Arthroscopic surgery

[Guest guest]

Hi Everyone, I saw pictures (under the photos section) of your knee

arthroscopic surgery and even one with lateral release. Has that been

a useful treatment?

Thanks

[Guest guest]

From what I have read, most doctors will do a lateral release most of the time

when they do arthroscopy, especially if it has never been tried on that

particular knee. This is something you need to clarify with your doctor before

the surgery. IMO the success with arthroscopic surgery is around 50%. In my

case I was desperate because of intense pain, and I would say the lateral

release eliminated about 50% of the pain at the time......maybe enough to give

me some breathing room for a time. In my case, I was not sorry I did it, but it

certainly is not a cure-all surgery.

Mike

MT

Arthroscopic surgery

Hi Everyone, I saw pictures (under the photos section) of your knee

arthroscopic surgery and even one with lateral release. Has that been

a useful treatment?

Thanks

[Guest guest]

My experience is not like Mikes. I had a severe " catch " in my knee that was

very painful. When the knee was not locked, I felt okay, but it kept

happening more and more to the point that I had to take a cane with me at

times.

They thought I had a torn meniscus. It tuned out to be damage was in the

trochlea groove. Doc cleaned it up and did a lateral release. So, I went

in thinking I would be okay in a few days and woke up being told I had about

a 4 month recovery.

After that, my knee never stopped hurting and the damage got progresively

worse.

I truthfully cannot say that the lateral release made it worse, but I

suspect it did.

The rest of the story? I had an ACI (Carticel) and a TTT.

I am finally feeling better and think I will be fine in the long run.

Of course every surgeon does what they think is best for the patient. (I

think) I kept the same surgeon though the whole process although I did go

and get other opinions.

If you have a lateral release, GET PHYSICAL THERAPY. I did not have PT at

first and that may have contributed tot he lack of success.

Don

On 5/14/07, Mike Bernhardt <mlbernhardt@...> wrote:

>

> From what I have read, most doctors will do a lateral release most of

> the time when they do arthroscopy, especially if it has never been tried on

> that particular knee. This is something you need to clarify with your doctor

> before the surgery. IMO the success with arthroscopic surgery is around 50%.

> In my case I was desperate because of intense pain, and I would say the

> lateral release eliminated about 50% of the pain at the time......maybe

> enough to give me some breathing room for a time. In my case, I was not

> sorry I did it, but it certainly is not a cure-all surgery.

>

> Mike

> MT

>

> Arthroscopic surgery

>

> Hi Everyone, I saw pictures (under the photos section) of your knee

> arthroscopic surgery and even one with lateral release. Has that been

> a useful treatment?

>

> Thanks

>

>

[Guest guest]

I visited your website and it made a lot of sense. My major problem has been

with pressure. What kind of recovery time do your patients usually have with

your TTT operation? I have had a lateral release and anterior interval release

on both knees. At the Mayo Clinic at Rochester they diagnosed me with very good

general knee mechanics, this at a time when I couldn't even sit without

excrutiating pain, or do steps. Now I function minimally well with compression

socks to keep the swelling and pain down.

Mike

MT

Re: Arthroscopic surgery

>

> From what I have read, most doctors will do a lateral release most

of the time when they do arthroscopy, especially if it has never been

tried on that particular knee. This is something you need to clarify

with your doctor before the surgery. IMO the success with

arthroscopic surgery is around 50%. In my case I was desperate

because of intense pain, and I would say the lateral release

eliminated about 50% of the pain at the time......maybe enough to

give me some breathing room for a time. In my case, I was not sorry I

did it, but it certainly is not a cure-all surgery.

>

> Mike

> MT

Hello! I am new to the group and have been monitoring the posts for

a while. I am an Orthopaedic Surgeon and have had an extensive

experience in patellar problems. The postings on this list mirror my

experience with patients. Arthroscopic lateral release has become a

standard treatment but unfortunately, rarely solves the problem and

frequently makes it worse. Most general orthopaedic surgeons are not

comfortable handling patellar problems. This has occurred over time

for many reasons.

I have developed a new website to explain my thoughts about these

problems and my approach to treatment. The information on this

website is my opinion based on my experience and results of

treatment. I invite you to study the information on this website

and hopefully gain some understanding of patellofemoral problems.

The address is www.patellamd.com. There is an email link on the site

that I will answer. I cannot diagnose and suggest treatment by email

but I will answer questions you may have that are not covered by the

information on the site. I welcome your visit to patellamd.com.

Shneider MD

[Guest guest]

I have repaired a previous lateral release many years later. The

instabiity it creates continues to be a problem and can be corrected.

I do not like the Macquet procedure as it is disfiguring and

overcorrects the problem in the wrong direction. I have revised several

of these over the years. 18 years after a Macquet, there is probably

some degree of patellofemoral arthritis.

[Guest guest]

>

> Ah, finally! An OS in the group. How many times have I referred

to people's experiences in this group & been laughed at by an OS.

There's something about the word " " or maybe they wouldn't take

patients' experiences seriously no matter where they came from.

Thank you for joining.

>

> I have a question. My CP has gotten better after a fairly inactive

period of several months. I can now go on 5-mile hikes. I'm

wondering if, if you don't irritate the knee much, does the articular

cartilage maybe grow over the lesions, or scar tissue?

>

> OTOH, now my menisci are falling apart (I'm 65). I'm going to have

a second operation for meniscal tear as soon as I can schedule it --

same knee, same place in the knee. It never stopped hurting after

the first one, even though the surgeon was one of the Big Boys in

Seattle, 70 miles away -- not convenient, and I think the least he

could have done was do the operation right. Won't be seeing him

again.

>

> Thanks if you have an answer to my question about something growing

over the lesion.

>

> Ann

Articular cartilage will seal with a fibrocartilage patch if

adequately debrided during arthroscopy. It will not heal if

untreated.

Regarding the menisci, three possibilities exist.

1. Arthritis is present that is preventing your improvement.

2. The symptoms you have are from the patella, not the meniscus.

3. The surgery was not done in a manner that will allow the meniscus

to heal and it remains symptomatic.

Shneider MD

[Guest guest]

Thank you Dr. Schneider very much for taking the time to answer our questions.

I don't know how many of us have had doctors look at x-rays and other tests and

come back saying we are within normal ranges, essentially telling us we can't be

in that much pain, and just telling us to go home and live with it.

Mike

MT

Re: Arthroscopic surgery

> I visited your website and it made a lot of sense. My major problem

has been with pressure. What kind of recovery time do your patients

usually have with your TTT operation? I have had a lateral release and

anterior interval release on both knees. At the Mayo Clinic at

Rochester they diagnosed me with very good general knee mechanics, this

at a time when I couldn't even sit without excrutiating pain, or do

steps. Now I function minimally well with compression socks to keep

the swelling and pain down.

>

> Mike

> MT

>

After a TTT most patients are on crutches partial weight bearing with a

knee splint for one month. After that they increase weight bearing and

discard the splint. By two onths most are walking well and are very

comfortable. At that point they begin PT if needed. Many do not need

PT at all. I like to have the knee functional and mostly healed before

starting PT.

Shneider

[Guest guest]

I don't know how many of us have had doctors look at x-rays and other tests

and come back saying we are within normal ranges, essentially telling us we

can't be in that much pain, and just telling us to go home and live with it.

YES, YES, YES!!!!!!! That is exactly what is happening with me. They all say

the gap between my bones are not great but ok and don’t show any arthritis

(the x-rays taken, according to Dr. Schneider’s descriptions, were not the

right ones to take) and that my alignment doesn’t look terrible, not great,

but not horrible. My knees are saying otherwise. They pop, catch, grind, and

are so painful that I can’t enjoy my family. It’s very frustrating! Having

Dr. Schneider send us the website address and confirm the fact that we

likely do have problems is refreshing and encouraging, at least it is to me.

I have repaired a previous lateral release many years later. The

instabiity it creates continues to be a problem and can be corrected.

My most “recent” lateral release was over 11 years ago and did not do

anything as far as helping the left knee. The right knee’s lateral release

was some 20+ years ago.

I do not like the Macquet procedure as it is disfiguring and

overcorrects the problem in the wrong direction. I have revised several

of these over the years. 18 years after a Macquet, there is probably

some degree of patellofemoral arthritis.

In my case, the Macquet procedure did help. I didn’t much care about it

looking disfiguring, which it really isn’t all that bad. I have the scar and

it looks slightly different, but most people don’t see anything but the

scar. I did get a round “bump” right over one of the screws, which later had

to be removed (the screws, not the bump) and people and Drs do ask what that

was from. I’d love to get rid of that. That was done on the right knee and

it was really bad. As for the arthritis…I can feel weather changes long

before they actually arrive and dampness is a killer. I do believe there is

arthritis in both knees, but it doesn’t show on the x-rays they took. The

docs all say the gaps look ok with the right knee showing a little

narrowing. They have always looked that way on x-ray (from the website, they

have taken the x-rays at the wrong angle and I have not had a standing knee

x-ray at all). What my biggest concern is, that it’s starting to affect both

hips. Probably from the way I have to walk. They always want me to walk for

them, but I’m not going to limp more on one side than the other because both

knees are affected. They just don’t seem to understand that. Now, I did get

a second opinion (for the scope surgery) and he seemed to better understand

my pain problem. He doesn’t seem to do the TTT surgery, just said the

arthroscopy and if that didn’t work a knee replacement. Boy, I wish I lived

in Michigan.

Joi and fids

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_____

From: chondromalacia treatment

[mailto:chondromalacia treatment ] On Behalf Of Mike Bernhardt

Sent: Saturday, May 19, 2007 4:27 AM

chondromalacia treatment

Subject: Re: Arthroscopic surgery

Thank you Dr. Schneider very much for taking the time to answer our

questions. I don't know how many of us have had doctors look at x-rays and

other tests and come back saying we are within normal ranges, essentially

telling us we can't be in that much pain, and just telling us to go home and

live with it.

Mike

MT

Re: Arthroscopic surgery

> I visited your website and it made a lot of sense. My major problem

has been with pressure. What kind of recovery time do your patients

usually have with your TTT operation? I have had a lateral release and

anterior interval release on both knees. At the Mayo Clinic at

Rochester they diagnosed me with very good general knee mechanics, this

at a time when I couldn't even sit without excrutiating pain, or do

steps. Now I function minimally well with compression socks to keep

the swelling and pain down.

>

> Mike

> MT

>

After a TTT most patients are on crutches partial weight bearing with a

knee splint for one month. After that they increase weight bearing and

discard the splint. By two onths most are walking well and are very

comfortable. At that point they begin PT if needed. Many do not need

PT at all. I like to have the knee functional and mostly healed before

starting PT.

Shneider