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Author Topic: 2nd Patellar Dislocation  (Read 4741 times)

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Offline honolulul

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2nd Patellar Dislocation
« on: February 21, 2011, 04:28:58 PM »
Hi guys,

I am a 20-year-old college student, studying in the US.  On the 24th of January, I have had my second patellar dislocation.  My first one was, when I was playing soccer with clutches, and I had a terrible accident, as I tried to turn, while the clutches were stuck on the ground.  It was a very bad field, but luckily, I did not have a major problem, my doctor said.  The MRI results came fine, and there was only a slight tear and a little cartilage damage.  He gave me some special braces with angle adjustments to use, and no rehab.  Up till my 3rd year in college, my left knee always felt weak.  It sometimes felt right as I spent more time in the gym, doing leg exercises, but never fully recovered.

My second time happened recently over an accident not as bad as the first one; I slipped on some ice, and my knee cap popped out of its place again, but this time not coming back.  I went to the hospital and they put it back in.  All the doctors that I have asked said that the place where the knee cap sits is shallower in me than an ordinary person, so the knee cap tends to pop out regularly.  Now, my doctor, who is also working for a soccer team, and has faced this issue multiple times before is trying to decide in between surgery and physical rehab.  At first, he said surgery is really needed to repair the retinaculum tissue because there was a Grade II tear, repair the cartilage, and maybe make some axial changes to reduce the tension on my left patella.  But after seeing the MRI results, he said my condition was not as bad as he expected and wants to give physical rehab a chance for 3 weeks to see if my knee feels right, after the muscles are stronger.  If I am not comfortable, he will sign me up for a big surgery because he believes that reforming the ligament does not really solve the problem.  He has to reduce the tension by making an axial change, so I never have to face this issue again.  He wants to cut through my bone and move the lower muscle connecting to the patella by half a centimeter so that the tension is reduced.  My questions about my issue are:

1- Do you think that I should have had phys. therapy when this problem happened the first time?
2- Surgery vs Phys Therapy? Risks, side-effects?
3- Anywhere that I look, I see that when this problem happens more than once, surgery is often required because risk increases each time because of the stretched ligament.  Another doctor that I have talked said that this might happen now even when I am turning the corner.  How can I determine if my ligament is stretched or not?  Are there people who stopped having this problem after rehab in their second time?
4- What can of surgery is right in my case?  Do you think that a small surgery for just renewing the MCL, and repairing the tissue and cartilage is enough, or do you think because of my abnormal knee structure that I should have a big surgery, involving making axial changes.

Help much appreciated,