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: Worried... need a trochleoplasty!  ( 363 )

leahjg-90

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Worried... need a trochleoplasty!
« : December 22, 2017, 02:33:47 PM »
Hi,

Itís my first post and Iím really looking for anyone who has recently had or going to have a trochleoplasty.

Iím 27 and have had dislocations since I was 13. The first one was a traumatic dislocation, subsequent ones all atraumatic.

Iíve had my MRI results today and have been told, amongst other issues (cyst on the knee, fluid and ligament damage) that a trochleoplasty is my best option as my knee and the groove are both completely flat.

Iím really anxious as it seems like a much bigger surgery than ligament repair and Iím worried about how it will go, recovery and recovery time and if it will really work.

Any help is greatly appreciated as Iím definitely a bit anxious!

Thanks,
Leah

Vickster

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Re: Worried... need a trochleoplasty!
« #1 : December 22, 2017, 03:57:22 PM »
its quite an unusual surgery, very few surgeons do them and not many people on year will have had one, so try putting trochleoplasty into the search function.  Also there's information in the learning portfolio

http://www.kneeguru.co.uk/search/node/Trochleoplasty

Where are you based and has your surgeon lots of experience of doing the operation? If so, he or she should best placed to explain the op and post op to you.

My understanding is that, as with any bone work, it's painful and with a long rehab u fortunately. Expect a reasonable time on crutches and in a brace, with some time off work to recover

Good luck
« : December 22, 2017, 03:59:31 PM Vickster »
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reflex_nl

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Re: Worried... need a trochleoplasty!
« #2 : December 22, 2017, 06:01:01 PM »
Indeed, they rarely perform this surgery, and only if there is no good alternative. My OS mentioned that only for young people this could help (<20 years). Ask for the MRI data, share it and check with at least two other Drís.
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

leahjg-90

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Re: Worried... need a trochleoplasty!
« #3 : December 22, 2017, 10:39:25 PM »
Thank you both.

My current consultant has referred me to the closest hospital / surgeon who has completed this surgery frequently. He will look at my MRI too and advise on the recovery and process.

I was told that as my knee cap is flat and my groove is pretty much non existent that any other surgery wonít solve the underlying abnormal anatomy in my knee that causes my dislocations - leaving me at risk of more dislocations. So, while itís extreme and rare to do - he believes itís my best option.

Iíve had no surgery before and this has left me quite anxious! But hoping itís the best thing to do!

reflex_nl

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Re: Worried... need a trochleoplasty!
« #4 : December 23, 2017, 12:35:52 PM »
Certainly, get an expert to do it. I had three surgeries and the quality makes a difference in the recovery.

My groove is also not there and the patella is flat as well. I had approx. 6 subluxations (4x left, 2x right) in my life so far. You can check my MRI here: http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=69981.30

My OS didn't recommend the trochleoplasty as I'm 36.

Can you share your MRI's or 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

leahjg-90

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Re: Worried... need a trochleoplasty!
« #5 : December 23, 2017, 02:03:20 PM »
Thank you again - it's much appreciated and does help talking to people with similar experiences.

I have one picture of my MRI that I took while I was there - didn't think to ask for a copy of them all, I certainly will next time. It looks a little similar to yours, very flat kneecap and a lack of a groove. I am assuming if they've referred me again I'm not too old, but it will definitely be a question I ask (along with a list of many I have building up).

My consultant yesterday said he could repair the ligament, however it wouldn't solve the underlying anatomical issue and would leave me still at risk of dislocations. Until my most recent dislocation - Oct 2017 - I hadn't had a dislocation for a few years and had relatively no pain or instability. Now, I feel quite unstable and do suffer mild knee pain daily.

Just wanting to make the right choice and not end up worse off than I was before any surgery!

reflex_nl

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Re: Worried... need a trochleoplasty!
« #6 : December 31, 2017, 03:54:35 PM »
Yes, tough call and indeed it is also flat. I would think the OS maybe wants to combine it with an MPFL/LR since your patella sits quite laterally. I would ask your physio to tape the knee on the lateral side and see if a small shift to the middle helps with pain/stability.

Ask many questions, make a list, and find some support on the forum. Recoveries of trochleoplasty can be challenging.

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

leahjg-90

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Re: Worried... need a trochleoplasty!
« #7 : January 01, 2018, 03:15:41 PM »
Thanks.

Iíve already started a book of all my questions.

I know there was a mention of MPFL recon - either as a layer surgery or in this one. What is LR? Iím knee to all the knee terms.

After my last dislocation - home alone, upstairs, having to get to a window and shout for help and putting it back in myself - I definitely want it fixed, as Iíd be concerned of it happening when Iím alone again.















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