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Offline Elise C

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Help - pin complications?!
« on: June 19, 2007, 11:29:12 AM »
Hi everyone, I'm Elise, new to the board.  This looks like the most informative site I've ever come across about knees!

I hope someone can help me with this one.  I'm worried about a pin I had put into my tibia 9 years ago. 

I had a tibial tubercule transfer, deepening trochleaoplasty, lateral release and patella repositioning 9 years ago.  This was because a combination of bone deformity (no femoral trochlea, small high patella) and EDS type 3 hypermobility were causing ever more frequent dislocations (daily) of my knee laterally and medially.  Memory is a bit foggy now but I think the idea of the tibial tubercule transfer was to build me a more 'normal' knee joint.  The surgeon pinned a section of bone from the front of my tibia to the bottom of the knee joint / top of tibia and moved my patella further down into the knee joint to stop it dislocating.  I hope that makes sense to someone. 

Sooo, the pin is now causing me a lot of pain.  The area has always been tender over the pin, and in the last two years I have begun to dislocate my knee again, always medially, as laterally since the surgery things are quite tight.  So I have more swelling and pain generally round the knee joint, but now where the pin is seems to be more sore.  I saw an orthopedic surgeon recently who said the pin needed to come out.  I'm glad to see it go but I won't get to have the surgery for at least 18 weeks due to NHS waiting lists. 

My question is I'm beginning to wonder if there are any complications that can happen with pins?    Could the swelling be loosening it?   I have been a bit feverish on and off since the last dislocation 10 days ago - it comes and goes, just as I thing I should worry about it, it goes, but comes back again if I move around too much.  The pin is inside and has been for years, but could it get infected or anything?

Thanks in advance for any insights guys. 


Offline tanyap

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Re: Help - pin complications?!
« Reply #1 on: June 19, 2007, 01:00:26 PM »
Hi Elise,
sounds familiar - Ive had a pin in for 18 years for similiar issues - biggest difference is that there was no bone deformity.
The pin at the top of the tibia is holding down the patellar tendon - they probably moved yours slightly to try and improve stability (thats what they did to me too).
I was tender over the pin for years, and then I started to build bone over it - theres a nice definable 'lump' that is clearly visible on my leg, and if you press it its bony. Ive seen my most recent X-Rays and you can see where the bone has built up over/around the pin.
My physio says that over the years Ive 'pulled' at the patellar tendon and that bony build up is a result of this pulling, no harm done, just means ive an extra bit of boniness over the pin. Its also an attempt on my bodies part to 'smooth over' a bone protrusion i guess.
In a case like yours where the pin is causing problems they can remove them - it means that the work done to pin in the patellar tendon no longer requires the pin to hold it in - the tendon now knows where its supposed to be if you know what i mean :)
I think its unlikely that swelling can loosen the pin after 9 years - however if you have had traumatic dislocations i suppose its possible that the tendon itself has been pulling on it?
If you are concerned that you may have an infection i think you should go to your GP and voice your concerns, its your body and if you have been feverish on and off for 10 days then perhaps its time to see the doc. Explain your fears that you wonder could the pin be a source of infection - your doctor should be able to tell if that is happening.
Are you seeing your OS again before surgery? what is the surgery for? they are going to remove the pin - are they also going to try and stabilise your knee?
best of luck.
1986 - recurrent dislocations of right patella began
1988 - Modified Hauser Procedure
1991 - dislocations started again
2005 to 2007 - 150 dislocations in 2 years - OUCH!!!
June 2007 - new OS, new physio
Oct 2007 - VMO woke up
Mar 2008 - big quads, still dislocating
Apr 2008 - next OS app