The WAITING ROOM => GENERAL KNEE QUESTIONS and comments (good for new threads) => Topic started by: kneehopper on August 23, 2011, 07:35:42 PM

Title: third kneecap dislocation - advice please?
Post by: kneehopper on August 23, 2011, 07:35:42 PM
Hi, I'm 31 yr old, new to this forum and would appreciate any advice. Not sure where's best to post this thread. Here's my story.

3 weeks ago I dislocated my  left kneecap - it popped out one morning when I rolled over in bed. Was in complete agony and my other half had to call A&E. This was my 3rd full patella dislocation of left kneecap. Had morphine and gas&air and went to A&E where doctor reduced it. It was out of socket all in all about 2 hours and looked to me, at times to be well over 90 degrees to the side.

Bit of background - My first dislocation happened when I was 8 months pregnant about 9 years ago, basically caught my foot in a towel on the floor, my foot went one way, I went the other and bam! On the floor. Ambulance called and it popped back in about 45 mins later when they shifted me onto a chair. Went to hospital for checkup (since 8 months pregnant at the time) - no treatment given, just a knee bandage. Was walking straightaway.  Second time was a couple of years later, at home when my daughter was sitting on my lap - this time I understood what had happened and although as painful, had the presence of mind to pop it back in after a few deep breaths. Did not have it checked up on, put on the knee bandage and was mobile. On both occasions the relief as soon as it went back in was instantaneous.

This time seems different though - once the emergency doc reduced it, although the pain went away it didn't feel "safe" if that's the word? They put me in a cricket splint and crutches and was discharged after some X-rays with appointment to see OS. Was completely traumatised this time for some reason and couldn't sleep for 48 hours for fear of dislodging my kneecap!

Went to OS appointment last week, was told it was still acute and given option to have it in plastercast - I opted no, as my knee was still swelling up (at times its hard to see my kneecap although the swelling is going down now). Was told I could have a long leg brace with hinge on it which I opted for. Something got lost in translation and when I got to plasterroom they put me in a short sporty type knee brace. (I was too traumatised at having my knee out of the cricket splint to even notice this until I got home! Embarrassingly I actually wept as they took it off!).

So am now unable to weight bear on left, completely reliant on crutches to get around (although can do leg raises using my thighs). Am not able to fully straighten knee nor bend a great deal. I tried in work today to put my foot down - as soon as I put a bit of weight on knee cap shifted nastily around (but not dislocated). Am terrified to take knee brace (such that it is) off. Am goiing back in 2 weeks to see OS, who mentioned trying PT before discussing surgical route. Must admit the thought of PT scares living daylights out of my, as right now I feel like I only have to breathe on it for it to pop out!

As a result of this insipid little injury I now have had to delay my final year in law college, my boss is driving me back and fore to work and apart from that am pretty much house bound. Sorry to go on, I know lots of people have been through this and much worse. It feels good to let of steam  >:(

Basically could anyone give me any advice please on what important questions I need to ask the OS to sort this out?

Title: Re: third kneecap dislocation - advice please?
Post by: Fathead D on August 23, 2011, 07:47:03 PM
From what you are describing, you have a fairly serious knee injury.  I doubt PT will help much but who knows.  Worst case is that PT will help you with strength prior to surgery and then you will be better off to recover post-op.  Just take it easy for now and ice and elevate your knee as much as you can.  you need to get the swelling down.
Title: Re: third kneecap dislocation - advice please?
Post by: kneehopper on August 23, 2011, 09:07:16 PM
hi, thanks very much for the reply. Will follow your  advice re: ice and elevation. I think you're right, there's some serious damage been done this time. Its not even been properly examined yet as I couldn't bear the OS to touch it last week. Will rest up for now and see OS again in 2 weeks.
Title: Re: third kneecap dislocation - advice please?
Post by: sarah123 on August 23, 2011, 10:43:23 PM
Years of dislocations, both knees, urged me to to see a specialist in knee stability at the age of 44 ( or instability in my case!!)...i did my research and saw a surgeon who understood my issues and history and had an excellent track record. I had a MRI which showed flat trochela grooves which was the casue of my dislocations for all these years. Just made that way ........I had 8-10weeeks pre-op physio and then surgery, a trochleoplasty, on the right knee. My adivice is that this was the best course of action for me. What I have learnt over the past few weeks from this forum is that everyone is different and you must take specific advice relating to your problem. Information is key to helping you making an informed decision. I did not have to have surgery...I could have put up with repeated dislocations for the rest of my life. I decided enough was enough and needed to fix my knees. Surgery is one thing, rehab another journey altogether...another important piece of adivice from this forum. It is a long hard journey, but I can see results now. I am 14 weeks post op and getting stronger and more confident everyday. And i need to keep going. Good luck with your journey. Noone understands the pain of dislocations and the consequences of the injury..swelling, pain, loss of mobility. Ive been there more times than I want to remember. Ice and elevation key to get swelling down...a must! And do your research and get all the scans etc.
Title: Re: third kneecap dislocation - advice please?
Post by: kneehopper on August 25, 2011, 07:02:12 PM
Hi, well done, sounds like you're doing really well after you op. I appreciate it must be a long journey. Years of dislocations with both knees - that sounds tough. I find I just cannot cope with the pain when it happens. I agree noone understands - this time I dislocated my knee when I merely rolled over in bed, but when A&E put on the cricket splint they told me that because of risk of blood clots I had to take it off to go to bed. Where it happened. Can you imagine?? I get flashbacks everytime I climb into bed, the duvet only has to touch my knee to send me into panic!
I'm following the advice re: ice and elevation, thanks. I take your point, I really need to be fully informed. I don't know whether I have an inherent knee instabilty or whether as a result of trauma (the first dislocation), the knee is just weaker now due to the previous dislocations. I may ask for an MRI. I don't even know the extent of the damage that's been done this time. Am seeing OS again in about 2 weeks. For now I will concentrate on getting the swelling down as you say, and research what I can. Thank you and good luck with your progress!
Title: Re: third kneecap dislocation - advice please?
Post by: kneehopper on September 15, 2011, 07:54:19 PM
Hi, I wonder if I can ask for your opinions on the medical care I'm receiving. My recovery is not going well - its been about 6/7 weeks since I dislocated my kneecap, and still wearing knee brace and cannot manage without crutches at all. This has not been my experience with two past dislocations as was walking around fine after these very soon after with just a support stocking.

I don't know whether the problem is my leg is just weakened from being immobilised and crutches. Its just that when I try to put weight on it, sometimes the kneecap shifts around. The OS says that the problem is my apprehension - but my instinct is that my knee is not right and cannot support my weight. At the end of the day, if I follow the OS's advice (which seems to be pretty much "patient, heal thyself") and walk unsupported, my knee will give way and I'm the one that will be writhing on the floor in agony.

After going back to my second appointment at the fracture clininc, I was shunted to bottom of the queue (I think because I haven't "broken a bone" - never mind that I haven't been able to walk unaided for over a month - folks with broken fingers were being more priority. When I finally got to see the OS he was impatient with me that I'm not walking yet (even though the last one told me to rest up for three weeks), was very negative about considering surgery, said that physiotherapy must be tried first.

Then he discharged me and referred me to physiotherapy. After two weeks I've now received a letter from physiotherapy to say I need to contact them to make an appointment and if they don't hear from my they'll assume I'm better.

Is it just me or am I being given short shrift here? I cannot walk, I cannot drive, I have not had a solid night's sleep since this happened because my knee keeps waking me in the night with a mild ache after I've been in the same position for a while, I cannot fully straighten my knee, I cannot bend my knee to any great extent. And all the while am maintaining a full time job. Sorry I don't wany to come across as a moaner  ???

Title: Re: third kneecap dislocation - advice please?
Post by: Sophiejo1990 on September 15, 2011, 09:40:14 PM
Hi Kneehoper

You seem to have a more severe injury than mine but I have had the exact seem treatment/experience as you. In fact, it sounds like we go to the same fracture clinic!!!!! My knee partially dislocates and pops back in place, last time it happened was about 4 weeks ago where the knee moved out about 3 inches then jumped straight back in. I know cannot walk without crutches and have worn cricket splints, braces and undergone intense physio. As with your case whenever I mention surgical intervention (i.e, diagnostic arthroscopy) they would shoot me down in flames saying I hadn't given the physio long enough and it was too expensive to just offer out to patients willynilly. I have seen about 8/9 different doctors/specialists in the fracture clinic and each has had a different diagnosis and opinion on how to treat me. I attended physio from January to August until the physio discharged me as he felt nothing was working and an investigation was needed to be taken out by a surgeon. I met a surgeon end of August who said that because my mri was clear he felt there was absolutely nothing matter with me but would give me the diagnostic arthroscopy to either confirm/deny his theory. This has been booked for December but I now have no other appts before then, I was back at my gp this morning to get better pain relief. The referrals team then made a mistake and made me a further appt to see a different surgeon at a private hospital with the nhs funding my treatment, that appt is for the end of the month. I was told to cancel this as I already have a surgery appt made but I decided to keep the apt to see if this surgeon says anything different but also in case he can treat me quicker. A little naughty of me I know but after countless lost hours sat in fracture clinic having my case passed on to any passing specialist who had a spare 5 minutes, I feel I deserve another opinion!

I totally understand if this is getting you down because I get down alot too, I work full time and ince my leg started dislocating llast November my work has been effected and travelling to and from work is a nightmare. I have found tough that posts from people on this forum really hel me as I have realised that I am not alone in my struggle and sometimes having a chat to someone who is going through the same thing can be really helpful. As loving and caring as my fiance is, he doesn't really understand the pain and frustration of having a knee problem. I have days when I want to ditch the sticks and be "normal" but then I have good days too.

I hope I have helped, typing my ranty email about fracture clinic has certainly helped me!

Sophie x
Title: Re: third kneecap dislocation - advice please?
Post by: pattifaler on September 16, 2011, 05:37:50 AM
I know what u are going through. About 7years ago. I had the same problem with my left knee. My knee cap kept doslocating on me. Pretty scarry. I had surgery, it was called a left laterral relese done. (hope I spelled it correctly) My knee has not doslocated since. The only advice I can give is if u need a second opinion, don't be embarressed to get one. That's one prob. I had. And, I am soo glad I went for a second opinion.  Good luck :)