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Author Topic: Knee specialists in London please  (Read 1002 times)

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Offline pmorgan

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Knee specialists in London please
« on: June 01, 2014, 05:17:31 PM »
Hi all, there are many positive recommendations on this forum. I'm looking to to have the torn part of the meniscus (white zone) shaved off.

Could I ask two questions:

1. Apart from the difference in the fee, what differentiates a fee-assured specialist and those that charge more, often times more than twice the amount approved by the insurer. I.e. if I have to choice to have everything covered by the insurance vs paying an equivalent amount, why would I choose to pay?

2. Any specialists that you would avoid and why?


Thank you.

Offline vickster

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Re: Knee specialists in London please
« Reply #1 on: June 01, 2014, 07:50:07 PM »
I think I would choose to pay because of a very strong personal recommendation to see a specific surgeon (be that another healthcare professional, such as GP or physio - which was indeed so for me, for my knee and elbow, or family/friend/team mate etc).

Or a need to see that surgeon because of his/her specialism meeting my very specific needs / goals / condition / wider health etc

I would want to see a specialist who specialises in knees and, importantly for me, practices locally and has convenient clinics, surgery slots etc

I assume the fee charged by the surgeon is driven by the cost of running his practice but also evaluation of his expertise, worth etc

None to avoid - I have seen two knee surgeons in the last 5 years.  I only saw the second due to an insurance issue that required a referral (it was very inconvenient to travel 2 hours each way for 15 minute consultations, and although I didn't take to him personally, he is a good surgeon).

 I am now back under the care of the first locally, who manages my knee, operated recently on my shin following an accident and is a good egg and highly experienced :)

As mentioned, I was referred to him in Oct 09 by my GP who says he is the best knee specialist in the area (I am Sutton, Surrey), I had a lateral menisectomy in Feb 10.  I have two more tears currently but we are leaving those, I am having physio (not specifically due the knee though)

I would avoid surgeons who aren't knee specialists.  If you look on the Bupa site, you can see the types and number of surgeries they do.  I would think any knee surgeon will do lots of menisectomies (on their own or alongside ACL reconstructions etc)

Whom have you seen who says that the menisectomy is needed, presumably you have seen a surgeon after an MRI?
« Last Edit: June 01, 2014, 08:04:43 PM by Vickster »
Came off bike onto concrete 9/9/09 (lat meniscus, lat condyle defect)
LK scopes 8/2/10 & 16/12/10
RK scope 5/2/15 (menisectomy, Hoffa’s fat pad trim)
LK scope 10.1.19 medial meniscectomy, trochlea MFX
LK scope 19.4.21 MFX to both condyles & trochlea, patella cartilage shaved, viscoseal, depo-medrone

Offline pmorgan

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Re: Knee specialists in London please
« Reply #2 on: June 01, 2014, 08:40:41 PM »
Thanks so much, I wasn't aware BUPA lists the number of operations.

I've got a horizontal meniscal tear that I otherwise don't notice except for prolonged dull ache after running. Which is the reason I had to stop running.

Saw a knee specialist who has further referred me to 4 operating knee specialists. The top of the list was a non-fee assured specialist, who did 5-50 arthroscopic meniscectomies and 5-50 several other types of knee surgeries.

I got booked to the second on the list who does:

only 1-5 arthroscopic meniscectomies,

but 5-50 multiple arthroscopic operations on knee (including meniscectomy, chondroplasty, drilling or microfracture)
 
plus 5-50 Autograft anterior cruciate ligament reconstruction (including arthroscopic and simple meniscectomy) 

I think these are more complex procedures than a standalone meniscectomy AND do sometimes include meniscectomy.

On this basis would it be acceptable to choose the 2nd specialist?
« Last Edit: June 01, 2014, 08:50:40 PM by pmorgan »

Offline vickster

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Re: Knee specialists in London please
« Reply #3 on: June 01, 2014, 08:46:45 PM »
Why were you referred by a knee specialist for a menisectomy?  Is he not a surgeon?  Did he recommend one over the others, give his opinion on them

Don't forget surgeons don't operate only on Bupa patients so it's only an indication, most also have an NHS practice too, and will be doing plenty of menisectomies there.  I wouldn't get hung up on the numbers.  The other techniques aren't really more complex, they have a different purpose and are quite commonly performed to deal with articular cartilage issues (nothing to do with the meniscus, in a trauma that causes a meniscus tear, the articular cartilage can be damaged too by the twisting, impact, which is what happened to me)

To be honest, if I were you, if no mechanical issues, I'd leave it alone for a while and get some good sports physio. 
Have a read of the meniscus primer in the information hub  http://www.kneeguru.co.uk/KNEEnotes/primers

Removal of the meniscus often leads to arthritis as that cushion is removed.  Ask the surgeon for advice (bearing in mind they are surgeons), see what vibe you get from him.  If he is open, honest, clear, friendly etc all of those are, in my view, good indicators (although privately, they have more time to discuss etc)




« Last Edit: June 01, 2014, 08:57:12 PM by Vickster »
Came off bike onto concrete 9/9/09 (lat meniscus, lat condyle defect)
LK scopes 8/2/10 & 16/12/10
RK scope 5/2/15 (menisectomy, Hoffa’s fat pad trim)
LK scope 10.1.19 medial meniscectomy, trochlea MFX
LK scope 19.4.21 MFX to both condyles & trochlea, patella cartilage shaved, viscoseal, depo-medrone

Offline pmorgan

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Re: Knee specialists in London please
« Reply #4 on: June 01, 2014, 09:04:05 PM »
Thanks, and correct, no catching or other mechanical issues. The person who did a referral is a well-known knee specialist, but I understand he doesn't operate often. Not sure how that works, but anyway.

No swelling after running either, but a dull persistent pain after a run that lasts days makes me type this stuff on this forum hoping that an op would sort it out  ;)

It's been over 6 month like that, and I really want to get back into running, even on a tread mill. In the meanwhile I did cycling and swimming, but oh boy it feels good after a run!

Offline vickster

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Re: Knee specialists in London please
« Reply #5 on: June 01, 2014, 09:07:46 PM »
My knee is so battered, no running for me (and I always hated it, so it's a good excuse)...I cycle though.  My meniscus is quite degenerate, so removing tears would probably just be a band aid, and more would happen, so am leaving well alone (and recovering slowly from the shin surgery, a result of being knocked off my bike  ::) )

Good luck with the surgery.  You won't be able to run for a good few weeks, if not months after, get a good physio on board
« Last Edit: June 01, 2014, 09:11:03 PM by Vickster »
Came off bike onto concrete 9/9/09 (lat meniscus, lat condyle defect)
LK scopes 8/2/10 & 16/12/10
RK scope 5/2/15 (menisectomy, Hoffa’s fat pad trim)
LK scope 10.1.19 medial meniscectomy, trochlea MFX
LK scope 19.4.21 MFX to both condyles & trochlea, patella cartilage shaved, viscoseal, depo-medrone