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Author Topic: Patella off center after ACL recon?  (Read 1225 times)

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Offline yuntigrl

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Patella off center after ACL recon?
« on: July 29, 2005, 02:47:59 AM »
HI Geeksters!  Hope this fine day is treating you all well and your knee woes are not giving you too much trouble.  I've posted before....quad strength.  Last Friday was my Last ;D PT appointment.  I had four months of PT to the day of my ACL recon.  My strength test was better and my PTA gave me some things to do on my own when I go to the gym.  I had a patellar graft, and I think (I hope) that is really the only thing that ever bothers me.  I think mechanically (like I'm a well maintained automobile -- what a laugh) my knee is coming along pretty well.  The graft site is the only thing that ever hurts, and the numbness which I know may or may not go away!  My question is this:

When I'm sitting in a chair with my knees bent to about 100 degrees, I can look down on my knees and compare shape, I think that my affected patella is off to the left.  The more I extend it, the more normal it looks.  My unaffected knee seems to have a flat knee cap, and my affected one looks round and egg shaped...and I think it might be because it's not centered.  I have a follow up with my OS on Thursday and I'm wondering if it's anything that I should worry about.  My OS has told me that the patellar tendon will regenerate over time, but I'm worried that if my patella isn't where it's supposed to be that could cause problems.  Am I nuts, or what??

I have to report though that I spent five minutes on a treadmill and actually ran, and then did an inaugural lap around the gym (jogging)!!  I felt every step, and it was tender, but I guess that's OK at four months.  I'm still very conservative with my knee, so I may have been a bit nervous and not very relaxed...but, all in all it felt pretty good to move a bit quicker than I have been.

Any insight to the question on my lopsided knee cap will be much appreciated!!  Kat
Tore ACL March 1992
Fixed ACL Patellar Graft March 2005 (That's right 13 years later)
TKR Sept 08

Offline Ferris

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Re: Patella off center after ACL recon?
« Reply #1 on: July 29, 2005, 08:48:06 AM »
Does that affected kneecap actually hurt or ache (ignoring ACL aches if you can) or is it just something that you have observed?  Did any discomfort draw your attention to it?  If not then you are probably ok but I would still ask your OS about it in order to ease your mind.  I suffered from patellar-femerol pain before my ACL reconstruction as the lax knee was causing my knee cap to move around.  I still get it occasionally even now (27 weeks post-op) and when it is playing up, I do tend to notice it - not always painful but aches instead.  I jerked my leg stepping off the pavement (sidewalk) last week and it has only just settled down after that.  Having said that, I am not seeking to get it treated surgically as I don't consider it enough of a nuisance or painful enough to put myself through more surgery - the ACL reconstruction was enough!  Both my PT and I manipulate my knee cap into better positions and before surgery I had it taped from time to time when it got painful which helped.  Now I rarely suffer from it since the surgery.

Rachel

Offline ski bum

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Re: Patella off center after ACL recon?
« Reply #2 on: July 29, 2005, 05:47:09 PM »
Yuntigrl,

My 2nd PT commented that my patella was low & lateral (off-centered) and called it 'patella baja.'  The reason seemed to be a combination of very weak/atrophied quad muscles (I couldn't 'make a muscle' when I did a quad set at all) and scarring under the patellar tendon adhering it to the fat pad.  You've posted before about weak quads--might that be the reason your patella is off-center?

Andy
12/23/04:  complete ACL tear, partial LCL, tibia bruise
1/19/05:  allograph ACL
7/8/05:  AIR-scar tissue & ACL graft girth reduction
8/4/05 nearly full ROM-released to ski
8/11/06: AIR-scar tissue, grade 3 cartilage potholes on femur
10/13/10:  Mfx, L knee to fix 3cm pothole

Offline yuntigrl

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Re: Patella off center after ACL recon?
« Reply #3 on: July 31, 2005, 02:53:32 AM »
Thanks Rachel and Andy for your responses...
Rachel, my knee only aches.  There's really no pain with my kneecap other than from the graft site and it seems to get better every day.
Andy, I was worried that the weak quad might be contributing...I have regained a good bit more strength in the quad, but it's still slightly smaller and I can tell there's a bit more atrophy than my good one. 
I'm going to ask my OS on Thursday and I'll let you guys know what he says.  Be good.

Kat
Tore ACL March 1992
Fixed ACL Patellar Graft March 2005 (That's right 13 years later)
TKR Sept 08