Advertisement - Hide this advert





Author Topic: Upcoming MPFLr with possible TTT after 11 years of patella dislocations!  (Read 715 times)

0 Members and 1 Guest are viewing this topic.

Offline Ouchy

  • MICROgeek (<20 posts)
  • *
  • Posts: 16
  • Liked: 0
So this is my first post on Kneeguru, I'm starting off in the 'general knee questions and comments' area as I'm not sure where I should be going!

I thought a good place to start would be the long and colourful history of my terrible right knee and my not so great left...

I'm 22 now and I've have trouble with my knees since I was about 11, possibly younger but I can't really remember. I'm hyper flexible and have had lots of trouble with various joints popping out, whenever my boyfriend squeezes my hand I lose at least 1 finger, but my knees have always given me the worst trouble.

I spent most of my teenage years in and out of knee supports, I've dislocated both knee caps doing silly things like sitting on a twisting desk chair and tapping my knee against the edge of the desk as I have turned... that hurts! I've also had more major dislocations through hiking and snow boarding (never again) and suffer from subluxations on pretty much a daily basis.

When I was much younger my parents took me back and forth to my GP almost monthly, but I was constantly told I would 'grow out of it' and more or less just gave up trying to get anything done about it. So, I carried on from 16 though to about 20 just putting up with it and trying to get on with my life. Stairs would be a major problem, and nights out were a no go as my knees couldn't stand it and I was also prone to fainting which just made it even worse, but I didn't hit anymore major problems until October 2010...

...Right, here goes nothing attempting to post this, if it is successful I will be back with the story of October!

2001-2010 - Multiple dislocations of both patellas
October 2010 - R patella dislocation during first aid training!
June 2011 - R arthroscopy with lateral release & debridement
August 2012 - R MPFLr

Offline Ouchy

  • MICROgeek (<20 posts)
  • *
  • Posts: 16
  • Liked: 0

It worked!  :)

So I will continue with my story... sorry if this is a bit longwinded, I just thought it would make sense to explain how I've got my knee into the state it is currently in before I start explaining what my surgeon is trying to do to fix it!

So, October 2010... I've worked part-time with disabled children for years and did this as a part-time job whilst at uni, on the day in question I was doing training for my job, including physical intervention training (to keep children safe when they are lashing out) and first aid training.

I had just been the 'child' in an emergency restraint exercise and the trainer asked if I would mind staying face down on the floor and pretending to be unconscious so that one of the other trainees could practice the recovery position. Obediently I closed my eyes and feigned unconsciousness, the girl took my leg and pulled it round and out...

...my leg moved, my knee cap stayed where it was stuck to the mat.

At this point the unfortunate girl pushed my leg up, causing a crunch and a lot of swearing. I don't think I have ever been in so much pain, I almost blacked out and could to see anything. I grabbed my leg and could feel my kneecap stuck towards the back of my knee, and had to concentrate as I knew if I could straighten my leg back out it should ping back into position like it has done before.

I managed to get my leg straight but it wasn't budging, my trainer was asking people to call an ambulance but I was refusing and spitting out words that I hope will never cross my lips again! Slowly, with lots of effective grinding noises, I managed to get my knee cap back into place.

I refused to go to the hospital or to my doctors as I've dislocated it before and I was sure it would be ok. A kindly colleague drove me home and my boyfriend picked me up some strong painkillers which my doctor prescribed after I phoned and said it was fine but hurt! It wasn't until 3 days later when I still couldn't put weight on it, and because I kept trying to, it gave way completely again and I ended up in A&E having X-rays with a very disapproving doctor!

I spent the next 3 months on crutches and 6 months after that with hinged knee braces on both legs (because my left one started going as well when it had to do all the work) waiting my my surgeon to do an arthroscopy and lateral release on my right knee. My physiotherapist during this time really really tried, as did I, but nothing I tried would make it settle down so in June 2011 I went in for an arthroscopy and lateral release, and I shall explain this next!

2001-2010 - Multiple dislocations of both patellas
October 2010 - R patella dislocation during first aid training!
June 2011 - R arthroscopy with lateral release & debridement
August 2012 - R MPFLr

Offline Ouchy

  • MICROgeek (<20 posts)
  • *
  • Posts: 16
  • Liked: 0
So, June 2011 - Right knee arthroscopy with lateral release and debridement (I didn't find out about the debridement until after I had it done!)

I went in as an outpatient to Exmouth hospital (I was in Exeter at the time and had just finished my undergraduate degree) very early one morning. The staff were all very friendly and after a quick pregnancy test (they always insist even when you are already sure you are not) I was good to go.

The surgeon, the first time I had met him, and the anaesthetist came and explained what they were planning to do and labelled up my leg. I went off to theatre and came back an hour or so later in no pain but shaking uncontrollably from the anaesthetic. Once this had worn off I had a dull ache in my leg but it wasn't too bad. I was sent home on crutches after about 5 hours, with instructions not to use my knee brace while it healed and to stay off it until I had seen the physic team back home in Wiltshire. I was given some minor exercises to do in the meantime and lots of painkillers.



Fast forward 1 year.... I recovered reasonably well from my lateral release, I was on crutches for a while and then used my knee brace occasionally for driving to start off with but no longer use it regularly. The lateral release definitely helped but my knee is still incredibly unstable and subluxes all the time, something as minor as pulling the duvet off it can make it dislocate completely.

I have been back to see my surgeon in Exeter and he thinks I may be a good candidate for a MPFL reconstruction. However, although he is a knee specialist and lovely he does not do many of them. He has a colleague in Cornwall who is apparently very good at them, so I was packed off down to Truro (only a 4 hour drive!) to see him...

If anyone has any questions about my lateral release and debridement and/or just the arthroscopy feel free to ask them. I'm now just over a year on so may be able to offer some sensible answers, you never know!

My scars so far are just keyhole and very neat indeed, I've attached some photos of it with the dressings (lovely) and then a few weeks after the surgery below.
« Last Edit: July 11, 2012, 08:53:42 PM by Ouchy »
2001-2010 - Multiple dislocations of both patellas
October 2010 - R patella dislocation during first aid training!
June 2011 - R arthroscopy with lateral release & debridement
August 2012 - R MPFLr

Offline lisa424

  • Forum Faithful
  • ****
  • Posts: 217
  • Liked: 0
Lateral releases are the worst thing possible for hypermobile knees. No wonder they were dislocating even more.

Offline Ouchy

  • MICROgeek (<20 posts)
  • *
  • Posts: 16
  • Liked: 0


I know, although they did explain their reasoning to me and it has seemed to help slightly.

The reason the consultant thought a lateral release was appropriate was that because my patella has dislocated so many times, and always outwards, where the muscle and ligament has healed the lateral ligament had healed up very short and the medial one was just waving around in the breeze like a piece of ribbon not doing a lot. This meant that the lateral one was actually pulling my patella out of position every time I moved my knee. He acknowledged the medial one was also a problem but felt that releasing the lateral one might do enough to stop my patella being pulled out. I agreed to try this first as obviously a LR is less extensive than a MPFLr, and if it had worked it would have been lovely!

Unfortunately it hasn't done enough, and while my knee isn't as bad as it was prior to my first surgery, i.e. I can walk without supports more of the time, although my folding walking stick and knee brace have a permanent home in my hand bag, it is still extremely unstable.

So the plan is now to go ahead with the MPFLr in the next month or so. I have an MRI last week which the surgeon ordered to see if I also need a TTT, I'm kind of hoping that I won't as I really don't want to be out of work for too long, and possibly to do a second lateral release as they have said that it is still extremely tight, despite the first one.

I hope that all makes sense!

2001-2010 - Multiple dislocations of both patellas
October 2010 - R patella dislocation during first aid training!
June 2011 - R arthroscopy with lateral release & debridement
August 2012 - R MPFLr

Offline Ouchy

  • MICROgeek (<20 posts)
  • *
  • Posts: 16
  • Liked: 0

I was also wondering, does anyone know what sort of recovery time is normal following a MPFLr? and if having a TTT on top of this would increase it and if so by how much?

I drive a lot for my work, so the main thing is how long it will take for me to get back to driving my manual car? Once I'm at work I can get about on crutches if need be, and I can work from home a fair amount, the main thing is that I run groups out in the community for stroke survivors twice a week, and need to get back to doing this as soon as possible after my surgery!

Any advice would be hugely appreciated!

Thanks  :)

2001-2010 - Multiple dislocations of both patellas
October 2010 - R patella dislocation during first aid training!
June 2011 - R arthroscopy with lateral release & debridement
August 2012 - R MPFLr

Offline lisa424

  • Forum Faithful
  • ****
  • Posts: 217
  • Liked: 0
Of course when your knee dislocates laterally it's the mpfl that's gonna get damaged. But your surgeon is wrong- those lateral ligaments actually help prevent lateral dislocations and that's why lateral releases are so bad.
A lateral release is way more invasive than the mpfl actually!

I had my lateral release "reversed" and also a TTT and mpfl reconstruction. The TTT usually takes 6 weeks to heal up. Of course having both surgeries can mean a longer recovery period. The rest depends on your surgeons post-op protocol. If you're not immobilized in a brace and you're full weight bearing and moving it as soon as possible it'll be a faster recovery. If its your right leg you probably don't wanna drive until you feel comfortable.

Offline krunzer

  • Forum Faithful
  • ****
  • Posts: 293
  • Liked: 2
I've been 15 years with patella dislocations and on Dec. 1 I had a LR along with medial plication.  So far everything is ok.  I am still recovering but I can walk normally and go up and down stairs with little trouble.  The true test will be this winter when I start back into my winter sports (snowmobiling).  But I no longer need to wear a brace, though I don't think it was helping anyways.  Good luck with your surgery.  You can look at my post-op diary, it's under Lateral Release and Patella stabilization surgery.
















support