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Author Topic: Medial Subluxation and me.... My never ending Saga.. UPDATE  (Read 4176 times)

Offline Silkncardcrafts

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Re: Medial Subluxation and me.... My never ending Saga..
« Reply #30 on: November 10, 2009, 10:34:47 AM »
Hi Sandman,

Please ask about doing some CT scans. They are the best types of scans together with plain x-rays to assess patella problems. My OS is one of the world's top knee surgeons on patella problems and he advised me at one point that MRIs are useless for patella problems.

I really hope you get the right help soon. It really saddens me.

Yesterday I saw my OS and am scheduled to have an arthroscope and trochleoplasty on my right knee in early February. Can't wait to have it as I am in so much pain and my stability is not great.
11/1996 - RK LR
07/1997 - LK LR
11/1998 - LK MPFL Reco
12/2005 - RK LR Repair
07/2006 - LK MPFL Repair
11/2006 - LK LR Repair
22/05/08 - LK Trochleoplasty
11/02/10 - RK Trochleoplasty
07/03/11 - RK Chrondroplasty

Offline sandmanusd

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Re: Medial Subluxation and me.... My never ending Saga..
« Reply #31 on: November 11, 2009, 12:56:27 AM »
Hi Sandman,

Please ask about doing some CT scans. They are the best types of scans together with plain x-rays to assess patella problems. My OS is one of the world's top knee surgeons on patella problems and he advised me at one point that MRIs are useless for patella problems.

I really hope you get the right help soon. It really saddens me.

Yesterday I saw my OS and am scheduled to have an arthroscope and trochleoplasty on my right knee in early February. Can't wait to have it as I am in so much pain and my stability is not great.

Thanks for the advice, I was sent some studies regarding stress X-ray and its use in this situation and told my current doc about the study.  He had never heard of it and said he would look into it.

Offline Silkncardcrafts

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Re: Medial Subluxation and me.... My never ending Saga..
« Reply #32 on: November 11, 2009, 06:17:41 AM »
I can't believe that. You definitely need to find a PFJ specialist. They obviously do not have the skills or experience to treat you. CT scans are just so important as they give important measurements of your patella.
11/1996 - RK LR
07/1997 - LK LR
11/1998 - LK MPFL Reco
12/2005 - RK LR Repair
07/2006 - LK MPFL Repair
11/2006 - LK LR Repair
22/05/08 - LK Trochleoplasty
11/02/10 - RK Trochleoplasty
07/03/11 - RK Chrondroplasty

Offline sandmanusd

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Re: Medial Subluxation and me.... My never ending Saga..
« Reply #33 on: November 12, 2009, 05:53:42 PM »
I can't believe that. You definitely need to find a PFJ specialist. They obviously do not have the skills or experience to treat you. CT scans are just so important as they give important measurements of your patella.

yeah my doc said he thinks i have just slight subluxation, and said that any surgery done would be like tring to make a micrometer adjustment with a chainsaw....

but i just think he doesn't have the right "tools" AKA studies to look at to see what needs to be done.  All he has done is looked at that MRI that he himself said was pretty worthless images because the way they were done.  But he said "If thats the way they did them, then thats the standard way that they are normally done"... which I dont buy... I just think the facility I went to doesn't know what they are doing.  And my doctor doesn't know what to ask for.

Offline crankerchick

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Re: Medial Subluxation and me.... My never ending Saga..
« Reply #34 on: November 12, 2009, 06:31:18 PM »
"If thats the way they did them, then thats the standard way that they are normally done" = clueless

run
fast

or

limp
fast

Seriously, I'm with Silkncardcrafts and ClippedWings. You need a real specialist if that is possible where you are. You are wasting your time otherwise and possibly setting yourself up for a bad diagnosis and inopportune possible surgery. I wouldn't keep fooling with this guy if it were me, he doesn't have a clue.
Mar '07 - plica excision
Oct '09 - femoral + tibial derotational osteotomy & TTT
Aug '10 - hardware removal
"You control your leg. Don't let it control you." -Smart trainer
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Offline sandmanusd

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Re: Medial Subluxation and me.... My never ending Saga..
« Reply #35 on: November 13, 2009, 07:38:56 PM »
Luckily he referred me to Kerlin-Jobe Clinic down in L.A.

He said something to the effect that I could have the Doctor down in L.A. do my surgery or he could do it, it was up to me.  Which is about as close to "I dont want to do your surgery cuz I dont know what to do" as I will get with this guy.  He is one of the most arrogant men I have ever met, regardless of profession... but especially the most arrogant Doctor I have met by far.

But I wont let anyone cut on me who isn't a specialist who has the confidence to do it and the experience to know what they are doing blindfolded.

Getting to where I want to go is a long process... as its Workers Comp... so they want to do things the cheapest and easiest, and have a say in whatever gets done.... They would rather send me to 10 doctors that they want before they would send me to someone I want.  efficiency is not their middle name... by far.

Offline Silkncardcrafts

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Re: Medial Subluxation and me.... My never ending Saga..
« Reply #36 on: November 14, 2009, 10:33:26 AM »
I would be running as far away as you can from the doc you've been seeing. Obviously has no clue about patella problems.

Just make sure the next doc specialises in patella problems. Ask them about a CT scan. If they don't believe in one they obviously aren't a patella specialist.

In the end it will cost them more money.
11/1996 - RK LR
07/1997 - LK LR
11/1998 - LK MPFL Reco
12/2005 - RK LR Repair
07/2006 - LK MPFL Repair
11/2006 - LK LR Repair
22/05/08 - LK Trochleoplasty
11/02/10 - RK Trochleoplasty
07/03/11 - RK Chrondroplasty

Offline sandmanusd

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Re: Medial Subluxation and me.... My never ending Saga.. UPDATE
« Reply #37 on: February 05, 2010, 10:02:49 PM »
Well, I finally saw another Doctor regarding my suspected medial subluxation.  A well known and respected Doctor who treats professional teams in Los Angeles.  He seems to think that medial subluxation was a red herring and that my true problem still stemmed from my lateral release, but that it is merely scar tissue.  He said this type of scar tissue is extremely rare and he has only seen it 2 other times in 35 years of treating athletes etc...   

he called it "Scar tissue formation of the lateral gutter"

And essentially told me that when my original doctor did a lateral release, the lateral retinaculum curled back underneath itself and is now "pushing" my kneecap out of alignment because of this scar tissue and the curling of retinaculum under itself. 

He called for PT and a heavy icing / stretching routine, along with massage therapy to try and correct the curling and the scar tissue.

He seems to think that this is the cause of my instability and not the medial subluxation.  He seems to think that 3 month of PT will correct this problem fully.

Has anyone ever had this happen to them?  this "lateral gutter scar tissue" where the lateral retinaculum curled under itself after a lateral release, causing symptomology of a medial subluxation?

I have no choice but to be optimistic about his findings but at the same time, in the back of my head, I cant help but wonder if maybe I actually do have more wrong then just scar tissue.  My first doctor did an "exploratory" surgery 6 months after my initial lateral release to look for scar tissue and said he didnt find any.  So I have mixed feelings about a problem I've had for over 2 years being just scar tissue, especially after one surgeon has already looked for scar tissue and found none.

Offline Silkncardcrafts

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Re: Medial Subluxation and me.... My never ending Saga.. UPDATE
« Reply #38 on: February 07, 2010, 04:55:34 AM »
Hi there,

I can't believe you can get such different opinions.

Never heard of this happening.

Is it worth getting a third opinion from someone that specialises in patella problems that is really experienced ?
11/1996 - RK LR
07/1997 - LK LR
11/1998 - LK MPFL Reco
12/2005 - RK LR Repair
07/2006 - LK MPFL Repair
11/2006 - LK LR Repair
22/05/08 - LK Trochleoplasty
11/02/10 - RK Trochleoplasty
07/03/11 - RK Chrondroplasty