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1
Thank you for your reply!  I ended up back in hospital today as my GP was concerned about a possible DVT and it turns out that I have a haematoma in my calf, no wonder it was so painful!  I've also lost the ability to go up steps (having been able to climb a whole flight of stairs to bed until yesterday).  But I've had excellent (UK) NHS care today and they've thoroughly checked me out and brought forward my first physio appointment in case there is anything they can do to help with all this.

Bit scary overnight last night whilst I wrestled with the "is this level of trouble in my lower leg to be expected or not" and "should I go to the hospital now or call GP in morning?" and the "I don't want to make a fuss/perhaps I'm not as tough as I thought I was" questions no doubt others have wrestled with.  But I did the right thing apparently.

Onwards and upwards, thanks again Tinydinosaur, I appreciate your reply.

Phew, long day!
2
The patello-femoral joint / MPFL reconstruction too loose
« Last post by villekuusela on March 29, 2017, 10:51:26 PM »
Hi,

First timer here at forum.

Has anyone had any experience with MPFL reconstruction ending up "too loose", and if so, what can be done to fix it, if anything?

My story:
I've had 2 pretty bad knee cap dislocations on one knee. First dislocation, torn VMO and medial retinaculum, probably also MPFL torn but MRI didn't show it to be torn. Second time torn medial retinaculum, torn cartilage on patella and probably also torn MPFL, but again MRI didn't show that MPFL is torn. So, both times treated without surgeries. However, since the second dislocation after 2 years of recovering, I have been experiencing sharp pain in middle of knee cap (right where torn cartilage is) at 20-40% angle when squatting or otherwise contracting quads, probably because the patella was sliding to the lateral edge of the groove and pushing against the torn cartilage part.

Had a MPFL reconstruction surgery and it has been about 1 month post-op. Quads are getting stronger, but now I'm feeling similar pain but on the lateral edge of the kneecap (not middle anymore). Thus, I'm getting a feeling that the new MPFL is too loose / not tight enough to hold the patella in the middle of the groove.


3
When I had my MPFL done at a certain point the patellar tendon below my knee became quite painful for awhile, my physio told me it was probably due to it not being used to having force put through it properly, it was definitely acute had some ultrasound done on it and eventually it resolved itself. I myself never did squats or anything as I had a severely wasted quad (still stay away from squats). It could be a bit of tendonitis, can you stationary bike or does that cause you grief as well?
4
I always found around two weeks post-op things start turning around, getting up to use the bathroom, get food/water isn't so much of a burden as the post-op inflammation is starting to settle, your body is removing the excess fluid. Cool packs really help accelerate this process or a cryo cuff, getting lots of water and vegetables even if your digestive system is still out of whack from anaesthesia and/or drugs.

Hang in there! Watch movies/tv or read or play video games any low energy activity that helps keep your mind off of it and helps you pass the time.
5
Hey Nathan,

I'm obviously not a doctor but to me that does not sound like an MCL sprain and a lot more like an ACL injury (of which I've had two).

I would recommend going to see your GP (I'm assuming you are UK-based?) and ask for a referral to a specialist in order to get an MRI scan, which should give a clearer indication of what exactly is going on with your knee.

In the meantime, do not try and force it by playing football (to be honest I'm amazed you've kept trying), but try and rest it as much as possible and ice it if the swelling persists. I'm guessing you want to stay active in some way, but it's important to get a clear idea of what the injury is before making a plan on how to return to sports. Cycling is something you can do to keep your muscles going, as well as upper body stuff in the gym, but a physio can give you much better instructions (but get a diagnosis first!).

All the best and let us know how you get on!


Thanks for your replies.

When you have injured your ACL twice before what kind of things would cause grief for you?

After my leg gives way which it only does when i kick through a ball with any power i'm able to get up after a couple of minutes the pain does start to ease after a week and a bit but it's still stiff and the strength seems to diminish a bit i do get more pain under my knee and the back behind my leg goes soar and stiff. I am going to re book the physio and let him take a look this time and ask if he feels it is worth getting the MRI like you recommended. I will let you know what he thinks and how i go on over the next few weeks. also The first physio i saw took a look and said that is wasnt snapped or cartilage at all. I'm at a cross roads at what to do im a 20 year old who's played football every weekend for 14 years so that's why i kept persisting. My own worst enemy at times lol. Thanks for the help so far :)
6
The patello-femoral joint / Re: Patella mal-tracking or more?
« Last post by Leena20 on March 29, 2017, 10:02:28 PM »
Hi, the femoral anteversion sounds normal, the tibial high though 25 degrees is not super high.

I'd try and find a specialist in rotational surgery to discuss as they are best placed to give an opinion based on previous corrections and outcomes, though would always try physio first - I've had both my femurs chopped and repositioned and it was fairly brutal but worth it. Most OS don't know much/anything about rotational surgery in my experience, so you really need a specialist.

Good luck
7
The patello-femoral joint / Re: Surgery on other knee
« Last post by tinydinosaur on March 29, 2017, 09:56:04 PM »
You can have the same genetics / anatomical variants and have one leg be fine and one leg be not. I have high grade trochlear dysplasia in both knees and until recently only my left had significant problems because of it. (After limping on it for 12+ years my other is starting to get sore regularly) In separate people, some people with high grade trochlear dysplasia only end up needing MPFL and not MPFL + trochleoplasty. It highly depends on the person and their body... i would never opt for surgery that is not necessary as a preventative measure in my other knee. Once you have surgery you change the chemistry in that area and can never go back. You risk causing functional damage to limb that might otherwise never give you problems.
8
Post-op diaries (<50 posts) / Re: Denovo NT
« Last post by mike723 on March 29, 2017, 06:06:30 PM »
Almost 10 weeks out.  Strength is coming back.  Able to go up the stairs with just a bit of pain, but I don't need handrails anymore.  Going down is more difficult.  I'm able to do it now without using the handrails, but bending my leg backwards as I go down is still difficult.  For a couple of weeks after I was going down one over the over, I was going down with my repaired leg very stiff and going out to the side.  But it's getting easier, but it's still in the back of my head as I go down, making me wonder how much of it is psychological. 

The scar is still pretty bad as there is hyperpigmentation. 

The ROM is almost the same as my good knee now.  Still a bit of swelling.  Knee doesn't bother me during my sleep anymore.  At PT, I'm doing leg presses and I'm biking regularly now.  But the exaggerated steps during PT is still difficult, giving me a reality check that the strength isn't there yet. 
9
Hey Nathan,

I'm obviously not a doctor but to me that does not sound like an MCL sprain and a lot more like an ACL injury (of which I've had two).

I would recommend going to see your GP (I'm assuming you are UK-based?) and ask for a referral to a specialist in order to get an MRI scan, which should give a clearer indication of what exactly is going on with your knee.

In the meantime, do not try and force it by playing football (to be honest I'm amazed you've kept trying), but try and rest it as much as possible and ice it if the swelling persists. I'm guessing you want to stay active in some way, but it's important to get a clear idea of what the injury is before making a plan on how to return to sports. Cycling is something you can do to keep your muscles going, as well as upper body stuff in the gym, but a physio can give you much better instructions (but get a diagnosis first!).

All the best and let us know how you get on!
10
Hello.. fellow Patells Fx. Folks..
I hate to say it but I joined you with a Fx patella Dec 15,2016. I had surgery with cage and pins holding a "unstable and fragile fx together..  They were unable to use screws due to osteoporosis.  UGH !!!
 I am now 3 months out.  The fx line is still present on X-ray but, getting better.  I have PT 3x a week.  I think what has helped me the most is the fact that My PT has a salt water pool that I use for 2 of my therapies. My pain level is good just lots of stiffness.  I am able to walk around the house without my brace and one crutch.
Before this injury I considered myself a active person walking at least 10,000 steps a day . 
I hope things get better for you... would love to join in in this thread!!!
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