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Offline The KNEEguru

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Lateral Release
« on: July 14, 2002, 08:09:46 PM »
Some of you have had good experiences with lateral release, and some of you really bad experiences. For those of you with bad experiences, do you feel that some of the problem has been that the knee was not fully assessed prior to surgery?
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Offline The KNEEguru

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Offline Kris

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Re: Lateral Release
« Reply #2 on: July 15, 2002, 10:00:26 PM »
I don't exactly know what's happening in my case with having lateral release surgery.  My right leg has for the last 2 years been considered the weakest knee because of the prior injury to the ankle, the atrophy of the calf muscle because of the surgery in the ankle, and just being on crutches on and off for that since 1999.  The left leg has developed the muscle because it had to bare all the weight.  It's my left leg that sent me back to my OS.  But it was the right knee we decided to do the lateral release first to see how it handled things.  That was done on Feb 2002.  I was in a brace for 4 weeks and had the stitches that entire time mainly because my OS was on vacation.  I started therapy at 5 weeks post op.  When I saw the OS again, the right leg was doing great and handling things very well.  The OS and I discussed going ahead with the left leg.  I thought it was early, but with his reassurance we went ahead with it in early May 2002.  Since that LR surgery, my right leg has been going downhill fast.  It can no longer do the exercises it did at therapy, but my OS will not see me until July 25th although I've complained a lot for the past month and a half.  My therapist is also concerned.  I'm not sure that a misdiagnosis caused my problem with my knee.  I feel that the surgery was done for the correct problem, however, I wished it was done differently as far as time.  Also, the fact that my left leg is doing better than the right leg has ever done also worries me in a way.  I know that no two legs are the same, but the amount of pain associated with the right one tells me something isn't right.  I hate comparing the two, but I find myself doing it quite often.
Right  LR on 2/8/02,  7/11/03, and 11/5/05
Left leg LR on 5/02, 4/05
Right achilles tendon lengthened on 2/01.   Synvisc injections on 2/17/03. 
Cortisone on 12/03 and 3/04, 12/05. 
Proximal Reallignment Right 5/23/05
R Microfracture 5/19/06
PFJR 6/20/07

Offline Alessandra

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Re: Lateral Release
« Reply #3 on: July 16, 2002, 11:56:46 AM »
Hi,
I had a LR 2 months ago on my right knee and things are going fairly well. My patella seems to be aligned and the pain on the knee's external side disappeared.
I saw my OS few days ago and he said that although my patella is not moving very well (it is not so fluid and smooth) the situation is under control. For this reason I need some more rehab: for fifteen - twenty min per day I strongly move my patella trying to get it free (for the moment it'is working...) . Moreover my hoffa's body is still sore and hurting. This is my only worry: I was supposed not to have hoffa's body pain after the surgery.....
Does anyone know any treatment/rehab for this syndrome? Has anyone had a similar experience with LR?
Thanks for your help
Cheeers
Ale

Offline Heather M.

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Re: Lateral Release
« Reply #4 on: July 16, 2002, 09:12:24 PM »
Alessandra,

Have you tried ice massage directly over the inflamed area?  That may provide some immediate relief and help things calm down at the same time.  Take an ice cube and move it over the bare skin for 3-5 minutes.  I think this can be done up to 4 times per day.

If you can't get any other relief, some doctors recommend injecting cortisone directly into the Hoffas body/fat pad.  OUCH.  But it seems to work....

Good luck.

Heather
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
http://www.flickr.com/photos/hmaxwell

Offline Alessandra

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Re: Lateral Release
« Reply #5 on: July 16, 2002, 10:19:35 PM »
Heather,
first of all: thank you so much for your help!!
I'm so curious to know why you have this information!
Did you have this kind of pain?

Cheers

Ale

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Re: Lateral Release
« Reply #6 on: July 16, 2002, 10:40:20 PM »
I've been on both sides of the fence and so I know what having a LR fail is like but also have the joy of having a successful one is like.

My first LR was 4 years ago on my right knee and was initially ok, after I asked for PT about 3 months post surgery, everything started to go wrong. My PT was very rough and pushed me very hard and was not very flexible to my knees. She ended up hurting me while trying to reposition my knee's and so my mal tracking started again.

My second LR 4 months later was an immediate failure, I knw the moment I woke from the anaesthetic that it had been a failure (what I didn't know at the time was I had a haemarthorosis). I don't know why I immediately knew, but I did. 10 days later they spotted the haem and I had another arthroscopy to remove blood and fluid and when the moved my knee the notice it was still maltracking!. And it still is 4 years later but diesn't bother me so I'm not doing anything about it until I need to.

My 3rd LR and second on my R knee was on Mon the 8th of July and boy, I knew it had worked, for the first time after the painkiller wore off I was in no pain from my knee. When my bandages came off,  noticed that my kneecap was in the centre of my knee rather than veering off to the right.

I've still not got my full ROM back but I am getting there slowly and things are brilliant, still got a lot of fluid, but the LR combined with the plica & scar tissue removal has been excellent for me.

Iona x

Stacey

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Re: Lateral Release
« Reply #7 on: July 17, 2002, 05:09:01 AM »
Yes I greatly feel my 'condition' was greatly misjudged.  My first OS was rushed to do something because i only had two months between my first visit with him and starting my first year at university.  He did a LR after onyl seeing him once.  I had a second opinion done last november and he believes that the LR was the worst thing that could have been done because i was hypermobile and it allowed my knee to go medially now as well as laterally.  I am one of the few people on this board who has had a LR reversed.  Let me tell you its not something you want done!!  Make sure your Dr knows that a LR is needed before doing it

Iona_-Uk

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Re: Lateral Release
« Reply #8 on: July 17, 2002, 12:19:55 PM »
When I hadmy first LR on the right leg, after I woke I saw my os who told me that I would need the L leg done as well because of "centre of balance". I had minimal pain in my L knee until my LR and subsequent haemarthorosis. For months and months after I was in excruiating pain.

When I asked my current os about the "centre of balance" he said it was the strangest thing he had heard in a long time and no I probably wouldn't have needed it at all.

As it was both were failures which makes me wonder if they should have been performed at all when I was 16. Maybe if I had left it later that they may have been more successful, I don't know.

Hindsight is a great thing.

Iona :P

Offline Heather M.

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Re: Lateral Release
« Reply #9 on: July 17, 2002, 11:47:52 PM »
I feel like my problem was adequately diagnosed, and I had the appropriate surgery...it's just that the appropriate surgery comes with no guarantees and a LOT of complications.  My surgeon would not even commit to doing an LR until he had a look inside the knee and could see the tracking from there, so I feel like we really covered all the bases pre-op.  I had grade IV chondromalacia, and my kneecap sat about an inch over--as soon as he did the LR, it went right into the perfect position.  I rehabbed well until I ran into...

The things they DON'T tell you, which are the long-term complications:  persistent swelling, scar tissue, inflammation and heat, IT Band syndrome, problems in other joints/limbs due to changing the way you walk, etc.

One thing I can say with complete confidence is that this surgery was supposed to stop my dislocations--and it did.  I've not had a single dislocation, and all popping has been related to quad atrophy after other surgeries.

However, I've lately been questioning the cost.  I'm coming up on 11 months post-op, I've had three other surgeries and a manipulation, IT Band tendinits, inflamed fat pad/Hoffa's body, patella baja, and severe arthrofibrosis.  I'm nowhere near the shape I was in before the surgery--heck, I still use crutches for long distances.

If someone told me their doctor had recommended a lateral release, I'd advise them to get at least 2 other opinions, try bracing and PT for at least 6 months, and make SURE they were limping before they went in for the surgery.  Because God knows they sure will be limping when they come out....

That's my rant for today.  Now I'm off to my 10th month of PT, something like over 100 visits....I think they are going to give me frequent flyer miles soon.

Heather
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
http://www.flickr.com/photos/hmaxwell

Offline snowcat

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Re: Lateral Release
« Reply #10 on: July 18, 2002, 09:36:33 AM »
I've had (and am still having) a fairly bad experience with my LR.  I do feel that my knee was fully assessed; I only wish I'd known about the assessment--that is, I thought that I was having a menisectomy & cyst drainage but woke up to find I had the LR as well.  Though I'd had plenty of problems with maltracking, my OS didn't discuss the LR possibility with me before the surgery.  From the surgery notes, I do trust that the assessment was thorough and the indications for the procedure were there.  

I don't know whether I would have had the procedure done if I'd had a say in the matter.  I probably would have, to prevent worsening chondromalacia and knee locking/popping; plus, my first knee surgery (just a menisectomy) went so well that I still had faith in arthroscopy and easy recovery.  Not anymore!  I'd have to be in MAJOR pain (limping, as Heather says!  majorly limping!!) before I'd have it done on my other knee.  

My knee doesn't pop or catch anymore and I no longer have the chondromalacia pain, so I guess the LR should help me in the long run.  But right now, almost a year later, the complications (ITB tendinitis/tendinosis, mysterious tibia pain--possibly patellar tendinitis) still seem as bad as, if not worse than, the original problem.  :(
5/00: partial lateral menisectomy (R)
7/01: LR, partial lateral menisectomy, cyst draining (R), followed by ongoing problems with illiotibial band syndrome & adhesions
6/04: Much better!

Offline Andrea

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Re: Lateral Release
« Reply #11 on: July 23, 2002, 11:49:21 PM »
I have had lateral releases on both knees.  The first one was done 10 months ago and the second one was done 4 months ago.  I can't really discuss long term effects because I am still fairly early post op.  As far as the dislocations go, those have stopped.  But I now have a lot of pain.  My knees are always sore and hot to the touch.  It is still very tender to touch the lateral side of my knee caps and I get a shooting pain when I try to use my quad muscle FE: standing on it bent, or doing leg presses.  I am having a hard time getting my ROM back from my second lateral release, especially if I am laying on my stomach trying to bend it, it feels like the lateral side of my knee is going to rip.  It is also very uncomfatorble for me to sleep on my stomach because when I lay on my knee caps it makes them throb.  I am having a hell of a time trying to strengthen my quadricep on my right leg.  It has only been four months, but by four months on my last one, I was much farther along.  I am very frusterated at this point.  I don't know if I would do it again given the option, but I still have to wait and see.  It might get better when they are stronger.  I can't really work on my quad that much because of the stabbing pain I have and I still have a lot of swelling and burning.  This is my experience, I hope other peoples is better.  Good Luck.
Andrea
I have had meniscal repair+plica excision (right knee 10/99, left knee 12/00) scar tissue excision and manipulation under anesthesia (left knee 4/00) and lateral releases (left knee 10/01, right 4/02)

Offline Kris

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Re: Lateral Release
« Reply #12 on: July 24, 2002, 02:58:37 AM »
Hi Andrea.  I know how very frustrating this type of surgery can be.  I've also had it done twice, one on each leg.  However, my legs are, I guess, reversed with your situation.  My first leg, the right one, is the difficult one, while the second surgery knee, the left one really isn't causing much problems at all.  I have full ROM in both legs and have had it since about the 4 weeks post-op time.  I never had trouble doing a straight leg lift with either one, which I here a lot of people do.  It's strange to me why my quad didn't get as weak as others.  Some say they worked out all the time, but afterwards couldn't get the quad muscle to work.  I guess I'm lucky.  I have no other reasoning for it.  As for the problem areas.  they are similar to yours on my right leg.  I can't bend and stand on it, anything with the knee forward is intense pain.  I see the OS on Thursday to see what he thinks.  But things were going so well until I choose to have the second surgery and then it all went down hill.  My therapist says a lot of the problems I have with the leg are do to the fact I have 18 degrees of hyperextension in the right leg and very little in the left leg.  I wish I could offer you suggestions in how to get those quad muscle to work, but besides doing leg lifts on each side with weight and the bungee cords in therapy, that's all I've been doing to strengthen it.  Keep up the work, I hope that it will get better for you.

Right  LR on 2/8/02,  7/11/03, and 11/5/05
Left leg LR on 5/02, 4/05
Right achilles tendon lengthened on 2/01.   Synvisc injections on 2/17/03. 
Cortisone on 12/03 and 3/04, 12/05. 
Proximal Reallignment Right 5/23/05
R Microfracture 5/19/06
PFJR 6/20/07

Offline Alessandra

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Re: Lateral Release
« Reply #13 on: July 24, 2002, 12:11:04 PM »
Hi,
after almost 3 months after my LR on the right knee I start to feel better. The only problem left is due to my patella mobility: it's less 'fluid' than the left one and for this reason I still have some pain on the upper side of my knee, especially when I stand up on it bent or I go upstairs.
I keep working out my right quad and I find it very hard as well as you do but, in my case, electrostimulation has been very helpful (I do it once a day for 25 min).

Good luck

Cheers

Ale















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