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Author Topic: Can you correct outward tilting kneecaps?  (Read 3763 times)

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Offline funkymunky

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Can you correct outward tilting kneecaps?
« on: January 28, 2005, 08:47:40 AM »
Hi,

I have just had my second lateral release donw on the same knee in 10 years and am now recovering. I went to see an excellent physio for the first time yesterday, and during conversation she recognised my kneecaps as being tilted towards the outside, which leaves me prone to dislocations & sublax instability issues.

What she said is true as I have dislocated my right knee twice and get frequent but not weekly sublaxes where it seems to pop in & out very quickly and just leavs me swllen for a couple of hours.

Is there any options to sort tilted kneecaps? She also said if I trained and built up the muscles on the outside of the knee I could be prone to more problems because of the pulling effect? Hopefully my lateral release would have help this slightly or am I wrong?

Any suggestions?

Thanks,
Nick

Offline c21joanne

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Re: Can you correct outward tilting kneecaps?
« Reply #1 on: January 29, 2005, 08:19:03 PM »
Before I had both of my knees TKR'd, both the knee caps were sublaxation.

But now the right one is straight, but the left knee is again, sublaxation.  Due to the surgeon making a mistake by putting in the wrong size implant.

Offline Linds

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Re: Can you correct outward tilting kneecaps?
« Reply #2 on: January 29, 2005, 08:33:43 PM »
Hi,
A Lateral Retinacular Release is indicated in the case of Laterally tilted Patellae, and while it cannot resolve all cases of it, this is what it is used for.   :-\  Sorry to hear that your kneecaps are still tilting. I have had  a LR on both of my knees and while I still have lateral tracking and recurrent subluxations my tilt has improved greatly.  In the case of a kneecap that tilts and tracks laterally (to the outside) you want to try and train the VMO (Vastus Medialis Oblique) muscle to help support the joint.  The VMO muscle is the quadricep (upper leg muscle) on the inner most part of the thigh and it tends to be weaker then the lateral (outside) muscles in the majority of people but definately in someone with Patella Femoral Problems.  It's very important to build up VMO strength as if it's functioning properly it can help to prevent further subluxation and lateral tracking.   Does that make sense?  However, in some cases muscle strength can't always solve all of these problems. Sometimes further Surgery, bracing and or PT techniques are required.  Best of luck with your rehab.


I hope that helped...
Hugs
Linds
1997 Scope RK
2002 LR RK
2002 Scope and hematoma evac RK
2004 LR LK
May 06 Fall from Horse, partial ACL tear and meniscus injury, Tibial plateau injury
2007 Scope, Plica Excision and Debride LK
2009/2010- Possibly Ankylosing Spondylitis?

Offline Cid

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Re: Can you correct outward tilting kneecaps?
« Reply #3 on: January 30, 2005, 06:36:33 AM »
I am the queen of tilted patellas.  I have had a lot done to get these babies to track in a more normal zone.  Mine were severly tilted to the outside.  I had LR on both and that didn't do me any good.  I have had good results with a VMO advancement on each one and I do whatever it takes to keep the VMO strong.  One of my big problems was that I didn't have VMO attachment and this was allowing my patella's to free float which caused a lot of dislocations.  I have had one knee that has had A LR VMO and ttt.  It is probably my most stable.  Now I just have to constantly fight the deteroation from the patellas tracking in the wrong place for so many years.  I don't have a lot of cartlidge left so I am looking at a cartligdge transplant in the next 9 months.  Good luck with the LR and focus on the inner VMO strenth to keep those knee tracking toward the center.  Sorry you are having to go thoroug this because I know what a pain it is.  Welcome to the wierd knee club.

Cid 8)
Cid
11 surgeries to date 5 on RT, 2 LR, TTT, VMO advancement & chrondroplasty with drilling and a few meinscal repairs
6 on LFT, LR, 2 VMO adv. & OCP with meinscal repairs

Offline c21joanne

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Re: Can you correct outward tilting kneecaps?
« Reply #4 on: January 31, 2005, 12:16:05 AM »
My new OS had fixed my sublaxation during a revision.  He told me he had wrapped one of my ligaments around the outside of my knee.  This was to hold it from dislocating....

But now, after 3 months since the surgery, my knee cap is again loose.

I had the revision for the first OS had put the wrong size plastic in my knee...


Offline LadyKanner

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Re: Can you correct outward tilting kneecaps?
« Reply #5 on: January 31, 2005, 01:18:22 AM »
My knee caps were also tilted and I had a patellar reallignment surgery last year.  Some even call it TTT.  Tibial Tubercle Transfer.  Feel free to message me for questions!

kim
Mal-alligned patellas w/ severe chondromalacia
04/02  Rt knee arthroscopy w/ lateral release
01/04 Rt knee arthroscopy
02/04 Lt knee arthroscopy
04/04 Rt knee patellar reallignment















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