Lateral Release Surgery - do I or don't I?

by Andrea
(Connecticut)

I am scheduled to have lateral release surgery and possible chondroplasty next week and now I am having second thoughts after all of the bad outcomes I have been reading about. The x-rays show that I have bilateral patellar tilt in both knees but I have opted for one knee at a time. I have also gone through 6 weeks or so of physical therapy to stretch out certain muscles and tighten others and they still cannot get my knee cap to move freely.


When I run or walk for long distances I have a very uncomfortable almost floating knee feeling and I limp. I have pain also but not all that extreme. Also when I do stairs I compensate because it is uncomfortable.

So I guess what I am trying to figure out is do I try a different physical therapist and cancel my surgery and see if there is anything they can do for me or do I move ahead with the surgery? Can physical therapy without surgery really help me? If I do not do either can things get worse?

I have crackling and awful noises in each knee which I am thinking is from the tilt and it is breaking down the cartilage.

HELP.

I am really scared about getting surgery and being worse off. I want to get back to exercising so badly.

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Aug 16, 2008
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you have to decide what is best for you
by: Bart - SII

Hi Andrea - your worries are normal, and part of everyones thoughts prior to knee surgery.

It is true, there are a lot of bad results after a lateral release surgery - and you can find them all over the internet - but, you have to remember that this procedure is sometimes used as a last resort to treat patella femoral syndromes - when everything else has failed. It has been shown through research that the best results for this surgery are when it is used to treat patellar tilt. In your case, this is what you are suffering from. So, you should have a good chance for a good outcome.

Patella femoral syndrome is a very complex problem, with lots of different factors. Before surgery you need to make sure you have exhausted all of your other options.

6 weeks of therapy, if it addresses all of the possible factors causing your knee pain, then it is time to consider it. But, if your 6 weeks of therapy was focused on leg lifts, quad sets, hamstring stretching, and doing squats squeezing a ball between your knees, then you may want to find another therapist with a more progressive approach and postpone the surgery.

The popping and cracking you are having is probably due to the lateral tilt, and the softening of the cartilage over time - which means that the surgery would help to alleviate some of that by smoothing out the rough spots in the cartilage - and the release could help the patella to track better - but all of that is for not if your rehab hasn't addressed other factors like mobility, strength (of the hips and core), balance, and neuromuscular control.

It is a difficult decision, and not one to be taken lightly. I hope some of my information has helped.

Comment back with other questions.

Bart

Oct 15, 2008
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Surgery?
by: Anonymous

Just curious after reading your post...did you proceed with the surgery? If so, how are you doing?

I am considering the same surgery and would like to hear a positive outcome.

Oct 27, 2008
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Surgery
by: Jessica

I had this surgery on both of my knee's when i was 15. I am now currently 17 and I am so glad i had the surgery. Since my recovery I haven't had pain in them since I would recomment this.

Dec 27, 2008
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Lateral release
by: Anonymous

I just had a LR on my right knee because it had been clicking or popping whenever i stretch my legs and do have knee pains everytime i get done playing soccer. I tore my ACL got that fixed and the poping started and never went my doc was so annoying that i had enough and went to another doc who said he would go in and clean and fix watever he finds well he did a LR on me its been 4 days i had it done on the 24th. I tell you my knee already feels different from before the popping has stopped the side of knee hurts do but that should go with time because thats were the release was done. So am really happy becos i know i can start playing soccer again in a couple of months its cold now so till summer. I think if you have a good doc that knows what hes talking about yea go for it but if u dont trust your doc dont. This is my second scope after the original acl surgery but i did this with a different doc who i told that i cant do another scope he needs to fix everything he sees and he did. Am really happy about that popping because my other doc didnt even know what to do he BSing me so i went somewhere else.

Apr 24, 2009
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Lateral Release
by: Ashley

Hi,
I had lateral releases on both knees one 11/08 and 2/09. My left knee was first and I recovered and feel great. I can actually do stairs now which I haven't really been able to do in years. Once My left knee was strong enough I opted to do my right knee since I had very similiar problems. I love My Ortho he's great and really knows what he is talking about. Buy my right knee didn't respond like my left. Stairs are even worse then it was before. I can not so squats what so ever. Now I am really in chronic pain. I can handle the pain its not bothering me where I can't walk but I should have thought it over a little longer. Now I am seeing another ortho just incase to see what other treatments are out there I am so done with PT. I have been doing that for years. Make sure if you do the surgery you do everything before hand and listen to your doc afterwards no walking on it for a few days. That was part of my problem after my right knee i was walking on it an hour after surgery might be my problem now....good luck it was worth it for me at least for one of my knees

May 03, 2009
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bilateral release on knee
by: Anonymous

I had both knees done at the same time. The dr. said it would be a little inconvience but its been alot. Hard to walk had to use crutches for 2 wks cause my knees want to buckle from under me. Alot of pain. My right knee feels like a rubber band is around it very tight most of the time. The THerapist said my left upper thigh muscle is not responding correctly that's why my knee wants to buckle. I keep praying it gets better then it was before surgery. Scared it will be worse. Wish whom ever has it done best of luck. Don't have both knee's done at the same time. Best of luck and GOd Bless

Jun 03, 2009
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Lateral Release
by: Shannon

I had a lateral release on my left knee on May 11th 2009. 1st 3 days iced continueously through the bandages the best I could with an ice pack used for headaches that you put on your head. Only got up to use the bathroom keeping it elevated on pillows. I was on 2 crutches the 1st week, 1 crutch the 2nd week and started walking at the end of the 2nd week. I started physical therapy on the 3rd day going 2 x per week and doing exercises at home 2x per day as time would allow. I went back to work 2 weeks after the surgery as I have a desk position. The stitches were removed right before going back to work. I would ice the knee through my jeans at work around noon during the day and get up and move ocassionally to keep from getting too stiff. The knee does tend to swell quite a bit by the end of the work day, so its hard to do the exercises at night when I get home. Some days I have to skip them. I am 3 1/2 weeks post op now. The only problem I have is a pain on the medial side of my knee now (before it was the lateral side). I mostly feel it when I have to do the wall slides, mini squats or leg lifts in physical therapy. I also feel it if my knee flexes too much. Does anyone know what might cause this? Will it go away?

Jun 03, 2009
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lateral release
by: Anonymous

I had mine done on the 24 dec 09 on my right knee I still feel some pain on the front of my knee but the have been back back playing soccer again. I do feel some pain afte soccer but am used to it now. I don't ice anymore and o yea I was given efflex injection and I think that's what do the work.

Jun 16, 2009
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lateral release
by: Anonymous

I had lateral release done 3/11/09 on my right knee which till now i stll have some pain especially after taking a fall 4/24/09.which set me back on my recovery. When i get up to walk, it feels like something catches on my upper right thigh and hurts to put weight on it.My knee gets very sore and swollen and want to give out on me,if i'm on my feet too long. PT has release me stating good range of motion. sent me home with exercises for strenghten my thigh muscle and knee. Ortho said no damage was done after fall and that some of the pain i feel is due to hip bursitis. I had my left knee done 3 yrs ago have IT band numbness,which ortho says thats part of the risk but it took a good 2 yrs for left knee to feel almost normal. I guess i have a ways to go with this one. The only thing i can suggest to anyone be very careful when walking do all PT exercises and don't rush your recovery.

Jun 17, 2009
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surgery.
by: Megan


i am still recovering from my surgery on friday 6/12/09. The dr said that my joint was so off track that he actually had to make another about 4 inch cut and move it over more. my knee is still swollen, but i just want to know how long i have to not walk on it. i'm usually a very active 19 year old and i hate the crutches. i just hope it works only if it doesnt work i need to get pins and screws in my knee. not looking forward to it. just i hope i did the right thing

Jun 20, 2009
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Worried
by: Chantal

Hey Guys,
After two years of knowing that i have had a patellar tracking disorder and trying various types of PT my doctor told me that i need a lateral release done. I need to get it done on both of my knees. My question is should i do them at the same time to get it over with or one by one. Also how long did it take to return to sports for any of you?

Jul 13, 2009
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Both knees?
by: Amber

I had both of my knees done at the same time on May 13, 2009. I am just now beginning to walk normally. It is still somewhat difficult to get up and get down. Your question as to do one or do both is a difficult one to answer. I am a professor and have the summers off, so it was best for me to do both and be incapacitated, than to do one and then go back and do the other. Plus, it saved on money (only one trip to the hospital and one bout of PT). Etc. However, from what I've read, my recovery has been a lot tougher from those who had one done at a time. I was on a walker for two weeks. Then, crutches for another couple weeks. (Although I mostly moved without them and just held them in case I lost my balance). I'm just now able to reach my own feet to put socks and shoes on. Getting into and out of the shower was horrible for weeks. On the other hand, I am glad I did it all in one bout because I won't have to do it again and once I'm recovered- I'll be all ready to go ;)

Nov 01, 2009
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one at a time!
by: Anonymous

I had a patellar release done two weeks ago and although painful, I believe in the long run it will be worth it. It was done outpatient, I was done in just a few hours and home with my ice pack and pain pills.
PT is painful, but no pain,no gain, right? Anyway, my other knee is in the same shape, but at 33 with a one-year-old, I just can't do it right now. I can't imagine the inconvenience of having both of them done at once, going to the bathroom was even a challenge the first day or so, not to mention getting a shower. I was only on crutches for two days, though, and had the stitches out in 10 days and can walk through the store now with just a little limp. Ice is your friend, make sure you get a good physical therapist. Good Luck!

Jan 28, 2010
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lateral release
by: Nicolette

Hi, I had a lateral release done on november 20th 2009 as well as a meniscus repair. I had very intense swelling up until a month after my surgery. It has been over 2 months since the surgery and i am still not able to walk, my doctor cant tell me what is wrong, he sent me for a second opinion and to see a sports med doctor. A couple weeks after my surgery my lower leg and foot including toes started to swell like they were being compressed, i also have very intense skin discoloration, it will go from a very bright red, to a very deep purple. I just had an MRI done about 2 weeks ago and i go in to see the doctor on monday the 1st of feburary. I havent met anyone who has had a lateral release and i dont know if this is part of the recovery :( my doctors havent given me any answers. I am a senior in high school and im not sure i will be able to walk for graduation and thats in june. Im scared that something is not right. If anyone has any answers, they would be greatly appreciated!
Thank you so much.

Feb 05, 2010
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WOW
by: George (32)

8 years ago (24 years old) I had my left knee cleaned out and thats when my doc notice that my patella was tilted. He said then that probably in the future I would need a lateral release. I was very active with sports, even with this condition. It finally give out on me Feb/2009. I just had lateral release surgery Jan. 5,2010. My doc wanted me to walk on it the next day, I used crutches for 2 days to be safe. They put a drainage tube in it to help with the swelling, which didn't really do much. They took it out 4 days after the surgery and my knee felt great until 2 days after they took the tube out is when it really got swollen. So I went to the doc and he drained 60cc of fluid out of it. And a week later he drained another 50cc out of it, he said it's typical with this surgery to swell like that. I've been throught 3 weeks of PT and I am seeing improvement every week. 1 month after surgery my knee feels very weak, but you have to build up the muscles around the knee to get it to feel better. You have to make the most out of PT and make sure you do your home exercises, then ice and elevate when you're done. Its the beginning of February and I intend to be back on the softball diamond by the middle of April and the basketball court in November. Do alot of research on your doc or get multiple opinions before you get any kind of procedure. I did alot of research for a good orthopedic surgeon and I got the best. I choose the Head of Orthopedic Surgery of a major hospital group in my area, a good doctor makes a HUGE differents. And the person wondering about doing both knees at the same time, I myself wouldn't do it. I would see how your body reacts to 1 surgery first. I will let you know how everything is going in a month or so.

Mar 08, 2010
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2 months after surgery
by: George (32)

It's 2 months after my lateral release surgery. There's still a little pain when I squat with all my weight on it and it throbs at night. I have 1 more week of therapy and my knee still feels a little weak. I'm about to start going to the gym and doing the exercises on my own to strenghten it even more. My therapist said that I am futher along then most people are that have this procedure. I have set a goals for myself and I'm not going to fall short of them. I will be returning back to my construction job 2 1/2 months after surgery and be ready to return to playing sports soon after that. You have to push yourself to get where you want to be.

Jan 15, 2011
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Don't try to do too much too soon
by: Anonymous

My 15 year old had LR following a dislocation of the patella. It was a freak accident, he had no underlying issues. Did the surgery because he is a competitive tennis player and wanted to continue with out having to worry about a repeat incident. Did rehab for 3 months. Returned to tennis, knee subluxed. Stopped all sports and concentrated on heavy conditioning of the legs to build the vastus medialis. This is the key. 9 months after the surgery he completed a sprint triathlon (run, bike, swim) but bear in mind these are all forward motion activities for the knee. Continued strength training and is now comfortably back to tennis after 12 months. So far so good. Don't try and do too much too soon and DEFINITELY you must build your quad muscles.

Jul 14, 2011
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Lateral Release Comment for 2011
by: Anonymous

I have lived with knee pain for 20 years and family doctors never cared. I even had one that took an x-ray to see if I had arthritis but he told me I did not. I finally went to a sports medicine doctor and he told me my knee caps were actually on the sides of my knees. Yikes. And the family doctor did not see that in the x-ray????

I had my lateral release the end of May 2011 and I am still going through physical therapy in July. My release was done by a well known sports medicine orthopedist in Phoenix and was done as outpatient surgery. I did not need stitches and everything was done through 3 small holes.

At my 1 week checkup I mentioned swelling on the right side of my knee to the doctor but he said it would go away. One week later it still had not gone away so I called his nurse and she said it would go away. Another week later I still had the swelling - then it got worse. I was calling it my alien because a bump about 1 inch wide and tall would pop out of the side of my knee at the lateral release site. When I woke up today (July 13th) the alien was surprisingly gone and did not even return at physical therapy.

My physical therapists are good - except when it comes to watching me do the exercises because I usually do everything on my own. They concentrate my exercises on movement, stretching, and balance. I do calf exercises, the elliptical machine, walk backwards on a treadmill at a 14% incline, stand with one leg on a wobbly foam pad while squatting and throw a ball into a net (tough), leg curls, leg press, stretching, a strange foam roll to target my t-band (roll the t-band back and forth on the foam roll), the crab walk, and they just added one legged squats (one leg behind me on a bench when I squat). One of the physical therapists there works really hard on the t-band because she said if she can stretch it out I may not need surgery on the other knee. I highly doubt that but I am willing to try.

After my experience I have many suggestions but need to point out that everyone is different. I was very physically active before my surgery and hiked every week (which I was told I had to give up or have the surgery). I went to a sports medicine doctor, which I highly suggest. Make sure you ask about swelling because I was not prepared for what the swelling would look like and how long it would last. I also suggest you ask your physical therapists what you can do on your own. I found my knee would get stiff on non-therapy days. One person told me to stretch and that helped. Another person told me to walk every day for 30 minutes in the pool. I am not sure if that helped. I would also go to the gym one day per week and do things I did in physical therapy.

I went hiking this past weekend for the first time in 7 weeks and even though I had some pain I iced the knee after and it was fine.

Good Luck!

Jul 19, 2012
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Everything will be okay
by: Breeanna

Lateral release surgery is not scary in anyway so please don't be nervous. I am 15 and had my surgery over a month ago to repair an anatomical problem with my knee that caused recurring dislocations (around 8 in one year) and I went under the knife on May 29. The procedure was not frightening at all. I went to the hospital at 1:00pm. and and actually went into surgery before 2:00pm. It was about three hours long and I had to stay the night at the hospital. I was released from the hospital with two long scars, two smaller scars and a huge full leg metal brace, but i was able to slowly hobble to the car. That was around a month and a half ago and now I am out of the brace and I walk four miles everyday. I have had to go to physical therapy twice a week throughout the healing process and a am rebuilding the muscles in my quads. Full bending has returned and also much of my hyperextension has returned. This surgery is no joke but it has improved my life greatly. The only bad thing is that I have two rather larger screws in my going entirely through the bone under my knee which can cause pain when temperature changes occur, like getting in a swimming pool or opening a refrigerator, it causes a toothache- like sensation which is kind of annoying. But otherwise I am healing perfectly, I am even going to dollywood tomorrow! So I think that the surgery is well worth the temporary discomfort. You just gotta cowboy up for a little while and afterwords your life will improve dramatically. Good luck;)
-Bree

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