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Author Topic: Recently diagnosed with Patella subluxation  (Read 8448 times)

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Offline Drackonn

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Recently diagnosed with Patella subluxation
« on: May 14, 2010, 05:07:26 PM »
After finally seeing my orthopedic, I have been diagnosed with Patellar subluxation in both of my knees. I have 6 weeks of physical therapy to try and strengthen the inner quad muscles and if I do not see an improvement the doctor wants to talk to me about surgery. So we will see. I am happy to finally know what has been going on with my knees though.

in the mean time, I was wondering if anyone could tell me if something like this brace will help me? http://www.sportsauthority.com/product/index.jsp?productId=1822148&cp=694043&view=all&parentPage=family

I train in braziliam jiu jitsu to stay in shape, but have not be able to actively participate in live rolling at the end of class due to my knees, but now that I know what I have I am trying to see if this is a good option to hold the patella in place?

Thank you so much in advance

RugbyGal

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Re: Recently diagnosed with Patella subluxation
« Reply #1 on: May 14, 2010, 05:28:18 PM »
you are better off with this sorta brace which has a soft rubbery thing at the side to prevent ur kneecap from subluxing

http://www.donjoy.ca/en_CA/detail_Patellofemoral_Bracing2_21659_15881.html

I have used it  before which helped in my rugby games however from my personal experience PT will improve the state of the condition of ur knees but ultimately you would probably need surgery

Offline Drackonn

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Re: Recently diagnosed with Patella subluxation
« Reply #2 on: May 14, 2010, 06:02:04 PM »
you are better off with this sorta brace which has a soft rubbery thing at the side to prevent ur kneecap from subluxing

http://www.donjoy.ca/en_CA/detail_Patellofemoral_Bracing2_21659_15881.html

I have used it  before which helped in my rugby games however from my personal experience PT will improve the state of the condition of ur knees but ultimately you would probably need surgery

Thank you so much, I will see if I can find something like that at a local sports store, if you dont mind me asking did you have surgery for the same problem? and if so how do your knees handle rugby after the surgery? Im asking because I am concerned about how well I will be able to perform in BJJ if I need the surgery.

RugbyGal

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Re: Recently diagnosed with Patella subluxation
« Reply #3 on: May 14, 2010, 07:08:35 PM »
You might need to order it from the store.  I did have 3 surgeries to correct this problem under one operation.  The doc did reassure me that I can return to rubgy later on.  At the moment its been almost 7 months (which is actually considered early days)  and I can do some jogging, deadlift, and squat.  Ive doing yoga for 3 months already but I m looking to learn Muay Thai at the end of this month

Offline anniehine

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Re: Recently diagnosed with Patella subluxation
« Reply #4 on: May 14, 2010, 07:18:18 PM »
Hi Drackonn,

Patella subluxation just means that your patella's sublux..but it doesn't explain why which is really what you want to know.  A lot of people on this site will have subluxing patellas but there are lots of different issues and surgeries.  Did your doctor do any x-rays or scans to see why this is happening?

I, like Rugbygal had problems with my trochlea which is the groove the patella sits in and so had to have surgery to create an adequate groove.  The surgeon found this out by doing a C.T. scan and taking X-Rays.  A subluxing patella could be down to many reasons though so it's very important that you see a patella specialist.

Good luck and let us know how it all goes!

Annie  :)
Left knee started dislocating at 7 years old
Hypermobile
Arthroscopic scope April 2009
Trochleoplasty at 28 years old (10.2.10)
Did 1st SLR 1.4.10 WHOOP!!
Walked through house without crutches (12.4.10) very pleased with myself!!

Offline crankerchick

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Re: Recently diagnosed with Patella subluxation
« Reply #5 on: May 14, 2010, 08:13:56 PM »
I agree with Annie. I'm curious as to how your doctor arrived at the diagnosis of patella subluxation.

Do you just have pain in your knees or are you kneecaps actually unstable? Patella subluxation means your patella leaves the trochlear groove it sits in but goes back on its own. It can also mean your patella is subluxed in the sense that it just sits partially out of the groove. In almost all cases the subluxation is lateral, or towards the outside of the leg.

Physical therapy, taping, and bracing are good conservative treatments to start. It may take longer than 6 weeks to see results though. If your problem is mechanical/structural in nature, there is only so much that strong muscles can do for you though. That is why it is important to have a solid diagnosis of the root cause of your problems, so the treatment course most likely to work can be embarked upon.
Mar '07 - plica excision
Oct '09 - femoral + tibial derotational osteotomy & TTT
Aug '10 - hardware removal
"You control your leg. Don't let it control you." -Smart trainer
"Get your a$$ in gear and go for it! Nothing will happen until you make it!" -Smart doctor

Offline doublemom

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Re: Recently diagnosed with Patella subluxation
« Reply #6 on: May 15, 2010, 04:05:19 AM »
^^^ Ditto exactly what Annie and Cranker said ^^^  You need to have a diagnosis of WHY the patellae are not lined up properly.  There are many different things that can misalign them, and treatment depends on what the root cause is. 

Andi
2000 R patella dislocation
2004 - Soccer injury - LK medial and lateral meniscectomies
2007 - Dx patellar tilt, lateral subluxation, grade III chondromalacia
5/13/08 - RK medial/lateral meniscectomies & patellar chondroplasty
4/6/2010 - RK TTT/LR scheduled

Offline Drackonn

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Re: Recently diagnosed with Patella subluxation
« Reply #7 on: May 15, 2010, 01:54:14 PM »
My orthopedic took x-rays, on the spot, the reason for the physical therapy is that my muscles on the outside of the knee are stronger than the ones on the inside of my leg, from what I understand this is a common problem?

This happened to me a lot when I was a child, my knee would feel like it would dislocate and then pop itself back into place during certain activities, or sitting in a weird position etc ... the doctors at the time told my mother I was "double jointed" (which I understand is a common misused term for being hyper mobile) and that I would grow out of it, but they were always concerned about the fact that my knee cap seemed to be in the wrong place ... for whatever reason it stopped for a long time although my knee cap still didn't look right the "dislocating" feeling stopped for the past 8 or so years, but I also stopped being physically active about that time, and has come back since I started training in BJJ about 1.5 years ago.

First of all thank you so much everyone for the replies and concern, I found knee braces like the ones suggested at a local store, and used them last night during sparring in BJJ, I cant really decide if they helped or not, they move around a lot and kind of annoy me. So here is my long response.

From what the doctor explained to me my patella tracks terribly to begin with, when I bend my knee my patella moves laterally as it moves up towards my thigh (towards the outside of my knee) and when he was checking my knee out, the patella will moves laterally very easily by just poking at it.

From what I understand he states that my patella tendon is actually attached in a weird spot on my bone which causes the bad tracking, and the muscles in my leg being disproportioned does not help the situation.

So to answer questions, I have pain in both knees, they feel weak and unstable, and pop/click constantly. both of my knees suffer from the subluxation, and iit happens during almost all types of physical activity.

The orthopedic I saw is a knee specialist, I live in Florida in the US, I know most of you are UK based, does any of this make sense?

Offline smillie

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Re: Recently diagnosed with Patella subluxation
« Reply #8 on: May 15, 2010, 05:07:17 PM »
A lot of us are actually in the US too.  You'll see a good mix of UK, US, Canada, Australia, with a little NZ, and other places around the world thrown in.  The interesting thing is seeing the differences in treatment and procedures done in the various countries. 

It is very common for an OS to see someone with patella tracking problems and send them to PT to strengthen their quads to see if that will tighten things up and pull the patella back into a good alignment.  That is a very general thing to do for patella tracking.  Other things that are generally done are lateral releases and tibial tubercle transfers (moving the patella tendon like you described).  The problem is that while these procedures can help, if there isn't a really good understanding of what your underlying problem is, they may not be done in a way that will help you.  What you will learn after hanging around here a while and reading about others' experiences and going to the information hub and reading the course on patello-femoral problems is that there are a lot of issues within the knee and leg that can cause the actual tracking problems.  So you will see everyone here encouraging you to see an actual patella specialist because that is someone who can really look for the underlying problem of your tracking and subluxing.  They have to look at the alignment of your bones, the depth of your groove, the position of your tendon, etc.  There are a lot of us on here who have had the TTT and LR and other procedures along with lots of quad strengthening, but haven't had our problems fixed to the extent we need because our doctors did the procedure without a full enough analysis of our problems.  Having a TTT to move that patella tendon can be great if your OS puts it down in the right place.  Or you can end up like many of us who have had it moved but it wasn't done as well as it should have.

So that is where the concern and caution comes in.  Read read read, ask tons of questions, and then talk further to your OS to be sure you are comfortable with his understanding of your knee and plans for the surgery.
patella pain began early teens
'94 TTT/LR/VMO adv.
'94 MUA
'10 tried PT again
1/11 scope/hardware removal
4/11 (Finally!) dx medial instability due to LR
5/9/11 LPFL reconstruction scheduled

Offline crankerchick

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Re: Recently diagnosed with Patella subluxation
« Reply #9 on: May 15, 2010, 06:02:36 PM »
Smilie said it brilliantly. The only thing I would add is you need the following:

- Lateral xray standing with leg bent to 30 degrees flexion
- Full leg length xray of leg to look for a knock knee or bowed legs malalignment
- xray of legs bent to various degrees of flexion. My OS does this standing now.
- CT scan to look for rotational deformity and among other useful things reveal the position of the tibial tubercle

A lot of doctors will do various procedures because they are common to do, but you have to go with the OS that will look at you as an individual and what your knee needs.

Pt bracing and taping are good starts and should be exhausted before going a surgery route. But it sounds like your problem is structural, so its important to get to the root cause.
Mar '07 - plica excision
Oct '09 - femoral + tibial derotational osteotomy & TTT
Aug '10 - hardware removal
"You control your leg. Don't let it control you." -Smart trainer
"Get your a$$ in gear and go for it! Nothing will happen until you make it!" -Smart doctor

Offline Drackonn

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Re: Recently diagnosed with Patella subluxation
« Reply #10 on: May 15, 2010, 06:53:31 PM »
Thanks everyone again, I will continue reading more, my OS did xrays from the side with me bending the knee (each knee), I couldn't give you an actual degree though, and me sitting down with my legs bent, knees by my chest with the xray machine in front of me, low aimed up at my knees, one of the back of my knees standing straight, and front of my knees standing straight.

I have not had a CT scan.

no one has ever told me my legs had any type of abnormality and I have had them looked at multiple times since I was young because of all these problems.

Is there any easy way to tell if I am possibly bow legged or knock knee'd without going to the doctor?
« Last Edit: May 15, 2010, 07:08:36 PM by Drackonn »

Offline Drackonn

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Re: Recently diagnosed with Patella subluxation
« Reply #11 on: May 17, 2010, 02:33:33 PM »
Sorry to double post but I had a question, when I was a child and this happened all the time I was extremely flexible, I could splits, I could put my foot behind my head etc ...

As time went on I did not keep up with it and I lost most of this flexibility. Since starting BJJ I have become much more flexible again, not to the extent that I was (I don't think that will ever come back) but people are still amazed at my flexibility.

It seems as soon as I got flexible again, the knee problem started again .... how is this related? my muscles/ligaments being tight kept the patella in place?

Offline anniehine

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Re: Recently diagnosed with Patella subluxation
« Reply #12 on: May 17, 2010, 04:31:14 PM »
Hi Drackonn

Personally I would imagine you are having problems because you've become more active and are probably moving your legs in ways you don't usually (sorry for my absolute ignorance of BJJ)!  I used to be able to do splits and put my leg round my head when I was younger too, think it's just a hypermobile thing and unfortunately it seems to go hand in hand with knee problems.

Just reading one of your earlier posts and you said your knee moved to the outside of your leg when you bent it.  Have a look at this video on YouTube, does it do this? Mine used to do this before my trochleoplasty and I wonder whether you have the same thing? 

http://www.youtube.com/watch?v=88cLnHG_TCE
Left knee started dislocating at 7 years old
Hypermobile
Arthroscopic scope April 2009
Trochleoplasty at 28 years old (10.2.10)
Did 1st SLR 1.4.10 WHOOP!!
Walked through house without crutches (12.4.10) very pleased with myself!!

RugbyGal

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Re: Recently diagnosed with Patella subluxation
« Reply #13 on: May 18, 2010, 02:03:24 AM »
haha! yeah mine was even worse before the surgery.  My doc actually taped mine the before and after op..and I could see a major diff

RugbyGal

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Re: Recently diagnosed with Patella subluxation
« Reply #14 on: May 18, 2010, 07:56:42 AM »
er NO! its not a really a particularly helpful video anywayz.  yes it does show the before and after but it doesnt show me doing sports or going back to rugby or anything or is it any evidence that I return back to my contact activities. 















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