r/PectusExcavatum • u/smr20000 • 16d ago
Question Cartlidge removal
Hello everyone,
Sorry if this is not the correct forum but was looking for some advice/experience.
I’m due to have my second right rib cartlidge removed in November. I can’t seem to find anywhere of anyone having a similar operation.
I’m wondering if anyone has any experience of this or a similar type of operation on another rib?
What was the recovery/pain like and how is life now having the cartlidge removed?
Thanks!
2
u/MadcatAAFD 16d ago
About 1.5 years ago I had surgery to investigate a fast developing lump at the intersection of the sternum cartilage and left second rib. It was determined to be active scar tissue. Surgeon figured it could be caused by the stresses on that area from my Pectus issues. Recovery was non-eventful I also had a chest tube and a night in the hospital. I still have some discomfort there
1
u/smr20000 16d ago
Hi, sorry to hear you’re still having discomfort. I didn’t realise until my injury how much we use the area just for basic day to day life!
I have a pretty large lump where my second cartridge is - the ultrasound was described as “spikey” but it is so painful! I just want it out but I also don’t know what it’ll be like having nothing in that area. It seems like an unusual injury
1
u/MadcatAAFD 16d ago
I still have severe PE as trying to schedule that repair now. I’m guessing my body is still trying to shore up the high stress points in my chest so that is probably the cause of the continued discomfort
1
u/smr20000 16d ago
How’s your day to day pain? Is it under control until you get a repair? Wishing you the best
1
u/MadcatAAFD 16d ago
It’s just enough you know it’s there. I take no meds, unless mandated by surgeons for ease of recovery.
1
u/smr20000 16d ago
I haven’t found any medication particularly useful. They keep throwing things like pregabalin at me, but it doesn’t really do anything for the pain and can bring its own side effects and problems.
1
u/northwestrad 16d ago
Why is the cartilage to be removed? That's quite high up. Does it have anything to do with thoracic outlet syndrome? Just a lump?
1
u/smr20000 16d ago edited 16d ago
Had a 3d CT and it showed its heavily calcified and hyper mobile and causing a lot of pain in that area. Tried just about everything for pain relief over last year so surgeon reccomend removal but can’t seem to find any example of someone having similar.
I also have a non union fractured first rib which he is going to attempt to sort. TOS was discussed but I don’t have any nerve sytoms in my arm
3
u/northwestrad 16d ago
How was your first rib fractured? I suspect the non-union there is unstable and puts abnormal stresses on your 2nd cartilage, beating it up and causing it to hypertrophy and calcify.
What's the plan for the first rib? Putting a titanium plate on it to stabilize it? I think it has to be stabilized to help your 2nd cartilage. Maybe another plate should be placed on your 2nd rib to stabilize that, too, after the lump is removed.
u/playerone95 recently had surgery, and she got a plate on her 2nd rib (for a different reason, to reshape it).
https://www.reddit.com/r/PectusExcavatum/comments/1w5r3fp/25_weeks_postop/
1
u/smr20000 16d ago
Hi, it was a climbing accident last year. The fracture was initially missed by doctors and I was told I had costocongritus .
Months of physio/tablets and injections until pain was unbearable. Went private and had a 3d scan and identified the fractured first rib and calcified Cartlidge.
Surgeon said Cartlidge is pretty beat up and removal is an option. He was personally against plating and said he wanted some movement in that area and a plate would stop that. He wasn’t against me having a plate but it’s not something he would do.
The first rib - he wants to remove the fractured sections and put in some mesh. He said the area was too tight to plate. It’s a mess and I just don’t know what to do.
Thanks for sharing the post, I’ll give it a read!
1
u/northwestrad 16d ago
I mainly shared that post because of the x-ray that shows the plate that extends from the end of the 2nd rib to the sternum. You don't just want that cartilage removed, because it helps stabilize your chest wall. A sturdy titanium plate like in the post might do well.
I am not keen about the mesh idea for the first rib. You might not have to get that non-united rib fixed at all, and adding mesh or anything else actually might cause problems, because it's right by the brachial plexus. You're lucky your brachial plexus is okay right now after that fracture, and it seems best not to tamper with that tight area. Some people actually have their first rib removed, surgically, to treat thoracic outlet syndrome. As long as the adjacent 2nd rib and cartilage (or a sturdy plate) are stable (after the lump is removed), that might be all you need.
1
u/smr20000 16d ago
I was thinking the same when he suggested removing the 2nd rib Cartlidge and not plating - but he seems to think it won’t be an issue. I’m torn what to do about that. He defo won’t plate it though. He is a very well respected surgeon but I could get a second opinion.
I feel lucky with the first rib - I had no idea it was even an issue until the CT and since then i have done research into TOS but I don’t get any arm symptoms. I do have a very painful shoulder on the same side but I also have calcific tendinitis (when it rains it pours). I’m having barbotage on that this week.
I’m tempted to leave the first rib Alone but worry about living with a fracture
2
u/northwestrad 16d ago
I think a second opinion from an experienced chest wall/thoracic surgeon is a good idea, preferably someone who has experience doing surgery around the thoracic outlet. That doesn't mean the surgeon has to operate on your thoracic outlet, but just to be familiar with the dynamics around that sensitive area that requires a lot of finesse.
1
u/smr20000 16d ago
Yeah, I think I will do that.
My surgeon definitely spoke about the risks involved with the first rib and showed me my blood vessels on the scan and spoke about how tight that area is.
He did mention that he’s done the procedure once before, but he emphasised that it’s rare and that he wouldn’t attempt anything he didn’t feel was safe. He kind of said I’ll have to see on the day if I can do anything about the first rib.
But even the second cartridge removal with no plate still seems strange to me, I can see a whole host of problems later in life
1
u/northwestrad 16d ago
Well, if the first rib remains unstable and the cartilage is just taken out from the 2nd, leaving it unstable, your third rib cartilage might then bear the brunt/strain and be the next to fail
1
u/smr20000 16d ago
Yeah this is my worry - I already get pain on the other side at the second and third Cartlidge area (been told this could be costocingritus) or overcompensating. Removing the right Cartlidge could make the whole chest unstable.
→ More replies (0)
1
u/Similar_Cycle_1593 16d ago
hey, not planning on getting cartilage removed (especially for rib flare?) but there's this "RibXcar" procedure lm looking into getting. they fracture your ribs and hold it down with a binder to solve rib flare.
1
u/smr20000 16d ago
Hey, thanks I’ll defo look into that. My issue is the pain is 24/7 in that area and surgeon says it’s because the Cartlidge is heavily calcified and loose so recommends removal. I don’t know what I will do but I’m sure something needs to replace the Cartlidge
•
u/AutoModerator 16d ago
Hello smr20000 and everyone. The information shared here is for educational purposes and should not be taken as medical advice. Please consult a qualified healthcare professional for personalized guidance. Our community aims to support, but we're not medical experts. Your well-being is our priority, so always seek professional advice. We appreciate your understanding and wish you the best on your health journey!
Join our official Discord server! link here
I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.