Hello..Ive posted on here before..I first want to apologize for the length of the post but I have had 3 surgerys in 10 months on both of my legs..Ive written a timeline of the whole injury..
December 2nd 2010: Patient went down sideways falling on left knee. Patella dislocates as the leg hits the ground. Almost immediately able to pop back into place. Before diagnosis patient suffered severe pain around patella, severe swelling in the entire leg. When walking patient would experience a caving in feeling and severe pain. When diagnosis patient suffered a MPFL Tear, Patellar dislocation, large tear of cartilage on the Lateral Condyle of the femur. A surgery was scheduled.
December 21st, 2010: Patient scheduled to have an arthroscopic MPFL reconstruction and was going to have screws inserted into the Lateral Condyle of the Femur. The MPFL reconstruction was done (graph of the hamstring to the new ligament.)Screws were inserted into the damaged cartilage area but due to Patellar Rubbing, they were later removed in the surgery. The patient then had Micro Fracture surgery. Holes were drilled on and just above the Lateral Condyle to allow the blood to create new cartilage. Patient was sent home with a pain ball, on weight bearing for 3 weeks and physical therapy orders.
December-April 2011: After MPFL site healed with successful progress and signs, patient started noticing a lot of pain and swelling around Lateral Condyle Area. Stairs and other medium strength activities on the knee were becoming increasing difficult for patient. The decision was made to contact the OS.A MRI showed that the cartilage in the Lateral Condyle of the Femur has not healed. After discussion with the OS, the decision was made to go in with an arthroscopic scope and inspect the damage first hand and do one of two things. If the cartilage damage is very extensive OS will perform the oats surgery. Second option is a Bioactive Nanomaterial type surgery if the damage has healed some.
April 15th, 2011: Patient was put on general anesthetic and the arthroscopic scope was inserted. Inspection of the damaged cartilage showed that the OATS surgery, a mosaicplasty surgery was needed to repair full damage. Cartilage was taken from the non-weight baring parts of the femur and inserted plugs into the Lateral Condyle. The surgery was successful and the damaged cartilage was repaired. Patient was sent home with a pain ball, on weight bearing and continued physical therapy.
April 2011-August: Patient was on crutches for 6-8 weeks after surgery. Physical therapy was continued all through summer 1-3 times a week. After passing strength tests and multiple tests and clearance from OS, the patient was allowed to start going out and start building up its skating skills again. Patient seemed to meet the standards, pain was minimal, and no swelling and the strength test showed that strength was almost equal in both legs.
August 30th, 2011: Patient was allowed to go back on the ice...During the time on the ice patient did medium exercises, not power skating but not skating lightly either. Patient did about an hour on the ice in total.Pateint left the ice with minimal pain.
August 30th 2011-September 2011: As time passed patients pain around the patella increased within little time after the ice skating session. Patient suffered swelling, pain between the patellar tendon, and a buckling feeling near the synovial capsule of the leg. The patient was diagnosed with a sprained MCL.Patient was put on crutches for 3 weeks along with a brace with no surgical treatment needed. Physical therapy was also on halt for this time. Patient also complained of a popping noise which had been going for a little while but there was no pain so no action was taken.
September 24th, 2011: Just getting into the car, the patients Right Patella dislocates in an anterior form. The patella was dislocated for axporlxmitanly 45 Minutes. A doctor in an ER put the patella back into place. A follow up appointment was made; the OS suspected a possible MPFL rupture. A MRI showed the MPFL on the Right Patellar was completely detached with little cartilage damage. First time dislocations are not usually operated on first, but due to the patients history a surgery was made for a MPFL reconstruction.
October 7th, 2011: Patient was put under general anesthetic and an arthroscopic scope was inserted to the Right Pattella.The OS performed a MPFL reconstruction, with a successful graph of the hamstring to the new ligament. The patient was sent home with a pain ball, crutches with weight bearing as needed and physical therapy orders. Patient was completely off crutches about 6-8 weeks. Patient performed well in physical therapy and showed good signs in the right leg and little pain in the left.
Current problems: Patient is currently having problems with Left Pattella.With triggering the Quad muscles the Pattler makes an Anterior shift to the left with pain. When standing the knee is very unstable and when bending the patella tracks to the left with pain. When walking and moving on the leg patient suffers a popping sound around the patella with pain. Now when walking the knee is giving out of patient with every step unless the Quads tightened. Swelling is occurring over the patella. Patient is suspected to possibly have a MPFL rupture, or weaking of the grooves.
Could anyone give me some feedback of my current problems?It is unstable,giving in,pain,swelling and everytime I walk the knee cap tracks..I got ahold of my os and the nurses said to not bear weight and crutch..Well I cant crutch on my right leg because I had surgery on that 4 months ago,whenever I crutch on it,it shakes alot..I need some help here..What is going on with my left leg..Are the grooves to shallow?If my MPFL messed up again?Please,anything would help---Sean