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Author Topic: advice for patella femoral  (Read 1186 times)

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Offline dwrucke

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advice for patella femoral
« on: August 23, 2007, 09:18:05 PM »
I just got back from my OS, PT hasn't worked for my patella femoral syndrome, in fact it has made the pain worse then before I stared because it was so aggravated, anyways, the doctor gave me a cortisone injection to see if that would help (it hurt pretty bad). My question is he said that if this doesn't work he wants to scope my knee and scrape underneath the patella. Any advice if this is even worth it and will help at all? Thanks
1992- Ligament surgery
2002- Lateral Release
2007- Lateral Release, Chondroplasty, Meniscus repair

Offline april

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Re: advice for patella femoral
« Reply #1 on: August 23, 2007, 09:28:45 PM »
Hey drwucke,

What kind of things were you doing in your PT for patellofemoral pain syndrome?

I was just diagnosed with that recently. I was told by a doctor that some of the exercises I was doing before, like straight leg lifts, aggravate it (confirmed what I was experiencing already). My new PT put tape on my knee to prevent the patella from tracking too far laterally -I found that that helped a little. Maybe that's something you can try if you haven't already? Patellar tendon straps are also supposed to help with maltracking issues, I found it was helpful in general for taking the load of the tendon to prevent aggravation of tendinopathy, which I also have, but not so helpful with the patellofemoral pain.

Why does your OS want to scrape your knee? Is there evidence of chondromalacia as well?

Offline dwrucke

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Re: advice for patella femoral
« Reply #2 on: August 23, 2007, 09:43:26 PM »
There is chondromalacia, they've tried taping, three different knee braces. My PT consisted of water exercises, bike, squats, and other quad exercises.
1992- Ligament surgery
2002- Lateral Release
2007- Lateral Release, Chondroplasty, Meniscus repair

Offline eaglemom

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Re: advice for patella femoral
« Reply #3 on: August 23, 2007, 10:48:40 PM »
When I was having patella femoral pain I started using a form roller.  It hurt like everything - very sore the next day.  However after being very consistant with it the pain did start to settle down some.  I then had a theraputic massage just in that area - wowie, now that was difficult.  However, after the massage and several days of being sore its slowly gone away.  I find its easier if someone strong roller the foam roller on that area as I can lay back.  However, during the day I do it on the floor.  My only problem is getting up and down off the flooor.  Its helped me.  Good luck.

Offline costumer

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Re: advice for patella femoral
« Reply #4 on: August 24, 2007, 12:54:59 AM »
There is chondromalacia, they've tried taping, three different knee braces. My PT consisted of water exercises, bike, squats, and other quad exercises.

        Out of curiousity: have you always had PFS (born that way) or has it suddenly happened from an injury or something?

         when I was starting PT after my arthroscopies, I was talking with my first (and best) PT about how to handle excersizes with PFS. I told her that people kept wanting to put me on the bike because it's so good for strengthening the quads - but that I would refuse to do it because it always made me worse (I have always had PFS). Interestlingly, she commented that she has heard and seen that many PFS patient do NOT do well with the bike, so she doesn't use it unless it's requested! Personally, unless i knew that my patella was tracking straight already, I'm not sure I'd be willing to do the squats, either. But then.. I'm a difficult patient.  ;)

            -Judy
Dx: bi-lat subluxating patellae w/chondromalacia 4/1977
6/78 LR - LK
1/80 TTT-Hauser LK; 12/80 Proximal Realignment Mystery- RK
1/82 Maquet TTT- LK
11/06 Meniscectomy; Mild OA- RK, 12/06 Meniscectomy; Mod OA- LK
3/07 Bi-lat severe arthritis
9/18/07 bi-lat TKR

Offline dwrucke

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Re: advice for patella femoral
« Reply #5 on: August 24, 2007, 01:20:58 AM »
I am a horrible patient, we know my patella doesn't track right, never has, probably never will. The lateral release didn't work so no one at this point knows what to do because my joints are so loose. The shot is supposed to help me be able to do my pt
1992- Ligament surgery
2002- Lateral Release
2007- Lateral Release, Chondroplasty, Meniscus repair

Offline kaci74

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Re: advice for patella femoral
« Reply #6 on: August 24, 2007, 04:22:05 AM »
I had a lateral release and my kneecap scraped about 10 years ago.  Before I went through surgery I suffered through 6 months of PT for patellofemoral pain.  The surgery went well, but as I recall it's not a cure (the lateral release is only a fix for a while, until the muscles get out of whack again).  I am back in PT for the same type of pain as before.  My new PT thinks the pain is caused by poor knee mechanics which a scrape will probably not fix.  I would ask your OS about whether or not the surgery he or she is proposing will last several years or be temporary.  On the other hand, a scope may find something that the x-rays/MRI/CT Scan could have missed.  If you have any doubt, get a second opinion. 

Regards,
Kaci

Offline costumer

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Re: advice for patella femoral
« Reply #7 on: August 25, 2007, 03:11:51 PM »
I am a horrible patient, we know my patella doesn't track right, never has, probably never will. The lateral release didn't work so no one at this point knows what to do because my joints are so loose. The shot is supposed to help me be able to do my pt

   ok, so if you're like me and have always had maltracking - and it's not from some injury or something 'out of the blue'...  I'm not surprised the LR didn't work. didn't work on me either (and didn't work on an awful lot of people on this board! I suspect it's a pretty low track record). What seems to have helped more were the TTT and the proximal release procedures. I had a TTT on my left leg - they have a newer procedure now than the one I had, and the proximal release was on my Right leg). The TTT involveds a lot of bone rearranging, the PR involves all soft tissue rearranging. So there are at least 2 more things your OS can do.

    I found out that my Tibial Tuberosities had developed a bit laterally on my tibia, no amount of excersizes was ever going to make the patellae track straight when the attachment is offset! Surgery is annoying and painful, but if it can help... it's better than crawling up the stairs.  ;)

               -judy
Dx: bi-lat subluxating patellae w/chondromalacia 4/1977
6/78 LR - LK
1/80 TTT-Hauser LK; 12/80 Proximal Realignment Mystery- RK
1/82 Maquet TTT- LK
11/06 Meniscectomy; Mild OA- RK, 12/06 Meniscectomy; Mod OA- LK
3/07 Bi-lat severe arthritis
9/18/07 bi-lat TKR