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Author Topic: Patella alta; pain and frustration :(  (Read 2599 times)

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Offline Gotic0

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Patella alta; pain and frustration :(
« on: June 16, 2012, 04:50:30 PM »
Hi everybody! I'm new to this forum. I'm 19 years old guy, so nice to meet you all !
First off I'm italian so I want to immediately clear up that i'm sorry for english mistakes.
Secondly, as you've just read it from the title of this topic i've patella alta in both my knees and i'm struggling with this issue since the first day i was born.
Unfortunatelly there are no italian forums like this one to talk directly to those people who have the same problem as well.

I discovered that pathology 4 years ago, while i was holding a tae kwon do exam.. I kicked hard with my left knee to the air and i fell over right away, the only memory i'm still having of that day is that i was lying on the floor with my left knee in pain.. but i think i'm going off the rail. Anyway the result was a sub dislocation (non complete). After this main injury some new ones followed but not as severe as the sub dislocation. I'll be clearer; I sometimes happen to have either my left or right knee blocked, completely blocked. As soon as i try to straighten it, i feel pain all over the whole area of my knee, but it takes a bit of energy to straighten it and listen to "cllck" and my knee joint turns to be normal. (i hope you understand)
Some months after that unpleasent event (sub dislocation), I did physiotherapy for a little cause i got bored, but after a while I trained my left knee in a gym for 1 month.



I also remember some episodes of those blocks happened some times when I was about 10, 13, and 14 years old. Each and every orthopaedic i went to (2 in total), said to me I did not need surgery but they did not explain me why.
I cannot live with this issue forever, because i really get angry with it every time i see my kneecaps and when i try to forget it, i can still feel the constant "creaks" in both my knee while i'm walking.. Also burst into crying when i think there's no way out!  :-\

I'm here to ask if there is any procedure which includes cutting the tibial tendon   transversely, removing some inches of that useless issue and sewing it back. I watched a procedure called TTT on youtube but it seems to be done by a butcher. :((

My passion now is dance, in particular breakdancing (7 years). I could be a professional dancer if had not patella alta.

Tell me your experiences, everything you know which may be helpful! Please. Thanks for your attention.
« Last Edit: June 16, 2012, 05:04:22 PM by Gotic0 »

Offline The KNEEguru

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Re: Patella alta; pain and frustration :(
« Reply #1 on: June 16, 2012, 05:19:56 PM »
Hi
Just to help you with words -

What you are calling 'sub-dislocation' - maybe you do mean that, but perhaps the word you are wanting is 'subluxation'. We have a dictionary here - http://www.kneeguru.co.uk/KNEEnotes/subluxation . Also, what you are calling 'blocking' - maybe you mean 'locking' or more probably 'pseudolocking'.

Here is a description of the TT procedure - http://www.sportsortho.co.uk/left-navigation/treatments/knee/patella-alta-high-riding-patella

You will probably need to know also if you have any trochlear dysplasia in addition to your patella alta.

There are details of the tendon shortening procedures here - http://www.patellofemoral.org/pfoe/PDFs/ISAKOS_Patella_Alta_Symposium_Outline.pdf
--
KNEEguru

Offline Gotic0

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Re: Patella alta; pain and frustration :(
« Reply #2 on: June 16, 2012, 09:18:44 PM »
Yeah, I didn't know it was called subluxation.
Does your third link claim that the operation I suggested brings only disadvantages than TTT?
According to my magnetic resonance diagnosis there is nothing about trochlear dysplasia written on it.

Those "locking" are really strange, do you think they're caused by patella alta? Once it occured while i was simply stretching my left knee..

What's your best advice even though you don't know my complete diagnosis at all? I'm quite aware of what post surgery may brings on at worst, but sooner or later i'm going to drive mad if don't cure my issue..
« Last Edit: June 16, 2012, 09:23:41 PM by Gotic0 »

Offline Adobec

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Re: Patella alta; pain and frustration :(
« Reply #3 on: September 06, 2012, 03:19:48 PM »
Have you done anything with your knee yet?

I also have patella alta in one knee.  I am 38 and was a competitive soccer player, never had problems with this left knee.  Had  left ACL and meniscus surgery in march 2011 and was having trouble running (mechanically i couldn't do the running motion) at 4 months post-op.  I was also having lots of locking/catching.  My doc said that the patella alta would work itself out once I got my quad strength back from the ACL surgery.

In January, I had my quad strength back but was still locking.  I also had pain, turns out my medial meniscus didn't heal from the repair 9 months previous, so we made arrangements to scope the knee and simply remove the damaged medial meniscus.

Lots of background, sorry :)

Anyway, during the operation my surgeon found a stage 4 chondral defect in my femoral trochlea.  I'd never had problems or pain under the kneecap, and one year ago during my ACL surgery, all cartilage was normal. 

So, in one year exactly, that cartilage went from PERFECT to stage 4, which is down to the bone!

I had microfracture performed in hopes that the pothole would fill.  It seems to have worked, but I am still having mechanical problems.

Right after this microfracture surgery I  asked my doc, who is a dear friend, why on earth my cartilage could have gone to hell in one year.  He didn't know.  It was devastating news, though -- you can recover from ACL surgery (or 3 in my case!!) and move on with things, but after microfracture it is highly recommended that you cool off your athletic pursuits.  So I went from playing soccer and doing crossfit-- to yoga, bike, elliptical and swimming (yawn!!!).

6 months postop from microfracture -- I can barely walk.  Hurts every time I bend that left knee. 
Went back to the doc, he is stumped but made a plan -- to start treating it very conservatively and progress from there.

I had a cortisone injection 2 weeks ago -- hoping to decrease inflammation from scar tissue or plica??
This helped with locking for a day or two.  Didn't make it go away completely, just reduced it from about 10 times during a yoga class to 2.
My locking happens when going from full extension (maybe even hyperextension) to bent with a strong quad contraction.

My doc also gave me a brace to help with patalla tracking.
I despise knee braces, but have found so much comfort from this thing.  I can mechanically go down stairs, squat, even walk without pain. 

So, how this relates to you?
You are young -- your cartilage is healthy, but in my experience, patella alta damaged the cartilage in my femoral trochlea VERY quickly.  I would do whatever it took to get my patella tracking correctly if I were you... whether it be surgery or simply a brace. 


Best of luck to you!!!!!!
1991 - R ACL patellar tendon, med. meniscus removed (50%)
2002 - R ACL revision, cadaver, lat. meniscus removed (50%)
2011 - L ACL patellar tendon, med. and lat. meniscus REPAIR. 
3/2012 - L Medial meniscectomy (didn't heal from 2011), microfracture
11/6/12  - L TTT (maquet). Micro fully healed

Offline warsang

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Re: Patella alta; pain and frustration :(
« Reply #4 on: December 28, 2015, 01:28:41 PM »
Hey I know you haven't logged in for some time now but I have exactly the same problem (dysplasia and breakdancing) and would really like to talk about it. Just leaving a message there hoping you'll give me an answer :)















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