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Author Topic: 15 year-old son battling chronic subluxations  (Read 1332 times)

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Offline 3Diggersmom

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15 year-old son battling chronic subluxations
« on: September 13, 2008, 06:37:15 PM »
Hi I am the mother of a 15 year-old who began with subluxation problems approximately one year ago.  It was the first jv soccer game of his freshman year and his left knee subluxed.  We were very naive and had no idea what was ahead of us.  He began PT a couple times a week and wore a brace, but was out of soccer for the season.  He then subluxed again in Oct. '07 while playing pickup bball at our local Y, and then had to have arthro surgery as he had a loose body in his knee.  He continued with rehab and then got in his first jv bball game in Dec. and lasted about 15 min. before he subluxed again with his brace on. 
He continued with rehab and by Spring was seeming to be doing well.  He got another brace-a donjoy and it seemed to work better.  He played AAU basketball, went to Duke U. bball camp (a family vaca), and played in our local Gus Macker 3:3 and was fine.  We should have left well enough alone (hindsight is so painful!), but we let him play another 3:3 where he subluxed his other (right knee) on August 17.  He fractured the cartlilage behind the patella and had open knee surgery on 8/23.  The OS put 3 tiny screws in and he is now on crutches for 10 weeks and doing the PT 2x a week.  In Nov. he will have another surgery...initially arthroscopic where the OS will manipulate the knee and decide if he can leave the screws in or not.  We would lean toward him getting the screws out which will mean another open surgery, but would rather not have to go later if there were issues with the screws.  Our son and family have been devastated by this (he will lose his sophomore year of sports too) and feel looking back that we have been so naive about everything.  He does have patella alta and grew 8in. in 2 years.  While not an elite athlete he has always been a competitive athlete. He is left footed and started in soccer and is a natural point guard.  He has lived to play HS sports.  He is my oldest and has 2 younger bros., 13 and 11.  I want to know about other similar cases as I feel so helpless on how to face the future with this.  I am brand new, so forgive my long rant.  Worried Mom
9/07 Subluxations of LK began-soccer
10/07 2nd sublux of LK-basketball
11/07 Arthro of LK to remove loose body
12/07 3rd sublux. of LK-bball
1/08-8/08 PT
8/17/08-violent sublux of RK, fract cartlg behind patella-bball
8/23/08-open surgery on RK, 3 screws, NWB 10wks, PT
11/11/08-2nd surgery scheduled

Offline nappa

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Re: 15 year-old son battling chronic subluxations
« Reply #1 on: September 15, 2008, 08:36:00 AM »
Hi Diggersmom,

Really sorry to hear about your son's problems, all I can say is that you are not naive - I had subluxations for ten years before anyone listened to me and I had a release done.  I feel that you just need to keep really positive for your son's sake and find alternative sports as I feel depression can set in for people who are usually really active (I know) - not weight bearing sports are probably best like rowing, cycling (perhaps stationary first), this will keep strength up in his muscles but reduce the risk.  You are doing everything right just keep going and who knows he may find another sport that he loves.   Seek medical advice before embarking on a new exercise regime.  Sorry can't be more help.  Will be thinking of you.
Jan 2006 - Arthroscopy and LR (L)
Sept 2006 - Discharged from physio
Aug 2008 - told would not run again due to lateral muscle either snapped or wastage

Offline 3Diggersmom

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Re: 15 year-old son battling chronic subluxations
« Reply #2 on: September 16, 2008, 04:17:46 AM »
Thank you for your response.  We try to stay upbeat and don't really talk about when or if he will play soccer or basketball again.  I guess none of us want to face the fact that they may be out of the realm of possibility for him.  It hurts just to think about it.  One day at a time I guess.  Right now we are focused on recovery and staying positive.  I just never thought we'd ever be in this situation.  Thanks again. 
9/07 Subluxations of LK began-soccer
10/07 2nd sublux of LK-basketball
11/07 Arthro of LK to remove loose body
12/07 3rd sublux. of LK-bball
1/08-8/08 PT
8/17/08-violent sublux of RK, fract cartlg behind patella-bball
8/23/08-open surgery on RK, 3 screws, NWB 10wks, PT
11/11/08-2nd surgery scheduled

Offline FormerlyActive

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Re: 15 year-old son battling chronic subluxations
« Reply #3 on: September 16, 2008, 05:41:13 AM »
Really sad, so sorry. Patella alta in and of itself does not necessarily cause the subluxations. Sounds like the surgeons are fixing the symptoms, which would be of course expected but at this point they may need to go further down the road. Would make sure to have an alignment assessment in whatever form they do in your area if they haven't done so already so they get a really good understanding of his structure and any possible issues (in addition to the patella alta) which are contributing to the vulnerability of his knees.
Also he will probably continue to grow so his structure will continue to change, which could be a good thing.
What is it he enjoyed most about those particular sports? Was it the team aspect, or the release of energy, or eye-hand coordination, sense of mastery, etc.? If perhaps you can understand that, it might guide you towards some new sports for him long term.   Some of those competitive team sports are difficult to maintain as lifelong hobbies for fitness. Also does he have other skills perhaps in his life which he can focus on during this time? Is he learning languages in school, an instrument, art?

Until you are able to get really good info on what is happening with his structure and long term prognosis it will be difficult to plan future sports. But some of it also depends on how much risk he (and you) want to take of future pain, and possibly worse injuries.
I hope this is somewhat helpful. Best wishes and let us know.   
3/82 - Medial Synovial Plica removal both knees
9/89 - Lateral Release both knees
3/08 - Reinjury left knee hiking Asia Pac
5/08 - Miserable Malalignment diagnosis
4/08 - 9/08 Five doctors diff. opinions
7/08 - 02/09 - In PT, no chg.
4/09 - Dr. 6 opinion femur & tibia derotation together

Offline 3Diggersmom

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Re: 15 year-old son battling chronic subluxations
« Reply #4 on: September 18, 2008, 01:46:52 AM »
Thank you for your response!  I appreciate any and all advice I can get.  What should we be looking for in  an alignment assessment?  What exactly occurs when this is done?  Maybe they have done this and I am not aware of it?  We go back to the OS on the 29th, so I hope to ask lots of ?'s.  The OS did say that he feels that when he is done growing things may tighten up. 
My son's favorite sport is basketball.  If I had to guess what he loves most about it, it would probably be the joy he gets from performing well.  He is a point guard and has always been an unselfish one.  He loves to pass the ball and he seems to have a great instinct for it.  He is a hard worker and competitive.  I have 2 other sons who also love the game, but this one seemed to be born to play.  I am not kidding when I say this...his first word was "ball".  I really can't bear to see him continue to get hurt and have to have surgeries, be on crutches, etc., but it is so sad to think before he ever got the chance to play in HS it is over for him. 
Boy, do I wish he was diversified.  He does not care for school, but is an honor student.  He has no muscial inclination (that would be his parents genes  :-\), fine motor skills are definitely not his forte either, so art is out as well.  Sports and friends seem to be about it for him.  I really wish there was something else...I keep thinking and watching though.  I will definitely keep posting as to our progress.  thanks!
9/07 Subluxations of LK began-soccer
10/07 2nd sublux of LK-basketball
11/07 Arthro of LK to remove loose body
12/07 3rd sublux. of LK-bball
1/08-8/08 PT
8/17/08-violent sublux of RK, fract cartlg behind patella-bball
8/23/08-open surgery on RK, 3 screws, NWB 10wks, PT
11/11/08-2nd surgery scheduled

Offline FormerlyActive

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Re: 15 year-old son battling chronic subluxations
« Reply #5 on: September 19, 2008, 03:49:45 AM »
Re alignment assessment there are others who could tell you better. At Tria they talked about an Alignment Film, which I think is a standing xray where they assess the line. However there are CT studies as well. There is a physical exam where they have you stand feet together, walk, run, lie on stomach, etc. I had a gait analysis.
I was just thinking is there something new he could do which he could really own and enjoy. If he likes the ball sports perhaps golf, however that is not particularly team oriented. Could he perhaps coach younger kids? or help at special olympics, or something, which could be his and build confidence and happiness? Just some ideas.
Keep us posted on how he is. Warm wishes.
3/82 - Medial Synovial Plica removal both knees
9/89 - Lateral Release both knees
3/08 - Reinjury left knee hiking Asia Pac
5/08 - Miserable Malalignment diagnosis
4/08 - 9/08 Five doctors diff. opinions
7/08 - 02/09 - In PT, no chg.
4/09 - Dr. 6 opinion femur & tibia derotation together

Offline 3Diggersmom

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Re: 15 year-old son battling chronic subluxations
« Reply #6 on: September 30, 2008, 04:03:39 AM »
Well, we went to the OS today, as it has been 5 wks. since John's surgery.  We asked many ?'s and the OS was very patient with us  :)  Basically when we asked about alignment the doc said that John's structure is not horrible and would not lend itself to inevitable subluxations.  He really said that John has had some "really bad luck!"  It seems funny to say, but I was almost relieved to hear this.  I guess because to me it means that we are not so vulnerable?  I mean I know that everytime you sublux you are more prone to doing it again, but I just felt that there was something else we were missing and that this was going to happen forever,....hope I'm not being naive about this again  ???.  The "bad luck" seems to suggest to me that somehow we might encounter some "good luck" in the future???
The OS does think that he will open John up again to retrieve the screws, which will me longer to recover, but we will just take it one day at a time.  He did scare me when I asked about taking the screws out and how that doesn't damage the cartlge.  He said there could be a possibility that its not healed, and may not heal.  That would stink to think we've gone through all of this and couldn't save the cartlge anyway.  Has anyone had this type of injury/surgery?  Did you leave your screws in?  Have them out?  What should we expect?  Thanks!
9/07 Subluxations of LK began-soccer
10/07 2nd sublux of LK-basketball
11/07 Arthro of LK to remove loose body
12/07 3rd sublux. of LK-bball
1/08-8/08 PT
8/17/08-violent sublux of RK, fract cartlg behind patella-bball
8/23/08-open surgery on RK, 3 screws, NWB 10wks, PT
11/11/08-2nd surgery scheduled