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Author Topic: Patella Subluxation Sugery: Two Doctors, Two Suggestions  (Read 887 times)

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Offline DJ Knee Cap

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Patella Subluxation Sugery: Two Doctors, Two Suggestions
« on: June 08, 2010, 07:26:33 PM »
5 years ago I subluxed my knee cap playing high school football and I partially tore my medial patellar supporting ligaments. At that time, I neglected to do any surgery and I was back on the field within the month.  The ligaments apparently healed themselves considering over the last 5 years I have not had any reoccurring knee cap injuries and I now play collegiate basketball.  This, of course, was until recently.  Two weeks ago I subluxed the same knee cap playing basketball.  The MRI shows about a 1/3 to 1/2 tear of the medial patella retinaculum.   I have obtained two opinions: one doctor suggests surgery while the other opposes. I want to know if there is a known probability of re-subluxation if I choose NOT to get surgery. My senior year basketball season starts on Oct 15 so I need to decide if I'm getting surgery NOW.   Recall that I had this same injury 5 years ago and, well, I was perfectly fine for 5 years worth of basketball, football, frisbee, volleyball, running, lifting etc.

Any thoughts or comments are greatly appraciated.


DJ Knee Cap

Offline DJ Knee Cap

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Re: Patella Subluxation Sugery: Two Doctors, Two Suggestions
« Reply #1 on: June 09, 2010, 04:11:39 PM »
Hmmmmm. 50%, eh? Any chance you know the probability of reinjury if i do get surgery? I'm an economist, so I really like probabilities.  It makes running the cost-benefit analysis much easier.

And, yes, I have had good physical therapy thus far.  We have really been trying to strengthen my VMO and overall quad muscles.

Offline crankerchick

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Re: Patella Subluxation Sugery: Two Doctors, Two Suggestions
« Reply #2 on: June 09, 2010, 05:31:06 PM »
The chance of reinjury is 100% if you don't have the right surgery to address your problem.

One of the best ways to increase your odds of success are to make sure the opinions you are soliciting and using to make your decision are coming from patella specialists. Without knowing anything about the 2 doctors you have consulted, I still can't stress enough the importance of having a qualified patella doc looking at your knee. You need a good set of appropriate x-rays taken and perhaps even a CT scan. An MRI to reveal a torn retinaculum is not enough. A torn retinaculum is likely a consequence of the subluxation/dislocation, not the root cause.

Do not just assume that because a doctor has a fancy sports affiliation or is touted as "the best in the area" is a qualified and competent patella doc. Ask your doctor what types of procedures he/she performs on persons with patella instability. Ask his/her success rate. Inquire on what kinds of x-rays and other imaging they use to diagnose and treat patella problems.

Your decision should not just be about whether to have surgery or not, but also a question of what is the right surgery to have and who should you allow to perform it.

Also, most ligaments don't really heal themselves.
« Last Edit: June 09, 2010, 05:34:59 PM by crankerchick »
Mar '07 - plica excision
Oct '09 - femoral + tibial derotational osteotomy & TTT
Aug '10 - hardware removal
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