The patello-femoral joint :

so I have a question... - - Posted by Linds (Linds), 4 January 2005

So I have been surfing around looking for info on OS's here in Canada and checking out their sites and all that.  This morning I found a animated photo of  lateral subluxation of the patella at extension.  How many people here have this happen when they tighten their quads I didn't know this was happening to me until I saw the picture then I checked out my own knees, when I contract my quads both of my kneecaps shift over atleast 1/4 of an inch,   The more,  I read, the more I learn...the more frustrated with my Os I get.

Just wanted to know anyone elses experience on this.
Linds



Carleton University Sport Med
Posted by shadehawk (shadehawk), 4 January 2005

Linds, you are just getting frustrated.  The surgeons that we have been seeing here, do not do the types of proceedures that might be necessary with our problems.  The maritimes has too small a population rate for the big knee surgeons to work in.  I still have not found one surgeon in atlantic canada that can do a ttt or tto surgery and if they can not do them they certainly can't offer them.
I do think that our malalignment problems baffle them as they are not used to seeing this problem and they just do not know how to treat it.  Three have told me to do 2 years PT.  What a joke after I have already been doing it for 3 years.  I have met some good PT instructors out there and they keep trying but there is only so many things they can try after 3 years - 4 by February.
Now that is a loose kneecap that you are showing, mine is not quite that loose.
Posted by Linds (Linds), 4 January 2005

I know Heather that i'm just getting frustrated, and I talked to my Dad last night and told him that I may have to go to another province to see a surgeon and to my surprise he's totally supportive of it.  So tha'ts good news...  
I guess I just get so frustrated because, I wish the Os's were just more open with you and would just say, we aren't sure what to do, instead of acting like it's your fault nothing is working.

Thanks for setting me straight
Linds

Ps, other than the fact that , that picture is a mans leg, that looks just like my knee in extension with contraction.
Posted by shadehawk (shadehawk), 4 January 2005

Yes, I understand you about the openess thing.  I just want straight answers also and find they are not giving me them.

My hubby is so angry all the time when  he watches me hobble around and he can't understand how anyOS could look me in the eye and tell me that there is nothing that can be done and then won't refer me to some other province and see if a ttt or tto might work for me.  
The OS do not even want my hubby to ask questions and tell him that they only speak to the patient.  That does not go down very well with him either.

I did not find these things when we lived in Alberta, but guess that is what it is like here.

Heading to GP right now, catch you later.
Posted by Linds (Linds), 12 January 2005

So, how bad is it if this is my knee? Yeah this is a mans knee, but my knee does this exact same thing, which is the patella subluxating with quad contracture.  My PT kind of did a re evaluation of both of my knee last night.  And this is my right knee...just with a hairy leg. The more I learn about my knees, the more frustrated I am with my OS and everyone else.. except my new PT.  I mean they convinced me that a LR surgery would really help me, that I only had a lateral tilt...that there was no maltracking. I am beginning to think it's pretty rare for someone to have just patellar tilt.  Atleast to the degree that I had.   Yeah in my xrays at 30 degrees, there is no more tilt... but hey do we all live with our knees at 30 degrees? I don't think so.  LAst night my PT was just kind of playing with my kneecaps ... I am in alot of pain now..but he was trying to tape them and we were talking about braces and stuff.. He tried to hold my patella in place with his fingers when I contracted my quads and he could not do it.
Anyone else have this sort of subluxation at extension?
Thanks for letting me write this down...it's beyond frustrating.
Hugs
Linds
Posted by maggimc (maggimc), 12 January 2005

Hi Linds, I feel so sorry for you, things are tough. I cant believe that your knee  movement is like my own . When the phsio saw it she was stunned with my knee mecanics. I have been following your progress as you have had lateral releases done. Apperently even though my kneecap was 40% out laterally it dislocated medially. I wish i had never had surgery as i feel that i am worse of now. I really hope you find a good OS to help you and i realy know how frustrating it is for you. Keep your chin up Maggi
Posted by Linds (Linds), 12 January 2005

Thanks Maggi, I am lucky in that I have found an absolute Gem in my New Physio . He is so patient with me, even when I get so frustrated I just want to scream. He is always trying new things, reading and learning...trying to do the best he can for me. He is always rethinking and re stratagizing.. he really wants me to get better.  Last night he told me I was Uniquely Constructed, and I congratulated him on Great word use as I would have just called me a freak of nature. It's just so frustrating cause I have this PT who can definately see everything that is so wrong with me and then all these doctors who are absolutely useless. Hopefully something is going to give here...  I too wish I had never had surgery...but I let myself be convinced that a LR would solve my problems, I was silly to believe them..but hey they're the proffesionals right?  
I hope that things start to come together for you too... I am so encouraged when I see people from this site have great things happen for them and it gives me the strength to keep looking, searching and praying for answers.
HUGS and thanks for your post
Linds
Posted by anasta5ia (anasta5ia), 13 January 2005

Linds-

That pic was pretty much my knee also....well, minus the hair and add a lot more tan to the leg from our Southern California sun (of course I don't even remember what the sun looks like now as we haven't seen it for a couple of weeks).  Of course, after all the surgery I have had things in my knee are not quite like that any more.

I also had it where you just could not keep my patella in place when I contracted my quad....even when I did the contraction while squeezing a towel roll between my legs.  Nothing we did could keep my patella in the groove.  Of course, I also ended up with my patellas both being to far medially and had to make the journey down that road too.

I am keeping my fingers crossed for you that you can get to a surgeon that will be able to shed light on the situation for you.

Hugs-
Heather G.

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