<p>^^^I know there are a lot of different issues with patellas. Our ortho did a “lateral release” and his description to me was that he cut & cauterized D’s ligament and moved her patella over about 2 inches. Mine will involve that plus cleaning out the “shag carpet” that my cartilage has become underneath. </p>
<p>No reshaping of the patella or pins. No casting. Your poor D! So glad the surgery was effective.</p>
<p>D’s surgeon explained to us that if the arthroscopy didn’t giver her relief, a next step might be patellar realignment, which is major surgery. Sounds like that’s what sryrstress is describing. After surgery, he said no way would that be an option for d1, but it can be necessary for some.</p>
<p>I have patellar issues and had a lateral release many years ago and it made my patellar track horribly afterwards. The release of that tissue which is called retinaculum caused my patella to not move nicely in a straight line but it felt like it tracked all over the place and for a few years it felt like a brillo pad was shoved under my kneecap. </p>
<p>GunnerDad, I was under the impression that lateral releases have fallen out of favor so I would definitely question why one is suggested if a ortho doctor want to do one. </p>
<p>As others have said, look below the knee to your feet and above the knee to your hips and pelvis to figure out where weakness is. Shoes may need inserts (not necessarily orthotics, that is a whole other story) and muscles above may be imbalanced and weak.</p>
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<p>Apparently that isn’t known in St. Louis. We see a lot of patients post-lateral release…</p>
<p>This is from About.com and was even written in 2004. </p>
<p>A lateral release is successful when performed in the right patient. For many years, doctors were performing this procedure too commonly, and some patients did not find relief. As we have gained experience with this problem, surgeons have become better at selecting which patients are likely to benefit from a lateral release.</p>
<p>[Lateral</a> Release of the Patella](<a href=“http://orthopedics.about.com/od/kneecappatelladisorders/g/lateralrelease.htm]Lateral”>Lateral Release of the Patella or Kneecap Realignment)</p>
<p>If you search the web you can find plenty of people, like myself that did not have a good outcome from having one done.</p>
<p>My D’s lateral release was a rousing success. After completing P/T, the knee that was “surgerized” (her term!) gives her zero trouble. Now there may have been other aspects, but lateral release was what I remember the ortho telling us was the main part of the surgery.</p>
<p>Thanks for all the opinions and stories. The orthopedist does not want to do any surgery for awhile, actually, he said I would need to back him in a corner before he would do it. I’m nervous as he said to take naproxen everyday for as long as I have pain. This is what worries me as my neurologist does not like this. According to the orthopedist on the x ray besides the obvious knee cap being on the lateral side, I also have a narrow space for cartilage on the lateral side. He said there is a good probability that I have lost some cartilage in this area or that there could be a fragment (didn’t say what) lodged somewhere. It’s getting better with the exercises but I will try a brace for the days it is really bad. I’m trying to find one with an “open” back because otherwise I break out in a rash. </p>
<p>I also got two new pairs of shoes through a shoe store that is affiliated with a private practice physical therapist. The lady who was working does not think I will need any shoe inserts but I can go back if I do. Now, my physical therapist didn’t sound to sure about the shoes but she did say they have a good arch. She also said my calf on the affected leg is .25 to .50 smaller than the other leg. I did notice the difference when showed me. If that gets worse I will be heading back to my doctor as it could be part of the problem according to her.</p>
<p>I will be seeing a second orthopedist one who is doing sports medicines. Not, that I want surgery but I want a doctor who is going to take an active approach not just take a pill a day and do x,y,z exercise. I don’t have a lot of visits to a physical therapist a year so I need to maximize the visits. I also want to return to doing some of the exercises I was doing.</p>
<p>fumafoo101, has your PT tried taping your patella into a position that would simulate the lateral release? If not you might ask them about doing that as an experiment. </p>
<p>Scroll through this pdf to see what I mean</p>
<p><a href=“http://www.mccc.edu/~behrensb/documents/PatellartrackingdisorderandMcConnellTaping.pdf[/url]”>http://www.mccc.edu/~behrensb/documents/PatellartrackingdisorderandMcConnellTaping.pdf</a></p>
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<p>This may be overkill, but possibly a consideration. </p>
<p>[Bledsoe</a> Products: 20.50](<a href=“http://www.bledsoebrace.com/products/2050.asp]Bledsoe”>http://www.bledsoebrace.com/products/2050.asp)</p>
<p>I have no affiliation with Bledsoe, but when I was looking at some other knee braces recently I thought it was interesting… </p>
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<p>I’m not sure what you’re looking for then… It’s either conservative “do these exercises” or it’s aggressive “have surgery.” </p>
<p>Another consideration is possibly therapeutic taping. This could be in the way of kinesio taping or McConnell taping…</p>
<p>Sorry for the delay…it was a busy week for me. I have tried kinesio tape but it was done before xray so it only made the pain worse. I have told PT I was willingly to try taping again and I will specifically mention McDonnell taping.</p>
<p>I know it is the two extremes of good conservative treatment, or surgery. I want a middle option. lol In all seriousness I just don’t want someone who is always going to be saying go back to PT. I cannot afford this and my insurance limits my visits per year. If I go in for my knee for say 10 visits and then go in for, say my back, for another 5 visits then I will have used half of my allowed visits. I pay for 20% of my treatment and since my schedule did not work out with my work’s hours I’m not working now and my parents won’t pay. I’m trying to find a new job that allows me to work on weekends but I don’t to return to fast food.</p>
<p>I like my primary as she always gives new ideas and tips on working out, or eating healthier but it was scary to hear her go from PT to surgery right after an x ray. I thought for sure she would’ve said CT, or MRI before that and even then at least let me do the PT first. So I guess I want an orthopedist who is willingly to give you new ideas/tips to getting better. I also want a PT, or orthopedist who will try to get you back to the same exercise routine. I miss using the treadmill and even though I disliked running, I know realize that I should use my legs while I can.</p>
<p>Thanks for the help/response again! I will look into that brace but it says page not found. I just would like to avoid surgery for a while, it would be best not to deal with it during fall/spring semesters. I will see a sports med orthopedist that a family member recommended as he did exploratory scope work after a 1 year and half of pain which found the cause of her problem and cleaning up the damage helped. The PT and shoes are helping! Only new problem is I’m more in-tune in with my knee which is a double edge sword. I can feel that the muscles behind my knee and on my side are tight.</p>