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Author Topic: opinion needed re 13 year old daughter's knee  (Read 56329 times)

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Offline cat

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Re: opinion needed re 13 year old daughter's knee
« Reply #30 on: May 15, 2005, 08:38:39 PM »
Lisa,
I have the same 'squinting patella' as the picture.BTW, here's where I obtained the pic-
http://www.veggie.org/run/chondromalacia/

  The condition where one's femur (thigh bone) is rotated inward and the tibia (lower leg bone) is rotated outward is called miserable malalignment. Foot pronation often coexists with this. Here' another link about this problem-
http://www.physsportsmed.com/issues/1996/07_96/arendt.htm

Treatment should always start with a correct diagnosis and then appropriate therapy to address the issues found. Analgesics, orthodics, bracing, stretching for flexibility deficits, and quadriceps strenghtening may all be a part of a conservative treatment plan.

Now having said that, it took 7 docs to diagnose my malalignment issues (which I now think are pretty obvious). Only 2 out of 7 ever examined me standing. So read up and do your homework. You need to be an informed advocate for you daughter. :)

Here's one of my fav links. It even has a little animation of a TTT which is often used if a conservative treatment plan fails.
 http://www.kneehippain.com/patient/for_patients.html

There is also a procedure called a derotational osteotomy. Haven't found any really good info on that but here's one link-
http://www.medscape.com/viewarticle/487789_2

Good luck to you and your daughter. And if you have any more Qs for someone who has 'been there done that' just holler. ;D

cat




"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 upset mom

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Re: opinion needed re 13 year old daughter's knee
« Reply #31 on: May 17, 2005, 12:56:41 AM »
Hi Morgan,

This is Heather, not my upset mom.  They told me that I was tense in physical therapy and that I was the most tense person they ever had.  They keep on telling me relax.  I agree that they do not feel the same pain as we do so they don't know that it's not as easy as they say.  They told me that I'm rotating in my hip and to hold my knee as far over to normal as I can.  I can't do that!  Sometimes they tell you things that you just can't do.  I stopped physical therapy for now.  They're sending me for a bone scan Friday.  Hopefully they will find what's wrong or my  mom is going to keep taking me to doctors until someone figures out what's wrong.  I hope that you feel better and get better soon.  Good luck with physical therapy.  I'm going to be 14 in June.

Heather

Offline upset mom

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Re: opinion needed re 13 year old daughter's knee
« Reply #32 on: May 17, 2005, 01:07:47 AM »
Hi Cat,

Thanks for all those websites.  I will definitely check them out!  I agree that I have to be well informed.  It's just a lot of information to process in my brain and to try and remember when I see the doctors.  I feel like I want to print things out and read it to them:)  Looks like we're going to be going to quite a few doctors as you did.  But first I'm going to see what this bone scan test shows.  Friday is the appointment and Monday 5/23 we go back to Doctor #2 and see what the results show.  I'm going to go with my motherly instincts and my gut until I find someone who makes me feel comfortable with their diagnosis.  So far, that hasn't happened.  Will keep the board posted to new developments.  Her knee looks awful - so indented to the inner side of her leg and she says it hurts and the iceing doesn't help.  I guess the main thing is that we are going forward and not stopping until we get an answer that makes sense.  Hope you have a happy Tuesday. 

Hugs,
Lisa

Offline morgan515046

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Re: opinion needed re 13 year old daughter's knee
« Reply #33 on: May 17, 2005, 01:41:40 AM »
hey Heather its good to hear from you....so i went to the ciropractor (dont know how to spell that) and he said that my knee the normal way your knee is supposed to bend...the top part of my leg is turned completely around so he popped it back into place and told me that i have to go back tomorrow and that i needed to go to PT right after i left and im sorry but it hurt terribly and i went to PT and they said that i need to bend it and that that is the only way that it is ever going to get better but the ciropractor told me that he was going to have to pop it back everyday this week because its going to go back to the spot that its not supposed to be in....so i hope that your bone scan goes ok... i would like to talk to you more cause its kinda lonely without sports all my friends are always gone to practices and everything....so if you have an email let me know
good luck with everything
-morgan-
*14 years old*

3/29/05 Track hurdle incident
7/6/05 surgery for menisectomy
8/9/05 Possible RSD???
10/11/05 Patella Tendonitis from not rehabing all the way.

VOLLEYBALL ROCKS!!!

Offline Studb

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Re: opinion needed re 13 year old daughter's knee
« Reply #34 on: May 17, 2005, 02:02:09 AM »
Hi there.  I've a little experience with knees and I agree with you that something's not right.  I missed hearing how she origionally did the injury.  Does she complain of ther knee giving way underneath her or has there been any episodes of locking? (unable to bend or strighten knee?)  How swolen is her knee?  Did it swell up immediatly following the injury or did it take a day or so to come up? ???
Sorry so many questions but it's difficult to get a picture without seeing the knee.  (tha's tough 'cos i'm in australia!!) 
Stuart Baptist
B.Sc (Hons) Physiotherapy
Total Physio Centres

Offline jillo

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Re: opinion needed re 13 year old daughter's knee
« Reply #35 on: May 17, 2005, 02:53:18 PM »
I developed that whole "hip to the outside, knee cap turned in, crooked leg" thing after dislocating my patella and it ultimately turned out to be torn meniscus that didn't allow me to stand straight on the leg so I was turning it to the inside to avoid the torn bit.  I couldn't bend it properly either, but it didn't lock.   My PT figured it out immediately, but it didn't show up on MRI so the first three OS I saw didn't think it was torn.  The fourth (!) one agreed with the PT right away, removed the torn bit and some scar tissue and the leg pretty much popped back to straight, although it is very weak and I have to work hard on walking normally and on stretching all the muscles out again.  Something to think about- tears don't always show up.

Offline upset mom

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Re: opinion needed re 13 year old daughter's knee
« Reply #36 on: May 17, 2005, 11:27:18 PM »
Hi Studb or Stu?

She originally injured her knee in gym - a boy fell on her leg after they both fell down.  She didn't go to the school nurse right away.  It didn't look very swollen at first.  After around 1 week her knee shifted off to the inner side of her leg.  She stands up with crutches and can walk without crutches but with a big limp.  She cannot bend her knee very much at all without having bad pain.  I have a digital camcorder that I'm just learning to use.  Maybe I will have a friend of ours try and take a still picture of her leg and post it on the site if that's possible.  Thanks for writing. 

Hugs,
Lisa

Offline upset mom

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Re: opinion needed re 13 year old daughter's knee
« Reply #37 on: May 17, 2005, 11:33:49 PM »
Hi Jillo,

That is very interesting that tears don't always show up.  The PT she saw was one the OS referred her to.  Wondering if going to a PT on our own would be better.  Do you think that the bone scan can show a torn meniscus?  Guess I have to wait until we see the doctor for the results of the bone scan on May 23rd.  Thanks for writing.  The more I know about knee problems helps, except the more I learn it seems to get harder to process all this info to tell doctors:)  But I have faith that eventually, hopefully real soon, this whole mess will get resolved.  I have to think positive!  Keep in touch.  Hope you are feeling alright.

Hugs,
Lisa

Offline jillo

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Re: opinion needed re 13 year old daughter's knee
« Reply #38 on: May 18, 2005, 02:22:08 AM »
My OS told me that only about 85% of tears show up.  I had a huge tear and two very good OS's I saw for a second opinion told me that they didn't think I had a tear, that they thought I had some kind of vaguely defined alignment problem.  My actual surgeon thought I did have a tear based on symptoms as nothing was visible on the scans and so did my PT and they were right.  I, personally, was pretty damn sure I had a tear as I could feel it moving around in there!

Offline upset mom

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Re: opinion needed re 13 year old daughter's knee
« Reply #39 on: May 19, 2005, 01:48:00 AM »
Hi Heather,

Me and my daughter, Heather, were laughing a lot when we saw your comment on the name "Heather".  Yep, maybe we should do a name change.  She has always been a calamity jane.  I almost started to write a journal on all the times she injured herself (not counting the knee lol).   At least, this evening things have calmed down.  I came home from work this afternoon to find my 14 year old son in the kitchen with Heather whose crutches were on the floor and she was sitting and crying in the kitchen chair.  Said her knee was killing her, felt like her whole knee was pulling she said with huge shocks and stabbing.  Anyhow the OS wasn't in so I took her to her regular doctor who said maybe she should have her knee tapped for fluid and then suggested in a low voice to look for another OS and then said maybe it's arthritis DUH?  I told him this happened right after the incident in gym at school.  These doctors get me crazy.  I was in tears with Heather.  Feel so helpless.  Anyhow will see how the bone scan goes - don't have much hope with that but I know we are going to go to another OS as soon as I get the results, unless the OS we are seeing says something logical.

Thanks again for your encouraging lol email.  I viewed your pictures.  You and Scott make a very cute couple.  Enjoyed looking at the other pics too - your poor knee - gosh has it been all these years since it first started - that's a little scary for me to think of but it's good to know we're not alone:)

Take care!
Hugs,
Lisa

Offline Heather M.

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Re: opinion needed re 13 year old daughter's knee
« Reply #40 on: May 19, 2005, 05:33:52 AM »
Lisa,

A lot of doctors won't give pain meds to teens, but if you control them, I think they could be helpful.  She's obviously in agony, and THERE IS NO REASON for this to happen.  Get her some relief.  Demand it--you will have to.  I was in the hospital in the cardiac ICU with a fractured sternum, broken collarbone, and cardiac contusion following a car accident, and those IDIOTS wouldn't give me anything for pain.  Said they were worried about addiction.  There were morons--I had broken the thickest bone in my body, for crying out loud.  My mom cornered the docs and forced them to admit that if she were in my position in the ICU she'd have been on a morphine drip!  She got them to finally consent to *codeine,* which was pitifully inadequate. 

Anyway, my point is that she shouldn't be suffering.  What is your daughter taking for the pain?

Heather (yep, another one).
Scope #1: LR, part. menisectomy w/cyst, chondroplasty
#2-#5: Lysis of adhesions/scar tissue, AIR, patellar tendon debridement, infections, MUA, insufflation
#6: IT band release / Z-Plasty, synovectomy, LOA/AIR, chondroplasty
2006 Arthrofibrosis, patella baja
http://www.flickr.com/photos/hmaxwell

Offline trekker05

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Re: opinion needed re 13 year old daughter's knee
« Reply #41 on: May 19, 2005, 02:02:05 PM »
Lisa,

Arthritis, huh?!  That's a good one!!!  Let's try something if your game;  I wouldn't normally try to suggest this without seeing the person except that your daughter is in quite a bit of pain, so maybe it'll help relieve some.  Have her lie on her stomach with her legs straight.  Then have her slowly bend her knee as though she is curling her leg.  When her knee is at 90 degrees, have her lift her leg about an inch off the ground.  See if she feels any tightness in her butt.  Have her poke the muscle with her finger if she doesn't until she gets the sensation of it tightening.  Hold it for about 20 seconds.  Repeat that 2 more times.  Then have her stand up and see if the knee feels better.  If the knee hurts to bend at the beginning of the movement, have her try to lift the leg up while straight and then bend it and hold.  Let me know what happens.

Offline jillo

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Re: opinion needed re 13 year old daughter's knee
« Reply #42 on: May 19, 2005, 02:13:46 PM »
You definetely need a new doctor, your daughter shouldn't be in that kind of pain and be made to wait.  Maybe you could take her to the ER or to a pediatrician who can push it through for you and insist that the orthos docs treat her as they would an adult who has had a severe trauma.  I can't see any reason for refusing to treat her pain under the circumstances.

Offline blackbeltgirl

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Re: opinion needed re 13 year old daughter's knee
« Reply #43 on: May 19, 2005, 02:22:39 PM »
Is your daughter seeing a pediatric OS?  Call the nearest children's hosptial for a referral.  At 13, she is not done growing, and should not be treated as an adult.  But she SHOULD BE TREATED.  My knee troubles started when I was 12, and no one would do anything for me till I was 16 (partly my mom's fault, not all the doctors).  But the longer an injury sits without the proper treatment, the greater the odds it can cause more damage down the road.  Bravo for believing in your daughter, and fighting the doctors.  She's lucky. 

(And my middle name is Heather.  Maybe that's why I have knee damage...)
ACI was supposed to be 2/21/06.  On 6/29/06 Insurance co said have another scope, and if it still looks good, they'll ok the ACI.
Microfracture Dec 7, 2004
   3cm x 6cm lesion, LFC; 3cm x 1cm lesion, trochlear groove; lateral tibial plateau lesion
2nd degree black belt, tae kwon do (had to stop)

Offline upset mom

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Re: opinion needed re 13 year old daughter's knee
« Reply #44 on: May 20, 2005, 01:23:40 AM »
Hi Heather,

The pediatrician gave us a prescription for tylenol with codeine.  Heather didn't want to take it.  They also gave her alleve prescription (Naiproxin - spelling).  She had taken a couple of those but said it really didn't help.  She seems to want to deal with the pain but after reading all the recent posts with me said she will take something.  I'm going to give her the alleve tonight as I didn't fill the codeine yet.  I agree with you that the doctors can be morons.   Now she tells me it feels like her knee is being pulled like a piece of cloth (she described it like a tug of war) and still has the stabbing pains, etc. sometimes worse than at other times. She also said she feels like something is moving in there.  Then again, she has been reading some posts with me and I sometimes wonder about the "power of suggestion" if you know what I mean.  But I know the kid is definitely suffering and she is so brave!   I spoke to my job today about getting her on my health insurance which is Aetna but first have to have her removed from BlueChip insurance for kids.  Thanks for writing.  I'll keep you posted.  By the way, how is your knee doing these days?















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