newbee with tons of ?'s and a really bum knee

[shellygirl55]

hi everyone...

my name is michelle and i am 33 from n. cal. when i was 21 yrs old i was jumping on a trampoline with a friend and dislocated my rt. knee. I tore 3  ligaments, and part of my miniscus (spell?) I had surgery then and the doc was able to fix 3 of the ligaments and did something to the cartalige, and after a year long recovery period i was doing pretty good. i was still able to work as an emt, and compleatly function and have a pretty normal life for about 10 years... as time went on though i started feeling more pain and started experiencing my knee cap sliding all over the place and sometimes popping out all the way!!

On sept 11 of this year I was getting in to my car, and the whole thing just dislocated again. went to my orotho and he wanted to do surgery. did orothoscopic,removed a foreign body about 2 inches, trimmed some cartalige etc. this all went fine, however when i woke up he had terrible news for me. apparently my knee is one of the worst he has ever seen. my ligaments are so loose that once i was asleep my knee just flopped all over. i have severe arthritis and absolutly no stability in the knee.

we have tried a brace which for some reason causes extreme pain, and makes the knee cap swell like crazy, now wants to refer me to a doc in a bigger town ( i live in a pretty small one) like los angeles or sacramento to do a procedure to "ancor down" my ligaments. I keep trying to discuss knee replacement to him and he keeps telling me I am too young... even with the amount of pain I am in!!

I just lost my job over this becasue they told me i can't come back without a "full release" frorm my doc..( can they do that??) I am starting to get really lonley being at home, I am freaked out because I will have to travel to get this other sergery, and he says that sergery has a year recovery period which is a really long time! I have 2 little kids that miss their mommy being active with them, arghhh!!

any advice from anyone? anyone ever hear of someone my age (33) getting a knee replacement? if so, how do i find a doc who will do it? any advi sorry this is so long, i am just starting to panic... arghhh

thanks for listening

[duckie857]

Shelly, I'm sorry to hear you're having such a rough time.

It sounds to me like you need to see a patellofemoral specialist...which is a specialization in orthopedics. KneeGeeks has a fairly good list of excellent surgeons by state:

http://www.kneeguru.co.uk/KNEEnotes/knee_surgeons_in_north_america

Don't rush into a TKR, you are definitely young and probably don't need one. However, it's important you find a doctor that knows how to deal with patients that are having specific patella problems. Most sports surgeons aren't equipped with the knowledge that the specialists are. You may also want to post in the patello-femoral thread:

http://www.kneeguru.co.uk/KNEEtalk/index.php?board=16.0

I had surgery to correct my knee dislocations. I had one in January 2010 and one in October 2010. Yes, it's a long process and the recovery takes a bit of time but it's worth it in the end! You've just got to find the right doctor with the right answers for your knee.

Good luck, keep us posted!

[dm]

It sounds like your main problem is ligament laxity from the injury you had, that things have loosened back up. There are procedures they can do to take the slack back out of the ligaments without having to do a knee replacement. They can clean up arthritic issues, if you have articular cartilage wear, they can smooth it down and clean it up. A knee replacement is not an instant solution, it's a last-ditch answer for severe trauma and age related problems, and it doesn't sound like you're there yet.

If you're in an area where you need to commute to a neighboring city to seek a patellofemoral or sports medicine specialist, do so ASAP. You need to see a doc who is a knee specialist, not a general orthopedics guy, sports medicine is going to be the next best thing to a patellofemoral specialist, depending on who's available in your area.

As for recovery periods, don't get depressed over it yet, find the specialist, go see them with your mri, surgical report from the arthroscopy, etc, and see what they have to say, before getting too worked up.

As for your job, because of the physical fitness requirements, yes, they can release you as medically unfit, unless they can use you in a position like dispatcher, where your incapacity is not a factor. You can't be lifting patients from vehicles and moving stretchers, etc with a knee that can dislocate unexpectedly, it's a liability because of potential scenarios like this -- you're moving a patient with a cervical instability, you slip and they're paralyzed because of it. You can ask them if you can get your job back once you can obtain a medical clearance, and how much time you have to do so, and get it on paper. If I were you, I'd ask about a transfer to another area, like training new hires, or a dispatcher, etc, so you could remain employed, while you get your knee fixed. I don't know how your company is, how big they are, etc, but it's something to evaluate as an option, depending on how long you've been there, the kinds of work available within your company, etc.

[cdubb]

If you need to travel to see the right physician, I would absolutely do that if I were you.  It's a nuisance, but you want the right care and the appropriate procedures to be done.  You don't just want to find a surgeon to do a knee replacement because that's what you want done.  A knee replacement at your age would be an absolute last resort.  The prosthetic knees only last for a limited time and the younger you are the more revisions you will need and with each revision, there are greater and greater risks and possible failures...then what do you do?

As for your job, they can require you to be able to meet your essential job functions. You may be able to apply for an ADA accommodation though, but if there are treatment options still for you, then you don't know what of your current limitations are may or may not be permanent.

[duckie857]

Everyone is very right. I travel 4.5 hours to see my surgeon. It's not easy, but I do it because he's amazing and I trust him that much with my knee...and there's a specialist right in my local town that I could go see.

As for the job scenario...I've been there. I was working as a school portrait photographer before I started having problems with my knee again. I was lifting boxes of 20-80lb equipment pieces for sets times a day from location to location, loading them into cars and then setting up the lighting studios (that took squatting, bending, lifting, stepping over wires, etc.)  I just couldn't do that job well. When I hurt my knee again I went to my boss and they told me they had nothing for me. There was just nothing available for me to fit what I needed.

I ended up going on temporary disability for the job. The paycheck doesn't even cut 1/2 of what I made, but it was something to tide us over for the next month or two. I know I'm a special case, though. New York State requires companies to take out disability on their employees and they're covered from day 1 of employment. I know this isn't the case in every state and that NY is a minority.

[crankerchick]

If you need to travel to see the right physician, I would absolutely do that if I were you.  It's a nuisance, but you want the right care and the appropriate procedures to be done.

^Definitely this!^

Along with everything else that has been said.

I would only add that if you are indeed going to travel, take some time to make sure you are traveling to a doctor that truly knows and understands how to address these problems. Just because one doctor says go see this doctor, doesn't really mean either of them know what they are talking about. Also, consider getting another opinion after you see this doctor in the bigger city.

People grasp on to this idea that a knee replacement is the be all end all and I just don't think it works that way. Finding the right doctor to look at your whole leg and work hard to preserve your natural parts if at all possible is imperative.