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Author Topic: Lateral Release instead of TTT?  (Read 625 times)

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Offline justlikemusic

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Lateral Release instead of TTT?
« on: February 20, 2015, 03:50:13 PM »
Greetings and thank you for taking the time to read my post. I was booked for a TTT and Lateral Release today since it was found that my patella tendon was 14mm the wrong way, and the threshold was 13mm. Apparently there is some 'subluxing and tilt' in the patella also, with the MRI showing Grade III or IV Chondromalacia.

SO.....  "operation: Right knee arthroscop, patellar chondroplasty, lateral releas"
The got the spelling a bit short... and so to the operation!

Turns out only a Chondroplasty and Lateral Release was done, no TTT! Great (sarcasm), what does this mean? I will post extracts from the surgeon's report below:

"Anterolateral, superolateral and anteromedial portals were created. Arthroscopic
examination of the knee revealed:

Patella: grade II lateral facet, chondroplasty performed, sits laterally subluxed and tilted,
engages trochlear notch at 70 degrees flexion

Everything else was 'intact' or in 'good condition'

Lateral release performed via anterolateral and superolateral portals.

Post release patella sits centrally, engages trochlear notch at 20 degrees flexion.

Thus tibial tuberosity transfer not indicated as this would lead to excessive patellar medialisation and possible instability.

- Can have contralateral knee surgery in 3 months"

Now my surgeon is unavailable over the weekend as it was around 6pm when I woke up. I am sure a doctor isn't going to sit down and give me a detailed response to my questions when they come around in the morning as it's a public hospital so I'd appreciate any comments on my questions below. I will also be actively googling this in the mean time as its nearly midnight and I cant sleep. They cannot give me any sleeping tablets since I am on an IV drip with Fentanyl and a release button.

Question 1: With my knee sitting laterally subluxed and tilted and 'engaging the trochlear notch at 70 degrees, does this mean my knee cap wasn't sitting in the right spot and only sitting in the trochlear groove at 70 degrees or more?

Question 2: With the patella sitting centrally and engaging the troclear notch at 20 degrees flexion, is this acceptable?

Question 3: Did they take the easy way out and should have done the TTT instead of the lateral release?

Question 4: They didn't elevate my leg or provide me with any ice pack. I have now requested a bag of ice and will put that on there for some time (Its 12am midnight now, so I'll ask for another one at about 5am if I pass out for a few hours). Should I elevate my leg? Should I be really focused on icing this knee? (I have a 1.5+ hour drive home so I can tell the wife to bring ice etc). I have a Donjoy ICEMAN3 with her which she can bring in the morning and we can setup, but the hospital is always funny about electric devices.

I have the nerve block still in effect, so I am anticipating a great pain when it wears off and I want to reduce downtime from working as much as I can.

Question 5: "Can have contralateral knee surgery in 3 months" - what does this mean? Does it mean I can have the left knee done now in three months time? (As both are bad).

Thank your for taking the time to read my post, and I really appreciate your feedback or comments.

Offline justlikemusic

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Re: Lateral Release instead of TTT?
« Reply #1 on: March 02, 2015, 03:39:46 PM »
Well I am eight days post-op and off pain meds... only anti-inflammatories and lots of icing. I feel very violated about the whole procedure and I doubt I'd have anything done in the 'public system' again, even though I went through a private/public surgeon who operates in a public hospital. They started my surgery 4:15pm Friday afternoon, so I personally think they just wanted to go home for the day so they tried to make the lateral release do as good as possible so they didn't have to do the TTT.

I am unsure what to do now... other than wait till the swelling goes down, get an MRI and Patellafemoral CT scan done, then get a random GP to give me a referral to a highly reputable surgeon and take my old and new scans there and ask what he would have done and if that lateral release is acceptable.