Re: Hi everyone, few questions

December 1, 2003

I'm not sure if they can tell in a LR will fail or not but I have had one on

both of my knees afew months apart along with scraping and polishing of both

knee caps. The only complaint I have about the LR is after the fact of having

it done the doctor prolonged the healing time. I have found that since I have

had the LR done I cannot rest myself on my knees because they feel too

" tender " . I don't see a LR failing unless you do not follow up afterward with

the

appropriate PT exercises to help your quads pull the knee cap in the right

position to properly track your knee caps. I must admit my doctor told me that

it

may not work as well in some cases but it is one of the most minimal

approaches in trying to correct certain knee complication. I'd like to ask if I

may,

is the LR the only thing your doctor tends on doing? The LR relieves the

pressure on your knee caps but if you are experiencing any grinding I would

question whether or not he would suggest trying to scrape and polish the

underside

of the patella to relieve any severe grinding as well. Hope this helps, I'll

try to keep track of the posts to answer any other questions you might have

about it.

December 1, 2003

There are several of us including myself who have had both lateral releases

and tibial tubercle transfers. I have severe Chondromalacia and just had my

13th surgery (age 27

). I've had bilateral lateral releases and TTT. The Hospital for Special

Surgery and Dr. Fulkerson are the best from what I've read. My patella

alignment

was so lateral that the TTTs had to be done and the lateral release only

helped temporarily. However, I am an extreme case- both of my kneecaps were

very

very lateral. Feel free to ask any specifics! Margaret in NC

December 1, 2003

Margaret,

Hey I hope you remember me I talked to you months ago my old email

address was taintedmelodies@...

I was wondering who is the new doctor you are seeing. I didn't get to

see Dr.Vail instead I am seeing Dr. Claude T Moorman who is the head of

Orthopedics at the Finch Yeager Bldg which I am sure you are familiar with.

Hope all is well with you!

http://www.kneetalk.com

December 3, 2003

Hi

Yes, I remember you! Thanks for emailing. Yes, I spent many years of my

life from 1989-1995 in the Finch-Yeager Building at Duke Univ with Dr.

Bassett who was the head of sports medicine/orthopedics and the father of knees.

Dr. Bassett has since retired but you can find a lot of his literature and

research on the internet. He had a fantastic bedside manner and was also Duke's

team doctor.

My doctor now is in Greensboro, NC at Greensboro Orthopedics and he

trained at Duke. He's written an orthopedics textbook also. He is very kind

and

most knowledgeable. He wants to wait as long as we can on the patellofemoral

replacement for me because he thinks my kneecap may be able to last a little

longer.

Hope your recovery is going ok. Margaret

December 3, 2003

Hi Farah-

Here's a link to an orthopedics textbook with technical info about all knee

surgeries- I linked you to the lateral release. I don't know how familiar you

are with medical terms,etc but you should be able to understand most of it.

You can go go the main knee menu and look at other topics also. The lateral

releases helped my knees for about 6 months but that told my doctor that the

problem was patella alignment because with the kneecap more medial, my pain was

better and it was tracking better. Here's the link. Margaret

http://www.ortho-u.net/o12/56.htm

December 3, 2003

You're welcome- I've got a lot more references- I'll send a list out. I'm so

desperate- I've done a ton of research. I'm going into orthopedics when I

graduate. Margaret

December 3, 2003

Margaret,

I have heard wonderful things about Dr. Bassett who like you said has

retired. Dr. Moorman is very patient and honest which I need but I can

honestly say Duke has been the only place so far that has offered me something

other

than pain medicine.

I hate to say this, but I hope I don't end up like you, because I'm

having surgery Monday and then they are planning four more surgeries after this

one. They plan to completely re-align my legs so that should eliminate all

the problems I've had.

December 3, 2003

Margaret --- This reference is invaluable. THANKS!

Ann

Here's a link to an orthopedics textbook with technical info about all knee

surgeries- I linked you to the lateral release. I don't know how familiar you

are with medical terms,etc but you should be able to understand most of it.

You can go go the main knee menu and look at other topics also. The lateral

releases helped my knees for about 6 months but that told my doctor that the

problem was patella alignment because with the kneecap more medial, my pain

was

better and it was tracking better. Here's the link. Margaret

http://www.ortho-u.net/o12/56.htm

December 3, 2003

Hi -

The good news about knees is that doctors today are more tuned into

patellofemoral problems. I've had both of my kneecaps realigned. My right knee

has done great (1998) , but my left knee (2000) has not. The left Q-angle was

much worse. My realignment surgeries were not done at Duke. Dr. Bassett had

retired at that point. My right kneecap was realigned in 1998 before my senior

year in college and it went smoothly, rehab,etc.

I was a serious gymnast for 10 years and that's what contributed to these

knee problems. I had qualified for nationals in my last meet. Dr. Bassett

made me quit gymnastics after I had 3 surgeries in 1991. I had 6-7 surgeries on

my right knee at Duke starting at age 12 because back in 1989 they weren't as

familiar with patellofemoral problems as they are now. They kept operating

thinking the torn meniscus from gymnastics,etc. was causing all my pain. One

of MRIs in 1990 clearly showed that both of my kneecaps were very lateral and

could easily dislocate. However, at the time the physicians didn't think the

patella alignment was the issue.

In fact, a doctor told my parents when I was 14 that my knee pain was in

my head and I needed a psychiatrist. They thought I had RSD. I was sent

here to Wake Forest for a nerve block to rule out RSD. It was very scary having

that done at age 14. I myself at age 14 called up the orthopedic surgeon and

told him I did not have nerve related pain and it was not in my head.

Anyway, as I said the right knee went great. However, the left knee was

worse from the start. I had terrible muscle spasms in the hospital after the

surgery. I had bad experiences with 2 physical therapists and I just wonder if

they pushed too much too soon. In December 2001, I had a scope to clean it

out and clean the tibia out from where the screw had been. For the past year,

I have been in awful pain again with griding,etc. and been to 4 doctors who

all said they wouldn't touch me. Finally, I had surgery in September after

an MRI revealed that the chondromalacia has progressed significantly.

Unfortunately, I have very little cartilage left under my left kneecap and have

developed subchondral bone cysts characteristic of grade IV chondromalacia

patella.

I'm working hard at developing my VMO again.

I knew going into the realignments that there was a chance that they

might not work, but it was a chance I had to take. I would do it again on both

of

them even with the complications. Otherwise, all of the cartilage would be

gone and my kneecaps would stay dislocated. I am a worst case scenario!

Margaret

December 3, 2003

How were you able to do cardio with your CP pain? What did you do? This is the

thing that's killing me -- weight gain due to inability to get cardio exercise.

I'm glad you said that what put you in your current situation was the meniscus

removal/repair -- my new doc wants to do that on me and I really really really

don't want to have it done, since pretty much all I've read about it is

negative.

I'd really like to know what exercises you did and how you stuck with it for a

year without seeing any progress in the beginning, and with it hurting.

Thanks.

Ann

RE: Re: Hi everyone, few questions

Hi Farah and Everyone,

I just want to put my 2 cent worth in about PT, stretching, etc. I have been

dealing with CP for about 2 years and stretching and weight lifting for about 16

months. I did not start to see much of an improvement until about a year of

work. I think everyone should really devote at least a year to a year and a

half to weight lifting, cardio, and stretching before considering an operation.

An operation is what put me in this predicament (meniscus repair/removal). I

have pretty sever CP, never had it graded, but the grinding is horrific. I can

not put my weight on my leg going up and down stairs. I went thru much much

pain as I was trying to strengthen my muscles and stretch, but it does pay off.

I have some days when I am almost pain free. I never thought that could happen!

I really thank this forum, and especially Doug, for encouraging me to hang in

there!! I still have a long way to go, but I'm hoping if I can stave off any

kind of surgery, new advances in medicine (cartilage repair, replacement, etc)

will provide the answers.

December 3, 2003

Margaret,

I couldn't agree with you more about the realignments. I am so

grateful everyday that I took the chance and had the surgery done. I was told

about

all the risks but I believe pain-relief was worth the risks!

I'm not surprised about the doctor's not wanting to help you. The

next to last doctor I saw, said he wouldn't do the surgery because he didn't

feel

that he was capable to do the surgeries I needed and he was afraid he would

do more damage than good.

December 3, 2003

Hi Ann,

About the only type of cardio I can do is walking on a treadmill. To keep up

with the cardio and the weight exercises even though I was/am in pain, I did/do

the following:

1) I read back thru the archives of this group and printed out EVERY message

that spoke to the benefits of exercise and how the benefits were real, but slow

in coming. I pulled out these messages and read them every time I was

discouraged (which was often).

2) Posted an article on my refrigerator about how a man riddled with arthritis

was climbing mountains. It proved to me that you can defy the odds and I read

it when I am discouraged.

3) When I was in PT, I drove the therapists crazy asking them if these

exercises REALLY helped actual people. I made them tell me over and over again.

4) I posted to this group when especially discouraged.

5) I called Doug a couple of times who was of so much help to me!

6) I tell myself that I have no choice. I will be DEVASTATED if a new method

or material becomes available to help CP " victims " and I'm not a candidate

because I've left my muscles to atrophy.

7) Once I could actually FEEL a VMO muscle (after many many months of work), I

looked at this as one of my greatest accomplishments.

8) I constantly search the internet for the benefits of weight bearing exercise

for arthritis/cp sufferers. I print out these article and read them when I'm

discouraged.

9) For the first 6-9 months, I laid on the couch all evening every evening

after my workouts. I iced my knees and begged friends to massage the sore parts

of my legs. By the way, each day brought a new and different pain. I would

look the pain up on the internet and try to find a corresponding stretch. For

example, when the pain and burning was SEVERE in my pes anserinus (sp??), I

read that I needed to stretch my quads. I thought this pain would NEVER go

away, but it did (with occasional flare ups).

10) I occasionally used pain medication when I just couldn't stand it anymore.

11) I try not to feel sorry for myself, although this is hard. I ran a

marathon in 2000 and it's hard not to compare what I can't do now to what I

could do then. My mom got really mad at me one day, though, and told me I

better start focusing on what I CAN do, rather than what I CAN'T do.

Here are the exercises I do at the gym:

1) leg press (one leg at a time)

2) calf raises

3) partial leg extensions (one leg) at a time)

4) leg curls (one leg at a time)

5) hip adductor

6) hip abductor

Exercises at home:

1) Stretches

2) Leg lifts with ankle weights. (I could not do these for a long time. Leg

raises caused MUCH more pain and burning afterward then machines. I now use the

ankle weight on days I don't go to the gym).

Re: Re: Hi everyone, few questions