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westtexas2012-02-22 22:18:11 +0000 #1
Hi all!

I haven't been on much lately because I haven't ridden my bike in over 2 months now. I was having some problems with my knee and went to see an orthopod who diagnosed me with a tight IT band, a luxating patella, and weakness in my VMO. It only affects my left side and we've been over my bike fit a million times to make sure it's not the source of my issue. But riding is painful for me now and so I'm staying off the bike (probably why I've been getting a bunch of colds and feeling blue lately) for now.

Today I went back to my doc after 3 weeks of PT and he was not happy with the results. Although my patella is more mobile now and my IT band is nicely stretching, my VMO is not responding/getting stronger. We're giving it another 3 weeks of targeted VMO exercises in PT 3x/week, but if it's not better then, he wants to do a lateral release arthroscopically.

I was wondering if any of you ladies had ever had an arthroscopic surgery done before? I've done it/seen it done in animals before, but not in people. He says that the main problem is the extreme swelling after surgery. I only ask because I live alone in a third floor apartment and I have no family/friends here who could help me out. Is this something where I could manage on my own or do I need to start planning to fly my mom out to come help me out? How about going back to work right away? What's the pain like afterward? I'm pretty much a huge wimp so I am dreading this if it has to be done.

Thanks in advance for any insight!

Kathi2012-02-22 22:22:26 +0000 #2
Three years ago I had an ortho who recommended lateral release surgery. I postponed it until after the ski season. So glad I did, the problem was in my hip, actually my left SI joint, not my knee. Since then I've had 2 pt's tell me that lateral release surgery isn't always successful. I've also been told by my PT's that most knee problems come from the hips, not the knee. I know this isn't much help but I suggest you think very carefully before having surgery.
Kiwi Stoker2012-02-22 22:30:53 +0000 #3
My sister had keyhole knee surgery this year. They normally have an icepack on your knee as soon as you are out of surgery and tell you to keep on icing it regulary.

The main issue is crutches and getting around. You probably can do this yourself BUT you have to be ultra prepared.

Cook and freeze a whole heap of meals- you won't want to be cooking and trying to crutch around.

Ask someone to fill a thermos with hot water everyday- you cannot carry a hot drink on crutches.

Wear a sling bag around your neck to carry things. My sister didn't and carried things in her teeth!

Have a mobile phone nearby or in your sling bag ALWAYS.

Get a plastic stool to sit on in the shower.

Clean the house before surgery.

Look into getting groceries delivered to your door. Well actually you kitchen bench would be better.

You probably need someone with you for the first day after discahrge, however if you do get your mom out, a week would be best at least.
pll2012-02-22 23:24:36 +0000 #4
I hope Knotted will read your post, but without any expertise in the area, I wonder what causes the problem only on your left side, and if you can correct/compensate whatever asymmetry is the root cause, then the muscles will be better behaved.
Possegal2012-02-22 22:52:36 +0000 #5
I've had a lateral release done. I am definitely much better off since my surgery. I had it done a year after I had a patella dislocation and prior to the surgery I couldn't comfortably walk up and down steps and I could only run 1/16th of a mile and even then it hurt. I had been in PT nearly that whole year.

I will say though, that the PT who had worked on me both post injury and then post surgery, said that I was the only successful lateral release she and the other PTs there had worked on. She said most others saw no real change after their surgery.

That is purely anecdotal though, but thought it worth mentioning. I'm glad that I didn't talk to her prior to the surgery, or I may not have had it. And I'm glad I did have it as it is really much better. The surgeon said my patella was textbook for a tracking abnormality.

That's a mixed bag of info and probably didn't help you much.

I did have a friend from HS that had one and she was much better after it too. I remember doing some internet searching and finding all sorts of people with bad stories. Then I was reminded that the people with the good stories were out doing things on their new happy knees.

I woke up with the giant ice pack on the knee, but I never needed crutches after the surgery. I got around pretty well from the day after onward. My sister came with me and stayed for about 36 hrs, but then I was on my own and it was no problem. For me I compared it a lot to the original injury and the injury was so much worse. That may have given me a different perspective to it. PT after the injury was really rough, after the surgery it wasn't.

Pain - I didn't have much pain at all. I think I took the pain pills the first 24 hrs but then didn't bother. I went out to lunch with my niece and sister on Sunday afternoon (and the surgery was Friday morning). I'm trying to remember how long I was off work (this was a while ago) and I'm thinking I took a week off. Then the first week or so back at work, well I wasn't running down the hallways

and I did wear sweats most of the time for ease of putting them on. But again, no crutches, at all. Did the Dr tell you that you'd need them? I remember asking mine if I should bring them (had a pair from the ER when I dislocated) and he was all - oh no, you won't need that. He told me to NOT immobilize it and to NOT stop from putting my weight on it. So like I said, I was very mobile very soon after the surgery.

Just my experience, but I did have the exact surgery you are talking about.
soprano2012-02-22 23:29:26 +0000 #6
Get a second opinion from a doctor who does not have a financial stake in your potential surgery.

I would absolutely fly my mom out. (Well, not my mom specifically because we don't get along, but you get the picture.)

Untill you get good with crutches, to get up stairs, turn around, sit down and scoot yourself up. Does this surgery require general anesthesia? Three flights of stairs is going to suck. Would you consider staying with a friend that night? My husband had two orthopedic surgeries a few years ago, and both times getting him up 2 steps and as far as the couch was quite an ordeal. I can't lift him, so he almost spent a night on the kitchen floor!
Sky King2012-02-22 22:44:02 +0000 #7
My lateral release was done in 1998 and I have never regretted it. I will say that my knee is really ugly though. I have a big dimple on the top outside of my knee where the ligament is attached. While he was at it the ortho "roughed" up areas of bone to stimulate the area.

I do not have regular pain

My knee still sounds horrible and it really "clunks" but it has be almost 12 years.

My knee does swell often, especially after long rides and long hikes or backpacking.

I am not as flexible as I should be

I avoid activity that involves side to side movements (soccer, volleyball)

I do not run, EVER

I do not jump, Ever

This is my left side, which is basically a mess but as PT isn't an option I do stretch and am bartering some yoga with a friend.

Good luck, I had stairs and did spend the first two nights on the couch but then was able to handle the stairs. See if your insurance will cover "home health" type stuff for the first couple days.

I was always able to put weight on my knee, just not full weight for the first week.
ehirsch832012-02-23 00:27:58 +0000 #8
I did about 4 years ago. I was able to get around on crutches starting the next day, granted I lived in an apartment building with an elevator though.

Stairs will be a challenge until you get used to them

One more thing, I know you have been over your fit- but have you had your cleats gone over by a professional fitter?(someone who is a certified fitter)



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