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Author Topic: Subluxed or mal-tracking patella??  (Read 27300 times)

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Offline austinknee

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Re: Subluxed or mal-tracking patella??
« Reply #45 on: February 04, 2008, 06:01:55 PM »
Wow...thats too bad that it keeps doing that.  I guess I would give the OS one more shot at it...let him see you Friday and see if he is passive again. If he doesn't seem concerned about it you might seek out an additional opinion.  If he seems to think it is no big deal...then ask him What is the etiology of that sharp pain you are having....if he can't tell you then he is just hoping it will go away...if he has a clear reason and can tell you why the PT might continue to help it then you can continue that course of action.   The wait and see thing is really annoying if you dont know what you are striving towards.    I know that my first OS kept telling me that my problem was normal...keep going to PT...etc....finally the PT told me to go get a second opinion...the next doctor..and all the others after him said I have a real problem.  Not sure why the first guy didnt want to deal with it. ...... 

Hang in there!  Good luck on Friday! 
LR 11/2006
LR Reconstruction scheduled 2/08

Offline arkitect06

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Re: Subluxed or mal-tracking patella??
« Reply #46 on: February 04, 2008, 06:26:53 PM »
yuntigrl:  It sounds like you are going through what I did for 6-7 years!  Sharp pains, wondering, waiting, therapy year after year.  I got stronger, but the pain was still there.  Nothing helped and it wasn't until October 2007 that they figured it out after seeing 3 different docs over time and having 1 surgery in 2002. I would find an OS that is a patella specialist! They can usually pin point the problem pretty quickly...at least once I went back to mine after 2 yrs, he figured it out right away from x-rays and examination b/c it had gotten so bad over the time I wasn't seeing him.  Good luck!

Farrah
11/16/10 Fulkerson TTT, chondroplasty, LR (Left Knee)
11/17/09 SCS re-implant
7/29/09 I&D
5/7/09 SCS removal b/c of MRSA
12/15/08 & 2/6/09 SCS Revision
10/30/08 Spinal Cord Stimulator Implantation
6/27/08 diagnosed with RSD
1/8/08 Fulkerson TTT, chondroplasty, LR (Right Knee)

Offline austinknee

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Re: Subluxed or mal-tracking patella??
« Reply #47 on: February 04, 2008, 09:00:44 PM »
Farrah, what did yours turn out to be?
LR 11/2006
LR Reconstruction scheduled 2/08

Offline arkitect06

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Re: Subluxed or mal-tracking patella??
« Reply #48 on: February 05, 2008, 04:07:34 AM »
Patella subluxation mainly... which has caused all kinds of cartilage problems.  The cartilage isn't bad enough down to the bone yet.  Since my surgery on Jan 8, the pain has persisted through today.  So I imagine that my knee cap is still rubbing on something to cause future problems.  I may have another surgery in a few months.  I find out more on Feb 15th.  I hope he can fix me.  My OS already told me before surgery that he may have to fix some more problems that I had.  He couldn't fix them until he fixed what he did no Jan 8.  So we'll see how it goes.  Go find a Patella specialist!!  :)

Farrah
11/16/10 Fulkerson TTT, chondroplasty, LR (Left Knee)
11/17/09 SCS re-implant
7/29/09 I&D
5/7/09 SCS removal b/c of MRSA
12/15/08 & 2/6/09 SCS Revision
10/30/08 Spinal Cord Stimulator Implantation
6/27/08 diagnosed with RSD
1/8/08 Fulkerson TTT, chondroplasty, LR (Right Knee)

Offline austinknee

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Re: Subluxed or mal-tracking patella??
« Reply #49 on: February 05, 2008, 05:20:18 PM »
Very interesting.  I have sharp pains too and they say I have medial subluxation. It is definately when I am in certain positions....and at specific degress of extension/flexion....what a pain in the butt.  Im afraid that what happend to Farrah is happening to me......that every time I have that pain or a pop I am rubbing off the cartilage.  Will see how much I have left on Friday.  Hearing the post op results may be depressing if I get even MORE bad news...sometims I think I cant take it...just want some good news for once!

LR 11/2006
LR Reconstruction scheduled 2/08

Offline arkitect06

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Re: Subluxed or mal-tracking patella??
« Reply #50 on: February 05, 2008, 06:02:41 PM »
Good news would be letting you know exactly what the problem is and how to fix it!  Hopefully that is what you will get!!  Good luck!

Farrah
11/16/10 Fulkerson TTT, chondroplasty, LR (Left Knee)
11/17/09 SCS re-implant
7/29/09 I&D
5/7/09 SCS removal b/c of MRSA
12/15/08 & 2/6/09 SCS Revision
10/30/08 Spinal Cord Stimulator Implantation
6/27/08 diagnosed with RSD
1/8/08 Fulkerson TTT, chondroplasty, LR (Right Knee)

Offline yuntigrl

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Re: Subluxed or mal-tracking patella??
« Reply #51 on: February 06, 2008, 12:18:13 AM »
So Farrah...how exactly do they determine that the patella is subluxing???  I can't duplicate the symptom on command...it just happens.  Is there something that is obvious in the MRI or x-ray?  I always thought my patella was off after my ACL recon...my good knee my patella was flat and centered, on my bad knee my patella seemed to be off kilter.  I asked my PT about it (way back when...) and she didn't see what I saw. 

Austin...keep us posted.  I'll be thinking of you.  Kathy
Tore ACL March 1992
Fixed ACL Patellar Graft March 2005 (That's right 13 years later)
TKR Sept 08

fawn2388

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Re: Subluxed or mal-tracking patella??
« Reply #52 on: February 06, 2008, 01:03:52 AM »
Sometimes and MRI/Xray will show a patellar tilit... have you had to the XRay while holding the film while your knee was bent... it's called a sunshine view. Most of the time if your knee is subluxing over time your cartiagle will wear off, but if it isn't showing up it may be doing it minor - have you done taping, and if so did it improve?

Offline arkitect06

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Re: Subluxed or mal-tracking patella??
« Reply #53 on: February 06, 2008, 05:52:27 PM »
What fawn said is right.  During my last set of x-rays before my surgery, my doc pointed out how far away my patella was from the groove after the sunshine view x-ray.  He said if I were to squat up and down with a camera in there he could see it happening.  He also did an exam and could feel it while I laid on my back and he extended my knee out and in.  I could feel it popping and grinding and he could feel it moving.  That is bone rubbing on bone...wearing down the cartilage.  My knees have been doing that for years. He also manipulated my patella in different ways to cause my usual pain and to see how far in and out my patella would move while it was straight.  Too bad he couldn't figure it out years ago before the grinding started! 

During my first PO x-rays I saw that my patella was in the groove!!  It was amazing to see the differences!  I still have other problems within my knee like worn down cartilage and a shallow trochlear groove.  So he warned me that I could still have pain and some subluxing after the surgery.  He said that I had a 90% chance of the Fulkerson TTT to work.  If not, then he could fix the other problems.  No matter what he had to fix the other thing first.  Unfortunately 4 weeks PO I am having all the same pain and some popping.  So lucky me.  I will find out what he thinks about it next week during my 2nd PO appointment on feb 15.  Good luck beth!

Farrah
11/16/10 Fulkerson TTT, chondroplasty, LR (Left Knee)
11/17/09 SCS re-implant
7/29/09 I&D
5/7/09 SCS removal b/c of MRSA
12/15/08 & 2/6/09 SCS Revision
10/30/08 Spinal Cord Stimulator Implantation
6/27/08 diagnosed with RSD
1/8/08 Fulkerson TTT, chondroplasty, LR (Right Knee)

Offline austinknee

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Re: Subluxed or mal-tracking patella??
« Reply #54 on: February 06, 2008, 06:55:47 PM »
Hi... I was told my subluxing occurred by several methods.  My sunrise view is "normal" but that only shows your patella in one certain angle.  I had two different things. I had a "Dynamic CT scan"  The put me in the machine..at numerous differnent angles......both knees for comparisson.  flat, 30, 45, 60, 90, etc degrees...   They had me lay still...then they would ahve me tighten my quad to see what happened.  only at certain degrees of flexion did I subluxate.   Another doctor did the same sort of thing....he had me do just the one leg..but sort of the same way...in an MRI machine.....The CT scan showed subluxing..and the MRI machine did not.  Who knows.    A doctor in San Antonio had me lay on my side.....on my good side...he held my bad leg out in the air at full extension. He had me totally relax my leg....so it was wiggly...then he showed me how my patella totally fell out of the groove.....when I tighten my quad it woudl pull the patella back up...so I guess that was a good sign.   He then had me sit flat on the table with my legs at full extension...he could pick my patella up and turn it on its side to a sharp angle...and sorta pick it up out of the groove.  I think one of my MRIs said I have a shallow femoral groove too.   Anyway....that is how I was told that I have medal subluxation.  ALSO....my PT started taping my patella from the outside towards the inside at three differnt directions. It helped me a great deal and my all day pain and slight burnign sensation decreased a LOT.

Hope that helps.   
Laura
LR 11/2006
LR Reconstruction scheduled 2/08

Offline arkitect06

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Re: Subluxed or mal-tracking patella??
« Reply #55 on: February 07, 2008, 01:43:10 AM »
That CT scan sounds cool!  I didn't have any other tests.  Once out of surgery though, he said that it was subluxing a lot and that he was glad he fixed it.  My other knee does it too. 
11/16/10 Fulkerson TTT, chondroplasty, LR (Left Knee)
11/17/09 SCS re-implant
7/29/09 I&D
5/7/09 SCS removal b/c of MRSA
12/15/08 & 2/6/09 SCS Revision
10/30/08 Spinal Cord Stimulator Implantation
6/27/08 diagnosed with RSD
1/8/08 Fulkerson TTT, chondroplasty, LR (Right Knee)

Offline yuntigrl

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Re: Subluxed or mal-tracking patella??
« Reply #56 on: February 07, 2008, 01:57:38 AM »
Hey all!  Was home with a sick grandchild Monday and Tuesday so I missed my Monday PT.  Curiously enough my knee didn't bump and grind since Sunday afternoon.  I had PT today and my therapist got a copy of my MRI.  She said the MRI indicated I have no medial meniscus.  I knew the OS cleaned it up a bit during the ACL, but didn't know he took it....or is it possible that he did just clean it up...and something else happened since then?  Is that possible??  I'm wondering...my Physical Therapy after the ACL recon was a typical ACL recon.  Wouldn't it have been different with the removal of the meniscus?  Just wondering.  It does feel like bone on bone though when it acts up...I guess.  I don't think God intended for our bones to kiss like that!!  Sorry...just my sick humor.

Austin..are you going to have access to a computer while in Atlanta??  I'm excited for you and can't wait to hear how it goes.  Don't be nervous!  

I want you guys to know how much I appreciate your input.  The folks around here look at me like I'm nuts....this has been going on for well over a month now, and I am not the type to be limping around like an 80 year old....with no answer.   Ahhhh, I want to be a kid again.  Have a great one.  Kathy
Tore ACL March 1992
Fixed ACL Patellar Graft March 2005 (That's right 13 years later)
TKR Sept 08

Offline austinknee

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Re: Subluxed or mal-tracking patella??
« Reply #57 on: February 07, 2008, 02:19:27 AM »
Thanks...yes, I will take my computer. Not sure if I will have it in the hospital or not.....no clue if they have wireless or what.  I hope to start a  post op report tomorrow night after I see the doctor to say what he plans to do exactly.  Im trying NOT to be nervous...but I am...my gut feels like I ate something terrible today...but it is just nerves.   Funny, I didnt have any nerves before my first surgery. This one seems so much more critical to me.....sorta like it COULD give me my life back. thats a pretty big deal.....and, yes, like you said...NO one gets it.  Everyone says...Oh you will be "fine"......they dont get it.   I should have been fine last time...but here I am......

Funny..I was at work today. I have worked in this medical office since 1999 with many of the same people this whole time  One doctor was nice, he took some pre op pics of my knee for me and will email them to me, said he will say a prayer etc.......One doc had no clue I was taking off...and didnt seem to care.......One woman brought me a nice gift pack of nutritional bars and a funny card (we used to do triathlons together)...and another woman who is supposed to be a "good friend"  left work today without even wishing me luck...just breezed out the door. I was pissed... never asked a ThING today even though everyone knows Im taking off   Funny how insensitive some selfish people can be. Oh well..

I should be packing but Im stretched out on the couch trying to tell my stomach that tying itself in a knot will not let it stay home.   Packing for a two week out of town surgery is hard.


About your MRI report...I dont think they would take the meniscus out without telling you....but, then again...I had all sorts of things on my operative report that no one told me about eiither.  They open you up and just start pulling out parts.  Sorta like a hair stylist that just keeps cutting too much hair......  Im glad that they grinding stopped for you over the weekend.   

You know, oddly enough.. I have not done PT since December 17th when my insurance dumped me...said I was "well enough"....and since I stopped.....my knee doesnt burn as much, my sciatic is normal again and my calf nerve isnt kiilling me. I think the knee cap likes it better when I DONT try to use my quad......

Ok. Have to get up and at least start SOME packing.  Will post tomorrow night!

Laura
LR 11/2006
LR Reconstruction scheduled 2/08

Offline yuntigrl

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Re: Subluxed or mal-tracking patella??
« Reply #58 on: February 07, 2008, 03:57:57 AM »
I forgot to answer the question...yes I had a sunshine view x-ray...doc said it looked normal, but after reading all of your stuff I'm beginning to wonder....

My PT showed me how to tape from outside inward.  I use my patellar graft scar as a landmark, and pull the patella medially.  I feel like I rely on the tape now...I'm afraid to be without it.

Austin I'm sorry your co-worker failed to acknowledge the fact that you are facing something pretty darned significant.  I know that hurts.  The world is full of selfish folks....I hate that.

Hey, don't worry too much about packing...just make sure you have enough fresh undies!!!  Made ya smile!!!!!  Hey, and you probably don't even have to pack a pair for surgery day...my hospital here took mine away when I was prepping for surgery!!! :o  First thing I did when I got up to my room was get my hubby to help me 'drawer up'.  I'm not fond of being commando!!! 

As for the PT...anything closed-chain seems to be better.  Anything that requires the influence of gravity seems to be the catalyst for the bump and grind, and I don't know why.  Maybe it has to do with the contraction of the quads.  Hanging my knee straight down is fine.  Doing hamstring curls is fine.  Getting in and out of my car with my leg at an angle is ... not at all fine.  The gravity and the angle tweaks the knee.  I wish I knew.  My PT told me today that she thinks it might be time for a new knee....I think I'm too young.  Maybe I'll know more in a few days.

God Speed!!!  I'm anxious to hear all about it!  Kathy
Tore ACL March 1992
Fixed ACL Patellar Graft March 2005 (That's right 13 years later)
TKR Sept 08

Offline tanyap

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Re: Subluxed or mal-tracking patella??
« Reply #59 on: February 07, 2008, 09:41:37 AM »
Hey austinknee - very best wishes on your surgery - i know its impossible NOT to be nervous but try not to be nervous!!! Tell them in the hospital that you feel a lot of anxiety and they might give you some anti anxiety meds - help stop you from freaking out!!

Dont worry about your co-worker not taking an interest, some people are only interested in themselves. We are all cheering for you here so remember that!!!

yuntigirl - my knee always feels much better initially when I dont do my PT also :) would put you off wouldnt it??? The thing to remember is that the PT hurts cos your knee is not used to having those quads contract normally and you need to get it recognising that its ok to contract them by doing the PT. Also an relatively unsupported joint (from weak quads) is gonna hurt from exercising it til you get the quads really strong.

They call those Skyline View x-rays here, mine is posted somewhere on this site - looks horrible, my patella is so close to bone but the OS says that its just not held in the right position cos the muscular support isnt there.

Austinknee - yuntigirl said it best - God Speed to you - we will all send the good vibes and await your post op posts!
xx
Tanya



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