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Offline AC

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Lateral Release - What to expect
« on: August 05, 2002, 12:44:58 AM »
Hey guys.

I posted in another post about my doc suggesting a lateral release.

I am planning to call him this week but was hoping some of you could share your opinions on my questions.

1)  I work in a software development office and can sit all day at my desk.  O/S said I could be back to work in one-two weeks.  Is this reasonable?

2)  He said you can be partial weight bearing almost right away, and might need crutches and/or a cane for about 2-3 weeks.  Is this accurate?

3)  How soon afterwards could you particiapte in sports?  I am thinking specifically of hockey and of skiing?

4)  How soon will you know if it worked or if it failed?

5)  Is it terribly painful?

6)  How soon afterwards did you start PT?  How often did you go in the beggining?  For how long did you go?

Thanks for the advice guys.  I want to know as much as possible before I agree to anything, all I know is that it can't go on the way it is now!

Thanks again. ;)
Lateral Release along with patella cleanup and bone spur shaving - Early September 2002 - Had a blood clot (DVT) as a complication.
TTT, Scope, and LR in mid June 2003.

Offline Heather M.

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Re: Lateral Release - What to expect
« Reply #1 on: August 05, 2002, 01:15:54 AM »

Here are my thoughts, for what it's worth.  Keep a couple of things in mind, though:  I've only had one LR done, my problems are apparently more severe than would be solved by the procedure, and I've had lots of complications since the first operation (namely excessive scarring requiring further surgeries).  Only you and your OS can decide if the procedure is right for you.  

There are some doctors who think they should start with the least invasive procedure, but are aware it may not work.  There are other doctors who skip the small stuff and go straight to the big surgery (TTT) if they think the maltracking is severe enough.  Sounds like your doctor is in the first group, as was mine.  I don't really have any problems with that philosophy, as long as the patient understands there is a chance of a) failure, and b) making the problem worse.  I was given an 80-90% chance of improvement when I saw my surgeon in post-op.   I somehow fell into the 10-20% that was not improved, and the smaller percentage still of those whose problems were made worse.  Your situation may be completely different, and I would hope you'd recover fully and return to sport.  It does happen.  I met a woman in rehab who had her LR 6 years ago, returned to skiing and jogging 2 years ago and just had her other knee done this spring.  

1.  Sitting at my computer is one of the MOST painful activities.  I have trouble sitting with my legs bent, even with ergonomic foot rests and adjusting platforms to take pressure off my feet.  When you sit, a lot of weight is pushed through the soles of your feet as they rest on the ground.  The pressure goes through your knees as well, but usually it's not a problem.  After my LR, it was a huge problem, and still is.

2.  I was partial weight-bearing the day of my surgery, off crutches completely in 6 days.  But I did not have medial reefing or any sutures to keep my kneecap in place--nor did I have an immobilizing brace.  Ask your surgeon what would happen if your kneecap doesn't snap into a good position once the lateral retinaculum is cut (generally then have to do some of the above things to keep it in place).  That may affect recovery.

3.  I'm coming up on one year post op, and sport for me is the exercise bike in rehab 3X per week.  There was a point early in my recovery where I could go back to the gym for upper body stuff and gentle biking, but I have not been able to return to sport so far.  I also had 4 procedures following my LR, which probably has a lot to do with it!!  BTW, skiing is brutal for bad knees.  I'd stick to cross country and the bunny slopes if you simply can't give it up.....

4.  It takes 6-12 months to determine success according to my surgeon.  However, we knew I had complications at 4 months post-op, when I plateaued in rehab and then started losing function quickly.

5.  In my case, it was painful for the first 3-4 months with anything involving weight-bearing.  I'm not talking pain of 10 on a scale of 10.  More like a constant 5, with daily activity-based flares that were worse.  Waking up in post-op is the least of the pain problems--I've found that it really kicks in when you start moving around.  It's all manageable with ice, meds, rest and elevation...unless you absolutely have to move around (i.e. work, grocery shopping, airplane travel, etc.) in which case it just plain hurts.  

6.  I started PT one week after my surgery, the day my sutures were removed.  I went 3 days per week, and had my own home exercises to do 2 times per day.  I am still in PT at one year post-op.

Looking back over my post, it seems I feel quite negative about lateral release.   :o  But like you, I was in a position where I simply couldn't go on as I was.  I would probably do it again...maybe not, I don't know.  I'm just looking for a solid block of time without complications, then maybe I can get the whole knee to calm down!  Once that happens, I'll be better able to decide.

Take care, I know you've got a tough decision to make.

Scope #1: LR, part. menisectomy w/cyst, chondroplasty
#2-#5: Lysis of adhesions/scar tissue, AIR, patellar tendon debridement, infections, MUA, insufflation
#6: IT band release / Z-Plasty, synovectomy, LOA/AIR, chondroplasty
2006 Arthrofibrosis, patella baja

Offline Kara

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Re: Lateral Release - What to expect
« Reply #2 on: August 05, 2002, 03:18:20 AM »
I have had 3LR on my rt knee. The 1st worked quite well and I was back at work in a week using one crutch for a few days. I started PT 1 week after surgery and went 3x week for 4 weeks. The swelling was the main issue with me and still is to this day.

I was never able to go back to volley ball with the vigor I used to have. And hiking would cause a flare up. But everyone is different. I think alot depends on how fit you are before you go in. Especially your quads. They are very hard if almost impossible to get back to full strength.

But you should be prepared for it to fail. I wasn't and was totally blindsided when I again need not one but TWO more LR's(I was out of work for 3-4 weeks with both).My pain subsided some but my knee is very weak and will never be the same. Which caused my left knee after years of taking it all to go under too.

But this time I had a TTT on my left. It is a more major surgery than LR ,but so far I am happy. The only problem again is the swelling issue. But overall I am glad I had a TTT this time instead. I hope to have another TTT on my original "bad knee" next year.

I hope this doesn't sound too negative on LR but you asked for our pesonal experiences.
rt knee: LR 10/88-3/94-2/00 ;
left knee: TTT 5/02

Offline Sharon

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Re: Lateral Release - What to expect
« Reply #3 on: August 05, 2002, 07:32:40 AM »
I've had a total of 3 LR's, the most recent was combined with a TTT as a result of the first 2 failing.  Everyones experiences are different but from my experiences I'd say:
1) You probably can go back to work within 2 weeks, especially since it's a desk job. After my first LR, I was working at a day camp about 1 month post-op on my feet all day with a group of 5 year old children.
2) I was partial weight bearing right away after my first 2 LR's. I used crutches for 2 weeks following the first and for about a week after the second.
3) I would definitely give it some time before participating in sports. It takes alot of work to get your full strength back. I have been skiing from the time I was 3-I'm now 23-today's my birthday :) but because of the pain I had I haven't gone in 2 years. I did ski though 7 months after my first LR and hopefully I'll be able to do it again next year!
4) I don't think anyone can really say. I knew my first one failed after about 8 months and with the second I knew about 2 months post-op.
5) It is painful for the first few days afterwards and the rehab can be painful at times but I wouldn't say it's completely unbearable, at least it wasn't for me.
6) I started PT at about 1 week post-op for both LR's. With the first I went 3X a week for about 3 months but because the 2nd caused me so many other problems I was in PT 3X a week for almost 8 months until I had my last surgery which was a TTT and LR.

Hope this helps! If you need any more advice feel free to contact me! Good Luck!!

Left knee:
LR-5/99 & 9/01
Distal realignment and LR 7/02
TTT revision 6/03
screw removal/MUA 10/03
d/x with severe patella baja
7/05 patellar tendon replacement w/piece of quad tendon
4/07 OATS


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Re: Lateral Release - What to expect
« Reply #4 on: August 05, 2002, 01:25:03 PM »
I've had 3 LR's, 2 on my right knee and one on my left.

1) Allow yourself as much time as you need to recover but you should be ok going back to a desk job two weeks post op, but if you don't feel up to it, don't.

2) I could not weight bear at all following my first LR's on R&L knee, took me three days to get out of the hospital bed, my most recent LR (4 weeks agao) I could fully weight bear 4 hours aftersurgery, although it was uncomfortable, not painful.

3) I've just started going back to gentle exercise, running and gym exercises, Skiing would probably be a bit longer because of the balancing on you knee, you might find it painful, also your o/s might not want you to go skiing because of the riskof twisting your knee and doing some damage.

4) After my first two, I knew almost straightaway they failed, subconciously, it was about 4 months later the o/s confirmed they had not been successful. My latest is going well and the whole recovery has been so different. I have found recovery harder but no pain whatsoever.

5) My first 2 LR's were the most painful thing I have ever experienced, I was on morphine for 3 days in hospital and I cried solidly for about a week after each one. This one has been fine, morphine in recovery and thats been it, no painkillers since then.

6) I started PT 10 days after each one, I would like to have maybe started a bit later because of tightness but best to get it moving.


Offline Jak

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Re: Lateral Release - What to expect
« Reply #5 on: August 05, 2002, 07:15:54 PM »
For what it's worth here are my thoughts on your questions.

1.  It is realistic to expect to be back at a desk job in two weeks.

2.  I used crutches for two days, shuffled a bit and then was away.

3.  Sports, well, now seven weeks post lateral release and have gone backwards a bit by trying to run too soon I think.  Take it easy, be patient.

4.  Reserving judgement on that one at the moment.

5.  No problems with the pain, post op I didn't feel anything at all, went through a period of taking pain killers at night to get to sleep.  I was completely off them until I went for intensive physio.

6.  I had physio the following day to get mobile and use the crutches.  Then twice a week for three weeks.  Just had ten days physio which helped a great deal.  Just missing the last few degrees of full extention.

Hope this helps a the best of luck.
June 2002 medial plica and supra-patela plica removal, chondroplasty on both knees and lateral release on right knee.