[emily]

hello
i am in desperate need of some advice-
i have just been to see my consultant at the northern general and he has given me a choice of two operations for my dodgy knee. I suffer from patella displacement, so that it is maltracking badly and very prone to disclocation which, in turn means i damage my medial patella-femoral ligament.
the choice are as follows
1) A tribial tribucle transfer with a medial advancement and lateral release
OR
2) A medial patella femoral ligament reconstruction.
 
number 2 is much less invasive than no. 1 (quicker recovery, no pins or screws, no braking and moving of bones and no big unsightly scar) BUT he has not done enough of them to know the success rate, whereas he has a 90% success rate with the major surgery.
there are some knee consultants that are ONLY doing the MPFL reconstruction ops now and swear by them, but I need to here it from the horse's mouth.
so...
have any of you or anyone you know had one of these ops? what was the recovery time? how strong is your knee now etc etc???
i would obviously like to go for the less invasive surgery, but i would like the assurance that is going to work.
i NEED to be able to do drop knees, fall off bouldering and ski and know that my knee is not going to pop out.
any info will be much appreciated.. please post here or email me at emily (dot) brazenall (at) gmail.com
thank you and merry christmas!

[Jim]

Greencar - I know nothing about knee op's, but I do know if you post your email address on a forum you will start to get loads of spam

[GCW]

You don't give much information here.
I assume you have been through VMOs already.
Have you had an MRI or a scope, as this will change things?  Medial patellar facet degeneration points away from soft tissue procedures towards something like a Fulkerson's.
What is your Q angle?  Is there a J sign?  Do you get patellofemoral symptoms or just subluxation?  Is there a crossing sign on your lateral knee X-rays (trochlear dysplasia)?
Noone here can answer your question- go speak to your surgeon.
All I will say is that everyone is different and the best choice of treatment varies greatly.

[fatdoc]

 

and I'm probably one of the few on here that could follow that (well, most of it..)

+,

get a second opinion (although i dont know a dodgy orthopod at the NGH, they're all good)

[emily]

ok, trying to digest some of that...
i have spoken to by consultant extensively and he is quite happy to do either operation but has left the ultimate decision up to me, recommending that I do some research and talk to people that have had the treatment.
i have had mri and ct scans and xrays and in layman' terms i have a slight grove, enought of one not to get the "chisel and hammer" out as he so kindly put it.
my patella, when straight 'leaves' the joint quite a lot, i presume this is trochlear dysplasia? yes i do also have patellofemoral symptoms, quite badly from my last dislocation and now it feels extremely weak.
If any of you know any knee surgeons that I could get a second opinion off it would be very helpful.
i am hoping to do my bar vocational course next year, so i can only really afford time for one go at an operation/rehibilitation, so i have to make the right decision!

[slackline]

i am hoping to do my bar vocational course next year, so i can only really afford time for one go at an operation/rehibilitation, so i have to make the right decision!

Whilst commitment to a vocation is highly laudable I wouldn't say its anything to risk your health over.  If your choice requires a second op, you'll need a second op, the bar vocational course (something to do with law or high-jumping?) will wait.  Make the 'wrong' decision (and to be honest if both are options then is there really a wrong decision?)  you may be sacrificing your health in future years to come and require further operations.

[GCW]

So you have trochlear dysplasia but not bad enough to warrant trochleaplasty.  Realignment procedures are what you are talking about.
You can ask for a second opinion anywhere, just ask your GP or your consultant.  I doubt he/she would mind.

[fatdoc]

i presume you live in sheffield?

[james]

no, live in manchester now, but started the treatment in sheff and its easier to keep it there.  i really like the physio's in sheffield, the ones i have seen are very knowledgeable when it comes to sport specific training instead of others that fob you off as soon as you can walk.  i am trying to get hold of a specialist in norfolk, who is one of the leading surgeons in developing this procedure. But i think i would have more luck contacting the queen. Anyone out there know any knee surgeons?
 

[Monolith]

Have pm'd you James.(Emily under James?)(not literally)

[fatdoc]

emily (james) you've had a sex change  

i'll PM you.

[fatdoc]

on the emily log in that is.