Advertisement - Hide this advert





: Patella Cartilage damage - what is next? (MRI Pictures - page 2)  ( 2563 )

Brandon123

  • Forum Faithful
  • ****
  • : 242
  • : 14
Private cartilage repair will typically run GBP 10-15k. That's based on numbers I was given 6-7 years ago (e.g. For AMIC, a single scope procedure)

Many thanks for the info! :)

reflex_nl

  • Regular Poster
  • ***
  • : 87
  • : 4
Hi Guys,

Quick update: I decided to go ahead with Shetty's proposal and get CT scans and MRI's and X-yas. The third MRI within a year. Hence, I traveled back to the UK - see below the results. His conclusion was that I do have tracking issues. Patella tilt and patella shift. Hence he recommended to perform an MPFL reconstruction, a lateral release and the MCIC cartilage repair. A bit of a shock to me; but without addressing the bio mechanics the cartilage repair would not hold. He gave it a 80% chance of success.

If you look at the pictures, you notice a few things
  • You can see the left knee patella is not in the same spot compared to the right
  • You can see that some (fibro) cartilage has grown back in the hole
  • The trochlear groove is flat, hence a risk of dislocating the knee cap
  • Their is a bony avulsion on the MPFL patella attachment area
  • Meniscus and other ligaments intact
  • The patella is clearly tilted laterally

Strangely enough...  sometimes when the knee cap sits "ok" I don't have much pain; but when it tracks wrong, simple walking already hurts (luckly this happens once twice/each month). However, after a year, I still cannot do any sports and I'm at risk for further damage...

Hence, I have to go to surgery to improve the situation.
RK Patella Luxation in 2000
RK Scope grade 2 damage to patella
RK PT for 4 mths, recovered 90% after 4 years
LK Patella Luxation in Oct'16
LK Scope to remove loose bodies (grade 4) to patella Nov'16
LK Lateral Release + MPFL Reefing + MCIC in the UK Dec'17

reflex_nl

  • Regular Poster
  • ***
  • : 87
  • : 4
and the MRI pictures...
RK Patella Luxation in 2000
RK Scope grade 2 damage to patella
RK PT for 4 mths, recovered 90% after 4 years
LK Patella Luxation in Oct'16
LK Scope to remove loose bodies (grade 4) to patella Nov'16
LK Lateral Release + MPFL Reefing + MCIC in the UK Dec'17

Brandon123

  • Forum Faithful
  • ****
  • : 242
  • : 14
You do really have a flat trochlear groove, no wonder you have suffered multiple dislocations :/

When will you have your surgery with Dr. Shetty?

reflex_nl

  • Regular Poster
  • ***
  • : 87
  • : 4
Yeah, surgery was done a week ago by Mr Shetty himself. He was quite pleased with the surgery it self. I stayed in the UK for 4 days. Currently in a brace locked to 20 degrees and on pain meds. So far so good... the stemcells need to do their job in the comming months :-)

It’s already the third time - getting used to it.
RK Patella Luxation in 2000
RK Scope grade 2 damage to patella
RK PT for 4 mths, recovered 90% after 4 years
LK Patella Luxation in Oct'16
LK Scope to remove loose bodies (grade 4) to patella Nov'16
LK Lateral Release + MPFL Reefing + MCIC in the UK Dec'17

Brandon123

  • Forum Faithful
  • ****
  • : 242
  • : 14
Sounds good! Keep us updated on how you are doing :-)

reflex_nl

  • Regular Poster
  • ***
  • : 87
  • : 4
A update after a knee surgery: MCIC + Lateral release + MPFL reefing all on LK

Week 1:
Surgery completed; stayed one day in the hospital and got some pain killers for @ home. Knee swelled a lot, as usual, but so far so good. Pain levels quite acceptable. No complications and I even got a pictures from the surgery itself. Shetty is as kind as ever and explained all the steps. I stayed 5 days in the UK for recovery and followup. I was in a CPM machine for 2 hours after surgery and the next morning the physio gave me a brace. I can bear full weight on the knee, but the flex is limited to 20 degrees. I can slow walk a bit with the brace and crutches. ROM w/o brace, not weight bearing: 20 degrees

Week 2:
At home. I can move around the house without crutches, just the brace. Pain is minimal, and wounds are healing nicely. The advantage of a swollen knee is that you hardly feel any cartilage or bone related pain. I do limit my movements around the home and ice the knee 3x a day. I do some light physio to keep the leg active. I stopped taking pain killers. ROM w/o brace, not weight bearing: 30 degrees

Week 3:
Enjoying my time off, the knee is a bit slimmer now. Increased the flex to 30 degrees per OS advice. I'm still amazed by how well the recovery is progressing compared to my two other knee key hole surgeries. These were far simpler, but both times I had for weeks a lot of "pain", "redness", "soreness" post surgery. Of course it will take at least 6 to 12 months before I know if the last surgery was successful, but a smooth recovery does help to stay positive :-). ROM w/o brace, not weight bearing: 60 degrees

Keep you updated - any questions, let me know!
« : December 31, 2017, 04:03:05 PM reflex_nl »
RK Patella Luxation in 2000
RK Scope grade 2 damage to patella
RK PT for 4 mths, recovered 90% after 4 years
LK Patella Luxation in Oct'16
LK Scope to remove loose bodies (grade 4) to patella Nov'16
LK Lateral Release + MPFL Reefing + MCIC in the UK Dec'17

Brandon123

  • Forum Faithful
  • ****
  • : 242
  • : 14
I'm still amazed by how well the recovery is progressing compared to my two other knee key hole surgeries. These were far simpler, but both times I had for weeks a lot of "pain", "redness", "soreness" post surgery. Of course it will take at least 6 to 12 months before I know if the last surgery was successful, but a smooth recovery does help to stay positive :-)

Quite amazing, based on my own key hole surgery, I have always assumed that a "real" knee surgery would be a rather horrible experience :-)

Btw, is the patellofemoral joint (and PF surgeries) Shetty's key area of expertise?

Vickster

  • SuperKNEEgeek
  • *****
  • *
  • : 3854
  • : 272
  • Neelie knee!
Knees, especially PF and cartilage repair (and hips which isn't unusual for a knee surgeon here)

https://www.spirehealthcare.com/consultant-profiles/professor-anan-shetty-c3444306/

A UK NHS surgeon will generally treat whatever is referred to him by GPs in the area in addition to tertiary referrals for any special interest
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
LK New MRI shows lat & medial meniscus tear & other stuff
RK MRI lat meniscus tear
8/1/15 RK Steroid jab,
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation

reflex_nl

  • Regular Poster
  • ***
  • : 87
  • : 4
To me it seems his main interest is helping people with cartilage issues. He is in favor of less invasive methods. If you still have knee pain, you can always visit him to talk about your concern.
RK Patella Luxation in 2000
RK Scope grade 2 damage to patella
RK PT for 4 mths, recovered 90% after 4 years
LK Patella Luxation in Oct'16
LK Scope to remove loose bodies (grade 4) to patella Nov'16
LK Lateral Release + MPFL Reefing + MCIC in the UK Dec'17

Brandon123

  • Forum Faithful
  • ****
  • : 242
  • : 14
Knees, especially PF and cartilage repair (and hips which isn't unusual for a knee surgeon here)
https://www.spirehealthcare.com/consultant-profiles/professor-anan-shetty-c3444306/
 

Many thanks for the info and link, Dr. Shetty has a very impressive resume indeed! I suppose he is one of UK's leading PF/cartilage repair knee surgeons?

To me it seems his main interest is helping people with cartilage issues. He is in favor of less invasive methods. If you still have knee pain, you can always visit him to talk about your concern.

Yup, I still struggle with my PF cartilage damage…Dr. Shetty seems to be a world-class expert on this area, so I will definitely keep him in mind for the future.















support