Advertisement - Hide this advert





Author Topic: Medial dislocation of the patella  (Read 1341 times)

0 Members and 1 Guest are viewing this topic.

Offline Shanona

  • MICROgeek (<20 posts)
  • *
  • Posts: 10
  • Liked: 0
Medial dislocation of the patella
« on: December 16, 2005, 03:02:37 AM »
I have a patella that dislocates on a regular basis (at least 7 times per day) medially.  I have had 3 surgeries to correct this issue with no luck.  My surgeon says that medial dislocations are rare and hard to correct surgically and basically, a patient trades stability for pain when you surgically stitch the patella back into allignment.  He also said that if he cannot correct my medial dislocation, I should consider the REMOVAL of my knee cap without a knee replacement!

Any information would be appreciated; if anyone has experienced medial dislocation surgery or removal of the knee cap.  Thank you. ??? ???
« Last Edit: December 16, 2005, 03:14:02 AM by Shanona »
lateral release 2003
DVT 2003
2 failed operations to stop chronic medial sublexation
4 knee operations
10 ulnar nerve/ulnar bone ops to right arm
14 operations since 1999

Offline Nettan

  • SuperKNEEgeek
  • *****
  • Posts: 13862
  • Liked: 7
  • Stronger then yesterday...thanks Sis...
Re: Medial dislocation of the patella
« Reply #1 on: December 16, 2005, 06:44:13 AM »
I would definately seek more opinions before doing any drastical like taking away the kneecap. I know I've read about this before on the board, someone having same issues, but don't remember who. If I come up with who its is I let you know. I'm sure there must be docs out there who are better on this and can get you other options, you just have to find the right one.But get moreopinions before doing this surgery or even thinking of it. I was also considered that some years ago, but you loose a lot of strenght in the leg after doing that, so I said no.
Good luck to you !!

HUGS NETTAN  8)
Surgery 6 times left knee torn meniscus, RSDS,chondromalacia, nervdamage cause constant nervpain,chronic inflamm.
Spinaldamage wheeler 100%.
Right knee damaged aug-06, use brace surgery 4/9-07.LCL tear.

Offline My Sister Sam

  • SuperKNEEgeek
  • *****
  • Posts: 2482
  • Liked: 0
Re: Medial dislocation of the patella
« Reply #2 on: December 16, 2005, 01:06:39 PM »
I agree with Nettan. You need to seek another opinion. There are, I would think, numerous surgeons who are capable of correcting medial subluxation of the patella. You just need to find the right OS.

I had medial subluxations too, in addition to other problems, and my medial trouble was corrected (don't exactly know what he did to correct it). If it were my knee, I would not agree to a patellectomy.

Best wishes.
'70 Auto accident - Salter Harris IV fracture distal femoral epiphysis - R knee
'71 R - Bony Bar Resection femoral epiphysis
'78 L - Epiphysiodesis
'79 R - Distal Femoral Osteotomy/LR
'04 R - TTT/Medial Reefing 
'05 R - Trochleoplasty/Medial Reefing/TTT
'05 R - AIR/LOA
'07 R - TKA

Offline anasta5ia

  • Forum Faithful
  • ****
  • Posts: 463
  • Liked: 0
Re: Medial dislocation of the patella
« Reply #3 on: December 17, 2005, 07:39:43 PM »
Hey!!

I just had surgery (on Dec. 9th) to address both medial and lateral dislocations of my left patella.  Choice of surgeon is really the MOST important thing with this problem and most likely if I had been treated by Dr. Fithian a few years ago I would not have had the number of surgeries that I have had to go through.

For my issue it required a revision of my tibial tuberosity transfer, medial patellofemoral ligament reconstruction, and lateral patellofemoral ligament reconstruction.  Of course I am only 9 days post-op and definitely in the pain to prove it, but am HUGELY optimistic about it.  Dr. F tried very hard to dislocate my patella in both directions in the OR after the reconstruction and was unable to, so we are keeping our fingers crossed.

A LPFL reconstruction is a rarely performed procedure and it will really require a patellofemoral specialist to perform it.  But a patellectomy is not an answer either as the entire extensor mechanism can still dislocate, even if the patella is gone.

If you have any other questions I can help you with, let me know.

-Heather G. 
Rt. knee-plica resection, LR, 4 TTTs, MPFL repair & 2 MPFL reconstructions
Lt. knee-2 TTTs, & 2 MPFL reconstructions...
Scheduled for bilateral hardware removal, lt. knee TT revision, MPFL recon and LR recon with new wonderful surgeon.
Plus 9 other orthopedic surgeries

Offline Silkncardcrafts

  • SuperKNEEgeek
  • *****
  • Posts: 3916
  • Liked: 6
Re: Medial dislocation of the patella
« Reply #4 on: October 02, 2006, 12:46:37 PM »
Hey!!

I just had surgery (on Dec. 9th) to address both medial and lateral dislocations of my left patella.  Choice of surgeon is really the MOST important thing with this problem and most likely if I had been treated by Dr. Fithian a few years ago I would not have had the number of surgeries that I have had to go through.

For my issue it required a revision of my tibial tuberosity transfer, medial patellofemoral ligament reconstruction, and lateral patellofemoral ligament reconstruction.  Of course I am only 9 days post-op and definitely in the pain to prove it, but am HUGELY optimistic about it.  Dr. F tried very hard to dislocate my patella in both directions in the OR after the reconstruction and was unable to, so we are keeping our fingers crossed.

A LPFL reconstruction is a rarely performed procedure and it will really require a patellofemoral specialist to perform it.  But a patellectomy is not an answer either as the entire extensor mechanism can still dislocate, even if the patella is gone.

If you have any other questions I can help you with, let me know.

-Heather G. 

Hi there,

I have had a lateral release and patello-femoral reconstruction on my left knee. Now I am experiencing medial dislocations and subluxations due to my muscle over-developing. To date I have tried pilates, strengthening exercise program, the gym and using a knee brace. However, I'm still experiencing quite a few dislocations and subluxations.

How did you respond to the surgery ? My kneecap is super mobile and am keen to learn as much as I can before seeing my OS at the end of October. In the past I have responded well to surgery.

My surgeon in Melbourne, Julian Feller specialises in this problem and so know I have the right surgeon.

Kirsty
11/1996 - RK LR
07/1997 - LK LR
11/1998 - LK MPFL Reco
12/2005 - RK LR Repair
07/2006 - LK MPFL Repair
11/2006 - LK LR Repair
22/05/08 - LK Trochleoplasty
11/02/10 - RK Trochleoplasty
07/03/11 - RK Chrondroplasty

Offline Shanona

  • MICROgeek (<20 posts)
  • *
  • Posts: 10
  • Liked: 0
Re: Medial dislocation of the patella
« Reply #5 on: October 03, 2006, 12:42:42 AM »
???On April 4, 2006, I had my third surgery to correct my medial sublexation issues.  I am now 6 months post op and my knee cap is still disclocating medially, although not as often as before the surgery.  However, if I lean against something or barely bump my knee against something it will pop out of socket.  I am in pain everyday and on a chronic pain medication regimine because of the sublexation issues and (which was found during the last surgery) I have 5 fissure cracks in my patella, grade 3 & 4 chondromalacia and massive arthritis to both the tips of my thigh and calf bones.  I am VERY frustrated and at this point confused as to how I should proceed ... IS A TOTAL KNEE REPLACEMENT THE ANSWER?  IF SO, MY LIGAMENT IS WEAK, WILL IT BE ABLE TO "HOLD" AN IMPLANT?  WHAT TYPE OF DOCTOR SHOULD I SEEK OUT FOR THIS TYPE OF SURGERY .... TRAUMA SURGEON?  SPORTS MED DOC? 

ANY AND ALL ADVICE IS APPRECIATED!!!!
lateral release 2003
DVT 2003
2 failed operations to stop chronic medial sublexation
4 knee operations
10 ulnar nerve/ulnar bone ops to right arm
14 operations since 1999

Offline kimmyxs

  • SuperKNEEgeek
  • *****
  • Posts: 558
  • Liked: 3
Re: Medial dislocation of the patella
« Reply #6 on: October 03, 2006, 11:07:54 PM »
I don't know if the answer is a TKR, but the doctor you will need to see is an OS who specializes in knees.  That is true whether it is to try to correct the dislocation issues or discuss a TKR.  Maybe seeing another OS is the solution to get a second or third opinion. 
6/03/89 - First Knee Cap Disclocation
7/05/89 - Returned to work
6/17/06 - Tramatic Knee Cap Dislocation and Vertical Fractured Patella
6/28/06 - ORIF - Screws - no wires
8/24/06 - Ditched the brace - start PT
9/20/06 - First spinning
1/15/07 - screw removal, LR , VMO Advanc  & patella cleanupl















support