Advertisement - Hide this advert





Author Topic: Fulkersons scheduled with existing quad atrophy  (Read 803 times)

0 Members and 1 Guest are viewing this topic.

Offline Jellybean

  • MINIgeek (20-50 posts)
  • **
  • Posts: 27
  • Liked: 1
Fulkersons scheduled with existing quad atrophy
« on: July 12, 2014, 04:58:59 PM »
Hi all,

I had a lateral release 15 months ago due to constant patella related knee pain that did not respond to physical therapy. My quad was not weak when I initially injured it but once the pain started it continued to weaken because the pain was preventing me from using it. After the surgery I suffered a great deal of quad atrophy as my knee would not tolerate exercises that targeted the portion of my quad that is on the outer side of my leg next to my knee. I have spent months and months doing a thousand straight leg lifts a day but it was not effective. Two different physical therapists referred me back to the surgeon saying they didn't know how to help because my knee would not tolerate any of the options to strengthen the atrophied area.  I can not bare any weight on my knee in a bent position so stairs are very difficult, lifting things is very difficult and most physical activity isn't possible although I can ride a bicycle with no real difficulty.

I am in the military and will be released soon if my knee doesn't improve. I am scheduled for a faulkerson  osteotomy in a month. Has anyone had this done with existing atrophy and had success?  My hope is that if the surgery is successful my knee will begin to tolerate the exercises that target the quad but I'm worried that isn't a realistic expectation. 
« Last Edit: July 14, 2014, 04:10:16 PM by Jellybean, Reason: typo »
11/12 MRI dx damage to articular cartilage with patellar mal-tracking
3/13 right knee lateral release, meniscetomy, chondroplasty of patella
09/13 Knee condition deteriorated. 3rd round Intense physical therapy
08/14 Fulkerson Osteotomy

Offline MDAL

  • Forum Faithful
  • ****
  • Posts: 450
  • Liked: 108
Re: Faulkersons scheduled with existing quad atrophy
« Reply #1 on: July 12, 2014, 07:02:04 PM »
I am sort of in the same boat regarding quad atrophy, although for different reasons, a series of surgeries which required long term immobilization, then problems with cartilage that kept on crutches for several months due to pain... I can't do stairs with the bad knee for example, since don't have the power, can only walk/limp in straight ground.

I have sorted out the cartilage problems, no more pain, and I have been trying to grow back muscle, and I am a relatively young male (mid 30s), but gaining the muscle back has been no piece of cake.

I would recommend a TENS machine to start (you can get good ones for less that a 100 dollars), but not sure if you can bear it, might cause you pain, but it's good to start to loose sensitivity...

Offline Jellybean

  • MINIgeek (20-50 posts)
  • **
  • Posts: 27
  • Liked: 1
Re: Faulkersons scheduled with existing quad atrophy
« Reply #2 on: July 14, 2014, 04:09:29 PM »
I am sort of in the same boat regarding quad atrophy, although for different reasons, a series of surgeries which required long term immobilization, then problems with cartilage that kept on crutches for several months due to pain... I can't do stairs with the bad knee for example, since don't have the power, can only walk/limp in straight ground.

I have sorted out the cartilage problems, no more pain, and I have been trying to grow back muscle, and I am a relatively young male (mid 30s), but gaining the muscle back has been no piece of cake.

I would recommend a TENS machine to start (you can get good ones for less that a 100 dollars), but not sure if you can bear it, might cause you pain, but it's good to start to loose sensitivity...

I am hoping this surgery will put me in the position you're describing. No more pain in the joint but still lots of work to build back the muscle. I know still not fun but it's very difficult right now being told by the OS the problem is just no muscle and being told by physical therapy we can't do anything about the lack of muscle because your joint can't tolerate anything that would strengthen it.

I have full range of motion its just as soon as weight is applied to the joint it goes way out of alignment and causes immediate unbearable pain. The physical therapy folks always want me to stop immediately and swelling and heat appear immediately in the joint.
« Last Edit: July 14, 2014, 04:16:51 PM by Jellybean »
11/12 MRI dx damage to articular cartilage with patellar mal-tracking
3/13 right knee lateral release, meniscetomy, chondroplasty of patella
09/13 Knee condition deteriorated. 3rd round Intense physical therapy
08/14 Fulkerson Osteotomy

Offline tinydinosaur

  • Forum Faithful
  • ****
  • Posts: 209
  • Liked: 19
Re: Fulkersons scheduled with existing quad atrophy
« Reply #3 on: July 19, 2014, 08:28:45 PM »
~not a doctor

i've read good and bad things about this surgery, it's commonly called a tibial tubercle transfer yes? i would definitely read up on as much of that as you can, look at complications, success and failure rates. google is your friend.

i too had a lateral release resulting in further complicating and aggravating my knee pain and causing severe instability, all of my quad muscles ending up literally wasting away to the point where my kneecap stuck out like a mushroom cap. my original surgeon basically said i just needed to do stuff, even though it was swollen like a balloon at follow-ups post-op.

eventually i made it to a surgeon who knew right away what the problem was, she performed a medial capsular plication (i think that's right, i could look up the specific name if need be). after i had that done i was able to rehab and gain *some* muscle back, upon following up with her later she told me that i needed the MPFL surgery, and that she did not do that initially due to the severe amount of muscle wasting. again after this surgery i was able to gain even more muscle back but pain persisted, she scoped my knee again hoping it would help but noted that it had progressed to a grade 4 lesion on my kneecap. however the plication and then MPFL surgeries fixed my kneecap instability while with severe atrophy. i think the atrophy is still causing problems but that's another story.

there is a brace for this, have you tried it? it did not work for me because of the lesion and being unable to tolerate pressure from a brace on the kneecap. but it works really well for helping those who can tolerate it and need to build muscle. it looks like this one, not sure of the brand as its been some years:
http://canada.betterbraces.com/donjoy-tru-pull-lite

~this is my opinion~ if you went back to see the surgeon who first recommended the lateral release i would go get a second opinion if possible. as others have stated (you can google it ;D ) the failure rate of lateral releases is HIGH, it almost always causes severe instability and lasting weakness - of 10-15% - and is usually only recommended if everything else has been tried, as a last gasp hail mary sort of thing. so i myself, knowing what i do now would be wary of said surgeon.

the horrible thing about it is that with the right physio, assuming there was no cartilage wear causing pain, the problem in the first place could have been avoided.


some thoughts:
can you do VMO exercises without aggravating it?

things i've discovered to help me gain some muscle back.. as long as my weight is not directly over my knee i can tolerate and exercise it that way... such as leaning forward to go upstairs (still cannot go down properly), practicing gentle weight shifting where your weight is forward and pressing through your toes.

i've been rehabbing my knee for three years (from the last major surgery) and it's at about 20% strength, it would be a lot easier if i had been able to do weight bearing exercise but alas, i'm stuck with straight leg raises and weight shifting (no squats, leg extensions or leg presses).

i wish you luck, and apologies for this wall of text!
« Last Edit: July 19, 2014, 08:32:42 PM by tinydinosaur »















support