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Author Topic: Lateral Release for Chondromalacia  (Read 780 times)

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Offline MattPJames4

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Lateral Release for Chondromalacia
« on: April 21, 2016, 08:13:44 AM »
Hello,

I'm a 23yo male, from Australia, and am in need of some further opinions. I'm currently 2 years post-op from a cartilage defect in my trochlear groove, for which a debridement and microfracture was performed succesfully. I've had no problems since the surgery and have been playing competitive sport (soccer) without worry, until a few months ago when I felt a "grinding" sensation in the same knee. A subsequent MRI showed grade 4 chondromalacia of the troch groove (same area).... back off to the specialist (same surgeon as last time) I went. At the first consultation, the doctor analysed the MRI and also performed exercises to see if there was a misalignment of the knee cap or any tracking problems, to which he thought it all looked okay. As such, he ran me through 3 treatment options:
1. Physio to strengthen surrounding muscles
2. Perform another microfracture and debridement
3. Lateral release

Upon discussing the pro's and cons of each, it was agreed that PT would be the best case of action, with a follow-up appointment a few months down the line to see how it was all reacting. He also requested an X-ray to determine if there was any patella tilt. Well.... 3 months later and following rigorous PT and with the X-ray in hand, I went back to see him today. Firstly, I told him that my symptoms had gotten worse, mainly putting weight on the knee when bent, and thus had stopped the PT 6 weeks in. He looked at the X-ray and said the alignment looked satisfactory, however there were 2 bone spurs on the underside at each end of my patella (a secondary finding). He then implied that there was not much he could do, and that any further surgery would not be recommended, as a permanent fix from here was highly unlikely. The only option he did give me, and with some hesitation, was the lateral release. He would perform the surgery as a last resort at my request.

Here comes my conundrum..... I'm 23 years old, and don't want to be retiring from sport so young, therefore I'm determined to give it one last crack. I'm moving away for work at the end of the year for 24 months, so would have all that time dedicated to rehab. I feel like I should get the surgery and give it one last go, however success stories with this type of surgery seem to be somewhat rare. If you were in my situation, what would you do?? Any other opinions or information would be greatly appreciated....

Matt

Offline Leena20

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Re: Lateral Release for Chondromalacia
« Reply #1 on: April 22, 2016, 07:29:38 PM »
Hi
Are you able to get another opinion? I really would before jumping into surgery - I had to see three surgeons before I was correctly diagnosed and given a logical surgery solution to my problem. I don't know much about lateral releases but have seen a lot of stories from people here who regret having it done. Also recently had surgery and they gave me general arthroscopy information pack which said LR's aren't performed so much these days as the success rate is much less than was originally thought...If you do go for it you should consider that you might be worse off after. Don't think I would rush into it if I were you and the surgeon is slightly reluctant. But keep searching for solutions - surgery is always advancing so likely there will be something you can do!

Offline tinydinosaur

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Re: Lateral Release for Chondromalacia
« Reply #2 on: April 23, 2016, 05:38:10 AM »
I would never ever recommend lateral release to anyone, honestly. So I would highly recommend getting a second or third opinion. I had (unbeknownst to me) grade 3 chondromalacia - I was given the option to wait 6 months for an MRI or have a lateral release and 'be back at sports within a month', of course being young I opted to get it over with, it ruined whatever stability I had left in my knee and ended up needing two surgeries to fix it and then a bunch more to fix all the damage under my kneecap (grade 4 by the time they fixed the instability), and I'm still trying to get it fixed.

There's a study from 1994 that details the success/fail rate of them, they seem to be a "I don't know what's really wrong so I'll do this, catch-all surgery. It tries to treat knee problems by inducing instability.

Please consider getting another opinion.
« Last Edit: April 23, 2016, 05:44:59 AM by tinydinosaur »