline lucha86

  • SuperKNEEgeek
  • *****
  • Posts: 676
  • Liked: 40
Re: An athletes mpfl reconstruction diary
« Reply #637 on: August 07, 2016, 11:27:04 AM »
Hey Snowy thanks for your advice......
i agree with you to be honestly frank, after looking on sagepub and the american publications of orthopaedics publication sites into research on the LARS and the allograft,  and sitting down with some people who i know in the medical world i think its very true to what you said snowy that Artificial grafts remain in an unknown area, and some surgeons are pessimistic regarding artificial ligaments due to lack of research, inability to look at future dates and the major ruptures that have occurred......

Allograft ( donor tissue) seems to be the best viable ligament, the graft can get weaker before it gets stronger but in the long term perspective it is stronger than a ligament used from the patients own tissue (autograft ligament)
In regards to hamstring usage snowy of my own i think the surgeon is against it for two reasons one as i have already had an MPFL reconstruction and the hamstring got used in the leg, it could imbalance the hamstring and also because im hypermobile and my ligaments could be seen as too lax to be an new ACL.......

but yes in terms of choice snowy i think your right and the research has proven that allograft is the best way forward for now..... artifical ligaments are too risky right now.......

still on cancellation list got called last week as a standby in case of a cancellation but they didnt nee me in the end so lets see if im on again for standby this week....... if not after the 16th of august my surgery will be for sure before the 10th of September

Offline Snowy

  • SuperKNEEgeek
  • *****
  • *
  • *
  • *
  • Posts: 2555
  • Liked: 93
Re: An athletes mpfl reconstruction diary
« Reply #638 on: August 08, 2016, 04:06:55 AM »
Keeping fingers very tightly crossed for you! I really hope you're able to get a date soon.
Mar 11: R Biceps femoris tear (skiing)
Jul 10: ACLr (hamstring autograft)
Mar 10: L ACL rupture (skiing)
Feb 06: L partial ACL tear (kickboxing)
Dec 03: R bone edema (motorbike)
Jan 01: R patellar chip (motorbike)
May 93: R ACL sprain (hockey)
Ongoing: bilateral PFS and OA

Offline lucha86

  • SuperKNEEgeek
  • *****
  • Posts: 676
  • Liked: 40
Re: An athletes mpfl reconstruction diary
« Reply #639 on: August 09, 2016, 09:22:54 PM »
the surgeon asked for the legs to be worked as you can tell since the ongoing stability this is normal.....

Offline lucha86

  • SuperKNEEgeek
  • *****
  • Posts: 676
  • Liked: 40
Re: An athletes mpfl reconstruction diary
« Reply #640 on: August 09, 2016, 09:50:08 PM »
So as a sport enthusiast i am trying alot of things to get a better comprehension of what works and what doesn't
ACL, and ALL is a rather defined annoyance of an instability because i find any pivot action weight motioned my knee goes quite literally even, on a TRX knee movements if i twist its buggered if i keep the leg aligned as in to do a plank with a trx its ok..... so what have i found works and what doesnt have become rather interesting....

So what does'nt work.....
- Lunges, and reverse lunges,               - rowing knee goes out laterally
-META Fit,                                           - pivot shift on polytechnic boxes
- pivot boxing,                                     - jump box,
- burpees                                            - some forms of HITT training
-running


What does work
- Battle rope and squat    ( more of a closed kinetic exercise but seems to be ok)
- leg press, leg abduction, leg abduction, leg curl, stepper
-trx no weight on leg parallel
- bike and  stepper
- wall squats, step ups, swimming.......

so when you consider the exercise which gives you the cardio is the crucial thing for me
in maintaining cardio in order to keep the weight off, so it goes to show how much it does effect
when you have an ACL and ALL injury, so its more closed kinetic that is working for me more than open kinetic work

Offline lucha86

  • SuperKNEEgeek
  • *****
  • Posts: 676
  • Liked: 40
Re: An athletes mpfl reconstruction diary
« Reply #641 on: August 13, 2016, 11:11:30 PM »
so i have been trying my best to keep my legs built e.g the vmo and quadriceps those dreaded words anyone with an ACL knee instability hates to hear lol
even some people are asking me for advice in the gym, which i find weird and they ask me how do you get up when your knee collapses and just trying to carry on or hop about and still keep going?
I replied i have two pictures of people in my head that makes me keep going to prove a point, surgeons....

My point is here is the following yes any patient can keep going with a physiotherapy process, but when it becomes a double edged sword and the work you put in you lose when your keep collapses and the quadriceps get inhibited, there must come a point where a line must be drawn.....

Yes Surgeons will also throw patients back at physio to out rule anything muscle issue, but when physio other doctors and trainers have written letters to say.... basically this girls knee is dodgey and needs sorted... you cannot argue against that on a medical or ethical basis or even stats of gym visits, physio receipts and sports massage receipts to prove you have done everything? as these are qualified medical people to create an opinion to help the surgeon reach a conclusion....

My collapsing knee (well now both lol) has also caused damaged to other areas of the body which effects the senses, so it has got worse, and with the left knee going now this surgeon cant come quick enough..... i have a check up on this in the week and im hoping it hasnt got any worse because this particular sense is important not to loose.!

Im on cancellation again this week and hope and pray i might get on board one of the cancellations or it will just have to be September after this week........so then i cant start fresh and know im finally sorted after 3 years !! lol

I think the biggest thing i have learnt from this for future reference is the following always research who your surgeon will be to make sure they have the expertise in the area needed, otherwise things that could occur further because the speciality you need they dont have experience in.....

Never be afraid to ask a question you are the patient and have every right to ask a question because you need to know what is going to happen no matter how a surgeon reacts to it or not, you have to make the right choice for yourself by asking the right questions to your surgeon and this should be respected and never felt to be a negative towards yourself due to your knowledge ....... its your body at the end of the day lol

Offline lucha86

  • SuperKNEEgeek
  • *****
  • Posts: 676
  • Liked: 40
Re: An athletes mpfl reconstruction diary
« Reply #642 on: August 21, 2016, 12:31:42 AM »
so i now have two weeks till surgery.... it will happen in the first week of September.....

I think i have gained a lot of respect in my gym as alot of personal trainers and people who go to my gym, keep saying how do you keep doing it , what drives you? can you train us?
Everyday the personal trainers come up to me saying how many leg days to go and how many i have done....
I suppose there is a lot of honour in that as they respect me for how far im trying to prep myself before surgery.. even with dodgey collapsing knees, as we know the stronger your legs are going in to ACL rehab, the better the recovery....

One gym member asked me a question they said "How can you ever trust another surgeon, after a surgeon has misdiagnosed you?" I thought about it for a minute, and i suppose in this situation it comes in three stages

1) denial - when you know something is wrong and the surgeon says their isnt..

2) anger/frustration- when you find out there is something wrong, and your life job career has changed because of it, and had no apology from the previous surgeon......

3) acceptance - when you finally have to realise that not every surgeon is the same and have hope and faith again as you cant change the past you have to move on......

All the gym members and pt's have told me they will help me if i need weights carried to me, give me disability access, and some of these are strangers in the gym that i talk to, which gives me profound hope, some are also doctors there and they have even offered their hope its nice to see, how everyone can work together.....

Am i nervous i suppose anyone would be after 4 knee surgeries to get it right, but i know this surgeon is a top surgeon, who knows their stuff, and generally deals with athletes and is a very important person when it comes to the orthopaedic world, i think sometimes the surgeon is shocked by my knowledge and doesn't know how to react to it as not many patients walk in using all the abbreviations for the Knee, and medical terminology

I hope now after this surgery of an ACL and ALL reconstruction to stop the pivot shift collapse that i can finally, gain my quality of life back, as my other good knee has an MCL ligament sprain because of this knee instability... so this will be my last post till after the surgery.........

sometimes i suppose we all have to take a deep breath and try, the past cannot be changed, the errors cannot be changed, but at least there is still hope............ as they say in some martial arts the brave do not life forever the cautious do not live at all, so there is always hope to achieve a better knee.........




Offline Clarkey

  • SuperKNEEgeek
  • *****
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • Posts: 4190
  • Liked: 75
  • Neil TheElephant knee packed up carrying his trunk
Re: An athletes mpfl reconstruction diary
« Reply #643 on: September 01, 2016, 05:52:21 PM »
Hi Lucha,

Not long now until you have your long awaited surgery, itís reassuring that you having an OS specialised in your specific type of surgery. Pre-op nerves are normal, surgery is always going to be a daunting experience to go through. I try to think before going under GA that I am in expert hands, it is very unlikely something will go wrong during the surgery.

I assuming the 1st week of September is from Monday 5th to Friday 9th. You are well prepared for the surgery, with good  in depth knowledge about it, that has impressed your OS.

Good luck, I am sure everything will go like clockwork for you.

[email protected]
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline lucha86

  • SuperKNEEgeek
  • *****
  • Posts: 676
  • Liked: 40
Re: An athletes mpfl reconstruction diary
« Reply #644 on: September 03, 2016, 06:47:55 PM »
hey nick i hope you are well?
Yes my surgery is early this week having to stay in the city, cheapest hotel i could find was £220 for the night before, so the hospital rang me for my pre op questions over the phone to check i was ok for the surgery to go ahead...

I have to stay in for a night for me as i person i prefer to go home so i can just recover and have a good sleep, but cant argue against the surgeon lol

The surgeon i have is like you say very experienced in multi ligament injuries, and i just hope he can fix me, im nervous burst into tears as just so much and i still have o much to do, but im glad its finally getting sorted after three years.....

this has just shown me always follow your gut instinct when something isnt right, because its a good instinct to follow.........