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Author Topic: Getting Better and Better... 6 down 1 to go?  (Read 5910 times)

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Offline randoknee

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Getting Better and Better... 6 down 1 to go?
« on: September 20, 2014, 02:05:40 AM »
It's been a long haul, but things are looking up.   I've had 6 knee surgeries since December of 2008 but there's finally some light at the end of the tunnel.

My knee story started back in Dec of 08 when I ruptured my L patellar tendon.  It was originally mis-diagnosed by a bone headed ER doc that said I had a simple sprained knee.  I finally got to see an OS had an MRI that was followed shortly thereafter by an ORIF to repair the totally ruptured tendon (mush).  About  a year and a half later I was walking across my back yard took a very slight stumble transferred my weight from the right leg to the left to keep from spraining my ankle when my left patella snapped in two diagonally.  Turns out  the tunnels that were made to facilitate the re-attachment of the tendon never back filled with bone tissue and the spectra sutures helped cause my knee cap to snap.   As I was attempting to heal up the fractured patella, I got in the habit of getting hard copies of my X-rays at follow up visits.  In comparing my patella with MRI's of a normal knee, I noticed mine didn't look quite right.  It looked like it was too high on my leg.  I pointed this out to my OS who confirmed I now had Patella Alta... and suspected when my tendon healed up, it healed too long.   He said that when my patella fracture healed, I could expect many painful years of traumatic arthritis till I was old enough to get a TKR.   Well, after about  10 months my patella was still a non-union and looked beat to s**t in the x-rays.  After trying what ever voodoo healing  to try to get the bone healed up, my OS proposed he go in take out the pins and wire and put in permanent screws and wrap a wire permanently around my patella and cross his fingers and hope my patella didn't fall apart.   I finally figured out he was just making stuff up and decided to get another opinion. ::)  It made no sense to me that, if I had crappy patellar bone health with 5 holes drilled through it a a fracture line that was still a non union, two more holes drilled through it was going to help.

So I found another OS who was  recommended to my as a "top Knee specialist".  I saw him and he proposed a different procedure but said most likely I'd have to loose  my patella.  ???  As someone who enjoys long distance cycling I consulted a cycling coach who'd never heard of anyone partaking in multi day rides of 400+ km/day without a patella.  He suggested I go see Dr. Eric Heiden (Olympic Speed Skater, bike racer and orthopedic surgeon). 

I flew down to Utah to see Eric and his partner Phil Davidson for my 3rd and 4th opinions.  I ended up having Dr. D remove the hardware and scope the knee as he felt there was some other stuff going on in the joint.  Turns out in addition to the partial  non union and patella alta, I also had bone on bone in the PF compartment. We came up with a long term plan to deal with my knee issues.   About a year later I had an MRI on my left knee to see the progress of the healing of the left knee cap and had my right knee scoped to clean things up and to see what was going on in there too.  He confirmed I was bone on bone in my right PF compartment as well.  I was at the painful deep burning pain in both knees when just sitting or lying in bed.   Last November I had Phil do a PFA on my right knee.  His plan was to get my good knee as good as he could get it before proceeding to fix up my left (bad) knee.  The right one done, about 13 weeks ago I had him do a PFA on my left knee.   

I'm now almost totally pain free in both knees!, but hey, I'm less than 4 months post surgery on the left knee PFA.   Now that the pain is decreased I'm less "guarded" in my daily activities and am now noticing the poor stability in my Left knee, due to the patella alta and my tendon being 23 mm too long.  If I don't consciously contract my quads to take up the slack in my tendon, my knee is unstable.  So in addition to continuing my rehab after the two PFA procedures and getting my endurance back in the legs I'll need to decide if and when to have a MPFL procedure to take the slack out of my left knee.  The MPFL is the final procedure I'm not very crazy about.   I know how much it sucks to do the immobilization thing, but it's probably an issue of 1 step back and two steps forward.

I've seen a number of postings on this site giving the Arthrosurface Hemicap - PFA a bad wrap, but so far, I'm very happy with the outcome.   My surgeon is working with me in a measured and staged approach that does not create conflicting rehab issues by trying to tackle too many things at once.  It's been great to have a plan and working with a practice that's interested in getting me back to doing the things I love to do.   I might not make it back to riding Paris-Brest-Paris next summer, but who knows, maybe I'll be there in 2019. 8)
12/08 L patellar tendon rupture (mush) -ORIF  -  8/10  fx of L patella  - 8/10 ORIF L Patella 9/10  dx patella alta  - 2/11 dx "delayed union" - 6/11  L knee scope / HW remvd.- 6/13  R Knee Scope - 11/13 R knee PFA - 6/14 Left knee PFA - 10/14 L Knee TTO- 11/16 L patellar tendon repair & augment

Offline zigmude

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Re: Getting Better and Better... 6 down 1 to go?
« Reply #1 on: April 28, 2015, 06:44:58 AM »
Hey Rando really happy to read about your success story. Im going through something similar and often feel like there is no light at the end of this tunnel.

Give us an update when you get the chance.
2011-Bilateral debridement
2012-Partial Meniscetomy
2012-Right knee trochlea paste grafting
2013-Left knee trochlea paste grafting
2013-Right knee ACI biopsy
2015-Right knee medial condyle abrasion