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Author Topic: Mis-aligned, mal-tracking, and looking for answers...  (Read 13715 times)

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Offline ElSquinto

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Mis-aligned, mal-tracking, and looking for answers...
« on: August 06, 2010, 10:00:38 PM »
First off, I realize that my own situation is not nearly as serious as most posting here.  Nevetheless, I am asking for help.

I'm 37 years old, male, and very fit.  I had recently taken up roller skating (it's called "quad skating" now) and almost immediately knew that something was wrong.  I was skating with a "knock-kneed" stance with my knees almost touching and my feet fairly far apart (sort of like a downhill skier).  After a few weeks of doing this a couple times a week I began to feel substantial inflammation in my left knee and some popping and clicking when going up and down stairs.  These symptoms, along with my unorthodox skating stance, led me to schedule an appointment with a local orthopedic surgeon.

X-rays were taken of both my knees while I was standing and while I lay on each side with one knee bent.  The surgeon also performed a quick (really quick) analysis of my gait and asked me to stand with my feet together and pointing straight ahead.

The news wasn't pleasant.  I wasn't given much in the way of specifics, but here's what I was told.

* Ihave squinting patellae.  Both my knees face inward when my feet are pointing straight ahead.  This is particularly true of the left knee.

* I am slightly bow-legged (which I already knew).  When my feet are touching and pointing straight ahead my the inside edges of my kneecaps are maybe 2.5-3 inches apart.

* My knees do not track over my feet when they are bent, especially the left one.  This is particularly true when the feet are close together.  Spreading the feet wider apart and turning them outward improves the situation.  This is a personal observation.

* He said the knees maltrack and that there is signficant "wear and tear" on the left knee.  He wasn't more specific than that (though I can *guess* this means chrondomalacia).

* He told me to avoid skating, skiing, weightlifting, running, jumping, squats, leg extensions, leg presses, leg curls, etc. 

* He asked me to begin a daily regimen of straight leg raises (3 sets of 10 reps) and to progressively add weight at the rate of 1 lb per week up to 10 lbs.

I immediately did everything the orthopedic surgeon asked and have continued to do so for the past 3 weeks, but I was not at all happy at the absence of information he provided.  I attempted to reach him again to get more information concerning my problem, such as whether to take over-the-counter anti-inflammatories, and why my knees "squint".  The only response I got was a brief voicemail stating "I'm sorry you're just not built well.  Your questions are not imporant - just do what I told you to do".

He didn't even answer the question about taking anti-inflammatories (btw: I'm taking them).

I will definitely continue to do as the surgeon has asked to avoid making the problem worse.  But having been asked to give up a lot of things (a couple of which are important to me), I feel that I deserve more answers than I was given.

So now I'm searching for them.  I have a plan.  Sort of.  I'd certainly be grateful to hear about what might have worked for

others as I can't imagine that I'm the first to have suffered from overly-brusque treatment from an ortho surgeon.

* I am going to obtain all the relevant medical records that I can.  This includes not only my two visits to this orthopedic surgeon but my pediatric records, too.

* My sister (a physician) knows an extremely good physical therapist with a Phd.  Hopefully she can prescribe some sort of additional treatments and recommend an orthopedic surgeon who is willing to analyze the problem, tell me what the specific mis-alignments are, how they happened, and what the options are to treat them.

Again, I know that my sufferings are very, very mild compared to most posters here.  But suddenly learning you aren't "built right" and shouldn't do the things you want to do is devastating for me.  I don't care about cosmetics, I'd be willing to endure considerable pain for the  treatment...I just want to be "normal".

Any advice is appreciated.

Thanks

Offline marksalot

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Re: Mis-aligned, mal-tracking, and looking for answers...
« Reply #1 on: August 07, 2010, 01:54:01 AM »
Sounds like you've got a similar problem to a few of us here.  (I even have the squinting patella thing.)  Though your OS seems a bit dismissive, it's true that you probably won't get a whole lot of detail about how your legs are "wrong."  Yes there's a lot of information out there, but a lot of it is inconsistent.  And even if you know exactly what's wrong, it doesn't really help you do anything about it.  This article was very entertaining and satisfying to me, though it costs $20 to purchase: http://saveyourself.ca/tutorials/patellofemoral-pain-syndrome.php.  It may seem a little hokey to pay when there's so much free info available, but I think it really helps get you into the right mindset from the start.

Here are the original medical journal articles with the same ideas: http://kneeexpert.com.  I'd recommend reading every one of the articles on that website, as well as the article above.  The basic idea is that the knee is very complex, and each person's knee can take a certain amount of punishment before it is painful.  And once that starts, it takes less punishment to make it hurt again.  The key to recovery is rest and pain-free exercise, gradually returning to regular activity.  You definitely want to avoid activities that aggrivate it (skating, etc.) until you think it's back to 100% again.  (Expect to take a couple months if you really want to avoid setbacks.)  Once you've recovered you should be fine, as long as you keep your individual limits in mind.  Have a rest day in between skating days, and only do it for an hour at a time.  (for example)

Only advice I can give is to take it seriously, and do not try to progress too quickly.  Physical therapy is a good idea, just to get an idea of what exercises are available.  If you're doing exercises and can walk without pain, that's great.  But if you get too confident and return to full activity too quickly, it can get much worse.  (Be sure to tell your therapist if any of the exercises cause discomfort.)  There are plenty of stories here similar to yours, that quickly got out of hand when we start ignoring little aches and pains...
04/10: right kneecap catching and pain during a brief bike ride, start resting
05/10: red spot on inner knee, painful sleeping, GP recommends 6 wks rest and exercise
07/10: stretching helps pain, but exercise brings it back, GP recommends knee sleeve and PT

Offline crankerchick

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Re: Mis-aligned, mal-tracking, and looking for answers...
« Reply #2 on: August 08, 2010, 06:54:03 AM »
ElSquinto, wow, a lot of what you describe is very consistent with "miserable malalignment" which is a condition in which the long bones of the leg have an excess amount of torsion or twisting. Torsion of the femur is called femoral anteversion and for the tibia is tibial torsion. It is normal for the femur to twist inward some, and normal for the tibia to twist externally some, but when one or both of them twist excessively, it can create a situation in which the knee joint behind the kneecap is wonky and there is pain and/or instability of the joint.

Squinting patellae is a pretty good visual indicator that excess torsion is a likely possibility.

Have you ever had knee pain or problems prior to taking up roller skating?

Giving up activities is never something a person wants to hear. You certainly deserve more answers then you are getting. But you will need a more experienced doctor to give them to you because any doctor, in my not-so-medically-educated opinion, that thinks some pt exercises and an RX to sit on one's rump for the rest of their life is the only answer for "squinting patellae" doesn't have a clue. Pardon my bluntness.

Now, what it takes to get some answers for something like this is to talk with an orthopod that has an understanding and appreciation for miserable malalignment that will take the time to answer your questions and give you a better perspective as to what is going on with your legs. Whether you eventually would choose to surgically attack the issue is of course on you which would have to be weighed against how much this affecting your life.

But answers being what you are seeking at this point, are most certainly available for you to get. Where, like what state, are you located? People here may be able to offer up a recommendation for a doctor for you to see.

To accurately determine the level of your "twistedness" if you are indeed twisted, would require a CT scan rotational study. But to just get answers about the condition, I would be more than happy to share with you the research I've collected on the condition, point you in the direction of doctors that might be able to answer your questions, and just offer help in any way I can.
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 ElSquinto

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Re: Mis-aligned, mal-tracking, and looking for answers...
« Reply #3 on: November 22, 2010, 08:46:22 PM »
Thank you both for the responses.  Sorry for the extended absence - but please take that as a positive; it means that knee issues have not taken over my life.

My condition is pretty much the same.  The inflammation from the chondro. comes and goes with the intensity and frequency not having changed much.  I'm still doing the single-leg raises daily which, as I expected, does nothing very useful.  If my VMO gets any stronger it will start beating me up for my lunch money...

I've got an appointment in January with a surgeon affiliated with New England Baptist Hospital in Boston who has performed DROs.  While there's not yet any evidence that these procedures will help my case, I think it's beneficial to talk with somebody who is familiar with the procedure and rotational/torsional deformities in general.

I also contacted the Hospital for Special Surgery in NYC and was given the name of three Orthopedic Surgeons who are hip & knee specialists.  I haven't yet selected which of the three to see but intend to visit one after consulting the specialist at Baptist.

Crankerchick - You've mentioned that you had excessive femoral anteversion.  Initially, I felt certain that I shared this condition, but now I'm not so sure.  The articles that I've gotten my hands on suggest that it predisposes the patient to "W-sit".  I can barely W-sit at all - my butt can't touch the ground in that position unless my knees are quite far apart and even then it causes quite a lot of discomfort in both my knees & hips.

On the other hand - I love to sit Indian-style.  In fact, I can more or less execute what is known in Yoga (my friend tells me) as a full lotus without any sort of warmup.  This feels just fine (even good) for my knees, but if I spend a long time in this position and get up I can feel some pain in the hip that is quickly walked off.  Could well be acetebular subluxation...I guess we'll see.

Anyhow, my focus for the next couple of months is simply to get some answers.  Rome wasn't built in a day...

Offline crankerchick

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Re: Mis-aligned, mal-tracking, and looking for answers...
« Reply #4 on: November 22, 2010, 10:10:28 PM »
I have (in my right leg) and had (in my left leg) femoral anteversion and excess tibial torsion, so not only is/was my femur twisted internally but the tibia is/was externally rotated in excess of normal.

I was always been able to sit indian style. I can still sit indian style now with one straight leg and one twisted one.

I have never had any desire to W-sit. Maybe I did it as a child, I don't know, but for all the years I can remember, my natural method of sitting on my knees has not been to w-sit, that's for sure.

Your knees pointing in when your feet are straight is super red flag indicator of femoral anteversion and/or excess tibial torsion. I can tell you for free that you are probably twisted given the description of your knees, be it the femur, tibia, or both. The CT scan is the best diagnostic imaging tool to reveal the torsion.

I think seeing a specialist with an understanding of rotational issues is a good idea. If you intend to travel though, you might as well make efficient use of your travel time and money and seek an opinion from the experts. I can pass on some referrals if you are interested.
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 vlm020

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Re: Mis-aligned, mal-tracking, and looking for answers...
« Reply #5 on: November 22, 2010, 10:59:10 PM »
Hi there,

I'm currently going through a similar process trying to find some answers.  My knees are also very turned in when my feet point straight.  I used to 'W' sit all the time as a child as I find it really difficult to sit cross-legged - I can sit with my ankles crossed but I can't get my feet under my knees without my knees sticking up in the air. 

I'm in the UK so it's a bit less flexible getting to see any specialists unless you pay privately.  So far I've found it difficult to get proper answers and have just been told to try orthotics (my feet badly overpronate) and carry on with physio.

Hopefully we'll both get somewhere - good luck in finding some answers!

Offline ElSquinto

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Re: Mis-aligned, mal-tracking, and looking for answers...
« Reply #6 on: November 24, 2010, 12:12:45 AM »
I have (in my right leg) and had (in my left leg) femoral anteversion and excess tibial torsion, so not only is/was my femur twisted internally but the tibia is/was externally rotated in excess of normal.

I was always been able to sit indian style. I can still sit indian style now with one straight leg and one twisted one.

I have never had any desire to W-sit. Maybe I did it as a child, I don't know, but for all the years I can remember, my natural method of sitting on my knees has not been to w-sit, that's for sure.

Your knees pointing in when your feet are straight is super red flag indicator of femoral anteversion and/or excess tibial torsion. I can tell you for free that you are probably twisted given the description of your knees, be it the femur, tibia, or both. The CT scan is the best diagnostic imaging tool to reveal the torsion.

I think seeing a specialist with an understanding of rotational issues is a good idea. If you intend to travel though, you might as well make efficient use of your travel time and money and seek an opinion from the experts. I can pass on some referrals if you are interested.
Crankerchick,

Yes, I am just about sure you must be right about the femoral anteversion.  In fact, I'd say I'm 95% sure I figured out how the pieces fit together (no pun intended...)

I dug out an AP hip x-ray from a couple years ago when I started experiencing hip & knee pain while practicing taekwon-do (don't ask).

As far as I can tell (and I can't be 100% sure as I am not an orthopedic surgeon)

Both hips seem to display coxa valga - which is a greater than normal angle between the femoral neck & shaft.  Having done a bit of readng it seems to always be accompanied by:

a) Genu varum (bow legs - yup, got 'em!)
b) Femoral anteversion (sure looks like...)
c) Developmental Hip Dysplasia arising from incomplete acetebular coverage of the femoral head (3 for 3 so far!)
d) External tibial rotaton (bingo)

That seems to be me to a "T".   Sure is complicated, isn't it?

Offline ElSquinto

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Re: Mis-aligned, mal-tracking, and looking for answers...
« Reply #7 on: November 24, 2010, 12:38:32 AM »
Hi there,

I'm currently going through a similar process trying to find some answers.  My knees are also very turned in when my feet point straight.  I used to 'W' sit all the time as a child as I find it really difficult to sit cross-legged - I can sit with my ankles crossed but I can't get my feet under my knees without my knees sticking up in the air. 

I'm in the UK so it's a bit less flexible getting to see any specialists unless you pay privately.  So far I've found it difficult to get proper answers and have just been told to try orthotics (my feet badly overpronate) and carry on with physio.

Hopefully we'll both get somewhere - good luck in finding some answers!

I can certainly empathize with your problem.  From my perspective I haven't found things much easier in the USA, though I now have at least some hope of getting answers.
 
Do you feet also point inwards when walking?  I've read the predisposition to W-sit is more or less due to the femoral anteversion that all children have (and that should decrease after the first few years of life).  The little I've read suggests that the W-sitting can lead to interal tibial rotation and a pigeon-toed gait, though again I am no surgeon.

Perhaps because my tibias seem to be outwardly-rotated (and possibly because I am dislocating my femoral heads?) I can sit cross-legged like a champ while any serious attempt by myself to W-sit would probably land me in the hospital!

Anyhow, I wish you luck in getting your answers.

Offline vlm020

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Re: Mis-aligned, mal-tracking, and looking for answers...
« Reply #8 on: November 24, 2010, 01:41:37 PM »
Well I certainly don't have internal rotation of the tibias - my knees are straight when my feet are turned out.  I think the 'W' sitting might be due to the fact that I have quite a large range of motion in my hips (if I lie on my front with my knees bent at right ankle and let my feet fall away from each other I can get my feet to touch the floor either side of me) or maybe I have femoral anteversion too.  Generally I seem to be a bit of an odd case.

From what I've read and been told, correcting any rotational deformity is major surgery involving breaking bones etc.  As I'm not suffering dislocations or severe pain I am willing to modify my lifestyle and accept that I wasn't built very well!  For many people on here surgery has been the only way of getting their life back so I think it depends on your individual circumstances. 

In terms of wanting to get a full picture, I can fully understand where you're coming from, having been there myself.  Although now I'm starting to wonder if I need to know how badly rotated my tibias and femurs are if there is nothing I can really do to sort it out.

Good luck with your appointments!  Hopefully you'll see someone who is willing to explain things to you rather than just tell you to do it - it doesn't seem very professional or show good patient care and I would have been really upset if that was the response I'd been given.

Offline ElSquinto

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Re: Mis-aligned, mal-tracking, and looking for answers...
« Reply #9 on: November 25, 2010, 12:42:21 AM »
Well I certainly don't have internal rotation of the tibias - my knees are straight when my feet are turned out.  I think the 'W' sitting might be due to the fact that I have quite a large range of motion in my hips (if I lie on my front with my knees bent at right ankle and let my feet fall away from each other I can get my feet to touch the floor either side of me) or maybe I have femoral anteversion too.  Generally I seem to be a bit of an odd case.

From what I've read and been told, correcting any rotational deformity is major surgery involving breaking bones etc.  As I'm not suffering dislocations or severe pain I am willing to modify my lifestyle and accept that I wasn't built very well!  For many people on here surgery has been the only way of getting their life back so I think it depends on your individual circumstances. 

In terms of wanting to get a full picture, I can fully understand where you're coming from, having been there myself.  Although now I'm starting to wonder if I need to know how badly rotated my tibias and femurs are if there is nothing I can really do to sort it out.

Good luck with your appointments!  Hopefully you'll see someone who is willing to explain things to you rather than just tell you to do it - it doesn't seem very professional or show good patient care and I would have been really upset if that was the response I'd been given.
Yes, correcting these deformities involves bone cutting (osteotomies) and it appears to be very grim stuff with the possibility of complications, necessary follow-up procedures, and extremely lengthy rehabilitation. 

I would suggest trying to find out what you can about your condition from a qualified professional.  Cartilage loss is irreversible and at a certain point the accumulated damage will be such that ostetomy (or osteotomies) no longer makes sense and joint replacement could become necessary.


I tried to perform the test you described in your last post and could not get my legs more than about 35 degrees from the vertical position.  So I suspect our issues are at least somewhat different.

Good luck with your own saga and keep us posted.

Offline ElSquinto

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Re: Mis-aligned, mal-tracking, and looking for answers...
« Reply #10 on: February 21, 2011, 05:32:20 PM »
Well I'm back to report after about 6 months.  My symptoms, as far as I can tell, are about the same - they are mild but they have not improved and show no sign of resolving despite lots of rest and lots of straight leg raises.

I saw a different Boston-based orthopedic surgeon in January.  The news seems to be mostly good, but I have lingering doubts.

The surgeon was highly-confident that I do not have osteoarthritis anywhere.  *That* was certainly good news to hear.  I probably do have a little chondral wear around the medial, distal periphhery of the left patella and there are a couple spots where the cartilage is a bit rough/bumpy but he wasn't concerned.  He told me he to stay away from exercises that required long-arc travel by the patella (full squts and lunges should be avoided - but I gave those up last spring for good when the pain first presented itself) but that roller skating should be ok to try in his opinion.

There was some maltracking (not serious) evident in one set of x-rays (taken with me seated with my feet up and knees flexed at some angle) but, while he did note it, he wasn't worried.

All seemingly good but when he discussed his assessment of my skeletal alignment based on the x-rays and a few clinical tests, I began to get concerned, though I was fortunate in that he was willing to go into quite a bit of detail which might have been due to the presence of a surgical fellow at the appointment.

* He felt the x-rays indicated my degree of acetebular/femoral anteversion was marginally-high but not too far off of the norm.
* He felt because of the somewhat high acetebular/femoral anteversion that my acetebular coverage of the femoral head was a bit marginal but he didn't think that I had hip dysplasia.  Instead, the slipping/clicking I could induce was just the IT-band snapping over a trochanter in the femur (which is something I should avoid, lest it become a nasty case of trochanteric bursitis).  He did say that my femoral heads were rather large and that there was a chance of slight FAI.
* Yes, I had some external tibial torsion particularly in the left knee - but he did not consider it severe.

These findings were in pretty stark contrast to the first orthopedic surgeon who told me I had severely-squinting patellae - particularly on the left side and that he felt certain that I had at least slight acetebular dysplasia.

So I did my usual post-appointment follow-up by asking the office for a copy of the X-rays and the surgeon's write-up a couple weeks later.  The write-up still hadn't been transcribed at the time (I haven't had a chance to go back for it since) but I did obtain a CD with the X-rays.

And you know what?  The AP Pelvic X-ray that was taken at the January appointment looks very noticeably different around the head and neck of the femurs than the AP Pelvic X-rays that I have from last July and the AP Pelvic X-ray that was taken in August, 2008 (which does resemble the one from last July and was also ordered by Orthopedic Surgeon #1 from the same site)

I am a layperson.  I have no background that makes me qualified to interpret an AP Pelvic X-ray.  But I do know when things simply look different...and these look different.  I also know that at aged 38, my skeleton isn't changing rapidly and it's probably a great deal more likely that the discrepancy results from my femurs being rotated a bit differently in my acetebuli when the January X-rays were taken vs. some sort of skeletal change.  I let the radiation technician orient my feet during the January appointment without any input from myself because I assumed he knew his business.

So to recap:

1) August, 2008: Orthopedic Surgeon #1 does not diagnose me with any mis-alignments
2) July, 2010: Orthopedic Surgeon #1 diagnoses me with severe mis-alignnments
3) January, 2011 Orthopedic Surgeon #2 diagnoses me with minor mis-alginments

And I remain confused with, more or less, no treatment.  Yes the pain/discomfort is mild, and I'm preparing to roller skate on Thursday night for the first time in 6 months (I specially-mounted some plates on the skates so that I can allow my feet to stay turned outward while my wheels point straight ahead - clever, huh?) - but I suspect my saga isn't over yet.
« Last Edit: February 21, 2011, 05:36:46 PM by ElSquinto »

Offline crankerchick

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Re: Mis-aligned, mal-tracking, and looking for answers...
« Reply #11 on: February 21, 2011, 06:15:17 PM »
If your feet point out when your knees point straight, then you likely are twisted. I believe a CT rotational study should be given the final verdict on which bones are twisted in excess of normal and by how much.
« Last Edit: February 21, 2011, 06:17:41 PM by crankerchick »
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 ElSquinto

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Re: Mis-aligned, mal-tracking, and looking for answers...
« Reply #12 on: February 21, 2011, 08:39:46 PM »
Thanks, CrankerChick, that is my belief as well.  In fact, Surgeon #2 has performed interotrochanteric varus femoral derotational osteomy surgeries on many patients.  It was this reason that I sought him out for an appointment.  I believe that he is very familiar with the diagnostic imaging techniques that would help determine whether a patient is a candidate for the procedure or not.

Unfortunately, although I am lucky to have very good health insurance coverage, the surgeon will probably not be quick a CT scan becaue it is very costly.  At this point, I have frequent irriation in my left knee and some light crepitus and have had to eliminate some forms of exercise.  There are many, many people far worse off than I am - so my plight doesn't really amount to the proverbial hill of beans yet.  It's depressing, yes, but on a scale of 1 to 10, my case is probably about a "1.3" in severity at the moment.

If the pain continues to present itself then I will visit Orthopedic Surgeon #2 once again.  If I am not satsified with the response, then it'll be time to consider other surgeons.

I have a feeling that anysurgeon will want to proceed slowly in my case because my symptoms are minor and I seemed to have been largely asymptomatic for more than 35 years.  I've never had a patellar subluxation.

At least I'm finally learning the patience that my mother tells me I have always needed... ;)
« Last Edit: February 21, 2011, 08:43:12 PM by ElSquinto »

Offline ElSquinto

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Re: Mis-aligned, mal-tracking, and looking for answers...
« Reply #13 on: April 08, 2011, 08:39:02 PM »
Well I have more news now...and none of it good  :-[

I managed to work some family connections to get a recently-retired radiologist with a specialization in musculoskeletal radiology to inspect my x-rays.  He very understandably declined to offer a diagnosis but offered to give me his opinion on whether my AP hip x-ray was taken properly and what I should do next as far as talking to a surgeon.  More on that second part later...

In his opinion - my AP hip x-ray (which was used to diagnose the degree of femoral neck antevesion) - is not accurate.  He stated it shows clear evidence of pelvic tilt that would tend to diminish the esimated degree of femoral anteversion and over-estimate the degree of femoral head coverage.

I also finally had an opportunity to obtain ortho surgeon #2's full write-up from my January appointment which characterized the mechanical issues as more severe than he had related to me verbally.  Most notable was a belief that my Q-angle was dramatically increased as a result of substantially greater than normal femoral anteversion and external tibial rotation.  He also measured a hip CE angle that was at least slightly dysplastic and cited very poor biomechancis.

And now, of course, the radiologist believes that the degree of femoral anteversion was probably even greater than ortho surgeon #2 estimated and the true CE angle somewhat lower.  Yikes.

Worse still was the radiologist's opinion that I'm going to have a very hard time finding an ortho surgeon who will want to treat me. Serious rotational abnormalities, he feels, almost always present with serious pain by the mid-20s and often erlier.  If a patient is 38 years-old and only just *starting* to have issues - he is already too old for a reconstructive osteotomy that could restore normal activity and mechanics. The responsible surgeon, he says, will simply leave well enough alone and emphasize activity modification in the hope that joint replacement does not become necessary during the patient's lifetime.

Bad, it seems, is simply not bad enough at my age.

Offline crankerchick

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Re: Mis-aligned, mal-tracking, and looking for answers...
« Reply #14 on: April 08, 2011, 08:57:39 PM »
I'm at a loss for why anyone is trying to quantify femoral anteversion with an AP hip x-ray when the authority on this subject strongly recommends CT scan. I understand that CT is expensive. I just think it's pointless to keep spending time and and smaller amounts of money to quantify it any other way.

As far as age is concerned, I would defer to the experts on that.
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