Pain from chronic patellar subluxations

Mal-tracking, lateral release, medial reefing, tibial tuberosity transfer, patellar arthritis, patellectomy, plica, patello-femoral braces. For patellar fractures, see Board on 'Bone Breaks around the knee'.
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Kippie
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Pain from chronic patellar subluxations

Post by Kippie »

I was born with type D trochlear dysplasia, patella alta, and hypermobile ehlers danlos syndrome. From a very young age, both of my patellae would sublux when I fully extended my leg and would also fully dislocate without warning between 5-10 times per month. Since 2017, I have had 6 knee surgeries to correct the issue. On both knees, I have had distal and lateral TTO, MPFL reconstruction, trochleoplasty, and bipolar osteochondral allograft transplantation of the patella and trochlea. Unfortunately, my left knee still subluxes with full extension and my right one maltracks pretty severely. My current doctor says there’s nothing more that can be done besides a partial knee replacement. I do not want to pursue this route because I am only 21 and if something goes wrong or needs to be replaced in the future, the solution will be a total knee replacement. Given my hypermobility, I am trying to avoid a TKR at all costs. I have tried taping and bracing (several brands and styles) and it has not brought any pain or symptom relief. Physical therapy and strengthening also has been largely unhelpful because of my general intolerance of exercise, limitations on what I can safely do with my HEDS, and the pain from my knees. Any advice on other forms of pain relief?
The_KNEEguru
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Re: Pain from chronic patellar subluxations

Post by The_KNEEguru »

You have certainly been through the mill with your hypermobility problems [(hEDS) = "Hypermobile Ehlers-Danlos syndrome"].

We have a list of surgeons with a special interest in patellofemoral problems, but it is a bit old and you may be able to help us update it - https://www.kneeguru.co.uk/KNEEnotes/ar ... al-surgery

Regarding analgesia, you are young and need to be careful with analgesics as all of them have potential problems if taken long term. What braces have you tried?
Kippie
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Re: Pain from chronic patellar subluxations

Post by Kippie »

I've tried DonJoy Tru-Pull Lite, Breg PTO brace, DonJoy Defiance w/t tru-pull attachment, and theBreg 20.50 Patella Knee Brace.
The_KNEEguru
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Re: Pain from chronic patellar subluxations

Post by The_KNEEguru »

You must feel very frustrated. The surgeries you have had all seem appropriate to your congenital anatomy problems, the braces are from good manufacturers. Have you worked on optimising your footware?
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