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Author Topic: Looking for Patella Specialist Near Boston. Possible Fat Pad and Plica Problems  (Read 784 times)

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Offline iwillwalkagain

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Hi,

After going to see a few orthopedists to try and diagnose my knee pain/disfunction I am looking for recommendations for an orthopedist experienced in treating patella femoral issues in the Boston area.   

I have been struggling with PFPS for about 1.5 years.  I started in standard Physio where exercises like quad sets and leg raises aggravated the issue.  After over a year I realized that fully straightening my leg doing these exercises aggravated my symptoms.  Possibly an enlarged fat pad.   Stopping these exercises and strengthening my quads doing wall sits and single leg work really helped my PFPS to the point that I was able to start biking and was becoming pain free.  Unfortunately I think I pushed too hard too fast on the biking and developed pain around the VMO/Patella insertion point and a snapping sensation with knee flexion which I never previously had.  This may be Plica syndrome.  Now I have issues with bending (tissues snapping) and hyperextending (swelling of the fat pad).

I have been very wary of surgery but I am now considering arthroscopy if I am diagnosed with Plica or Hoffa Fatpad issues and I find the right surgeon that I can trust.  Any feedback or suggestions would be greatly appreciated.   

Thanks!

Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
Hi There,

What you are describing sounds similar to my right knee on-going problems; I have already been through 2 knee surgeries. Scope #1 was medial plica excision and fat pad trimming, scope #2 was AIR surgery to remove excessive scarring from scope #1. I am more prone to excessive bleeding and scarring after surgery.

I have also been told to do calf stretches and single leg squats, I can also hear a loud clunk/snap at the bottom of my kneecap near to the tibia while doing single leg squats. It only happens once while doing 20 squats, I can feel something is not right at the bottom of my kneecap.

Think carefully before considering surgery for plica and fat pad excision? Many KG members have come off worse post-op than they were pre-op. Then you read success stories of plica excision surgery. It depends if you are prone to scarring, I am more at risk of making the knee problem worse rather than better. 

I do not live in the USA so cannot advise you which OS you should be seeing. I know that the Sanders Clinic and Steadman Clinic have an excellent team of OSís and medical staff with high praise from US KG members. 

Good luck in trying to solve your ongoling knee problems.

[email protected]
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline iwillwalkagain

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Hi Clarkey,

Thank you for the response.  I am planning on visiting the Sanders clinic.  Avoiding surgery is good advice.  Has there been any rehab exercise or routines that have lead to improvements in your case?  Walking seems to help me.

Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
Hi Clarkey,

Thank you for the response.  I am planning on visiting the Sanders clinic.  Avoiding surgery is good advice.  Has there been any rehab exercise or routines that have lead to improvements in your case?  Walking seems to help me.

The anterior knee pain is still there contributing towards the pain and discomfort around the tibia that's sore and tender to touch compared to my left tibia. I am not in constant pain and discomfort, I tend to notice it more if I try to do large strides or attempt to run or overdo it walking long distances. The final option of treatment that's now looking likely is 'inferopatellar accessory pole excision with decompression surgery'. Open surgery exposing the patella tendon to clear away any scar tissue build up around the tendon is what I think is done?

Surgery is an option for consideration after all conservative options have failed, when youíre PT and Sports Physician can no longer help to improve your on-going knee problems then would say go for a diagnostic arthroscopy. I know that members of KG are very impressed and happy with the way the Dr Mark Sanders and his team have treated them.

Good luck in trying to sort out your on-going knee problems.

[email protected]
« Last Edit: April 12, 2016, 05:16:49 PM by Clarkey »
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming