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Author Topic: Knee realignment surgery v Physio for 13 yr old  (Read 6299 times)

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Offline Debbie13

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Knee realignment surgery v Physio for 13 yr old
« on: December 10, 2013, 05:24:49 PM »
Hi, I'm hoping to get some advice here please. My daughter is 13 and had her 1st patella dislocation on 3rd Oct this year. Since then she's had 8 more subluxations and dislocations, most of those with a brace on. Her orthopedic surgeon decided yesterday that realignment surgery is necessary and has booked her in for surgery next Monday. My problem is that she's only had physio for about 6 weeks and I'm concerned that he's rushing into surgery that may be unnecessary. If anyone has had any similar experiences, especially in someone so young I'd really appreciate hearing them.
Thanks

Offline fire535

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Re: Knee realignment surgery v Physio for 13 yr old
« Reply #1 on: December 11, 2013, 08:02:01 AM »
Ensure a full work up is done.  Make sure to rule out rotational issues with both the tibia and femur.  Only the proper approach surgically will aid your child.  Make sure to go to a patellofemoral specialist.   

Offline Debbie13

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Re: Knee realignment surgery v Physio for 13 yr old
« Reply #2 on: December 11, 2013, 10:37:40 AM »
Thanks fire535
At the moment I think I'm going to postpone the surgery and try for a second opinion. It all seems very rushed. My main problem is if the surgery is necessary I'll have lost our surgery slot and waiting lists are very long here :-(

Offline Vickster

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Re: Knee realignment surgery v Physio for 13 yr old
« Reply #3 on: December 11, 2013, 10:39:39 AM »
What country are you in.  Perhaps someone can suggest a surgeon for a second opinion :)  This forum is pretty global
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline Debbie13

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Re: Knee realignment surgery v Physio for 13 yr old
« Reply #4 on: December 11, 2013, 01:35:25 PM »
Thanks Vickster, that's a good idea. I'm in Ireland so if anyone can recommend a good paediatric orthopedic surgeon I'd really appreciate it :-)

Offline Vickster

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Re: Knee realignment surgery v Physio for 13 yr old
« Reply #5 on: December 11, 2013, 02:23:49 PM »
There was a poster not so long ago in Ireland called bradyj7 who spoke very highly of a surgeon called Ray Moran

Here's one thread

http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=62258.10;wap2
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline Debbie13

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Re: Knee realignment surgery v Physio for 13 yr old
« Reply #6 on: December 11, 2013, 05:30:51 PM »
Thanks Vickster, he's actually my dads doc and is a great surgeon but doesn't see kids unfortunately

Offline Vickster

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Re: Knee realignment surgery v Physio for 13 yr old
« Reply #7 on: December 11, 2013, 06:03:39 PM »
That's a shame.  Could he perhaps recommend someone?
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline Debbie13

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Re: Knee realignment surgery v Physio for 13 yr old
« Reply #8 on: December 11, 2013, 07:12:25 PM »
Haha Vickster I'm on it - my dads going to give him a call tomorrow for me :-)

Offline Vickster

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Re: Knee realignment surgery v Physio for 13 yr old
« Reply #9 on: December 11, 2013, 07:32:04 PM »
There's a knee surgeon directory on here, by no means exhaustive but two others in Ireland in addition to your dad's chap

http://www.kneeguru.co.uk/KNEEnotes/specialists?field_pro_type_tid=4189&country=ie&city=&title=

Plus 3 in Belfast

http://www.kneeguru.co.uk/KNEEnotes/specialists?field_pro_type_tid=4189&country=gb&city=belfast&title=

Might be worth checking their websites

Good luck, I certainly wouldn't rush into anything  :)
« Last Edit: December 11, 2013, 07:38:19 PM by Vickster »
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline Debbie13

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Re: Knee realignment surgery v Physio for 13 yr old
« Reply #10 on: December 11, 2013, 08:16:06 PM »
I'll have a look at those Vickster. Thanks, you really have been very helpful

Offline Vickster

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Re: Knee realignment surgery v Physio for 13 yr old
« Reply #11 on: December 11, 2013, 08:25:00 PM »
I don't think any have a paediatric specialty, more sports injuries

Is there an orthopaedic centre at the children's hospital perhaps?
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline Debbie13

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Re: Knee realignment surgery v Physio for 13 yr old
« Reply #12 on: December 11, 2013, 09:17:50 PM »
Yes, we've been attending the orthopedic team at our childrens hospital. She had another dislocation this evening with a return to severe pins and needles. And this with her brace set to full extension! I'm really feeling under pressure but still feel I need a second opinion before we can go ahead with surgery  :'(

Offline rob2278

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Re: Knee realignment surgery v Physio for 13 yr old
« Reply #13 on: February 14, 2014, 03:44:57 AM »
Hey Debbie.. I know this thread is a few months old, but I'm wondering what the outcome was..

From the knee issues you were describing, I would think that surgery is (was?) in the card for your daughter. I had 'stabilizing' surgery myself 20 years ago when I was 14. It's not an easy decision, and my parents choose the 'least invasive option' of a lateral release/medial reefing. The surgery was essentially a band aid, as my need continued to sublux for 20 years until I had another dislocation and underwent a MPFL reconstruction a few weeks ago. Looking back, I wish I had the more invasive option, which might've kept me from having to deal with this now.. Who knows- as they say, hindsight is always 20/20!

Good luck!
Knee History:

01/1990 - R Knee - removal of bone chips
05/1990 - L Knee - dislocation
Fall 1991- L Knee - 2 dislocations
12/1991 - L Knee - LR/MR
1992-2013 L Knee subluxations
04/2008 - R knee reconstruction (torn patellar/quad tendons)
04/2013 - L knee - dislocation
01/31/2014 -MFPL reconstruction

Offline Debbie13

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Re: Knee realignment surgery v Physio for 13 yr old
« Reply #14 on: February 15, 2014, 03:24:17 PM »
Hi all, just a quick update. I decided to go with the surgery and we are now 8 weeks post op. She had VMO advancement, medial reefing and lateral release. We had major difficulties with the cast but that is off 4 weeks now and she's doing great! Thankfully she's taking rehab very seriously and is in the pool every day and exercises are done without me nagging (miracle for a teenager ☺)
So thanks to everyone for the advice and support, hopefully she'll be returning to sport by the summer, all going well.

Rob2278 your situation is my worst nightmare in all of this! I'm glad that you seem to be on the mend now and hope you finally see a full recovery. I'm praying that we don't end up down that road!!!















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