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Author Topic: patellar dislocation--treatment timetable  (Read 1361 times)

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Offline JR

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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!

Offline 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.
Dislocations since age 12
Trochlear Dysplasia
Maltracking
Hypermobile
LR/MR-failed
TTT, LR, MR L knee 95-Success
TTT, LR, MR R 02-Success
Screws out
Partial tear ACL
Severe end stage OA
4 Debridements
Partial Meniscectomy
Failed Microfracture
11mm Defect LFC
Bone Spurs, Kissing Lesions

Offline 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).
MPFL reconstruction 10/03

Offline 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.

Offline LisaL

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Re: patellar dislocation--treatment timetable
« 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.
1991 - 1996 Multiple L Patellar Subluxations
1996 - LR & TTT Left Knee
2004 - R Patellar Dislocation & Avulsion Fracture
LR & Chondroplasty 7/14/04

Offline 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!
1991 - 1996 Multiple L Patellar Subluxations
1996 - LR & TTT Left Knee
2004 - R Patellar Dislocation & Avulsion Fracture
LR & Chondroplasty 7/14/04

Offline 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!

Offline laurG

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Re: patellar dislocation--treatment timetable
« 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.