The WAITING ROOM => GENERAL KNEE QUESTIONS and comments (good for new threads) => Topic started by: MartialArtsChick on June 07, 2010, 10:31:45 PM

Title: New, 25 and Told I need TTT/LR etc.
Post by: MartialArtsChick on June 07, 2010, 10:31:45 PM
Hello Everyone,

I have been reading a lot of posts (some similar to where I find myself) and I  just wanted put my situation out there for anyone who may have some advice.  I first dislocated my knee when I was around 14.  Prior to that it had been loose and started to go out only twice but never tore anything.  I ripped the muscle that holds the patella in place badly.  It took over a year (with out surgery due to my mother looking out for me) to get back to sports.  Fast-forward 11 years.  I am 25 and about 3 weeks ago it went out on me causing a lot of pain.  I do a lot of martial arts, softball 2x wk, I even box.  In the past three years it has started to go out on me several times a month.  I've gotten very good at paying attention to it and immediately taking my weight off of it (even when I am sparring :P ).  I had an MRI last week and I was told (and shown) that my patella is resting half out of it's socket.  I have arthritis in my knee cap (sometimes this causes pain with walking and stairs but it is tolerable). I was told that in it's current position I shouldn't be doing any of the activities that I love to do as they are too high risk.  I am worried that if I don't have surgery my knee will go out and rip things (currently all my tendons and things are strong and healthy).  I am also afraid that if I don't have surgery my arthritis will get worse.  On the other hand I am terrified that the knee surgery will have complications and I'll be left worse off.  Are there any super active people out there who found themselves in a similar situation?  I am told I need a TTT and LR along with some Medial Repair thingy.  After reading posts I'm thinking I probably don't need all three.  I am waiting for an appointment I made to get a second opinion.  I rarely have any pain and my knee only seems to go out at this 'magical' angle/twisting motion.  All I want is to be able to stay active and do the things I love. :(
Title: Re: New, 25 and Told I need TTT/LR etc.
Post by: Lottiefox on June 07, 2010, 10:53:52 PM
Hi and welcome..

This is a tricky situation! Firstly, I would urge to follow up with the second opinion and also to make sure that any suggestion of surgery for patella realignment and strengthening is back up by comprehensive X-rays and CT scans as well as an MRI. An MRI will show some information, but to accurately establish a treatment plan the surgeon needs scans of your patella tracking through a range of motiong (with quads tensed and relaxed), X-rays of your knees from the side, and with the knee bent, and full length standing X-rays to look at bones/rotations etc. There can be a LOT of reasons why your kneecap goes out, and whilst a tilt or poor alignment as you describe can cause this, there may be other reasons too such as a shallow trochlear groove, etc etc. You need a patella specialist to formulate the best plan for you.

The second question is weighing up the risks of surgery against the risks of things getting worse and restrictions on our lifestyle. I have an arthritic kneecap, and similar issues although I never dislocate, just click a lot and grind! The relaignment processes you describe aim to shift the weight from the damaged areas to good areas and make the patella track and sit more centrally. What you don't want is an OS who has a "menu" of things he will do - e.g. TTT, LR and the MPFL you mention for any person he sees with instability. Each process must be right for your knee or it won't help and might make things worse. These surgeries require extensive rehab but there are many success stories on here. Check out posts and diaries by fraud ninja and her TTTs - she is now very active and running! There are also several current diaries running by people going through similar surgeries. Other people have got back to sports and activity too after surgery, but any surgery carries a risk. Only you can decide when that risk is worth taking.

Where are you based?

Take care

Lottie  :)
Title: Re: New, 25 and Told I need TTT/LR etc.
Post by: MartialArtsChick on June 07, 2010, 11:03:35 PM
I'm in Western Mass.  My second opinion appt. is with a group out of Sprigfield that has a very good reputation.  The first guy is from an outfit in Northampton, MA but does not seem as well known.  Thank you for the tips about the CTs and X-rays.  I'll be sure to ask my OS about that.
Title: Re: New, 25 and Told I need TTT/LR etc.
Post by: crankerchick on June 08, 2010, 01:55:48 AM
I agree with everything Lottie has said. Good to hear you are going for a second opinion. Hopefully the opinions are coming from patella specialists. A doctor that relies soley on MRI in my opinion certainly doesn't qualify as a patella specialist. Hopefully this second opinion doctor will do the x-rays Lottie has mentioned, and if necessary, the CT scan.

Having a three procedures at once doesn't have to be too much. It's far more important to have the right procedures than to worry about how many procedures or how invasive they are. I had three things done at once for my knee, but all three were things that were revealed as abnormal based on CT scans and x-rays and medical literature supported surgery for the abnormalities.

For these things, it is important to see a good patello-femoral specialist to get to the root cause of the problem and come up with the best course of action to correct it. This combined with an educated patient and the likelihood of a successful outcome goes up drastically in my opinion.

Another person's posts to check out are those by agresknee. Her daughter had a TTT and has since returned to basketball. She's a bit younger, but successful outcome nonetheless.

Try to take the horror stories on here with a grain of salt. Remember, there are a lot of people that have this procedure that never come online. Most people that come here are either in your position, or they are on here because their surgery failed and they are looking for answers. People who have had successful outcomes are out enjoying their knees, not posting on a website.