Lateral release but more pain three months after surgery in an athletic teen

Patient: I have a 16 year old daughter who is a very competitive horseback rider. She is homeschooled beacuse of it. She was one of four junior riders recruited to ride for TLP enterprises and we have been told by multiple coaches she could go pro. She had knee pain in both knees for over two years and then it became so severe that she had a lateral release and medial reefing on both knees. She just had her last one on december 27, 2010. In the middle of march she started to have pain in that knee again. She wears a brace when she rides and she puts ice on it daily. The other knee is completely fine and she had the same surgery on it! She is very frustrated because she is in so much pain and she leaves for a show in london in a few days. She tried resting it for a few weeks and she does her exercises and works out and rides four hours a day so her athletic trainer doesnt think its too weak. She has convinced me not to take her to the doctor yet but i just cant bear to see her in pain! I know it bothers her but she just pushes it aside. She is afraid she will have to have another surgery. What are her options because her lateral release has failed? Thanks so much!

Doctor: Not all the patients heal the same way, it is a possibility that the lateral release and medial reefing it did not work k as good as the other knee, but for sure, your daughter needs to be re-evaluated by an Orthopedic Surgeon to determine the cause of the pain. In the meantime it is not recommended that she keeps doing activities beyond the limits of her capabilities that reproduce the pain. Once, she is re-evaluated (physical exam and imaging tests, meaning MRI) and the cause of the pain is determined, then the best treatment option will be chosen.