Advertisement - Hide this advert





Author Topic: Patellar Infera/Baja  (Read 2802 times)

0 Members and 1 Guest are viewing this topic.

Offline KinnaMarie

  • Regular Poster
  • ***
  • Posts: 98
  • Liked: 0
Patellar Infera/Baja
« on: August 19, 2012, 01:56:42 AM »
I was wondering if anyone knows about or have dealt with patellar baja or infera?  I've had 4 knee surgeries after dislocating my knee cap 2 years ago.  I have been in physical therapy since the original injury and my last measurement for ROM was 47 degrees.  I went to a new OS and he was feeling around my knee and said I clearly have a lot of scar tissue, and then got really concerned that my knee cap was sinking/sitting low which explains why I can't fully extend my leg as well as explains why it hurts when I bend my knee.  He then wanted an x-ray of me standing and bending my knee as much as I could tolerate and from the x-ray he says I clearly have patellar baja because from the images my kneecap is at least 1 cm lower than the good leg. 

So if anyone has any experience with or information about patellar baja please let me know!   

Offline greatfulgann

  • Regular Poster
  • ***
  • Posts: 123
  • Liked: 6
Re: Patellar Infera/Baja
« Reply #1 on: August 19, 2012, 03:33:14 PM »
You will get more responses if you post in section Soft Tissue-Arthrofibrosis. 

Offline missmyknee

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 2083
  • Liked: 20
  • From the Land of OZ
Re: Patellar Infera/Baja
« Reply #2 on: August 20, 2012, 08:14:52 PM »
Kinnamarie

I had arthrofibrosis (excessive scar tissue ) so bad that I developed patella baja and infrapatellar contracture syndrome. I developed this after surgeries to repair a broken leg and the surgery thru my patella tendon to place an IM rod down my tibia. My OS had no knowledge of arthrofibrosis or patella baja. Early recognition and treatment are key to preserving the function of your knee. You need to see a doctor who has seen and treated many cases of AF and patella baja.  Here is a link to an older post that was recently added to, about patella baja. Make sure you read all the links listed in the post.

http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=7937.0

Here is a link to doctors who specialize in treating arthrofibrosis

http://www.kneeguru.co.uk/KNEEnotes/node/427

Here is a link to information on arthrofibrosis in the Information Hub. Read it thoroughly esp the 12 part tutorial from Dr Frank Noyes, an arthrofibrosis expert, esp with patella baja

http://www.kneeguru.co.uk/KNEEnotes/taxonomy/term/71

You might want to go down to the arthrofibrosis section

http://www.kneeguru.co.uk/KNEEtalk/index.php?board=9.0

Feel free to ask questions. You will become a well informed and proactive patient in your care by reading all the info in those links.

Pam
4Fx Clsd red
IMrod fib plate
derotate osteotmy tibfib
AF
IPCS patbaja
DeLeeOsteotmy,LOA,LR Zplasty,bongrf,chondrplty
chondrplty,LOA,fatpad remvd
TKR
openLOA,neurectmy,ITB Zplasty,fabela
PLC recon,revison,LOA,synovec
MCL,revison LOA
openLOA,prox Zplasty
openLOA, 6 neuromas excised,synov
3 Fusions

Offline KinnaMarie

  • Regular Poster
  • ***
  • Posts: 98
  • Liked: 0
Re: Patellar Infera/Baja
« Reply #3 on: August 21, 2012, 03:59:47 AM »
Hi Pam,

Thank you for the reply and helpful information.  I tried doing some research by just googling patella baja, but have found little information so I turned to here.  I did have a form of a TTT (fulkerson osteotomy) and MPFL, LR, and removal of scar tissue in January of 2011.  I then had the screws removed and more scar tissue removed in July of '11 and then sutures removed and more scar tissue as well as my OS fully bending and stretching my knee in January of 2012.  So each of the surgeries I have had scar tissue removed plus have been in PT twice a week for 2 years.  So I don't get why scar tissue keeps coming back....  Plus I have been working on strengthening my quad which seems like forever, but its still weak and my knee still gives out at times.  I am just frustrated and kind of mad that this has been going on for so long, and then it scares me that you say early recognition and treatment is important.  I am only 23 and was very active, but I try to ignore it, but its hard when you struggle bending your knee.  I see the new OS again on Wednesday because he needed a week to review my 2 years of almost weekly visits with my OS, 9 MRI's, millions of x-rays, and countless other tests/reports before he tells me what he truly thinks.  I want answers, but am afraid of the truth.  I am also starting a new job in 2 weeks so essentially if he does say surgery is the only option, I can't do anything till next summer because I just graduated as a teacher. 

Offline missmyknee

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 2083
  • Liked: 20
  • From the Land of OZ
Re: Patellar Infera/Baja
« Reply #4 on: August 21, 2012, 08:51:42 PM »
Kinnamarie

Scar tissue forms when there is inflammation. It is normal for a body to experience this the first 2 weeks after surgery, as it heals, but then it shuts off. In arthrofibrosis, it doesn't shut off and continues the process. If your knee has remained swollen, is warm to hot and painful this sets of a cascade of events at a cellular level the promotes scar tissue production. Physical therapy that is aggressive will cause the knee to become inflamed. Forceful bending can cause micro tears to tight tissues adding to the inflammation cycle. Some people are predisposed to this scar tissue formation.

Doctors who are specialized in arthrofibrosis have surgical techniques for scar tissue removal and know all the places it can hide. They use prescription anti-inflammatories, cortisone shots, medrol dose paks to help break the inflammation cycle. They have their own PT dept with PT trained to do the specialized rehab for arthrofibrosis. It takes a lot of patience and diligence to rehab from arthrofibrosis. ROM is worked on before strengthening.

Read thru all the info links I gave you esp the 12 part tutorial. It will help you understand what you are experiencing. I would highly recommend seeing a doctor on the AF list as they truly know what to do and how to do it. Most of us in the AF section have had to travel to see one. I travel 700 miles to see mine.

Pam

4Fx Clsd red
IMrod fib plate
derotate osteotmy tibfib
AF
IPCS patbaja
DeLeeOsteotmy,LOA,LR Zplasty,bongrf,chondrplty
chondrplty,LOA,fatpad remvd
TKR
openLOA,neurectmy,ITB Zplasty,fabela
PLC recon,revison,LOA,synovec
MCL,revison LOA
openLOA,prox Zplasty
openLOA, 6 neuromas excised,synov
3 Fusions

Offline KinnaMarie

  • Regular Poster
  • ***
  • Posts: 98
  • Liked: 0
Re: Patellar Infera/Baja
« Reply #5 on: August 25, 2012, 03:53:45 AM »
Hi Pam

I truly do thank you for all the information you have provided.  I saw the OS this week, who was not very nice, and he came in the room and sat down and pretty much said i'm screwed and there is nothing he can do.  He said I need to help myself and tell my brain to tell my leg to work right.  He said it is completely full of scar tissue and the tendon is shortened and pulling my knee cap down a significant amount, but he can't do anything for me.  I refused to look at him because I was going to cry and said I would be more than happy to bend my knee if it didn't hurt when I would bend it.  It just doesn't fell right and it feels as if bones are rubbing together.  He also informed me that he should do surgery, but refuses to do the surgery on me because I can't bend my knee now so why would he remove the scar tissue and fix the tendon when it will just scar up again (I wouldn't/can't have surgery now because I just graduated and am now a kindergarten teacher...but I was hoping for a simple fix to make this all stop hurting and I don't want to do more damage.)  So I guess I am just stuck in pt till I will eventually give up (which will probably be very soon.)  This new OS also didn't tell me to come back...just gave me a new prescription for pt.  Plus I really don't see the point to seeing my other OS, who really is amazing and has done so much for me, but he is at a lose at what to do but says he is concerned and tells me to keep coming back (but I am sick of hearing the same thing...)

     

Offline missmyknee

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 2083
  • Liked: 20
  • From the Land of OZ
Re: Patellar Infera/Baja
« Reply #6 on: August 27, 2012, 09:13:20 PM »
Hi Kinnamarie

The OS telling you that you can bend your knee if you really want to is absolutely wrong, despicable and irresponsible. No amount of PT can help when you have a knee full of scar tissue.Patella baja is a very serious condition for a knee to have....if not the worst ( as my doctor told me)  You need to see one of the arthrofibrosis experts to get it resolved and the sooner you take care of it, the better. With your patella pulled down too low, it causes damage to the cartilage on the backside, which leads to a TKR.  Scar tissue needs to be treated early, before changes to your patella tendon become permanent. There are ways to correct this problem. One involves a special TTT for baja, called, a Delee osteotomy, for patella baja, another is a patella tendon lengthening. You need to see an AF expert because they do know how to do the surgeries for scar tissue, the post-op protocals and special rehab that AF requires to try and keep scar tissue from forming.

You are at a very crucial period where you need an AF specialist. Dr Noyes in particular has treated many cases of baja and performs the tendon lengthening procedure. You can put skibum9, in the search box and bring up her old posts. She had it done in 2007 or 08. I had the Delee osteotomy for patella baja done in 2002.

I don't mean to scare you but you need to see one of those AF docs for your AF and patella baja.

Pam 
4Fx Clsd red
IMrod fib plate
derotate osteotmy tibfib
AF
IPCS patbaja
DeLeeOsteotmy,LOA,LR Zplasty,bongrf,chondrplty
chondrplty,LOA,fatpad remvd
TKR
openLOA,neurectmy,ITB Zplasty,fabela
PLC recon,revison,LOA,synovec
MCL,revison LOA
openLOA,prox Zplasty
openLOA, 6 neuromas excised,synov
3 Fusions