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Author Topic: Patella maltracking - any advice please?  (Read 2938 times)

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Offline spradders

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Patella maltracking - any advice please?
« on: June 27, 2005, 07:20:39 PM »
Hi,

Hope some people can give advice or share experiences with me.  I have been to see an OS today, and have been told that I have patella maltracking (subluxation).  He has told me that I will have 2 months of physio to try and strengthen a muscle to pull the patella back into place, and if it doesn't work I will have surgery.  He said the problem I will face is that the pain may make it difficult to follow through with the PT, so surgery is more likely.

Has anyone had a similar experience, and does anyone know what the surgery will involve?  I seem to remember he said something about the fat pad....

I have had a history of knee problems including surgery for meniscal tear and a lateral release, in the same knee I am having problems with now.

Thanks in advance,

Spradders
« Last Edit: June 27, 2005, 07:33:33 PM by spradders »

Offline Patty0513

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Re: Patella maltracking - any advice please?
« Reply #1 on: June 27, 2005, 07:41:40 PM »
Hi Spradders,
   I have 2 maltracking patellas and have surgeries for both.  Definitely try the PT first, and hopefully it will work.  There are several surgeries to correct this so it is hard to say what the surgery will involve without knowing exactly which surgery he was going to perform.  The surgery could be a lateral release, VMO advancement, medial plication, TTT or something else.  Do any of these ring a bell?

Good luck,
Patty

Offline spradders

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Re: Patella maltracking - any advice please?
« Reply #2 on: June 27, 2005, 07:53:54 PM »
Patty,

I'm pretty sure that it's not the lateral release, as i've already had this done.  He also said that the lateral side felt quite loose.  All I remember was him saying something about cutting into the fat pad and doing something with the muscles.

My knee cap looks like it has moved around my leg medially (towards the middle).  I'm wondering if the lateral release I had before has worked too well and is now TOO loose??

Spradders

P.S.  It's been a few hours since I saw the OS but my knee is still quite painful and swollen from the poking and prodding.  Any advice other than ice and NSAIDS?

Offline Patty0513

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Re: Patella maltracking - any advice please?
« Reply #3 on: June 27, 2005, 08:07:00 PM »
Hi Spradders,
   One of the complications of a LR is that the patella can start maltracking medially.  He may be going to do something to tighten up the lateral side and I am not too familiar with those procedures as my LRs didn't do anything and my patellas continued to track laterally.  RICE  is the best thing to do for your knee right now.  Good luck and hopefully the pain and swelling will subside soon.

Patty

Offline khaley80

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Re: Patella maltracking - any advice please?
« Reply #4 on: June 28, 2005, 12:19:27 AM »
Hi Spradders,

My kneecap is doing the same thing. I had a LR last July and now I am subluxing medially.  I have been in PT for about a month now and I have a second opinion on Thursday.  I will let you know if he has anything helpful to say.
plica removal 11/2000
lateral release 7/2004
arthroscopy 7/2005
TTT/VMO 6/29/06
Hardware removal 5/24/07

Offline painisevil!

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Re: Patella maltracking - any advice please?
« Reply #5 on: June 28, 2005, 04:39:33 AM »
Hi Spradders,

i have two maltracking patellas, i've done the p.t. route 4 times to "strengthen the muscles" but haven't had any success.  my doctor has mentioned surgery but is now concerned that i may have other problems and he can't seem to identify them.  other than that the procedure he was explaining to me is a TTT.  wish i could be more help.  good luck.

Sandy
~*15 yrs. old*~
~*PFS 3 yrs.*~
~*knee pain since May 02*~
~*osgood schlatter(spelling?) rt. knee*~
~*diagnosed severe misalignment- both knees*~
~*P.T. off and on for 3 yrs.(grrr)*~
~*trying to get a real diagnosis*~

Offline spradders

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Re: Patella maltracking - any advice please?
« Reply #6 on: June 28, 2005, 11:42:16 AM »
Thanks for all the replies, I really appreciate it.

I have been wearing a knee brace for the last few weeks as I have found that this stops the knee giving out so much.  I asked the OS yesterday if he thought I should still wear it and he was very vague.  He said that I just had to be careful not to become reliant on it and that I need to be strengthening the muscles, but use it if I feel I need it.
 I can't go to work without it as I am a teacher and on my feet all day.  If I don't wear it, it starts giving out and I am in alot of discomfort.  On the other hand, if I didn't wear it, would the muscles strengthen and fix it anyway???

To wear or not to wear, that is the question!

Offline Franbrown22

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Re: Patella maltracking - any advice please?
« Reply #7 on: June 28, 2005, 11:56:34 AM »
Hi,
On the question of wearing your brace all the time. I have worn one for the last two years everyday. I take it off to do my physio/swimming and stuff and try to do as much physio as I can tolerate. My OS seems to think that my knee is not dependant on it as I can walk without it. I just use it all day as I am on my feet pretty much all the time due to my job. I think as long as you do as much muscle physio as possible and don't use it when you are innactive or not at work it should be ok.
I do however think that for some people barcing is ineffective and physio to strengthen the muscles is better. I can't tolerate enough physio to get rid of the brace so compromise is best.
Hope this helps

Fran

Offline spradders

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Re: Patella maltracking - any advice please?
« Reply #8 on: June 28, 2005, 02:02:13 PM »
Fran,

Thanks for the advice.  Just out of curiosity, what is the problem with your knee?

Offline Em.m

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Re: Patella maltracking - any advice please?
« Reply #9 on: June 28, 2005, 02:43:11 PM »
Hi Spradders

I also had Patella subulaxtion and tried PT but it didnt work.  I then had a lateral release which worked for about a year then failed.  I was on crutches for 2 1/2 yrs but now I am 10 wks post op from a Roux Goldthwaite procedure.  Which is another Lateral Release, Medial Reefing and a tendon realignment and tuberosity transfer. Similar to a TTT.

I would try the PT route first though and then discuss all the options with your OS

As regards wearing your brace, I the OS or PT have told you to wear it you should.  You dont want to damage it anymore or put undue strain on it.  Also keep up at regular times with the painkillers as if you miss them it can cause more pain.  I know you dont like taking them but for short time it could help.

Take Care
Em
Lateral Release (R) 1983
3 years of Physio (R).
Failed operation (R)
Continuous Dislocations for 20 yrs
Roux Goldthwaite, (R) April 05
Lateral Release & Medial Reefing
(R) MPFL 07
(L) Worn away doing 2 knees work !
(L) knee TTT scheduled 8/08

Offline Little Ally

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Re: Patella maltracking - any advice please?
« Reply #10 on: June 28, 2005, 07:23:26 PM »
Hi Spradders!!

Sounds like our knees were made in the same mould!! I have problems with a maltracking kneecap and tilt. I had a LR last November that hasn't seemed to help any. My OS and PT told me to wear a knee brace to keep everything in place and let things settle. They keep telling me it's still early days, yeah yeah, I just want my life back!!! I am a teacher too, for my sins and find I can't work without wearing my knee brace. It gives me support, but more importantly it protects my knee from the little herbs!!
I recently went to see my OS and he told me about an operation to correct the maltracking problem but he would only do it if I could take no more pain as the operation was quite nasty. I do have other complications, my thigh bone and shin bone have softned and any procedure on that area would be tricky, or so he tells me! I'm not sure what to make of that, all I know is my knee hurts like crazy most days and I can no longer do all the stuff I used to enjoy!!

On that happy note, I wish you all the best with your knee and if you find a solution please let me know!!

Ally xx

Offline AK_Eric

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Active Release!
« Reply #11 on: June 30, 2005, 12:11:21 AM »
I've been going through a lot of tracking problems as well and you should find somebody that practices Active Release Technique  (ART)  it is a deep tissue technique similar to Rolfing, but with a sports medicine specality. It is REAL treatment, rather than having a PT just tell you to strech and ice.  you will probably still need to do some strengthing to get the tracking back where it should be.  Avoid the lateral release... surgery is permenant