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Author Topic: "Different Surgeon, Different Outcome"  (Read 87 times)

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Offline CaliCoast

  • MICROgeek (<20 posts)
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"Different Surgeon, Different Outcome"
« on: June 24, 2022, 05:50:37 PM »
Hi All, I got a meniscectomy and fat pad debridement 15 months ago and haven't been able to stand since the operation. I can no longer extend my knee fully (-20 deficit when trying to stand)and believe I have an inflamed fat pad impinging my terminal extension.

I've been touring the US and seeing the most accomplished and recommended arthrofibrosis specialists in the country. In one camp, surgeons say that operating the fat pad nearly guarantees scar growth that will put me right back where I started, while the second camp balks at the idea and suggests resection. How can the most experienced doctors on this topic have such radically different and mutually exclusive post-op observations??

I recently visited the most knee famous clinic in the US and the surgeon simply suggested that I re-do the exact surgery--fat pad debridement--that took away my ability to stand. The logic to re-do the same operation and expect different results makes me feel like I'm taking crazy pills. I pressed the surgeon's medically assistant on why the fat pad won't grow right back, and he replied "Different surgeon, different outcome."

I always saw fat pad debridement as a simple surgery, and I primarily attributed my post-op tragedy to inflammatory dysfunction. A reality that wouldn't change surgeon to surgeon. Yet, his statement made me wonder if debridement is more of an art than science. More like a chef than a mechanic. Technique matters of course, yet should I consider scarring, inflammation, and post-op fat pad healing primarily driven by poor artistic technique? Should I inverse my thinking about the dangers and pursue a second debridement and expect a "different outcome with a different surgeon"?