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Author Topic: Anyone in the same boat?  (Read 967 times)

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Offline citychick

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Anyone in the same boat?
« on: July 13, 2012, 04:17:56 PM »
Hello,
I am a 27-year-old female who has been struggling with prolonged left knee instability, pain and weakness. Although I am surrounded by an amazing team of specialists and surgeons, everyone seems perplexed by my continued problems. I was wondering whether anyone is having, or has had, a similar situation.

I experienced my first patellar dislocation at the age of 7, running straight ahead in my backyard. There was no trauma or injury leading up to this event. Because my patella was so loosey goosey, it always returned to position on its own. By the time my parents took me to the pediatrician, it was no longer out of position, and the doctor never ordered any x-rays or MRIs. As dislocations occurred regularly for the rest of my childhood and through high school- I always just thought it was sort of the way my knee was. I would usually be so embarrassed by the dislocation (and as a result, falling to the ground for seemingly no reason from everyone else's perspective) that I quickly became used to just getting up, shaking it off and going back to whatever I was doing. It finally became more intolerable in college, and I decided to have my first surgery before my senior year. That's when everything went from bad to worse.

Within a few weeks of having the lateral release/ medial tightening in August of 2006, I lost all muscle tone in my quad, and my patella began dislocating frequently before I was even out of the immobilizer. The pain that I felt during that recovery was the absolute worse that I have ever felt, and after switching doctors, it became apparent that a lateral release was not what I needed for my particular circumstances. In fact, it made things much, much worse. For the next nine or so months, I experienced dislocations approximately one-to-two times per week. In May of 2007, under the care of my new doctor, I had my first MPFL reconstruction (using my hamstring) and a Tibial Tubercle Osteotomy. For at least a few months, the instability decreased, and I had no complete dislocations. But the pain never went away, and despite aggressive PT, my strength would not come back. In April 2009, I had a hardware removal, after discovering that one of the dissolvable screws had broken apart. A few months after that, the instability once again worsened. I had a second MPFL reconstruction, this time using a cadaver graft, in March of 2011. And, again, less than a year out, my patella was back to subluxing. Since then, the instability, weakness and pain has increased so much, that we're looking forward to a third MPFL reconstruction, possible adjustment to the osteotomy and a cartilage transplant early this fall. None of my doctors are confident that this is the sure fix to my problems, based on my history, but they also all agree that I can't leave my knee the way it is now. It seems like our only option.

I turned 27 just a few days ago, and am heading into my fifth and sixth surgeries (the fifth to harvest healthy cartilage and the sixth for the rest of the procedures) in the last six years. I usually keep a pretty positive attitude, knowing that all of this could be worse. But there doesn't seem to be any real solution or end in sight. Any recommendations out there? Thank you in advance.

Offline kneepaincure

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Re: Anyone in the same boat?
« Reply #1 on: July 14, 2012, 12:30:13 AM »
It sounds like a hellish journey so far. Have any of your doctors checked you for rotational abnormalities of the femur or tibia? As well as the trochlear groove structure?

I don't think a TTO will solve your problems even if it is adjusted. Most likely that is not the cure for your instability IMO.
Have had tilted kneecaps for many years, and occasional patellar tendinitis.

Offline lisa424

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Re: Anyone in the same boat?
« Reply #2 on: July 14, 2012, 03:10:05 AM »
Yea you should definitely get checked for rotational abnormalities, varus, valgus and trochlear dysplasia.

Does your knee always dislocate/sublux laterally?

There are a lot of reasons grafts can fail such an improper placement, tension, fixation etc.

Are you seeing a patellofemoral specialist?

Offline citychick

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Re: Anyone in the same boat?
« Reply #3 on: July 15, 2012, 07:06:17 PM »
Yes, I've actually been to see Dr. Fulkerson in Connecticut as well as a great team of specialists here in NYC. It's for no lack of their efforts and incredible expertise...that's for sure!

My patella always dislocates laterally. Early on, the doctors did indicate that I have patella alta and a rather shallow groove, which is definitely feeding into my issues. I've never had any problems with my right knee, nor do I have laxity/ hypermobility in other joints.

In most scenarios, the MPFL reconstruction and osteotomy should have really fixed the problems I was experiencing. Everything went well in all of the procedures (with the exception of the lateral release, which I still think is the root of so many difficulties within my recovery process); the screws were placed correctly, etc. My feeling is that I have to have this next surgery done, because I really don't have any other options and I absolutely can't leave my knee the way it is now. BUT I'm also being realistic that, based on my history, it may not have the desired outcome. So fingers crossed! I appreciate the feedback :)