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Author Topic: Bilateral MPFL Reconstruction-7/25  (Read 19339 times)

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Offline YogaGirl

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #45 on: October 03, 2012, 02:49:08 AM »
Whoa whoa whoa... Hold on.
Are you saying that your kneecaps are dislocating again? While swollen and post-surgery?! 10-20 times a day?? I'm hoping I'm reading this wrong because I don't think you had previously mentioned new dislocations since the surgery...

Well, I'm glad to hear the graft is still healthy and where it needs to be. I feel your pain about wanting some kind of answer. But, I guess a new med and working through PT might just do it for you.

How's work going? Keep on trucking is right!! Definitely more virtual hugs to you! Keep it up, you're doing amazing :)
www.peaceloveknees.com <---- check out my MPFLr blog
www.brightskyyoga.com

Offline Teacher2Many

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #46 on: October 03, 2012, 02:53:21 AM »
Indeed they are...not full dislocations but definitely subluxing multiple times/day.  I'm really hoping it's due to the swelling and muscle weakness.  The R was shifting a bit with bending, such as stairs, but this past weekend they were both back to the subluxing.  :-(

Can't get worried about that though...it's the least of the issues!  Whether the surgery worked to fix that issue or not isn't my main concern (as odd is that is to say that)-got to get rid of the pain and the limitations with flexion first!
6/07-L TTT & LR
6/08-R TTT & LR
6/09-Bilateral ACI
7/10-R derotational femoral & tibial osteotomies, LPFL reconstruction
6/11-L derotational femoral & tibial osteotomies, R hardware removal
1/12-L tibial hardware removed, R scapulectomy
4/12-L femoral hardware removed
7/12-L & R MPFL reconstruction

Offline YogaGirl

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #47 on: October 03, 2012, 03:11:30 AM »
Oh man. I'm so sorry. You're right though... work on getting the swelling down and then worry about if the surgery was a success... though it seems iffy at this point. But you could be right maybe things need to strengthen. One step at a time! I'm pulling for you!!
www.peaceloveknees.com <---- check out my MPFLr blog
www.brightskyyoga.com

Offline Xeplasma

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #48 on: October 03, 2012, 04:01:01 PM »
Oh my, just read about the subluxations.  :o  This is a scary thought and just cannot believe it is happening to you right now.  :'( Does your OS agree they will stop or reduce in frequency as your strength improves?
Ice those babies and let's work on getting these super duper extra muscular legs that shall never dislocate again!!!!

Offline Teacher2Many

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #49 on: October 04, 2012, 04:06:47 AM »
Thank you everyone for your concern; what a ridiculous journey this has been just to have come to the realization over the past 48 hrs. or so that it may all have been for nothing!   :'(

I had not consulted with my OS about the subluxations as I felt at this point, it would be pointless.  There's nothing that could be done to 'fix' it and I need to focus on the two major issues that are wreaking havoc on my life-pain and limitations with flexion.  I figured I would address it prior to my next appt. at six weeks (usually I send an update via e-mail about a week before) which would give me time to figure out if it is really subluxing due to a mechanical issue or if it is simply due to swelling and quad weakness.

Today was a horrible day and I stopped counting how many times I had to pop it back into place (usually just subluxations) after 25 and that was well before my lunch time at work.  The left had gotten 'stuck' and it took me a while to get it unstuck.  So when I got to PT, I had mentioned this to my therapist mostly out of frustration.  Actually I think my exact words were "you now have my permission to push flexion really hard since there is no need to worry about babying the graft since I had to pop it back into place at least 25 times each knee today.  Why be careful to not harm the graft?"  She asked if I talked to my OS about this and I told her no, I see no point right now to discuss it as treatment options wouldn't change and we need to get the pain and flexion rectified.  Little did I know that while I was doing my heel slides, etc. she had sent him an e-mail to get his input as to what's going on.

I was LIVID when I found out.  Granted, I know she was doing it out of best interests to get to the bottom of this but really, I didn't want this addressed right now.  And when he finds out that it's been going on since Saturday and yet I didn't say anything when I saw him on Monday, I'm sure that's not going to sit well.  I've been working with my OS for the past 4 years (okay, it'll be 4 yrs. in November) and now it's as if that patient-dr. relationship/trust is thrown out the window because he heard it from her and not me.  Maybe not but that's what it feels like.  So we'll see if he replies to her e-mail and if he does, if she sends me the reply, as she's out of town on Friday so I won't see her until Monday.

One of my OS who did the derotational osteotomies felt that both the MPFL and LPFL needed to be rebuilt on both knees.  My OS here doesn't do LPFL and after conversations back and forth, it was decided that MPFLr should be enough BUT my other OS said we won't know for sure until it fails and then it's too late.  You always go for the least amount of work and hope for the best...now I worry if the least was enough.

And so I keep on trucking...pushing through the pain and flexion, being the best teacher I can be for my kiddos, despite my crappy mobility, and hope that one day (preferably sooner rather than later), all of these knee issues that I've dealt with for the past 6 years with 16 surgical procedues done over those 6 years are rectified and resolved on a more permanent basis!
6/07-L TTT & LR
6/08-R TTT & LR
6/09-Bilateral ACI
7/10-R derotational femoral & tibial osteotomies, LPFL reconstruction
6/11-L derotational femoral & tibial osteotomies, R hardware removal
1/12-L tibial hardware removed, R scapulectomy
4/12-L femoral hardware removed
7/12-L & R MPFL reconstruction

Offline Teacher2Many

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #50 on: October 11, 2012, 03:47:48 AM »
So by this time next week I am hoping to have some answers!  I am heading back up to MI on Tuesday to see my OS who did my derotational osteotomies.  My concerns about my knees subluxing/dislocating were a tad 'blown off' with comments of it's virtually impossible following MPFLr.  I'm concerned as the sensation is the same as prior to surgery and surfaced at about 9.5 weeks post-op (was completely non-existent for those first 9 weeks or so post-op).  Also while I was reviewing my previous e-mails to my various OS, I saw that my OS in MI had originally recommend both MPFLr and LPFLr and possible deepening of the trochlea groove  so am wondering if the MPFLr just wasn't enough to provide the stability.  So I decided I needed confirmation in either direction-either I was right and the instability is back or my OS is right and it's not instability but rather something else (and hopefully he can tell me what the something else is).  Plus I need to consult with him on the hip and follow-up with him on the nerve damage in the foot so it's going to be a thorough ortho appt.  Leaving my house around 7 AM and hope to be back home by 11 PM.

Not looking forward to the 5 hr. car ride, especially since the knee gets pretty unhappy after about 30-60 minutes so I'm sure many steps will be in the plan just to stretch/straighten out the leg.  Might pick up some of those instant cold packs as well (the ones you crack and shake) just to help with some of that discomfort as ice really does seem to help.  We'll see how things go.

On an off note, I took my percocet on Monday night (as I've been doing for the last week or so) and ended up staying up a bit longer than usual afterwards (made my hot tea too hot so had to wait for it to cool off).  Anyhow, I as literally going crazy.  I became so hypersensitive to noises (the water running in the shower, tissue paper being crumpled up to get a present ready for the next day, etc.) that I laid in bed until after 2 AM crying because those noises physically were painful.  I then became afraid to take it so I didn't last night and was up constantly in pain so I guess I will go back to my usual routine of taking the meds, then a shower, then hot tea, and right to bed.  Hopefully it was just a fluke but either way, not something to repeat.

On a plus side, at 11 weeks post-op the R measured today at 120 and the left at 114 with much pain and tears.  Active flexion is not nearly as good (tried kneeling today while getting up off the floor and think I was at maybe 75-80 degrees)and is something that we will be addressing but it was nice to get there.  I did tell my 2 treating PTs that I really want them to push flexion and they did (although while doing so, I really wanted to scream 'mercy' and have them back off but I knew that wouldn't accomplish anything so instead, I just cried while they pushed it).

Hope everyone is healing well and enjoying the start to fall!
6/07-L TTT & LR
6/08-R TTT & LR
6/09-Bilateral ACI
7/10-R derotational femoral & tibial osteotomies, LPFL reconstruction
6/11-L derotational femoral & tibial osteotomies, R hardware removal
1/12-L tibial hardware removed, R scapulectomy
4/12-L femoral hardware removed
7/12-L & R MPFL reconstruction

Offline YogaGirl

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #51 on: October 11, 2012, 02:42:16 PM »
What a nightmare.  :'(

I am so sorry that you've had to go through so much crap. But hopefully this trip will give you lots of new things to consider, plans, and a better outlook. Let us know what your old OS says.

We're thinking about you! Lots of hugs!
www.peaceloveknees.com <---- check out my MPFLr blog
www.brightskyyoga.com

Offline Teacher2Many

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #52 on: October 14, 2012, 10:28:14 PM »
Getting things put together for Tuesday's road trip to MI, as I won't get home tomorrow night from PT until about 8:00 pm and don't want to run the risk of forgetting anything.  Getting nervous as well-either way, the info can't possibly be good.  Either the knees are indeed subluxing or they're not and they have no idea why they are the way they are. 

On another note, I reviewed the info for my hip surgery and didn't get what I requested so now I need to e-mail that OS for the specifics-his AA must not have understood what I wanted.  The part that isn't sounding too good is spending 2-3 hrs./day on my stomach.  I hate being on my stomach to begin with-so uncomfortable and painful on the knees.  We'll see what he says in response to my questions-originally, he told me in a brace and on crutches for 6 weeks but this paperwork is saying you're off of both by 3-3.5.  Makes a big difference when you're trying to plan surgery around Christmas/winter vacation from work.

Hope all are doing well-quite an icky day here with rain and wind; makes me want to cuddle under a blanket and take a nap!
6/07-L TTT & LR
6/08-R TTT & LR
6/09-Bilateral ACI
7/10-R derotational femoral & tibial osteotomies, LPFL reconstruction
6/11-L derotational femoral & tibial osteotomies, R hardware removal
1/12-L tibial hardware removed, R scapulectomy
4/12-L femoral hardware removed
7/12-L & R MPFL reconstruction

Offline Teacher2Many

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #53 on: October 19, 2012, 04:01:20 AM »
And just when I thought it couldn't get any worse....

Was diagnosed with shingles tonight, probably reared its ugly head due to the emotional & physical stress from surgery, rehab, & pain.  Let me just say that this pain is intense, relentless, & unbearable.  I'd rather have all my past & present ortho pain combined as at least then it goes away with rest, positions, etc.; this pain shows no mercy.  On anti-viral drugs & was given the ok to up the Percocet to two at bedtime for a max of five days to help with the pain so I can sleep.  Any type of rubbing, breeze, touch, etc. is electrifying-if this is what RSD feels like, I feel for those w/that dx.

On the bright side, my pain receptors are so busy w/the shingles pain that I haven't noticed the knee pain too much today although would rather deal with the knee pain right now.

Taking tomorrow off from PT-not going to do any good if they can't touch me due to the hypersensitivity. 
6/07-L TTT & LR
6/08-R TTT & LR
6/09-Bilateral ACI
7/10-R derotational femoral & tibial osteotomies, LPFL reconstruction
6/11-L derotational femoral & tibial osteotomies, R hardware removal
1/12-L tibial hardware removed, R scapulectomy
4/12-L femoral hardware removed
7/12-L & R MPFL reconstruction

Offline Teacher2Many

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #54 on: November 08, 2012, 01:09:18 AM »
So realized I haven't updated in a while, probably because there isn't really much to update.

15 weeks post-op today; passive flexion is improving (think around 120 now) but the pain it causes is still making me see stars and active flexion a little more than 100 with increased pain.  Swelling is still an issue but oh well.  Strength is improving but the limitations with flexion and increased pain are making functional activities difficult.  Still hard to get in/out of chairs and the car, kneeling is impossible due to the pain from bending the knees to 90, hard to get on/off the floor and sitting on the floor is difficult due to not being able to cross the legs, etc.  Stopped taking all pain meds-just not good to be on them, body becomes too sensitive and pain gets exaggerated, and don't want to risk dependency.  Plus if the pain gets really bad, I need them to work and if I take them regularly, that isn't going to happen.

But such is life...hoping it gets better but if not, I will just learn to manage.  I'm picking up some speed with my kiddies at work, probably because I keep getting new ones so I have to learn to be quick.  By the end of the day, I am so sore with elevated pain and swelling but proud of what I do, regardless of the cost to my health/rehab/etc.

Back to the doc on Monday-we'll see what he says.  Hopefully good news as I need to start looking into scheduling the L hip for December and then the R for the summer of 2013 and if needed, try to double it up with any future knee surgeries.

Hope all are healing well!
6/07-L TTT & LR
6/08-R TTT & LR
6/09-Bilateral ACI
7/10-R derotational femoral & tibial osteotomies, LPFL reconstruction
6/11-L derotational femoral & tibial osteotomies, R hardware removal
1/12-L tibial hardware removed, R scapulectomy
4/12-L femoral hardware removed
7/12-L & R MPFL reconstruction

Offline joanfan123

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #55 on: November 08, 2012, 12:49:48 PM »
I also have hip impingement and I was trying to do both my hip and knee at once and told I couldn't since the rehab contradicts each other too much. For example you cannot do SLL after hip surgery. I was also told I could not do both hips at once either:(
May '10- PT LK
June '11- PT LK
October '11- Cortisone LK
11/8/11- Arthroscope Fat Pad trimmed LK

Offline Teacher2Many

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #56 on: November 12, 2012, 04:22:31 AM »
Follow-up visit with my OS tomorrow at 15 weeks 5 days post-op!  Eager to see what his thoughts are on the flexion and continued pain, as well as swelling, AND the notion of possible chondral defects causing the clunking in both knees.  2:45 pm tomorrow can't come soon enough!
6/07-L TTT & LR
6/08-R TTT & LR
6/09-Bilateral ACI
7/10-R derotational femoral & tibial osteotomies, LPFL reconstruction
6/11-L derotational femoral & tibial osteotomies, R hardware removal
1/12-L tibial hardware removed, R scapulectomy
4/12-L femoral hardware removed
7/12-L & R MPFL reconstruction

Offline martussa

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #57 on: November 13, 2012, 09:31:36 PM »
let us now how your appointment wend, I'm curious about clunking issue.

Offline YogaGirl

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #58 on: November 15, 2012, 05:48:28 PM »
Hey Teach! Hoping the appointment gives you some answers and some next steps!
www.peaceloveknees.com <---- check out my MPFLr blog
www.brightskyyoga.com

Offline Teacher2Many

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #59 on: November 16, 2012, 05:05:15 AM »
Quick update before I call it a night:

Saw my OS this past Monday and he is still perplexed as to why the significant amount of pain, as well as issues with limitation and daily activities.  He prescribed another round of meds to take as needed at bedtime, which is nice to have for those really bad days when OTC meds don't cut it.

As for the clunking, he agrees it is a chondral defect.  He thinks it is the same defect as in the past but I'm thinking it's a newer defect as the crepitus has almost completely resolved from the original defect and when he did the MPFLr, he looked at the defect and they were looking good.  The clunking didn't start until 8 weeks post which leads me to believe it's a new issue.  But since the symptoms, sensation, etc. are completely the same as prior to surgery, I can't 100% convince myself that they are not subluxing and the only way to tell for sure is stress radiographs under anesthesia. 

He is hesitant to go back in and do any surgery on them due to the immense number of previous surgeries and the fact that some didn't work.  But at the same time, knows there's issues to address.  So I have surgery scheduled for mid-February which I'm trying to change for the end of January due to work meetings in early-mid February.  The plan is to scope the knees, clean out the scar tissue, and some sort of release/manipulation of sorts to help with flexion.  He says he'll only do one knee at a time with a minimum of 8 weeks in between surgeries but I'm hoping he'll change his mind and agree to doing both at once.  No brace or crutches and back at work on Monday (surgery will be on a Wednesday).

After tremendous tears flowing in the parking garage, I sent a follow-up e-mail with a few thoughts, etc. after I had some time to process everything.  He is sending me to see a colleague of his out of IN for consultation on the MPFLr in hopes that he can see something we're not.  I saw him a few years ago, again per my OS thoughts, and he's the one who first noticed/diagnosed the excessive femoral anteversion so for that alone, I have faith in him and that this appt. will prove useful.

I was able to get in right away so am heading to IN on 11/26.  It's about a 3.5-4 hr. ride so not as long as when I went to MI but dreading it with it being the Monday after the holiday.  Thankfully the shingles have almost completely resolved so that is not going to be a contributing factor like it was for my MI trip.

Still contemplating when to fix the hips...will be sending out a few e-mails to inquire about dates as well as to my MI doc to see if he'd do them both at once.  And just when I thought the surgeries were done...facing at least 4 more!  :-(
6/07-L TTT & LR
6/08-R TTT & LR
6/09-Bilateral ACI
7/10-R derotational femoral & tibial osteotomies, LPFL reconstruction
6/11-L derotational femoral & tibial osteotomies, R hardware removal
1/12-L tibial hardware removed, R scapulectomy
4/12-L femoral hardware removed
7/12-L & R MPFL reconstruction















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