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GENERAL KNEE QUESTIONS and comments (good for new threads)
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patellar dislocation--treatment timetable
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Topic: patellar dislocation--treatment timetable (Read 1451 times)
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JR
MICROgeek (<20 posts)
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patellar dislocation--treatment timetable
«
on:
June 29, 2004, 12:30:56 AM »
I dislocated my patella about three weeks ago. I spent 10 days in an immoblizer, then switched to a soft brace. After two PT sessions and minimal home exercize, I am able to bend my knee only 45 degrees. Today my Ortho told me this is not good, and he suggested investigative arthroscopy. Is there something wrong? Should I be able to bend more? Thank you for any help!
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Natalie.D
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Re: patellar dislocation--treatment timetable
«
Reply #1 on:
June 29, 2004, 02:32:07 PM »
JR,
I don't think that only 2 PT sessions is enough to get your ROM back, (although maybe I'm wrong, I'm not a doctor), but it took me at least 4 or 5 sessions before I started seeing any significant improvements and that was with working REALLY hard at home too. I would suggest talking to your OS and your PT first before going ahead with surgery. To me it seems like early days to be talking about going under the knife, I would have thought they would prefer to do MRIs and x-rays first. Good luck.
Natalie.
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Dislocations since age 12
Trochlear Dysplasia
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Hypermobile
LR/MR-failed
TTT, LR, MR L knee 95-Success
TTT, LR, MR R 02-Success
Screws out
Partial tear ACL
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4 Debridements
Partial Meniscectomy
Failed Microfracture
11mm Defect LFC
Bone Spurs, Kissing Lesions
bdmrad
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Re: patellar dislocation--treatment timetable
«
Reply #2 on:
June 29, 2004, 02:49:29 PM »
Your OS may be concerned about an osteochondral injury that may be impeading ROM. That usually could be detected on plain XRays and would certainly be seen on an MRI. I personally wouldn't rush to surgery unless had an extablished surgical lesion. However, I am quite conservative about surgery and a bit of a therapeutic nihilist (I did put up with recurrent dislocations for 35 years before having any surgery).
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MPFL reconstruction 10/03
JR
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Re: patellar dislocation--treatment timetable
«
Reply #3 on:
June 30, 2004, 03:37:02 AM »
Thanks for your input! I am going to give it another day or two and see if I can't get up to 70 or 80 degrees. I am hoping my limited ROM is due more to my lack of intensive PT than any blockage. I did have an MRI, the results of which were pretty clear. So I am hesitant to go ahead with surgery.
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LisaL
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Re: patellar dislocation--treatment timetable
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Reply #4 on:
June 30, 2004, 06:57:56 PM »
JR - I dislocated my patella back in January and the doctor did not make the decision to do a scope until the end of May. And my MRI back in January showed an avulsion fracture that could possibly have been a displaced osteochondral fracture.
He kept me in PT for 3 months before deciding that it didn't work (I was immobilized for 3 weeks to give the fracture some time to heal).
Progress in PT was slow at first, but I eventually gained back most of my ROM. I think, for me at least, it was worth it to wait before making the decision to do surgery. I am having mine done on 7/14.
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1991 - 1996 Multiple L Patellar Subluxations
1996 - LR & TTT Left Knee
2004 - R Patellar Dislocation & Avulsion Fracture
LR & Chondroplasty 7/14/04
LisaL
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Re: patellar dislocation--treatment timetable
«
Reply #5 on:
June 30, 2004, 08:52:35 PM »
Just another follow up on this. I remember my OS saying very early on that he would not "even think of operating until the knee was working properly".
I had a lot of swelling initially and very little ROM. When they scope my knee on 7/14, they are going to do a lateral release, possibly a medial imbrication and a general cleanup. I would imagine it would be more difficult for them to determine how much to loosen or tighten when the ROM is not there.
Well that's my 2 cents for what it's worth.
Good luck!
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1991 - 1996 Multiple L Patellar Subluxations
1996 - LR & TTT Left Knee
2004 - R Patellar Dislocation & Avulsion Fracture
LR & Chondroplasty 7/14/04
JR
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Re: patellar dislocation--treatment timetable
«
Reply #6 on:
June 30, 2004, 10:03:44 PM »
LisaL,
My OS said the reason he wants to operate is that he thinks there may be some blockage preventing me from bending. But I am up to about 70 degrees, comfortably. Given my clean MRI (just a contusion), I think I'l give PT some more time.
Thanks for your advice, and good luck with your scope!
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laurG
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Re: patellar dislocation--treatment timetable
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Reply #7 on:
July 01, 2004, 03:57:01 AM »
hi JR
i am surprised at how fast your doctor suggested arthroscopy. My patella has dislocated 10 times and it took about the 6th time for my doctor to realize there was a big problem. now however because of the damage to my knee i need full patella realignment surgery. i would suggest giving the PT some more time aswell, however if it does occur again do not put off the arthroscopic surgery.
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