The patello-femoral joint :

Femoral Anteversion & Tibial Torsion - - Posted by Lizzie (Lizzie - UK), 21 January 2005

Hi,

I went and saw one of the guys that works out of the Royal National Orthopaedic Hospital in Stanmore, Middlesex, UK and he diagnosed that I have femoral anteversion and tibial torsion.  

I just wondered if anyone else has ever had this diagnosed.

I wonder if this is why I have had soooo many surgeries.  Or whether my private OS just wanted to make some money out of me - only kidding.  I have the utmost respect for him.  It just makes me wonder why I would have so many torn medial menisci in both knees.   He has also performed lateral releases in both knees and in the right, he performed a medial reefing.

In fact, I am waiting to get an MRI to see what damage is in my right knee as this new OS I am seeing wants to see before he scopes my knee to see whether or not I will be a candidate for ACI and HTO.

I do feel at this moment that I might have a medial meniscal tear.  It keeps catching and locking.  The usual symptoms you get with a meniscal tear.  I also have 15 degrees mal-tracking which although isn't much is probably another cause.

I'm just hoping that this chap, Mr Tim Briggs is as good as I've been told he is.  He used to work with Professor Bentley at the RNOH and he is famous in my neck of the woods.

Has anyone else had continuous meniscal tears?

I have also been told that I have Hypermobility Syndrome and with a fall I had in December 2001 that has triggered Fibromyalgia, I am wondering what else I am going to end up with.

I did go and see another guy after I had a fall in May 2002 and he had to remove a plica and found that I had a patella ulcer too and you might have guessed it, another torn medial meniscus in both knees when he did bilateral arthroscopies.  I would never have both knees done at the same time again.  It was just too hard on the knees when I was in rehabilitation.

My mom has been told by my old private OS that she had torn her medial meniscus too, but she went away and did tons of physio and when it hurts has accupuncture.  This was 8 years ago!!  I wonder whether or not I should have not had the first surgery!
Posted by shadehawk (shadehawk), 21 January 2005

Hi Lizzie, you can google search  miserable malalignment to find out more information about this condition.  Hypermobility, flat feet, hindfoot valgus, maltracking patella and high q-angle are all part of this.  I have this miserable malalignment, but have never had any knee surgery, I have been trying through PT (since 2001) to get my situation corrected.   I  faithfully do PT exercises daily.  I live in a small area and the OS here do not see conditions like this often.  All they do here are LR and scopes and TKR, nothing in-between.  They look at my crooked legs and loose knees and won't even do a diagnostic scope, it has been frustrating.

If appropriate PT does not work, bracing, taping and exercises for 6-8 months,  then they usually check to see if your are a candidate for surgery.   Don't try and second guess what has already been done.  Maybe this new OS understands your condition and will know what to do to fix your knee problems and will give you some options to consider.

Hope all works out for your doctors appointment, let us know how you do.
Posted by Lizzie (Lizzie - UK), 22 January 2005

Shadehawk

Thank you ever so much for your reply.  I have done a search, both in here and as well as google and it is amazing how much data there is.  

Now I know why John Skinner at the RNOH didn't want to do anything with my knees and was surprised at how many (14) surgeries I had procedures done.

However, I have been for a second opion, mainly because my private OS wanted me to and have now seen Tim Briggs at the RNOH, which is the only NHS specialised hospital for Orthopaedics in the UK.  He specialises in ACI's and has told me that depending upon the MRI, I might have an ACI, but if that goes ahead, he will definitely perform an HTO.

Again, thanks for your help.  I now don't feel such a freak.  I just hate it when I am bed laying on my back and my legs just feel like they are being twisted.  It is an awful feeling and doesn't help me with my pain levels, especially when I am receiving the wrong messages to my brain for pain anyway.  I suffer from Fibromyalgia (Chronic Pain and Fatigue syndrome) and this is so tiring and painful.

Trying to stay as positive as possible.  Love to everyone.  Lizzie xxx
Posted by shadehawk (shadehawk), 22 January 2005

Lizzie, glad to hear from you.  Hope everything goes well for you with this new doctor.  I know how it is, I have been to 3 OS now and none of them even want to touch me when they see my crooked legs and my loose patellae.  Guess it has been a good thing though as I do not want anyone doing surgery that does not seem to know how to treat this condition.  Think it is a real knee specialist thing.
I can relate to what you referred to while laying on a bed.  When I lay down at night, say to watch tv I can feel my leg roll over, twisting.  It is a wierd feeling, my GP doctor says that is the tibial torsion.  It is so hard to explain though as you seem to be the only other person on this site that also has the tibial torsion.  It is not fun to be in the rare dept.
Next month, my hubby is taking me to Ottawa and I will be seeing one of the knee surgeons on this site.  He has my history and is willing to try and figure out what to do with my situation.  I have been just trying to hang in there until he sees me.  It has been a long journey and I am hoping that if nothing else there will be some answers at the end of this trip.  It is a 12 hr. drive, but well worth it if we find out how to treat my condition.  
I have tried PT, bracing, taping etc. and nothing has worked so far, but I have never given up as I want to be able to walk properly again.  I have always been active until this and hope this OS can give me back some quality of life again.
Good luck to you on your OS visit, I will keep you in my thoughts.  Maybe we both will get some answers that will help us get on with our lives.  Keep the spirit!
Posted by Lizzie (Lizzie - UK), 22 January 2005

Hey

I can only say that I wish you all the luck in the World for your OS visit next month.

It is so weird this feeling.  I also feel it in my femur.  A real dragging pain in a sense.  Try and think of a young child hanging off your arm.  That is how I feel it is at times.  

I also find that I have pain where the Illiotibial Band is - I don't know if I have the Illiotibial Band Syndrome as well.  My old OS thought that I might have.  

The new OS - Tim Briggs did say when he walked into the room and looked at me and said that I was a difficult case.  I didn't realise how much a difficult case I would be.  

I really hope that both of us can come to some relief with our knee problems, as it doesn't just affect one knee and probably is causing a lot more problems too that we might know about.

I'm going to have to end this post, because I feel like I am getting cramp just above my patella on the lateral side.

Bye For Now
Take care of yourself FA&TT Twin!

Love Lizzie
Posted by shadehawk (shadehawk), 22 January 2005

Thanks Lizzie and try and take care of yourself also.

It has been nice chatting with you, I'll be crossing my fingers that the both of us will have good news ahead and find help for our problems.

Bye for now FA & TT TWIN  

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