Thanks, looks like it can be a tough recovery from the ligament reconstructions. Also given the age of my injury, I have to wonder about the screws into the kneecap, maybe a fracture is a higher probability.
Further I had a lateral release making my knee somewhat more unstable and now may need an LPFL recon too , I've heard LPFL recon is even more risky than MPFL? .. the release was very agressive as well, an extended release across i think the entire lateral retinaculum until the patella could be everted 90 degrees . So now there is medial and lateral instability
Don't know if its in my head, but I feel extra strain above and below the kneecap, I guess without ligaments on either side of the kneecap the patella tendon and quads tendon would work harder?
My kneecap hasn't dislocated again, I have good trochlear grove depth, at least with a 'sunrise' view x-ray of patella, i still need to get CT scans
The main problem I have is the last 20 degrees extension, there is tons of instability. I've worked very hard with the physio so the muscles are there, to untrained eye just looking at the knee flexed it looks to be a normal knee, in fact it looks very strong.
I've tried to work on endurance and proprioception as well, lots of hip strengthening and mobility work, ... I can do biking without too much difficulty, 10 minutes with good resistance isn't too bad. Further, I can do a wall sit for above 3 minutes which I think even in a normal knee is pretty tough to do.
I've tried to get control in the last 20 degrees but its just not happening. The instability makes walking very difficult, and it seems to be getting worse for me, i have to limit it how much i'm moving around. If I walk too much, the quads just start shutting down, and I'm pretty sure it isn't an endurance issue, it is a structural issue.
I really don't like the idea of hardware in my leg and its quite a bit of surgery, but at this point its either live this way and sit around most of the time, or I go with the reconstructions with the hope I could move around and do day-to-day activities without extreme difficulties ..
I think you've raised some good points, i'll still have to think this through and really understand as much as I can about the recovery and risks.