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Author Topic: A dislocated knee and very vague answers given to me by hospital....please help!  (Read 9653 times)

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Offline Calimero

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Hi everyone! I'm new here.  :)

On Oct31 this year I had a fall and dislocated my right kneecap.  I went to the A & E the same night and over the course of November I had an Xray- this was done 12hours after the fall and according to the nurse who reviewed it 'everything looks normal', was referred then to the fracture clinic, where I was then told to get an MRI privately, which I did, I came back and was told that the patella *had* dislocated and popped back into place, chipping some cartilage along the way.  They prescribed a course of PT for me to do at home and told me to come back the day before Xmas Eve for a check-up to see how I am doing. 

The knee, now, is still quite swollen a month post-dislocation.  I have not been able to do a straight leg raise since the fall either.  Does anyone know why this is? Is is to do with quad muscles simply shutting down when there's trauma to the knee, or is it symptomatic of other damage? My hospital have been saying they may or may not do surgery, may or may not put me in a cast, a lot of talk of 'we'll see'.  I left my most recent appointment at the clinic feeling confused and annoyed...I've been doing my PT religiously and icing my knee every day.  I can put weight on it, and bend it quite ok but there is still loads of fluid to the above right of the kneecap.  I use crutches outside the house constantly, inside not so much.

I was wondering has anyone out there have any advice or similar stories of not really being sure at what your diagnosis really means for you?  How long does it usually take to recover from a dislocation?
Thanks so much!
Cali.

Oct31:fall in kitchen, dislocated right patella
Nov21:diagnosed after MRI
Dec23:Quads still asleep. Ultrasound shows frayed meniscus
Dec24: electro-stim 'wakes up' quads. Begin intensive PT
Feb5:RK scope,cartilage removed.

Offline fatcats6

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Hello Cali,

I dislocated my knee after a fall on 17 Oct.  Xray showed a fracture as well.  I was put in an immobilising brace for 6 weeks, rexrayed, cleared with a healed fracture, brace ditched and PT started.

SLR...they're a killer, it takes awhile for the quads and VMO to wake up, keep trying, eventually your brain and muscles will reconnect and you'll get movement.  It increases every day, expect pain in the ligaments and tendons, they've been stretched, probably some tearing.  You really shouldn;t be bending your knee until 6 weeks, fracture or not, the tendons and ligaments need time to repair themselves.

The swelling will take months to go away.  Your kneecap pushed through tissues it's not supposed to and it causes alot of damage, going out and coming back in.  Bet the bruising was pretty severe, although this should be starting to fade now.  Use your crutches outside all the time, walk carefully around the house without them.  Once you've dislocated, you're at risk of dislocating again and fairly easily I've been told.

Ice, ice and more ice, elevate it as much as you can so that you can push the fluid back towards your heart and not down to the ankle. 

The hospitals "we'll see" attitude is alittle odd.  My hospital was very decisive....in a brace, NWB for 6 weeks, re-xray, testing for instability after the immobilisation, PT, followup 6 weeks later.   Ring the Fracture Clinic and tell them you don't understand what's going on.  The see hundreds of us and I think they forget that whilst they do this all day everyday, this is a first for us and we're freaked out man!

I've been told that a straight dislocation is a quick recovery, 0-90 degrees 3 weeks after the brace is off.  Full recovery under 3 months, if everything goes to plan.

Hope some of this helps alittle.

Adrienne

Feb 08 Fractured left patella
Jul 08 Released 115 degrees ROM
17/10/08 Dislocated & fractured right patella
2/12 45 deg
6/12 Drove car
16/12 92 deg
21/1 105 deg discharged from PT

Offline Floydsters1

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Hey there. I dislocated my knee cap during a game of football. i know what you must be going through.

You are right to think that the hospital is not doing much for you because that is exactly how i felt.  The main thing to do is keep it elevated and put ice on it for 20 minutes every hour for the first 72 hours after your injury.  Then after that time period, you need to again keep it elevated and alternate between ice and a heat pack. So ice it for 20 minutes and then the next hour heat wrap it for 20 minutes and repeat.  This will allow your leg to heal alot quicker.

I didn't fracture my knee cap like you but the mri result showed that some cartilage was floating around in the knee.  I was worried at first but it's not causing me any pain whatsoever and not interfering at all.

All i can really say is look to the future and be positive as it's hard when you have been injured, and it's also hard on the people around you.

I was playing football again in 7 weeks, although i shouldn't have, but it's hard to stop yourself sometimes.  Also, if it's continually hurting then don't just put up with it. Make yourself a nuisance, and go back to the hospital, and over exgarate your problem! It's the only way.  Quiet people just end up with the problem and put up with it.

When i dislocated my knee, i thought that i'd never play again, and i wouldn't be the same on the field.  But i have come back to full fitness and my knee is now better than ever before! I also went online and researched about a dislocated knee cap, i read somewhere that 60% of dislocated knee do not require surgery, so there is hope!

Hope you get better

Gareth
Left Knee - Tear of the Lateral Meniscus (Athroscopic Surgery - Dec 08)

Right Knee- Knee Cap Dislocation - No Surgery Required

Offline tanyap

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Hi there,
My first (and worst!) dislocation sounds similiar to yours, kneecap popped out and in so it was all in place by the time I got to hospital and it was diagnosed more by my description than anything else.

Anyway, it took me around 6 weeks for it to stop hurting and being swollen. I would say 2 months after it I was almost back to normal (then I dislocated it again but hopefully this wont happen to you!!).

If I hadnt had the second dislocation Id say it would have been 3 months to be normal again. Its a pretty severe injury and takes a lot of patience and physio to get through it.

If you make it 2 years without another dislocation then youve probably beaten the odds and wont dislocate again so easily.

You hopefully wont need surgery but you will need physiotherapy, already after just 4 weeks you will have lost muscle.

Just realised the date of your post - how did it turn out?

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

Offline Silkncardcrafts

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Hi Cali,

How did things work out ?

I don't like the attitude of the hospital you went to. There is a pretty clear way that dislocations should be managed.

Swelling can often be a reason why you can not do leg raises. It will take time. Doing some PT is incredibly important to the strength back around your knee as well as your glutes and hips.

A bad dislocation can take several months to fully recover from. I hope you don't have any further problems. Good luck with your recovery. :)
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 Calimero

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Hi everyone, sorry I have been slack in replying! lots has happened the past while.

well the quads finally woke up christmas eve or so, which was amazing. I had been to my PT and she recommended this electro-treatment 'bandage' type thing called Kneehab (here's a link http://www.neurotech.co.uk/kneehab_home.php ). Withing two 20minute sessions of using it my knee 'woke up' again, cue much excitement especially as I was surrounded by family it being Christmas and all!
Now, I have been doing physio pretty intensively for the past month, bar this week where I've been a bit lazy (BAD I know...paying for it now, I don't know why I suddenly kept putting physio off, but I resumed it today). I went to the Fracture Clinic last week and got a young doc who reckoned it was about time to get an arthroscopy as it's still pretty swollen and they think some loose cartilage is bothering me.  They had given me an ultrasound where they saw 'fraying' but they were still unsure what to do at that time, as *that* was my apt immediately before Xmas where my quads were not working so they have been very conservative in my treatment until last week, really.

Adrienne, funnily enough i had no bruising except for a vaguely yellow look about a week after the fall! It's strange, I wouldn't bruise that much in general, but a small injection would still cause a little bruising so you see my surprise at the lack of bruising when I got a dislocation.

Gareth that's really reassuring to hear you're back on the field playing football again. I used to long-distance cycle for much of 2008 and loved it, but I'm confined to the static bike in the gym for now, but at least I'm able to do a little work out! TanyaP, that's awful that you dislocated more than once...I was told of the recurring risk too so I am trying to do lots of leg presses on the machine in the gym to strengthen the inside of my quad so it compensates for the hypermobility of my patella..fun fun. Kjwilkin yeah it was a pity about my initial hospital visits....I live outside Dublin (Ireland)so I go to a hospital in Dublin city centre, we've a two-tier healthcare system and I do have insurance thankfully but I was informed that I'd have to go through the public system for the most part (this was incorrect) but finally I am going private where you are instantly treated better (sad but true)...if I was going public I would have to wait for 4 to 6 months for an arthroscopy. 

Arthroscopy on Thursday yayayyay!! I've been reading some of the threads on post-op recovery so perhaps I shouldn't be looking forward to it as much as I am but the sooner the better really. Knee is still in lots of pain each day, not all day but when I move it in certain ways, and it's so stiff sometimes. It's still super swollen too. Cold does NOT help either and it's snowing at the moment  :P

Cali xx  :D
Oct31:fall in kitchen, dislocated right patella
Nov21:diagnosed after MRI
Dec23:Quads still asleep. Ultrasound shows frayed meniscus
Dec24: electro-stim 'wakes up' quads. Begin intensive PT
Feb5:RK scope,cartilage removed.

Offline Silkncardcrafts

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Hi Cali,

So pleased to hear that you have made progress with your strengthening program.

All the best with your arthroscope on Thursday. I hope it yields some results.

Sounds like our system. Fortunately I have private recover. So, always go privately.
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 tanyap

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Hi CAli,
Im in Dublin - i went public for my last op (scope to repair meniscal tear) and I only waited 6 weeks - I say the OS private though - he was great, I had a REALLY bad OS for years who kept shouting at me that nothing was wrong when it was (this is from my most recent round of problems, not from my original dislocations - which resulted in a TTT 20 years ago at the Childrens Hospital in Crumlin.).

Hope your scope goes well - who is your OS? Hopefully he is a nice one - some of them are desperate with the interpersonal skills!!!

Thats mad about the Kneehab - I have one too - theyre great arent they? Woke my VMO up for me after serious problems getting it going. Where do you go for physio?

I was scoped last MAy and walked out of the hospital same day and never needed crutches at all after it, was back in work 4 days later - overall it took 6 -8 weeks to fully heal from it and then I got onto the real work of regaining quad strength. But as surgeries go it was easy enough - I felt very sick after the GA though, that whole evening it was like a hangover without the headache. If that happens just keep having small sips of water and rest - the queasiness comes and goes. Its ok though.

Very best of luck on Thursday - will be dying to hear how it goes for you!
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

Offline Calimero

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Hey Tanya!
my OS is Keith Synott, he seems grand, though admittedly I haven't seen much of him because whenever I go to the Mater clinic I am usually seen by at least 3 different people. It's not the most consistent place in the world which made it pretty exhausting having to tell the same story and med history to every single person.

Your old OS sounds horrendous, how awful :( Glad you have a nice new one. I go for physio in Maynooth with one of the associates in Mairead O'Riordan's practice. Her name's Germaine, she's good!
Thanks for the GA advice, I've no idea what to expect in some ways as it's my very first operation.  I am feeling pretty calm about it but a bit nervous about the recovery afterwards.
Getting the quads into any kind of shape is so hard. My right leg has completely wasted, it just hangs off the bone with no muscle support visible at all! Also tons of cellulite around the injury which is very attractive. Aside from the pain and inconvenience of this whole injury one of the worst aspects for me is the weight gain....I'm quite petite 5ft 3", but I am rapidly gaining weight from lack of activity.  My doctor also *freaked* at me for being on the pill while I am not moving around that much lately, I guess he's worried about DVT, any ladies out there have similar reactions from their GPs?

Thanks for the good luck wishes, I'll let you all know how I get on :D

Cali xx
Oct31:fall in kitchen, dislocated right patella
Nov21:diagnosed after MRI
Dec23:Quads still asleep. Ultrasound shows frayed meniscus
Dec24: electro-stim 'wakes up' quads. Begin intensive PT
Feb5:RK scope,cartilage removed.

Offline Silkncardcrafts

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Cali,

All the best for tomorrow. I hope it goes well.

Thinking of you. :)
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 Calimero

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cheers!  :)

Cali
Oct31:fall in kitchen, dislocated right patella
Nov21:diagnosed after MRI
Dec23:Quads still asleep. Ultrasound shows frayed meniscus
Dec24: electro-stim 'wakes up' quads. Begin intensive PT
Feb5:RK scope,cartilage removed.

Offline Calimero

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hey guys..
started a post-op diary so that's where i'll be

Becca (Cali)
x
Oct31:fall in kitchen, dislocated right patella
Nov21:diagnosed after MRI
Dec23:Quads still asleep. Ultrasound shows frayed meniscus
Dec24: electro-stim 'wakes up' quads. Begin intensive PT
Feb5:RK scope,cartilage removed.