Lateral release

[Guest guest]

I had a lateral release done 8 days ago and feel great after four

years of hell. This was my seventh surgery in four years and after

the last one in November/03 my knee went to crap. The lateral side

was so tight and it tilted my patella into the groove every time I

bent my knee, and led to a whack of subfluxing.

The more I worked it at PT the worse it got. My muscles atrophied and

there was nothing I could do but continue on, and live with a lot of

pain and percicet.

I still have the surgery pain from the but the bone on bone pain is

gone. I was riding the stationary bike 4 days after surgery just to

see if I could, as before it was impossible without pain. I do leg

raises all day long and ice and elevate when ever I have a chance.

Started PT last Tuesday and she said my Patella is now sitting

perfect now. I know it's still pretty early to tell but I'm sure this

was the correct surgery for myself and I was getting to the end of

the line with surgeries. My surgeon also mentioned that I might have

CRPS and I think that would be expected to some point with all of the

surgeries that I have had. Every time you have surgery they do cut

the nerves but I'm pretty sure it was secondary to my tracking and

tilting problem. I thought it was just a circulation problem but CRPS

makes more sense with the discolouring and temperature change of my

knee all the time since this all started.

I have read a lot of unsuccessful stories about LR so I thought I

would write about my positive experience so far. I did lots of

research before this surgery and if it's done for the right reasons

and you work your butt off at rehab and follow your surgeons advice

it will work.

[Guest guest]

Ann,

CRPS (Complex Regional Pain Syndrome) is the same as RSD (Reflex

Sympathetic Dystrophy). I have looked it up since I received my

surgery report a few days ago. Read up on it as it is very

interesting. Like I said before I thought I just had poor circulation

but this could be the reason for some of the pain and burning (and

cold) feeling in my knee with spotted color on the skin. I took a

picture a few days after surgery and you can see the different

colours of my skin all around the knee. My knee is a mess and I will

need a TKR in the future but I'm to young right now. I will always

have pain but at least I will be able to function now.

Not doing any rehab right away after surgery is not good. I'm

surprised you where able to work your muscles back after a year. If

my muscles don't react to the rehab this time I will look into the

CRPS/RSD issue more because I might need a nerve block. I could live

with the pain I have now but without strong muscles around the knee

the chance of another subfluxing/dislocation is very likely.

When I fell the first time I sheered a large chunk of lateral

femoral cartilage(grade IV) and he also found grade III

chondromalacia of the patella. My knee progressively got worse with

the repeated subfluxing/dislocations and kept ripping everything

inside apart even with all the rehab I had done. I was in too much

pain before to work my muscles after the last surgery as the more I

did the worse I got. I had a hell of a fight with WCB and my employer

to get the LR done as it's a 50/50 surgery, it works or it doesn't.

The mental part was getting worse than the actual injury. I still

might lose my job even if my knee improves since my surgeon has

changed my restrictions to sedentary for the rest of my life because

my employer still thinks my knee is not as bad as my surgeon reports.

You can check out the picture if you want at:

http://ca.f2.pg.photos./ph/kneessuck/album?.dir=/a5ca

>

[Guest guest]

I also used to be a hiker (though not as much of a Terror on the Trail as you).

I also thought I had ITBS and it turned out to be a torn meniscus. The meniscus

was torn a lot more than showed up on MRI, and the removal of 2/3 of it got rid

of that pain entirely.

As for LR, I had one in '95 and it completely " cured " me until I got a job where

I had to sit with my legs bent all day and then they had me crawling under desks

looking for computer serial numbers for two years. From that I got CP and the

torn meniscus. When I had the scope this year (Jan.) for the meniscus and he

smoothed the CP area on my kneecap, he didn't do a LR because my thigh muscles

were somewhat atrophied. I've been working on the VMO & the general quads to

build them up, stretching, etc. (I've found that the tendon that connects my

vastus lateralis to my kneecap is very tight, and also the lateralmost tendon of

the hams is much tighter on that leg than on the other one). I can see the

muscle development, but have had no improvement in the CP pain (I use McConnell

tape to do the exercises, otherwise I couldn't do them), and also I now think I

tore my medial meniscus hiking on snow, when my leg (the bad one, of course)

went through unsupported snow twice in late May -- it's never gotten better. If

that meniscus shows up torn, and I get another scope, I'm going to try to get

the doc to do an LR for my CP.

I hate to say this -- you're not going to welcome it and probably not going to

follow my advice, since adventure racing is probably a large part of the way you

think of yourself (I was that way about hiking & mtn climbing, so I understand),

but if you continue using your knees so heavily, you'll probably end up in way

worse shape than you'd ever want to be. Could you just pleasure hike (being

careful on the way down slopes)?

Also I'm curious -- your paddling -- is that kayak or canoe? If canoe, do you

put your weight on your knees? I'm also a canoer, and did put my weight on my

knees, but obviously with CP can't now. I hate having to sit on the bench with

my legs out in front of me & paddle!!!

Ann

lateral release

Hi,

I'm an adventure racer, specializing in 2-3 day races which typically

cover 50-60 miles on foot (running or trekking), 100-150 on a mountain

bike, and 40-60 of paddling (white water, flat water, etc.). I've

struggled with what I thought was ITBS for many years -- pain on the

outside of the right knee. Through yoga, and about 3 months of chiro a

few years back, I've mostly been able to keep that pain in check, though

it's never fully been healed and I've had to limit my training accordingly.

Then, about 6 weeks ago, the nagging pain came back. Well, I thought it

was the same, but now looking back, it may have felt slightly different.

And then 2 weeks ago, I got very sharp twinges of pain, culminating in

" fall down and cry " kind of pain when starting a lawn mower. Then I

could barely move it for a few days, though now I have decent range of

motion without pain, though still some twinges of discomfort if I move

it wrong.

So x-rays and mri show that I have bone contusion on my femur, and that

is caused by poor tracking of the patella. (There is a slight chance I

have a torn meniscus -- there was some irregularity in the MRI but the

Dr. said he could not tell for certain if there was a tear unless he

went in and looked.)

Anyway, he wants to do a lateral release. All of this is new to me

since I thought I had been dealing with ITBS all these years, and maybe

that's what the old issue was and now I have something different.

I definitely have poor alignment of the hips/pelvis, that cause a leg

length descrepancy, etc. I'm wondering if a lateral release is a safe

thing to do and what the probability of success is. The Dr. says about

4 weeks of doing next to nothing, then 6 weeks of re-hab, and I'd be

back to where I am now (or at least close). He thinks I'll be able to

train much more once the patella tracks better.

Thoughts? Anyone have this done before? I'll likely get a 2nd opinion

but thought I'd check here as well.

Thanks,

[Guest guest]

I am a hiker & climber and I agree with Ann. Running downhill on

mountain trails is murder on your knees, especially with the kind of

mileage you are putting in.

-

>>>>> I hate to say this -- you're not going to welcome it and

probably not going to follow my advice, since adventure racing is

probably a large part of the way you think of yourself (I was that

way about hiking & mtn climbing, so I understand), but if you

continue using your knees so heavily, you'll probably end up in way

worse shape than you'd ever want to be. Could you just pleasure hike

(being careful on the way down slopes)?