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Author Topic: Q-angle question  (Read 1434 times)

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Offline goose

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    • Jennifer Linforth, Author
Q-angle question
« on: October 17, 2004, 06:25:28 PM »
Hey guys,

I have a few new questions for you...Does anyone out there know the nitty gritty regarding Q-angles?  I was wondering if we are all born with these messed up Q-angles or do they change over the years depending on muscle condition?  I've been wondering why, at age 33, my Q-angles are now the root of my problem (angle is at 28)  Especially since I am at the best physical conditon I have ever been in.

Also, here's an insurance question for those of you who have had the surgery already.  Did your insurance cover the locked brace you  were put in after the surgery?  My insurance did not cover my neoprene Donjoy claiming it was an orthodic and they do not cover those. So when i asked about the locked brace my insurance company told me they may not cover it, it all depends on how it is coded.  I am sure they will as it is neccessary for the surgery, I just want to cover all my bases with them before Nov. 11th.

Thanks
Goose
RK-LR 1988
RK-LR 1999, chondromalacia, torn cartlidge removed, debridement
LK-LR 2002, chondromalacia
LK 11/2004 diagonstic scope, lesion removed, debridement
LK-TTT 12/8/2004

Offline cat

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Re: Q-angle question
« Reply #1 on: October 17, 2004, 09:44:36 PM »
Hey there,
I have no idea if Q angles can change. I wondered that myself after having kids. Seems like the hips like to spread. Anyway, I have malalignment issues and my Q-angle was said to be around 22. (Cant' imagine what your legs must look like. Mine look pretty funny!) I made it to the ripe old age of 44 without too many problems. My very unscientific guess is that years of  the patella riding bumpity bump where it shouldnt' eventually wears it down and thus the pain.

As for the brace, my insurance covers orthotics (my shoe inserts and my Breg brace) if prescribed by my doc and purchased from an in network provider. My post op brace and ice machine were also covered. You can call your insurance company for more info on your coverage.

Good luck to you and feel free to ask more questions.
cat ;D

"Miserable malalignment"
 Lateral release, medial reefing, VMO advancement, and TTT-  3/2/04
Screw removal- 5/24/05
Cortisone injection to pes anserine- 7/27/05
Femoral derotation osteotomy, TTT revision- 10/18/07

Offline Janet

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Re: Q-angle question
« Reply #2 on: October 18, 2004, 12:30:28 AM »
This is how I've found out if a procedure is covered under my insurance. I'm sure it would also work for your brace. First, call your doctor's office and find out the diagnosis codes and procedure codes for the brace (or surgery, whatever). Everything billed to insurance has to come with a diagnosis and procedure code. Then you can call the insurance company and they will be able to tell you exactly what is covered. I currently have two diagnosis codes. If they bill with a certain one as primary, everything is covered. If they bill with the other one as primary, nothing is covered.

I found this out because all of my PT was billed incorrectly. Imagine my heart attack when I saw a monthly bill for $4,000 when I didnt' expect to pay a penny. I was eventually able to get everything straightened out, but it took hours of phone calls back and forth and letters written, etc. I also found out that certain injections needed to be billed a certain way. If they were billed one way, it was considered a surgical procedure and needed prior approval. If it was billed another way, it was considered part of an office visit and didn't need prior approval.

It helps you to be a little proactive in this area and get your answers beforehand. Besides saving you a lot of hassle, it helps your doctor get paid faster and they won't be after you to cover it until the insurance gets straightened out!

Janet
Torn quad tendon repair & VMO advancement 4/99, MUA with LOA 10/99, Patella baja and arthrofibrosis, LR & medial release & LOA 5/01, LOA & chondroplasty 6/03,TKR on 11/06, MUA 12/06. From perfect knees to a TKR in 7 years, all from a fall on a wet floor...and early undiagnosed scar tissue.

Offline mainegal

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Re: Q-angle question
« Reply #3 on: October 18, 2004, 02:47:13 AM »
All my stuff was paid by insurance, but even my OS says I have the best insurance in Mi thanks to my company. I was a little concerned about things being paid so my OS office called the insurance company for me to confirm it. The post-op brace was covered, though when I got my bill it looks like it was included in the general hospital fee. Just ask your docs office to check for you. Mine did it while I was meeting with my OS about the surgery. Then again I also have an awesome OS and staff.

Q-Angles... not positive whether they change or not, but my OS explained they can be aggravated by activities like running, hiking or other activities which require a lot of knee tracking. You said you were in the best physical shape of your life, so maybe the activities you now participate in are causing the q-angle to act up. I have a high Q in both knees and only the right bothered me. OS said sometimes high q's are a problem, sometimes your body works with it.

Good luck with your upcoming surgery. Maybe next time I am in ME, we can compare scars.  :)

Melissa
RK TTT (Fulkerson) & LR - 8/31/04
RK - genetic PF maltracking, chronic patellar tendinitis
RK - Q-angle was 25, post-op= 15

Offline BuffettBarbie

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Re: Q-angle question
« Reply #4 on: October 18, 2004, 03:36:12 AM »
Goose,

Yes, your Q-angle CAN change over time.  It can improve (sometimes, with just building the right muscle groups) or get worse (despite building the right muscle groups.)  I watched my own Q-angle go to hades, despite a rigorious physical training routine which should have improved it.  I am a veteran of tape and braces- I found the Breg PTO brace to be the best for me to continue an active lifestyle prior to my TTT.

Weird, your insurance SHOULD cover your braces.  Talk to the billing department at your OS' office, and see if there is a way to code it in the system.  I have never heard of insurance not covering a brace.  Best of luck and many hugs!

Chris  :)
Lateral Release- Left Knee (Feb 2001)
Lateral Release- Right Knee (April 2001)
Fulkerson's TTO, Lateral Release, & Scope- Right Knee (20 Aug 2004)

Offline sienna

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Re: Q-angle question
« Reply #5 on: October 18, 2004, 09:44:31 AM »
Okay, dumb question time.

What is a q angle?  I have never heard of this term even after all the time I spend on here.  Please enlighten me.

Good luck getting the right codes etc.  Sounds like your health system is really complicated.
rk posterior meniscus tear. Successfully repaired 10 Sep,03. Now have nerve damage and cps which goes with it.  I want to slap the person who said 'It just takes time....'

Offline ATsoccergirl

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Re: Q-angle question
« Reply #6 on: October 18, 2004, 04:34:29 PM »
The Q angle is formed by two lines, the first line is from the ASIS to the midpoint of the patella, the second line is from the midpoint of the patella to the tibial tubercle.  The angle where these two lines intersect (midpoint of the patella) is measured.  Anything greater than 13 degrees for males or 18 degrees for females indicate a positive finding.

The Q angle is slighly indiciative of the force vector of the quadreceps.  Which also can show maltracking.  However, this is a very vague measurement and has very little clinical use.  
1999 LR, 2002 ACL/PLC recon, reversal of LR, 2004 ACL revision, 2006 Car accident torn PCL and small fractures resulting in bone chips in my knee.  Torn MCL 3 times.  Wicked screws under IT band and Pes Anserine.  June 2008-Hip Arthroscopy.

Offline sienna

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Re: Q-angle question
« Reply #7 on: October 19, 2004, 12:11:20 PM »
Thank you.  ;D
rk posterior meniscus tear. Successfully repaired 10 Sep,03. Now have nerve damage and cps which goes with it.  I want to slap the person who said 'It just takes time....'