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Author Topic: TPF - who is right, Swiss OS or NHS Dr?  (Read 1237 times)

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Offline nobubblesdave

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TPF - who is right, Swiss OS or NHS Dr?
« on: March 05, 2015, 04:39:26 PM »
So, first the background.  Skiing accident gave me a type II TBF.  Swiss medical team are obviously fairly experienced with these types of injury and I was operated on the next morning and fitted with screws and plates.  Discharged 3 days later with some basic PT to keep up the ROM:  0-90 deg regular exercises every day.  Obviously, NWB at this stage.  All seemed fine, little pain (no longer taking any meds), just the expected boredom!

Now I'm back in the UK and under the NHS.  First thing is they didn't even want to look at the lovely x-ray and CT images taken in switzerland and so professionally loaded on to a CD, but subjected me to more radiation so they could do their "own" x-rays.  As expected I was then discharged until week 6 for the next check up.

So the  big difference is that before I left the NHS Dr, he said I needed to wear a knee brace and restrict movement to 0-30 deg for 2 weeks, then increase to 0-90 for another 2 weeks. When I queried why this was different from Swizterland, he says Swiss Dr's are more "aggressive" in their treatment plan than the NHS.  Within hours of wearing the brace I felt my knee stiffen and start to feel sore, so I have ditched it.

Research on-line suggests the Swiss OS advice is better.  Anyone else had similar experiences and can help.  Losing faith in the NHS......

thanks
« Last Edit: March 05, 2015, 04:49:26 PM by nobubblesdave »

Offline vickster

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Re: TPF - who is right, Swiss OS or NHS Dr?
« Reply #1 on: March 05, 2015, 06:01:47 PM »
No experience, but as you are clearly concerned, can you afford to get a private second opinion from an orthopaedic surgeon specialised in skiing injuries, someone like Jonathan Bell in Wimbledon?

I believe he posts on a skiing forum, perhaps you could post there and hope he replies? 
Kaputt_knee, a member here, will probably come along at some point to say which forum

The NHS doctor you saw is likely not a reflection on every orthopaedic surgeon in the NHS, just possibly that hospital / team

Good luck :)
« Last Edit: March 05, 2015, 06:04:36 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 Kaputt_Knee

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Re: TPF - who is right, Swiss OS or NHS Dr?
« Reply #2 on: March 05, 2015, 09:45:40 PM »
@nobubblesdave

definitely look for a surgeon who agrees with the Swiss plan! I didn't in my naivety when I was returned to the UK after a knee wreck in Austria and ended up in a full hip-to-toe plaster of Paris jobbie (this was 1989). I had one of the top surgeons for my town but he was totally inexperienced in sports injuries and the treatment I had received. A visiting surgeon from Jordan recognised the procedure they had used to reconstruct my ACL for example and explained it to them and me! My surgeon decided to ditch the carefully translated treatment plan and I spent the next 3 months in a wheelchair with the plaster being regularly replaced. Not knowing any different back then I just had to suck it up. As a PE teacher back then, it was no fun being told I'd never ski again nor walk without a stiff knee and a stick until I was old enough to have a total knee replacement. By the time I was released from my plaster cast my muscles had disappeared and my whole leg had shut down!

Jonathan Bell posts regularly on the snowHeads Forum (www.snowheads.com) in the Health, Fitness and Injury section. If you are not already a member it costs nothing to join. He will be able to point you to someone in your area who maybe has a more open mind to different ways of rehabbing your knee.

Good luck, most of the TPFs I've come across are back skiing by the next season if that is any consolation!
1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline nobubblesdave

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Re: TPF - who is right, Swiss OS or NHS Dr?
« Reply #3 on: March 06, 2015, 11:53:44 AM »
thanks for the advice folks.  much appreciated.

Offline Kaputt_Knee

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Re: TPF - who is right, Swiss OS or NHS Dr?
« Reply #4 on: March 06, 2015, 02:14:31 PM »
Already seen your posts!  ;)
1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline maryc

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Re: TPF - who is right, Swiss OS or NHS Dr?
« Reply #5 on: March 06, 2015, 07:48:14 PM »
My US doctor had me bending my knee almost immediately post -surgery.  He said the hardware he installed would keep everything in place during the healing process.  I was at 90+ ROM when I was released from the hospital and at 120 by the time I was able to weight bear.  I only had the wear my brace if I got up from bed or the couch.  He said it was more to support my soft tissue than anything else.
All TPFs are different, but I would go with the Swiss doctor's advice.
Sending healing rays your way
« Last Edit: March 06, 2015, 07:49:59 PM by maryc »
8/4/07 fell
8/5 diagnosed TPF
8/6 surgery plate and 6 screws
8/12 out of hospital NWM
8/21 staples removed
9/18 OS appt - WBAT with crutches
10/10 - WBAT with cane
10/27 - back to work w/cane
12/26 - no cane, slight limp when tired
1/25/08 - released from PT, no limp
2/3/09 - Released by OS















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