Joe A Shaw PA-C - 3/8/2009

Question
On 3/25 I will be having the first of 2 knee surgeries.  After a year of PT with 2 different therapists, 2 doctors, my GP and my ortho, decided further action was necessary.  I had 3 MRIs done.  My right knee was the original problem and that's been going on for over a year. It was determined to be chondral malasia patella.  About 3 months ago, the interior of my left knee began to hurt and that's when I went to an orthopedic dr. (who I trust because he just preformed corrective surgery on my mother's shoulder) and upon examination of the MRI results and physical, decided to try a cortisone shot in each knee.  The relief was only temporary.  Now we've decided to progress to surgery and he's decided to begin with the left, as he feels the plica is causing the pain, and that would be the easier of the 2 recoveries.

Can you please tell me what to expect from the 2 surgeries in terms of the surgery, pain, recovery, PT, and %range of movement?

I feel the better informed I am before the surgery, the less anxious I will be.  I look forward to hearing back from you.

Answer
Amanda,
In very severe cases of chondromalacia patellar or in cases that don't respond to nonoperative measures, surgery may be the best treatment. However, before doing surgery, generally a CAT Scan is done to find out the exact type of malalignment and the severity. The type of surgery performed depends on the findings of the CAT Scan and also on the degree of cartilage damage (which is evident at the time of surgery when the arthroscope is introduced.
It seems I recall that there has been studies recently w/i the last year or so that the results of this surgery has not given the pain relief that patients/Drs once thought it gave. I know it is a long healing process of 2-3 mos of gradual progression..but I would not expect 100% pain relief, but maybe 70-80% at best. But again your surgeon knows your case and condition the best