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Author Topic: Oats and lateral release  (Read 2038 times)

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Offline MelissaFox

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Oats and lateral release
« on: March 22, 2018, 04:44:21 PM »
Oats autograft at medial femoral condyle and lateral release on 9/28/17.

Still have post-op type pain 4 out 7 days, can't do the stairs (never had an issue before surgery) and a brand new patellofemoral pain I never experienced before surgery.
Before surgery, my issue was only periodic horrific medial pain which was untouchable even on 6 Advil every 4 hours. 

Ultimately, I feel worse now than I did before surgery. Is this normal? Am I still healing? Any advice? All help is greatly appreciated. Thanks in advance.

Online Vickster

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Re: Oats and lateral release
« Reply #1 on: March 22, 2018, 05:07:36 PM »
Is your knee unstable from the LR? Why was that done if it was your medical conduke that was the issue?

Has the OATS taken on MRI?

How old are you? What the rest of the knee like?

How are your muscles working? Strong and well balanced? What does your Physio say?

6 months in you are still healing, but Iíd hope things should be feeling a little better and not New pains

These are big surgeries and not without risks. Plenty of surgeons are too gung ho and scalpel happy (esp in the US it seems)

Good luck
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 MelissaFox

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Re: Oats and lateral release
« Reply #2 on: March 22, 2018, 07:31:11 PM »
Thank you for replying.
The knee feels unstable when I am standing up from sitting on a low chair or walking on an uneven surface. It was done because of the tilt which caused mild osteoarthritis.
No MRI after the OATS.
38 years old. Mild osteoarthritis which is not symptomatic.
Muscles are definitely no where near as strong as other leg. I should find a new physical therapist.
Doc says the new pain is from the weak leg? Knee used to only hurt at that medial point before surgery.

Offline neptronix

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Re: Oats and lateral release
« Reply #3 on: March 23, 2018, 06:15:09 PM »
Sounds like your doctor never addressed the original problem that created the patellar tilt.
You got new cartilage, and you're grinding down that new cartilage.
The patellar realignment probably did not fix the original alignment problem. Super unlikely.

How is your foot alignment in relation to your knees? does your foot go in.. or does it go out?

If you have medial pain, i imagine your foot on that one leg goes inwards.
Just a wild guess.

Offline MelissaFox

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Re: Oats and lateral release
« Reply #4 on: March 23, 2018, 06:41:34 PM »
How is your foot alignment in relation to your knees? does your foot go in.. or does it go out?

If you have medial pain, i imagine your foot on that one leg goes inwards.
Just a wild guess.

I wish doctors thought this way! Yes, my foot goes in and my ankle hurts on the inside! It always has. Any suggestions as to how I can fix this problem?

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Re: Oats and lateral release
« Reply #5 on: March 23, 2018, 06:59:36 PM »
Consulting with a foot and ankle specialist with links (e.g. same hospital) to your knee surgeon would be a good first step.  They need to be communicating with each other :)
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 MelissaFox

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Re: Oats and lateral release
« Reply #6 on: March 23, 2018, 10:28:28 PM »
Really appreciate the support on this board. Like knowing others are still healing 6 months out. Love all the intelligent suggestions and honest feedback.

Offline neptronix

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Re: Oats and lateral release
« Reply #7 on: March 24, 2018, 12:32:23 PM »
How is your foot alignment in relation to your knees? does your foot go in.. or does it go out?

If you have medial pain, i imagine your foot on that one leg goes inwards.
Just a wild guess.

I wish doctors thought this way! Yes, my foot goes in and my ankle hurts on the inside! It always has. Any suggestions as to how I can fix this problem?

Bingo. You need to see a foot specialist as soon as you are able to see if something like orthotics could even help you ( for now ). One that is skilled with things like tibial torsion/rotation and gait analysis. Call around. I had to do some serious investigatory work to find a competent foot doc in my area. He instantly pointed out that one foot that goes outward had caused an abnormal wear pattern in my cartilage. Which is exactly what i suspected was the problem for years... but the usual knee/leg doctors will just straight up ignore the lowest part of the leg as the cause. Isn't that insane?

If your foot is significantly turned in, the ultimate solution is a nasty one and depends on what is causing the turn in. Surgeries used to correct this deformity are high tibial osteotemy, distal tibial osteotomy, and i believe proximal tibial osteotomy is also used. Essentialy, they will cut and then rotate the bone into place.

However, your turn in could be at the femur and not the tibia. A competent doc can figure that out.

In the meantime i would take it easy on that leg until you can get yourself in a position where you can. The biomechanical problem is not solved, yet.

I have the opposite problem. One foot is turned out and i have thrashed the lateral cartilage area on both legs, trying to compensate for it. I also nearly blew a hip out by overusing my hip on the leg with the out turned foot. Don't do what i did!

Offline MelissaFox

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Re: Oats and lateral release
« Reply #8 on: March 24, 2018, 01:49:38 PM »

Bingo. You need to see a foot specialist as soon as you are able to see if something like orthotics could even help you ( for now ). One that is skilled with things like tibial torsion/rotation and gait analysis. Call around. I had to do some serious investigatory work to find a competent foot doc in my area. He instantly pointed out that one foot that goes outward had caused an abnormal wear pattern in my cartilage. Which is exactly what i suspected was the problem for years... but the usual knee/leg doctors will just straight up ignore the lowest part of the leg as the cause. Isn't that insane?

If your foot is significantly turned in, the ultimate solution is a nasty one and depends on what is causing the turn in. Surgeries used to correct this deformity are high tibial osteotemy, distal tibial osteotomy, and i believe proximal tibial osteotomy is also used.

The biomechanical problem is not solved, yet.


Thank you so much for replying. Doc sent me to a children's hospital for a full length leg xray to determine if I needed that bone breaking surgery first. They determined everything was good with the leg. Should I still pursue the foot doc route?

Offline neptronix

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Re: Oats and lateral release
« Reply #9 on: March 25, 2018, 11:02:58 PM »

Bingo. You need to see a foot specialist as soon as you are able to see if something like orthotics could even help you ( for now ). One that is skilled with things like tibial torsion/rotation and gait analysis. Call around. I had to do some serious investigatory work to find a competent foot doc in my area. He instantly pointed out that one foot that goes outward had caused an abnormal wear pattern in my cartilage. Which is exactly what i suspected was the problem for years... but the usual knee/leg doctors will just straight up ignore the lowest part of the leg as the cause. Isn't that insane?

If your foot is significantly turned in, the ultimate solution is a nasty one and depends on what is causing the turn in. Surgeries used to correct this deformity are high tibial osteotemy, distal tibial osteotomy, and i believe proximal tibial osteotomy is also used.

The biomechanical problem is not solved, yet.


Thank you so much for replying. Doc sent me to a children's hospital for a full length leg xray to determine if I needed that bone breaking surgery first. They determined everything was good with the leg. Should I still pursue the foot doc route?

I am not sure if they are the people to talk to. If you can afford a foot doc, i'd go get a second opinion. Just find one that can do a gait analysis.. he may be able to find some things that other docs don't notice.

Offline MelissaFox

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Re: Oats and lateral release
« Reply #10 on: March 26, 2018, 10:30:29 PM »


I am not sure if they are the people to talk to. If you can afford a foot doc, i'd go get a second opinion. Just find one that can do a gait analysis.. he may be able to find some things that other docs don't notice.

Thank you. Will do!

Anyone have anything further to add on pain at 6 months post op? Oh how I wish I could hear some OATS success stories! If I get better, I promise to post it to make everyone feel better!  Regardless, the support here is great. Nice group.

Offline MelissaFox

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Re: Oats and lateral release
« Reply #11 on: March 27, 2018, 02:31:08 AM »
Update: Spoke to my doc. Wants to do Euflexxa. Thoughts?

Online Vickster

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Re: Oats and lateral release
« Reply #12 on: March 27, 2018, 08:38:02 AM »
Give it a go. Iíve had maybe 4 rounds of hyaluronic acid (different brand) over the years. Has worked pretty well giving a couple of years relief. Works really well for around half, better for mild to moderate arthritis than severe.

I never found the injections painful as long as knee very well relaxed, but my OS is extremely good. Youíll have a full feeling for a few days worse, may feel worse for a few weeks, and takes 2-3 months to feel the benefit

The course of 3 substance less painful than the single as less viscous
« Last Edit: March 27, 2018, 08:40:20 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 MelissaFox

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Re: Oats and lateral release
« Reply #13 on: March 27, 2018, 01:00:01 PM »
Give it a go. Iíve had maybe 4 rounds of hyaluronic acid (different brand) over the years. Has worked pretty well giving a couple of years relief. Works really well for around half, better for mild to moderate arthritis than severe.

I never found the injections painful as long as knee very well relaxed, but my OS is extremely good. Youíll have a full feeling for a few days worse, may feel worse for a few weeks, and takes 2-3 months to feel the benefit

The course of 3 substance less painful than the single as less viscous

This is great info. Glad he wants the 3 shot series. I will try to stay positive if it hasn't worked well initially with the hope for continuous improvement over months.

Offline neptronix

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Re: Oats and lateral release
« Reply #14 on: March 31, 2018, 02:19:38 AM »
Look up potential side effects before you get any of those injections done. The real nasty ones are the cortisone shots that have been found to actually degrade cartilage ( just what a knee patient needs ! )

Just keep in mind that those are symptom relievers. You can get some temporary relief, but the underlying problem will still need to be addressed. The sooner you deal with the underlying problem, the better.

Rather than take those shots, have you considered some very light exercise to get the joints lubricated? ie bicycling at a low intensity, aquatherapy etc? bicycling is how i've managed to manage the pain of my deformed legs and the cartilage grinding nightmare that they've always been. 

Offline ZeeKnee

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Re: Oats and lateral release
« Reply #15 on: March 31, 2018, 09:49:53 AM »
Hey Melissa I had a medial femoral chondyle oats in 9/15 and certainly still had pain 6 months later. About a year is when I really hit a milestone and was pain free even with high impact activity and getting underway in bumpy seas. As for the new pains I had the lateral release too. It caused a lot of tendonitis type burning pains which the OS explained to be there because my kneecap moved and my body needed time to adjust to it. That also took about a year.
2 years later I'm back in with a new physical therapy office. As others have mentioned the whole body approach is a huge difference. Building my quad back up even this late in the game drastically improved my stability. I remember the exact buckling you were mentioning and it's gone now too.
Recently I had a 3rd surgery for meniscal cysts and the surgeon said most of the oats looked really good but a small portion had delaminated so he handled that. But all in all its a success :-)! One thing I will say is that I didn't understand how invasive OATS was until recently. It involves a bone graft and drilling and a transplant. When you look at it from this perspective it makes time that you need more time to recover. Hang in there and keep actively working to recover those muscles and deficiencies.



I am not sure if they are the people to talk to. If you can afford a foot doc, i'd go get a second opinion. Just find one that can do a gait analysis.. he may be able to find some things that other docs don't notice.

Thank you. Will do!

Anyone have anything further to add on pain at 6 months post op? Oh how I wish I could hear some OATS success stories! If I get better, I promise to post it to make everyone feel better!  Regardless, the support here is great. Nice group.
4/2015 - L knee meniscal repair and surprise microfx
9/2015 - L knee OATS, meniscal trim (or not according to the new Dr?), lateral release
3/2018 - L knee meniscal cyst decompression, microfx, chondroplasty, scar tissue removal

Offline MelissaFox

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Re: Oats and lateral release
« Reply #16 on: March 31, 2018, 12:08:20 PM »
Look up potential side effects before you get any of those injections done. The real nasty ones are the cortisone shots that have been found to actually degrade cartilage ( just what a knee patient needs ! )

Just keep in mind that those are symptom relievers. You can get some temporary relief, but the underlying problem will still need to be addressed. The sooner you deal with the underlying problem, the better.

Rather than take those shots, have you considered some very light exercise to get the joints lubricated? ie bicycling at a low intensity, aquatherapy etc? bicycling is how i've managed to manage the pain of my deformed legs and the cartilage grinding nightmare that they've always been.

I agree! Denied cortisone for that very reason. Supposedly this works as a lubricant. Doc believes I am having trouble with the synovium after surgery and this will help get it producing synovial fluid again in order to help me strengthen and heal.

I am still taking your advice and going to the foot doc though. It can't hurt!

Yes, biking is great! Been exercising a lot since after the surgery but doc thinks my muscles still aren't strong and balanced. He thinks every time I have pain and swelling the muscles are shutting down again so I am on a bit of a roller coaster in my progress. He believes that if we can get the joint lubricated and bring the pain and swelling down I will have better results in the gym and finally put an end to all these knee issues. One can only hope...

Offline MelissaFox

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Re: Oats and lateral release
« Reply #17 on: March 31, 2018, 12:31:47 PM »
Hey Melissa I had a medial femoral chondyle oats in 9/15 and certainly still had pain 6 months later. About a year is when I really hit a milestone and was pain free even with high impact activity and getting underway in bumpy seas. As for the new pains I had the lateral release too. It caused a lot of tendonitis type burning pains which the OS explained to be there because my kneecap moved and my body needed time to adjust to it. That also took about a year.
2 years later I'm back in with a new physical therapy office. As others have mentioned the whole body approach is a huge difference. Building my quad back up even this late in the game drastically improved my stability. I remember the exact buckling you were mentioning and it's gone now too.
Recently I had a 3rd surgery for meniscal cysts and the surgeon said most of the oats looked really good but a small portion had delaminated so he handled that. But all in all its a success :-)! One thing I will say is that I didn't understand how invasive OATS was until recently. It involves a bone graft and drilling and a transplant. When you look at it from this perspective it makes time that you need more time to recover. Hang in there and keep actively working to recover those muscles and deficiencies.

You have given me the understanding, support and hope I have been needing.  You've gone through the exact same surgery, overcome the new pains and you're a success! Thank you for taking the time to visit this site and be an inspiration for those of us still struggling. I wish there were more I could say to properly express my gratitude. There just aren't enough words. Thank you. Thank you. Thank you.















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