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- Thu May 28, 2009 3:43 pm
I am a very active 18 year old female. I have played competive soccer for 14 years. I have had pain in my right knee for 6 years and recently had surgery to correct it. On December 23, 2008 I had a lateral release of my lateral retinaculum and the removal of a medial plica. I went through PT for approximately 8 weeks without a problem. For no apparent reason, I began experiencing pain with activities I had been doing pain free for several weeks as well as significant instability in my knee. My PTs removed me from all open chain activites and I began the PT process all over again for another 6 or so weeks with some improvement. I became frusturated with my degression and lack of improvement and stopped going to PT. I still have excessive amounts of pain during activities such as running, squating, weight training, etc. I am actually experiencing more intense and much more frequent pain now than I did before my surgery.
I do not know what I should do. My Ortho suggested more surgery, but feels that it will be too invasive. My PT suggested more physical therapy. Do I continue with PT, have another surgery, or get a second opinion from another doctor? I plan on returning to play this fall, whether I am pain free or not, but I would definitely prefer pain free.
| Tom Plamondon PA-C
- Mon Jun 15, 2009 9:34 pm
The treatment plan: surgery vs therapy depends on the cause of the pain and dysfunction.
If this is a patella femoral joint problem then I tend to go more conservative (vs operative) whereas if there is internal damage then arthroscopy may be best.
So, I would get an MRI of the knee to see what is going on inside the knee then determine the next step.
I have seen this type of scenario (persistent knee pain following lateral release and plica removal) drag out and it can get frustrating to everyone because despite the pain and dysfunction nothing shows up on MRI and the knee just doesn't respond to therapy. This would be worse case scenario.
It may turn out that decreasing the activity level for some time and building strength and flexibility and proprioception is the best. Then gradually return to activity.