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Author Topic: MPFL repair problems  (Read 1177 times)

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Offline mphilpott

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MPFL repair problems
« on: December 27, 2012, 01:44:47 PM »
Hey guys, I thought I would post what has happened to me and the problems, any knowledge or advice is greatly appreciated.

(PMH) So I've always had problems with my knees, I was sporty as a kid and played a lot of football but struggled to keep it up because I had pretty bad Osgood-schlatters bilaterally. I then subluxed my left knee when I was about 15, and as the pain and swelling persisted over several months, I had an arthroscopy which (as far as I know) found no major pathology but general wear and tear. I'm now 21 (6 years post any other major knee problems. 

Back in May I decided to have a kick around for the first time in a long time, and 10 minutes I swiped at a ball with my R foot, and my L patella dislocated. I can't be sure if it was medially or laterally as at the time I was more focussed on the excruciating pain. It then relocated when I stood up again. I left it for 24hrs but then finally went to A&E, was put on crutches and a knee splint and it was arranged for me to see an orthopod the following week. An MRI was arranged quite urgently (god bless the NHS) which showed as far as I know quite a heavy tear within the MPFL and a lot of bone bruising. 16 days later I underwent MPFL repair and was on crutches for 6 weeks.

(POST OP) I've now done physio for around 5 months, strengthening the proximal muscles, and although the measured strength is now higher than my R knee in both flexion and extension, I seem to have more problems now than I did before having surgery. The main trouble I have is constant effusions I get after doing any exercise, or standing up too long. It comes along after doing just a few knee dips and makes the patella very mobile within the joint, and it's very common that I'll feel it 'slip' and I have to double take when walking, which can be a real pain. It also makes the joint quite stiff, which makes a prolonged physio session very difficult. The pain has as good as gone now which is good, but comes back when doing particular exercises. Step downs are the main thing I really struggle with, and can still only step off something like a book, as a stair causes too much pain.

So that's it really now.. I'm 7 months post surgery, 5 months physio. Anyone else struggle with these problems after an MPFL repair (was not reconstruction)? There is very little literature as it's a relatively new procedure as far as I can tell and some doctors still prefer the non-surgical approach.

Anything would be great guys, Many thanks.


 

Offline RLE

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Re: MPFL repair problems
« Reply #1 on: December 27, 2012, 06:17:19 PM »
I had a reconstruction not a repair so I'm not qualified to comment but honestly it sounds like by 7 months you shouldn't be having these problems. What do your OS and PT say? My PT has been a wealth of information. She was the only person who figured out what was going on with my knee until I found my final surgeon. But the good ones (PTs) are really good. Also it it joint or muscle stiffness?
Accident 2011: permanent dislocation, hole under the patella, bone fragments/debris embedded, scar tissue, 3 torn ligaments, fracture, cartilage sheared off, contracture,
2011 MUA
PT on-going
2012 MPFL reconstruction,TTT
        TTT
        Lateral lengthenin
        Arthroscopy/clean out
Thx Dr. T

Offline mphilpott

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Re: MPFL repair problems
« Reply #2 on: December 27, 2012, 06:29:57 PM »
Thanks for your reply, that was my feelings as well, although it's so difficult to tell due to the massive lack of journal literature. My OS I haven't actually seen since the surgery, I went in to clinic 6 weeks post op which was ran by a different OS, who asked me if my scar was healing nicely and then just discharged me (great patient care). My PT is awful, and I try avoid going now as he is of no help at all. I've told him consistantly about the recurrent effusions and pain, and he has no answer, nor any recommendations. He keeps telling me to wear a brace as then the patella won't move as much, which doesn't really help me in finding out why it's happening. I don't want to be wearing a patella brace for the rest of my life as it's god damn uncomfortable. I'm finally hopefully getting another appointment with the OS in the new year, but really don't know what to expect.

Offline allyd

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Re: MPFL repair problems
« Reply #3 on: December 27, 2012, 06:59:58 PM »
I don't think it's uncommon to still have some swelling/stiffness in your knee 6-7 months post-op in generality. I know I did - I also had a reconstruction, not a repair. To hard to say if yours in normal or being caused by some complication, definitely try to get in to see your OS. Our bodies all react differently... and normalcy can sometimes take up to a year. It took almost a year before my knee didn't swell up some after activity. Are you taking NSAIDS or anything like that to try to control the effusion?

You may want to check out the post-op diary of a user "Krunzer" as I know she had a repair (medial imbrication).
04/09 RK - Dislocated Patella & Grade III MCL Tear
06/10 RK - Re-Dislocation Patella
09/11 RK - MPFLr + Lateral Lengthening

Offline RLE

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Re: MPFL repair problems
« Reply #4 on: December 27, 2012, 10:00:22 PM »
Thanks for your reply, that was my feelings as well, although it's so difficult to tell due to the massive lack of journal literature. My OS I haven't actually seen since the surgery, I went in to clinic 6 weeks post op which was ran by a different OS, who asked me if my scar was healing nicely and then just discharged me (great patient care). My PT is awful, and I try avoid going now as he is of no help at all. I've told him consistantly about the recurrent effusions and pain, and he has no answer, nor any recommendations. He keeps telling me to wear a brace as then the patella won't move as much, which doesn't really help me in finding out why it's happening. I don't want to be wearing a patella brace for the rest of my life as it's god damn uncomfortable. I'm finally hopefully getting another appointment with the OS in the new year, but really don't know what to expect.
By your original post your kneecap is still dislocating or slipping out of place correct? That definitely shouldn't be. The whole point of surgery is not to wear those stupid braces (I wore one for 10 years, gosh I hate them) Now my kneecap is firmly in place.
 If you have any options a new PT at least would help. You don't want him to cause any damage to the knee until you've talked to the OS.
Accident 2011: permanent dislocation, hole under the patella, bone fragments/debris embedded, scar tissue, 3 torn ligaments, fracture, cartilage sheared off, contracture,
2011 MUA
PT on-going
2012 MPFL reconstruction,TTT
        TTT
        Lateral lengthenin
        Arthroscopy/clean out
Thx Dr. T















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