The patello-femoral joint :
I have PFS and need help AND advice! - - Posted by labfall (labfall), 30 October 2004
Well, to start, i am almost 15 years old and have been suffering from patello femoral syndrome (PFS) for a year and a half now. I have done tons of PT and seen sports medicine doctors and an OS. The OS wants to do a lateral release, and im beginning to lean toward it. Im afraid that i might get worse though, and I am a trisport athlete, and have a future in sports (At least college). I saw a chiropracter today, and he is trying to loosen my lateralis muscle (?). Im not quite sure what thats going to do, but he says it works. I was wondering what different people's expierence with LRs was, and also if anyone had any advice for me. Im so young now and i dont want to ruin it early on 
~Liz
Posted by PattiAnn237 (PattiAnn237), 30 October 2004
Im now 12 week post-op from a very unsucessful lateral release. Its possible, although Ill never really know, that the surgery acctually made my knee worse.
I know that there are people on here who have had some sucess with this surgery, but to me it seems like often doctors decide to do it because there is no good step inbetween trying PT and bracing, etc., and something like a TTT.
However, its also true that compared to the more intense surgeries a sucessful LR can be in someways a "simple solution".
I hope this makes sense! Whatever you decide just make sure you think it through! Good luck and take care!
~Patti
Posted by Kimby (Kimby), 31 October 2004
Hi Liz -
I have had PFS with chronic dislocations from about the same age as you are describing. I took the surgical route - early versions of the TTT. Just to let you know a few things about that:
1. As an adult in my early 30's, they failed and I had to have them redone (R 8/2003 and L 10/2004);
2. I was active in sports - I played a lot of softball and believe it or not soccer (there weren't many girls playing when I did - I had to play on a boys' team!). Having surgery does put you out of commission for a while.
3. I've been told multiple times that I would be in better shape now if I had foregone surgery then (ie I have severe deterioration of the cartilidge behind the kneecap).
4. The patella tendon transversals, because the break was made at the growth plate in the patella, caused my growth to stunt. Estimates are that I would have been about another inch or two taller than I am. Husband refers to me as "shorty", but I am exactly 5'5 3/4" because they had to do my legs based on my height so I wouldn't be taller on one side than the other.
5. Would I have done the surgery knowing what I know now? No.
The flip side is this:
My current OS says that what they should have done for me back when is exactly what he did this time in addition to the TTT's, that is, the ligament reconstruction. He said that would have fixed the problem of the laxity in the patellafemoral ligament and probably would have saved me the grief of all these other surgeries involving breaking my leg. It is my understanding (and if I'm wrong you will see a flurry of activity telling you that I am) that the ligament reconstruction is a version of lateral release, but not a full replacement of the ligament. I don't know how much good your chiro is doing loosening up your ligaments when, if you are having PFS and have dislocations, it sounds like your ligaments are already loose enough.
Just consider very carefully your options. I've been told that lots of teenage girls have this problem and many grow out of it. But, like you, I was active and it hampered me severely when playing sports. I did get a good 15 years out of the surgeries without dislocations and that was good for me. But the surgeries, no matter what you have done, have their own drawbacks and you should know all of them before having it done. As Patti says, several people have had the LRs done and ended up having TTTs anyway.
If your parents have the means, I would find another doctor for a second opinion. The more the merrier, especially if you're looking to play college sports. You might check the net and find names of OSs who specialize in PFS/knee issues either in addition to or instead of sports medicine. My doc does both.
Good luck, Liz. Let us know what you decide.
Kim
Posted by labfall (labfall), 1 November 2004
Hey,
First of all thanks for all the information. I think im going to hold off on the surgery for a little longer, and hopefully wont have to get it.
This chiro im seeing i guess has fixed a bunch of people that have the same problem. He thinks that the hospitals and doctors do this surgery more often then necessary, because they make more money both on the surgery and on the PT following it. It makes sense i guess. Anything is better than surgery at this point, so Im going to stick with the chiro. Its also good because now i dont have to miss my basketball season.
Again, thanks for all the information, i definatly dont think im going to get the LR now. 
~Liz
Updated Thu Apr 29 2010
