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Author Topic: Knee surgery using the NHS?  (Read 4191 times)

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Offline Georgie28793

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Knee surgery using the NHS?
« on: December 26, 2014, 03:52:50 PM »
Hello everyone,

I'm hoping there are a few people on here who have had surgery through the NHS and would be willing to share their experiences with me.

I'm due to have a TTT, MPFL reconstruction, distal tibial derotational Osteotomy and trochleoplasty in a couple of months, but I'm aware there are not many surgeons in the UK who perform the trochleoplasty.

I've had a look through a lot of diaries and post but haven't found my surgeons name mentioned anywhere and would love to hear from any of his other patients.

I am especially interested in the trochleoplasty but any info on any of these procedures would be greatly appreciated :-)

Thanks in advance

Georgie
2000/14 - multiple dislocations of both knees
August '14 - bad LK dislocation
April '15 - LK MPFL reconstruction, tibial tubercle osteotomy and supramalleolar derotational osteotomy

Offline vickster

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Re: Knee surgery using the NHS?
« Reply #1 on: December 26, 2014, 04:18:34 PM »
There was a lass called Summer007 who had several surgeries including trochleoplasty. I think on the South Coast, possibly Bristol if you do a search. She hasn't posted much lately

http://www.kneeguru.co.uk/KNEEtalk/index.php?action=profile;area=showposts;u=37655

Where in the UK are you? I think there was another trochleoplasty patient in Cardiff

There's some information on the procedure here

http://www.kneeguru.co.uk/KNEEnotes/search/node/Trochleoplasty
« Last Edit: December 26, 2014, 04:23:35 PM by Vickster »
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline Georgie28793

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Re: Knee surgery using the NHS?
« Reply #2 on: December 26, 2014, 06:57:16 PM »
Thanks Vickster, I will read those now.

I am located in the south east, in Berkshire. I have read a lot of accounts from people in the US who have been able to talk to their surgeons previous patients, I would really like to hear from a patient from my OS but don't really have any way to go about it due to patient privacy!

Thanks for your reply,

Georgie
2000/14 - multiple dislocations of both knees
August '14 - bad LK dislocation
April '15 - LK MPFL reconstruction, tibial tubercle osteotomy and supramalleolar derotational osteotomy

Offline vickster

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Re: Knee surgery using the NHS?
« Reply #3 on: December 26, 2014, 07:09:19 PM »
I don't think you would be able to in the UK.  Best to have a proper discussion with your surgeon.  You will need to be prepared for pain (all the bone work), a long period on crutches /in a brace, a long time off work, tough rehab.  You'll want to understand what each part of the operation entails and what the rehab is for each

Personally, I wouldn't be fussed about talking to patients.  Consultant surgeons working in the NHS are highly trained and continually assessed and monitored, if they are approachable, open and are happy to spend time explaining everything, that would be enough for me (I've been seeing the same knee surgeon for over 5 years, albeit privately in my case.  He ticks all these boxes, and came highly recommended by my GP).  One potential with the NHS is that the actual surgery is done by the registrar, not the Consultant but that won't be the case with something as complex as your op

Who's the surgeon, someone on here may well have been treated by him if he is a top knee specialist? I'll see if I can remember anyone!
« Last Edit: December 26, 2014, 07:11:08 PM by Vickster »
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline Georgie28793

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Re: Knee surgery using the NHS?
« Reply #4 on: December 26, 2014, 08:11:57 PM »
To be honest until I started reading up on the operations I'll be having I was perfectly confident with my surgeon, and now that I've read only a few surgeons do the trochleoplasty, I am slightly more nervous!

All of my surgery has come as a bit of a surprise - there was a lot to go through when I last spoke to my surgeon so I understand not every detail of the surgery was gone over but I am hoping I will have another appointment with him before the operation, I am just waiting for a letter with the date now. I am hoping I will see him again to discuss further before the op as there is a lot I would like to go over.

I met both the registrar and my consultant, Mr Chissell. I have looked through the knee guru pages and haven't come across his name yet. Any help would be greatly appreciated!
2000/14 - multiple dislocations of both knees
August '14 - bad LK dislocation
April '15 - LK MPFL reconstruction, tibial tubercle osteotomy and supramalleolar derotational osteotomy

Offline vickster

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Re: Knee surgery using the NHS?
« Reply #5 on: December 26, 2014, 08:19:20 PM »
I do recognise the name (quite apt for an orthopaedic surgeon :D ) but not for several years.  I think he was the surgeon for one forum member, but she doesn't use the forum any more as all fixed.  Had an ACL reconstruction

If you search for him, he comes up as experienced in derotation osteotomy :)

http://www.kneeguru.co.uk/search.html?cx=partner-pub-1712090951856680%3Arbli5914bwc&cof=FORID%3A9&ie=ISO-8859-1&q=chissell&sa=Search+Site

http://www.kneeguru.co.uk/KNEEnotes/specialists/knee-surgeon/dr-mr-hugh-chissell
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline WonkeyDonkey

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Re: Knee surgery using the NHS?
« Reply #6 on: December 26, 2014, 11:22:19 PM »
You may find out more information about him on this website. It is the website of the OS' of Frimley Park Hospital.

http://www.jointreaction.co.uk/consultant.php?id=2

This would be my local hospital, but I venture slight further to Basingstoke.

Offline Georgie28793

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Re: Knee surgery using the NHS?
« Reply #7 on: December 27, 2014, 12:19:22 AM »
Vickster and WonkeyDonkey -

Thank you for your replies! Both were very useful - like I said in my previous post, all this surgery has come as a great surprise. When I was told I would need surgery, I thought it would be a minor keyhole surgery at most so you can imagine my surprise to hear the amount of work that needs doing to my leg, the trochleoplasty and derotational Osteotomy are my biggest worries so I'm very glad to read he is experienced in the Derotational Osteotomy. Can't seem to find much anywhere about the trochleoplasty.

I have met Mr Chissell (definitely had to be an orthopaedic surgeon, Vickster!) twice now and both times I have felt very confident with him, so I am not worried as such but more nervous about the scale of the surgery.

If you don't mind me asking, do you both have private health care?
2000/14 - multiple dislocations of both knees
August '14 - bad LK dislocation
April '15 - LK MPFL reconstruction, tibial tubercle osteotomy and supramalleolar derotational osteotomy

Offline vickster

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Re: Knee surgery using the NHS?
« Reply #8 on: December 27, 2014, 12:31:50 AM »
I do yes, although I do occasionally have to pick up the tab. My employer covers the cost.  My OS does have an NHS practice too however, as sooner or later the private insurers will probably say enough is enough!  I had an accident in February and I needed surgery on my leg for which they picked up the tab plus imaging and quite a lot of the physio cost
« Last Edit: December 27, 2014, 12:36:59 AM by Vickster »
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline Georgie28793

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Re: Knee surgery using the NHS?
« Reply #9 on: December 27, 2014, 08:59:24 AM »
wow that's excellect, sounds like a good company to work for!

I am already considering seeing if I can get my physio privately. I have had physio through the NHS for my knees before and whilst I felt an improvement, I want the best possible recovery and I don't think the NHS physio is my best bet.

Do you mind me asking just how much physio you had, and how it was spaced out? I know everyone's recovery will be different but I'm trying to get an idea of how intensive it will be and how likely it is I'll be able to pay for it privately!
2000/14 - multiple dislocations of both knees
August '14 - bad LK dislocation
April '15 - LK MPFL reconstruction, tibial tubercle osteotomy and supramalleolar derotational osteotomy

Offline vickster

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Re: Knee surgery using the NHS?
« Reply #10 on: December 27, 2014, 09:54:02 AM »
I've had lots of physio over the years, but I've not had a major leg/knee op so can't really speak to post op rehab. I had a couple of sessions after each arthroscopy.  I needed quite a lot after my recent injury, but more because it affected my back, or getting back into cycling too quickly did!

 You would be best to talk to your surgeon.  You'll also want to work with a physio who has experience in rehabbing your type of surgery, so probably be one who works with his patients? Don't know how close you are to the hospital or what your support network is like. I assume that given the surgery you ate having, you won't be able to drive for several months, depending on which leg, you mustn't drive until the surgeon has cleared you to do so for insurance reasons. So lots to consider, you might be best off with the hospital NHS so there can be communication with the surgical team if necessary. Then move onto private if needed for strength work after a few months
« Last Edit: December 27, 2014, 10:34:12 AM by Vickster »
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline Georgie28793

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Re: Knee surgery using the NHS?
« Reply #11 on: December 27, 2014, 11:01:03 AM »
Vickster -

You have given me a lot to think about! Sounds stupid but I didn't actually think about driving.... Obviously knew I wouldn't be driving initially but thinking about it I probably won't be able to drive for a quite a while. I am having my left leg done first and a similar surgery on my right leg approx 6 months after, depending on my recovery.

I am very worried about my work, feels like they are just going to fire me with all the time I'll be having off! I am 21 and do not have anyone who would be able to drive me to work anyway.

Good idea with the communication by using the NHS physio. To be honest, the more I think about it the more I need to clarify things with my surgeon, however I'm not sure how to go about having a meeting with him? I'm assuming I'll have another appointment with him before the op anyway.

Thanks for your replies, so helpful to hear from people who have already had surgery!

The waiting is killing me now!

2000/14 - multiple dislocations of both knees
August '14 - bad LK dislocation
April '15 - LK MPFL reconstruction, tibial tubercle osteotomy and supramalleolar derotational osteotomy

Offline vickster

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Re: Knee surgery using the NHS?
« Reply #12 on: December 27, 2014, 11:19:27 AM »
Contact the surgeon via his secretary and ask if you can see him.  Otherwise, he may be ok with answering questions by email.  If you do see him, make a list of all your questions before you go and try to take someone else to the appointment with you to listen

The most important thing is to know how long you'll be off work.  I expect it'll be at least a couple of months, same for driving (perhaps you could work from home a bit)

You'll need to look at your contact around sick pay etc, statutory is almost nothing.  Are your family close, you'll want to stay with them (or some friends) for a few weeks if you live alone.  Crutches make everything difficult, I assume you won't be able to put any weight through the leg for at least 6 weeks while the bones heal

There are quite a few practical guides that people have posted about how to cope after major knee surgery, have a search with the search function :)
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline Lottiefox

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Re: Knee surgery using the NHS?
« Reply #13 on: December 29, 2014, 09:45:29 PM »
I know a member from here who doesn't post now - she had a successful trocheoplasty some years ago in UK on NHS - not sure who did it. If you private message me with an email address I can try and get her in touch with you.
Bilateral patella OA since 2009, no surgeries.
Euflexxa working well x3 to current
Right forefoot CRPS post fusion surgery 2011
Refusing to let the ailing parts stop me....

Offline Georgie28793

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Re: Knee surgery using the NHS?
« Reply #14 on: December 31, 2014, 03:40:19 PM »
Lottiefox - thank you! Will pm you now :-)
2000/14 - multiple dislocations of both knees
August '14 - bad LK dislocation
April '15 - LK MPFL reconstruction, tibial tubercle osteotomy and supramalleolar derotational osteotomy

Offline vickster

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Re: Knee surgery using the NHS?
« Reply #15 on: December 31, 2014, 03:54:27 PM »
I think you need at least 20 posts to send/receive PMs, so you might want to post a few times in the social sections of the forum :)
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline Georgie28793

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Re: Knee surgery using the NHS?
« Reply #16 on: December 31, 2014, 05:18:47 PM »
Literally just spent so long trying to work out how to send a private message....

Haha thanks for telling me!!

I have just watched a video on how the trochleoplasty is performed. Not sure how I feel right now....

I can't stop researching all the procedures and recovery etc, not sure if this is a good thing or a bit OTT?! I'm hoping once I talk with the OS I will calm down a bit!
2000/14 - multiple dislocations of both knees
August '14 - bad LK dislocation
April '15 - LK MPFL reconstruction, tibial tubercle osteotomy and supramalleolar derotational osteotomy

Offline vickster

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Re: Knee surgery using the NHS?
« Reply #17 on: December 31, 2014, 05:24:42 PM »
Personally, I wouldn't want to watch operations, especially ones where bones are  cut, drilled etc ...I'd rather not know what they are doing!  Especially after A&E tried unsuccessfully to drain the haematoma on my shin under an ineffective local anaesthetic (job finished properly by surgeon a few days later under GA)!  I can just about deal with the dentist!

I think you need to understand the implications of having all of the surgeries together - the post op, how long will be laid off, length of rehab, physio etc :)  Don't stress yourself out, especially as every surgeon, surgery, protocol and especially patient is different
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline WonkeyDonkey

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Re: Knee surgery using the NHS?
« Reply #18 on: January 01, 2015, 05:49:15 PM »
Sorry, only just round to replying.

I do not have private health care, however I did pay for my first appointment (my choice of OS) and arthroscopy, then I transferred to my OS' NHS clinic as my high tibial osteotomy was out of my reach financially. I have since had another arthroscopy on the NHS as well.
As for physio, I have had both private and NHS physio. After my HTO and my largest op, I had 6 weeks of NHS physio and 7 weeks of knee class physio, although I had loads of exercises to do at home in between appointments. Then I felt that I still needed help, so actually found my NHS physio also worked privately so booked in with him privately to continue getting help. I have also worked with two other physio's within the same practice. Physio costs around 40 per half hour.
For my HTO I watched it online, but actually found that mine was done slightly differently, but I needed to know what was going to happen, so can understand why you have done it.
During my recovery I borrowed a wheelchair from the Red Cross, just needed a signed letter from my GP, think you live fairly locally to me, and I used Yateley branch.
Vickster - did you have another bike accident? Hope all is getting better now. How are you finding the Ostenil Plus injection. I had one in October.

Offline vickster

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Re: Knee surgery using the NHS?
« Reply #19 on: January 01, 2015, 06:21:06 PM »
Hi Wonkeydonkey, I've sent you a PM :)
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline Georgie28793

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Re: Knee surgery using the NHS?
« Reply #20 on: January 02, 2015, 10:26:31 AM »
WonkeyDonkey,

Thanks for the reply, I actually live very close to Yately! Very useful to know about the wheelchair loan - I never knew you could do that, and it will definitely be something I will look into nearer the time.

As for the physio, it must have been great to find out your NHS physio worked privately too, I wonder if a lot of them do? I have had physio with the NHS for my dislocations before, but only entitled for a few weeks like yourself. So I think I will look into the private physio, hopefully I will have a similar situation to you and be able to use my NHS physio privately!

My post op mobility is what I am most worried about. I am only 21 and my surgeon has told me already that I will never have the same range of motion as I do now. I am worried that having 4 operations at once will prevent me from ever having the amount of muscle and strength in my leg that I do now. I guess my surgeon wouldn't have put me forward for these surgeries if they weren't necessary though!

Thanks for your replies, it is so useful to hear about recoveries etc from other patients!
2000/14 - multiple dislocations of both knees
August '14 - bad LK dislocation
April '15 - LK MPFL reconstruction, tibial tubercle osteotomy and supramalleolar derotational osteotomy

Offline Lottiefox

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Re: Knee surgery using the NHS?
« Reply #21 on: January 02, 2015, 02:15:38 PM »
Hi

Yes you need 20 posts to send PMs - if you head down to the Games section you'll quickly stack up some more posts. I have sent the girl I was talking about a message so i am sure she will be happy to exchange emails with you. I'll message you when she replies.

I think a degree of research and information is a good thing. I think watching the surgery may not always be a positive, although it does help you understand the dynamics of the knee but it is often quite horrific when you're not a medic! Being well informed means you can be aware of what has happened and what you need to do to maximise your recovery. Being totally submerged in it isn't always positive as it can mean you focus on the risks and negatives rather than the very real benefits the surgery should bring you.

Take care,

Lottie
Bilateral patella OA since 2009, no surgeries.
Euflexxa working well x3 to current
Right forefoot CRPS post fusion surgery 2011
Refusing to let the ailing parts stop me....

Offline vickster

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Re: Knee surgery using the NHS?
« Reply #22 on: January 05, 2015, 04:09:22 PM »
Georgie, although you are having multiple procedures, you might find this new KneeGuru video interesting

http://www.kneeguru.co.uk/KNEEnotes/specialist-commentaries/ms-dorte-nielsen/2014/rehabilitation-after-arthroscopic-trochleoplasty
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline Georgie28793

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Re: Knee surgery using the NHS?
« Reply #23 on: January 05, 2015, 09:49:27 PM »
Vickster - thank you for the video!

Very interesting to watch, and amazing how people can be doing physio 3 days after a knee operation?!

My surgeon has told me they will be doing open surgery on my knee, with an incision about 10-12cm in length. So I'm not sure if my post op would be the same as an arthroscopic trochleoplasty, as I'm guessing there has to be some time for the incision to heal?

I wonder if having a larger incision changes the post op recovery at all? I would be grateful for any information on this!!
2000/14 - multiple dislocations of both knees
August '14 - bad LK dislocation
April '15 - LK MPFL reconstruction, tibial tubercle osteotomy and supramalleolar derotational osteotomy

Offline vickster

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Re: Knee surgery using the NHS?
« Reply #24 on: January 06, 2015, 03:18:57 PM »
Ah yes, I expect the rehab will be very different with the bones being moved with the TTT and osteotomy

You'd be best to look through some of the post op diaries.  Cbrady is a poster who I think has had both legs de-rotated and she's a youngster like you  ;D

Have you any more news from the surgeon?
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline Georgie28793

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Re: Knee surgery using the NHS?
« Reply #25 on: January 06, 2015, 07:20:42 PM »
Nothing from the surgeon yet, I am waiting for a sort of confirmation letter regarding the surgery, so I will see what that says and go from there.

He is fully booked until late March/early April anyway so I have a few months to prepare!

I will look Cbrady up now - so comforting to read about other people's experiences!

I am wondering about doing my own post op diary when the time comes!
2000/14 - multiple dislocations of both knees
August '14 - bad LK dislocation
April '15 - LK MPFL reconstruction, tibial tubercle osteotomy and supramalleolar derotational osteotomy

Offline Summer007

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Re: Knee surgery using the NHS?
« Reply #26 on: March 15, 2015, 07:07:33 PM »
Hi Georgie,

I'm not sure whether you are still using this thread or not as it was a few months ago that you originally posted. Have you had the surgery yet?

As Vickster said, I'm on the South Coast. I haven't posted for a long while, its probably even been a couple of years, so my post-op diaries aren't complete and more recent surgeries haven't been included. I'd be happy to answer any questions or just have a general chat if you would still like to. Feel free to message me if you would prefer.

Summer :)

October 2011-L LR
August 2012-L MPFL Recon
July 2013-L TTO & MPFL revision
March 2014-L Arthroscopy surgery

Offline Georgie28793

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Re: Knee surgery using the NHS?
« Reply #27 on: March 16, 2015, 04:50:24 PM »
Hi Summer,

Funnily enough I just checked Knee Guru today and saw your post! I have not had my surgery yet (24th April) so would really appreciate some info on your surgeries! I assume you used the NHS?

What sort of brace were you in after your ops? And how long were you in hospital for?

Thanks for your help :-)

Georgie
2000/14 - multiple dislocations of both knees
August '14 - bad LK dislocation
April '15 - LK MPFL reconstruction, tibial tubercle osteotomy and supramalleolar derotational osteotomy















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