Advertisement - Hide this advert





Author Topic: X-Ray accuracy over time. Opinions please!  (Read 295 times)

0 Members and 1 Guest are viewing this topic.

Offline PwordsB

  • MINIgeek (20-50 posts)
  • **
  • Posts: 46
  • Liked: 10
X-Ray accuracy over time. Opinions please!
« on: July 06, 2018, 01:36:50 PM »
Hey, guys.

I'm scheduled for a distal femoral osteotomy on August 10th. I had my long leg alignment x-ray showing around 12 degrees valgus last October. I believe preoperative planning for an osteotomy uses these images to calculate the angles and sizes of the osteotomy.

Considering that my x-ray will be over 9 months old, and my leg looks and feels more valgus now than it did, do you think I need to somehow get another X ray before surgery, or do you think the surgeon will just deal with it appropriately at the time? He is very experienced. I'm in the UK so it's pretty awkward to get a scan and have the surgeon see it.

Thanks.
Snowboard injury 21/01/16
Open cartilage graft (Chondrotissue) 29/06/16
Sub-total lateral meniscectomy, LTP cartilage removal 20/01/17
11mm Closing Medial DFO and LTP Microfracture 10/08/18

Online Vickster

  • Administrator
  • SuperKNEEgeek
  • *****
  • *
  • Posts: 4426
  • Liked: 350
  • Neelie knee!
Re: X-Ray accuracy over time. Opinions please!
« Reply #1 on: July 06, 2018, 02:55:23 PM »
 Who's the surgeon? ask him? I'd be surprised if they don't do fresh X-rays pre op (maybe even CT?)

Adrian Wilson recognised as probably the best osteotomy surgeon in the U.K. has very good info on his website

https://profadrianwilson.co.uk/knee-treatments/knee-realignment-surgery-osteotomy/

I'd want all my imaging to be up to date before having such major surgery even if it meant paying for (assume you're doing on nhs) and to be honest a second opinion from Wilson

There's an osteotomy course in the learning portfolio, http://www.kneeguru.co.uk/KNEEnotes/courses/realignment-osteotomy-knee-pain/high-tibial-osteotomy-and-distal-femoral-osteotomy
« Last Edit: July 06, 2018, 06:07:41 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
More tears and wear, scope planned in Jan 2019 to tidy up

Offline PwordsB

  • MINIgeek (20-50 posts)
  • **
  • Posts: 46
  • Liked: 10
Re: X-Ray accuracy over time. Opinions please!
« Reply #2 on: July 06, 2018, 07:24:56 PM »
Who's the surgeon? ask him? I'd be surprised if they don't do fresh X-rays pre op (maybe even CT?)

Adrian Wilson recognised as probably the best osteotomy surgeon in the U.K. has very good info on his website

https://profadrianwilson.co.uk/knee-treatments/knee-realignment-surgery-osteotomy/

I'd want all my imaging to be up to date before having such major surgery even if it meant paying for (assume you're doing on nhs) and to be honest a second opinion from Wilson

There's an osteotomy course in the learning portfolio, http://www.kneeguru.co.uk/KNEEnotes/courses/realignment-osteotomy-knee-pain/high-tibial-osteotomy-and-distal-femoral-osteotomy

Thanks for your reply.  I've read a bit about Mr Wilson.  He does sound good.  Yeah, I'm going via the NHS (I would absolutely go privately if I could afford it).  I'll try to get hold of the surgeon's secretary and get his opinion.  I just have these images of him calculating the osteotomy and then doing it, realising the calculations are no longer appropriate and worsening the outcome by having to faff around more.
Snowboard injury 21/01/16
Open cartilage graft (Chondrotissue) 29/06/16
Sub-total lateral meniscectomy, LTP cartilage removal 20/01/17
11mm Closing Medial DFO and LTP Microfracture 10/08/18

Online Vickster

  • Administrator
  • SuperKNEEgeek
  • *****
  • *
  • Posts: 4426
  • Liked: 350
  • Neelie knee!
Re: X-Ray accuracy over time. Opinions please!
« Reply #3 on: July 06, 2018, 11:00:03 PM »
Pretty sure he still has an NHS practice? But if you have an experienced osteotomy surgeon, all good
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
More tears and wear, scope planned in Jan 2019 to tidy up

Offline PwordsB

  • MINIgeek (20-50 posts)
  • **
  • Posts: 46
  • Liked: 10
Re: X-Ray accuracy over time. Opinions please!
« Reply #4 on: July 07, 2018, 09:27:30 AM »
Pretty sure he still has an NHS practice? But if you have an experienced osteotomy surgeon, all good

Have you heard of Professor Martyn Snow?  I paid to see Mr Ian McDermott in London, who my months of reading suggested is one of the best, and he said that Professor Snow was incredible.  I also need some cartilage grafting, a meniscus transplant and possibly an ACL reconstruction, and MrDermott said Snow is one of the few surgeons he would trust to do all that well.  All of that is lateral damage, but annoyingly I also have a medial meniscus ramp lesion, probably, so I'm very keen to find out how Snow is gonna handle it.
Snowboard injury 21/01/16
Open cartilage graft (Chondrotissue) 29/06/16
Sub-total lateral meniscectomy, LTP cartilage removal 20/01/17
11mm Closing Medial DFO and LTP Microfracture 10/08/18

Online Vickster

  • Administrator
  • SuperKNEEgeek
  • *****
  • *
  • Posts: 4426
  • Liked: 350
  • Neelie knee!
Re: X-Ray accuracy over time. Opinions please!
« Reply #5 on: July 07, 2018, 12:44:43 PM »
Clarkey is treated by Prof Snow

Tim Spalding in rugby is expert too

Who’s doing your op? Snow?
« Last Edit: July 07, 2018, 01:14:56 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
More tears and wear, scope planned in Jan 2019 to tidy up

Offline PwordsB

  • MINIgeek (20-50 posts)
  • **
  • Posts: 46
  • Liked: 10
Re: X-Ray accuracy over time. Opinions please!
« Reply #6 on: July 07, 2018, 03:54:13 PM »
Clarkey is treated by Prof Snow

Tim Spalding in rugby is expert too

Who’s doing your op? Snow?

Yeah, Snow is doing it. Ive been referred to him because I'm quite a difficult case.
Snowboard injury 21/01/16
Open cartilage graft (Chondrotissue) 29/06/16
Sub-total lateral meniscectomy, LTP cartilage removal 20/01/17
11mm Closing Medial DFO and LTP Microfracture 10/08/18

Online Vickster

  • Administrator
  • SuperKNEEgeek
  • *****
  • *
  • Posts: 4426
  • Liked: 350
  • Neelie knee!
Re: X-Ray accuracy over time. Opinions please!
« Reply #7 on: July 07, 2018, 04:07:58 PM »
Good stuff.  He has a very good reputation.  For some reason, I thought you are in London
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
More tears and wear, scope planned in Jan 2019 to tidy up

Offline PwordsB

  • MINIgeek (20-50 posts)
  • **
  • Posts: 46
  • Liked: 10
Re: X-Ray accuracy over time. Opinions please!
« Reply #8 on: July 07, 2018, 04:21:19 PM »
Good stuff.  He has a very good reputation.  For some reason, I thought you are in London

I traveled to London to see McDermott, but I'm in Birmingham. I'm glad you think Snow is a good surgeon. Thanks for that.
Snowboard injury 21/01/16
Open cartilage graft (Chondrotissue) 29/06/16
Sub-total lateral meniscectomy, LTP cartilage removal 20/01/17
11mm Closing Medial DFO and LTP Microfracture 10/08/18

Online Vickster

  • Administrator
  • SuperKNEEgeek
  • *****
  • *
  • Posts: 4426
  • Liked: 350
  • Neelie knee!
Re: X-Ray accuracy over time. Opinions please!
« Reply #9 on: July 07, 2018, 05:23:59 PM »
I have no personal experience but he has a very good CV :)
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
More tears and wear, scope planned in Jan 2019 to tidy up

Offline PwordsB

  • MINIgeek (20-50 posts)
  • **
  • Posts: 46
  • Liked: 10
Re: X-Ray accuracy over time. Opinions please!
« Reply #10 on: July 09, 2018, 09:42:15 AM »
I have no personal experience but he has a very good CV :)

Hey, Vickster. Just for your information, I spoke to Snow via his secretary today and he said there's no need for an updated X ray. He'll have a look on the day of surgery and do an x-ray if he thinks it's necessary. I'm considering getting one privately, but I also might just take his word for it, since he is rather good at his job.
Snowboard injury 21/01/16
Open cartilage graft (Chondrotissue) 29/06/16
Sub-total lateral meniscectomy, LTP cartilage removal 20/01/17
11mm Closing Medial DFO and LTP Microfracture 10/08/18

Online Vickster

  • Administrator
  • SuperKNEEgeek
  • *****
  • *
  • Posts: 4426
  • Liked: 350
  • Neelie knee!
Re: X-Ray accuracy over time. Opinions please!
« Reply #11 on: July 09, 2018, 10:05:58 AM »
That's good. I wouldn't worry about the private one in that case, no point exposing self to more radiation than necessary
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
More tears and wear, scope planned in Jan 2019 to tidy up















support