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Author Topic: Patella Alta/Patella-Femoral Pain Syndrome; second opinion?  (Read 726 times)

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Offline Vickster

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Re: Patella Alta/Patella-Femoral Pain Syndrome; second opinion?
« Reply #15 on: February 15, 2020, 03:50:45 PM »
Are the orthoís youíve seen specialists in kneecap issues or more generally knees?
What country are you in? Can you access a PF specialist? Or a knee expert PT? They all have different levels of knowledge or specialism (and not often anatomical PF problems)
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 Userhere123

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Re: Patella Alta/Patella-Femoral Pain Syndrome; second opinion?
« Reply #16 on: February 16, 2020, 05:02:04 AM »
Userhere123
Look for posts by a member called Suspectdevice through the search function. Heís been on a very long (years) PFPS journey and has posted about his experience, rehabilitation and advice.
A book called Saving My Knees by Richard Bedard has also proved useful to PFPS patients.
Thereís also info around PFS in the patella primer in the learning portfolio

Youíve mentioned a issue with the trochlear ridge showed on tour MRI. Have you discussed the implications with a specialist? It might be impacting the way your knee tracks in the trochlea and causing problems to the structures. Also the impact of the long patellar tendon and high positio
n of the kneecap?
Do you think that lateral trochlear ridge is causing the pain?
I don't know the cause of my pain. Is still the same burning pain above the knee. My PT and the doctor, both are not sure why it's happening.
They didn't say anything about trochlear ridge. So, my current PT treatment plan is for Patella alta and pfps. I am also trying dry needling. That doesn't help too. Any inputs?

Offline Vickster

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Re: Patella Alta/Patella-Femoral Pain Syndrome; second opinion?
« Reply #17 on: February 16, 2020, 08:07:56 AM »
Burning above the knee? That sounds more muscular or is it due to the high patella? PFPS is more burning around the knee cap or below (fat pad). Does regular icing relieve the pain?

Sounds like you need to find a more specialist doctor or physio who can think more holistically? Has the PT does a thorough assessment from lower back and hips to feet?
Have you had the usual rheumatology blood tests to check itís not systemic?

You might find some useful information here
https://www.kneeguru.co.uk/KNEEnotes/primers/patella
« Last Edit: February 16, 2020, 08:14:48 AM 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 Userhere123

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Re: Patella Alta/Patella-Femoral Pain Syndrome; second opinion?
« Reply #18 on: February 16, 2020, 11:40:26 AM »
Burning above the knee? That sounds more muscular or is it due to the high patella? PFPS is more burning around the knee cap or below (fat pad). Does regular icing relieve the pain?

Sounds like you need to find a more specialist doctor or physio who can think more holistically? Has the PT does a thorough assessment from lower back and hips to feet?
Have you had the usual rheumatology blood tests to check itís not systemic?

You might find some useful information here
https://www.kneeguru.co.uk/KNEEnotes/primers/patella
My burning pain is around the kneecap. But not below the knee, it's above the kneecap.more on the lateral side. I have little swelling too on the top of knee cap (above) where I have the burning pain. The MRI says I have congentinal or developmental Patella alta and lateral trochlear ridge. So, I don't know what causes the burning pain. If it's congentinal/developmental, we cannot change it right? I was selling a PT for 3 months and no improvement. So, I have changed my PT last week and he did dry needling. No improvement yet. He said I might need 4 sessions of dry needling.
Also, what systemic blood tests? I told my concerns to my GP and she tested for CRP,SR,ANA,RA,uric acid, iron, ferritin.
Everything is normal except iron. So she put me on iron supplements.
I don't know how to proceed further. My pt didn't diagnose from hip. They did check my foot and said i need arch support inserts. Also, they said they did some gait analysis.
The way I walk is different in right leg from left leg. I am not bending my knees and just dragging my left knee sideways.
I am really feel helpless right now. Hope I get some solution soon. Atleast,I should get some proper diagnosis and the cause.

Offline Userhere123

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Re: Patella Alta/Patella-Femoral Pain Syndrome; second opinion?
« Reply #19 on: February 16, 2020, 11:59:31 AM »
Are the orthoís youíve seen specialists in kneecap issues or more generally knees?
What country are you in? Can you access a PF specialist? Or a knee expert PT? They all have different levels of knowledge or specialism (and not often anatomical PF problems)
I am in the US. I saw an orthopedic and sports medicine doctor.
Both of them are general Orthopedic doctors who also see knees..not very specific to kneecap.
I don't see any doctors nearby who are specialised in Patella.
Even for PT, all the PTs here are trained to see all body parts. They are not specialised in knees. I changed my PT now. Even the new PT is general orthopedic specialist. Not specific to knee. I have called around many other places to see if there are any knee specialist PT. None of the offices have any knee specialist PT. My previous don't even have any idea about the knees. She was completely naive and not able to answer my questions..they have never seen the patella specific issues.
I am from India ,  currently living in US. I am even thinking to go to India to check my knees..it's been 6 months and have the same level of pain.

Offline Userhere123

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Re: Patella Alta/Patella-Femoral Pain Syndrome; second opinion?
« Reply #20 on: February 17, 2020, 05:07:30 PM »
Burning above the knee? That sounds more muscular or is it due to the high patella? PFPS is more burning around the knee cap or below (fat pad). Does regular icing relieve the pain?

Sounds like you need to find a more specialist doctor or physio who can think more holistically? Has the PT does a thorough assessment from lower back and hips to feet?
Have you had the usual rheumatology blood tests to check itís not systemic?

You might find some useful information here
https://www.kneeguru.co.uk/KNEEnotes/primers/patella
What blood test is required to check if it's systematic?

Offline Vickster

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Re: Patella Alta/Patella-Femoral Pain Syndrome; second opinion?
« Reply #21 on: February 17, 2020, 05:32:32 PM »
Burning above the knee? That sounds more muscular or is it due to the high patella? PFPS is more burning around the knee cap or below (fat pad). Does regular icing relieve the pain?

Sounds like you need to find a more specialist doctor or physio who can think more holistically? Has the PT does a thorough assessment from lower back and hips to feet?
Have you had the usual rheumatology blood tests to check itís not systemic?

You might find some useful information here
https://www.kneeguru.co.uk/KNEEnotes/primers/patella
What blood test is required to check if it's systematic?
The ones youíve said youíve had I think. Plus maybe Vit D.
Are you male or female as for women, hormones can affect joints, cause inflammation etc
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 Userhere123

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Re: Patella Alta/Patella-Femoral Pain Syndrome; second opinion?
« Reply #22 on: February 17, 2020, 09:44:13 PM »
Burning above the knee? That sounds more muscular or is it due to the high patella? PFPS is more burning around the knee cap or below (fat pad). Does regular icing relieve the pain?

Sounds like you need to find a more specialist doctor or physio who can think more holistically? Has the PT does a thorough assessment from lower back and hips to feet?
Have you had the usual rheumatology blood tests to check itís not systemic?

You might find some useful information here
https://www.kneeguru.co.uk/KNEEnotes/primers/patella
What blood test is required to check if it's systematic?
The ones youíve said youíve had I think. Plus maybe Vit D.
Are you male or female as for women, hormones can affect joints, cause inflammation etc
My vitamin D is very low and am taking supplements for that. My vitamin D is 19.1. I am taking supplements  50000iu/ week.
I am a female , 34 years old. My hormones levels were normal when I checked a couple of years back. I didnt check it after that..I don't see any symptoms for that.
I have even tried few anti inflammatory. Tried voltaren gel. That doesn't help. Then doctor prescribed diclofenac sodium DR tablet75 mg twice a day for a month. I took it for only one week. Because that makes my BP level high and also caused some.stomach issues. So, the doctor told me to stop it.
I don't know what could be the reason and also the solution for this. I am researching a lot for this..I couldn't find any specialist or PT specialist for knees in my state.

Offline Vickster

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Re: Patella Alta/Patella-Femoral Pain Syndrome; second opinion?
« Reply #23 on: February 17, 2020, 09:48:40 PM »
Did you search on Georgia in the link I posted? Those are specialist knee surgeons, they showed in Augusta, Atlanta, other places
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 Userhere123

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Re: Patella Alta/Patella-Femoral Pain Syndrome; second opinion?
« Reply #24 on: February 18, 2020, 01:17:23 AM »
Did you search on Georgia in the link I posted? Those are specialist knee surgeons, they showed in Augusta, Atlanta, other places
I did search the link. I couldn't find any doctors/ Physiotherapist/knee doctors in Georgia and also Atlanta.
I don't find any specialist in the link.  Attached the screenshot.

Offline Vickster

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Re: Patella Alta/Patella-Femoral Pain Syndrome; second opinion?
« Reply #25 on: February 18, 2020, 07:02:08 AM »
Right, you need to just put Georgia, it'll come up as you type, click on it. The database doesn't recognise state labels. I get 11 hits for Atlanta, none are in the PF specialist list. You can access their /hospital sites and CVs through the names. Screenshot attached  :)
« Last Edit: February 18, 2020, 07:51:12 AM 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 Userhere123

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Re: Patella Alta/Patella-Femoral Pain Syndrome; second opinion?
« Reply #26 on: February 18, 2020, 10:13:21 AM »
Right, you need to just put Georgia, it'll come up as you type, click on it. The database doesn't recognise state labels. I get 11 hits for Atlanta, none are in the PF specialist list. You can access their /hospital sites and CVs through the names. Screenshot attached  :)
Thanks again!!!
I did check for Georgia in the link. It shows 24 doctors for knee surgeon category. No one for PF specialist.
I have been to one of those doctor's clinic. I didn't get proper diagnosis. So, I went for second opinion to the sports medicine doctor.

Offline Vickster

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Re: Patella Alta/Patella-Femoral Pain Syndrome; second opinion?
« Reply #27 on: February 18, 2020, 12:58:45 PM »
Maybe see someone else?
Otherwise, could you consult with Dr Dye whoís a PF specialist in San Francisco by phone 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 Userhere123

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Re: Patella Alta/Patella-Femoral Pain Syndrome; second opinion?
« Reply #28 on: February 18, 2020, 08:18:57 PM »
Maybe see someone else?
Otherwise, could you consult with Dr Dye whoís a PF specialist in San Francisco by phone perhaps?
Sure. I will see if I can see some their doctor opinion in Atlanta or try some other doctor in other states.
I am from India and currently living in the US. I am also looking for some doctors in India too. If I get some good doctors , I can travel there to get an opinion.

Offline Vickster

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Re: Patella Alta/Patella-Femoral Pain Syndrome; second opinion?
« Reply #29 on: February 18, 2020, 08:56:56 PM »
You can also search the database for India and check the who's who in the primers
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















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