Severe pain from Miserable Malalignment

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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CaliGirl86
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Severe pain from Miserable Malalignment

Post by CaliGirl86 »

I have been diagnosed with Patellofemoral pain syndrome last year due to maltracking of both my knees. I went to physical therapy for awhile. It did help at first but now even doing the exercises only gives temporary relief. Lately I have been in so much pain especially at night. The only thing that helps is wearing knee stabilizers, but obviously I can't wear them all the time. Is there anything else I can do to relieve the pain?
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vickster
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Re: Severe pain from Miserable Malalignment

Post by vickster »

Can you get a further opinion from an orthopaedic surgeon as well as from a PT with specialism in PFS

Have you discussed potential surgical solutions if the maltracking is anatomical rather than the result of muscle imbalance?
Came off bike onto concrete 9/9/09 (lat meniscus, lat condyle defect)
LK scopes 8/2/10 & 16/12/10
RK scope 5/2/15 (menisectomy, Hoffa’s fat pad trim)
LK scope 10.1.19 medial meniscectomy, trochlea MFX
LK scope 19.4.21 MFX to both condyles & trochlea, patella cartilage shaved, viscoseal, depo-medrone
Leena20
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Re: Severe pain from Miserable Malalignment

Post by Leena20 »

I would suggest finding a surgeon that can give you a CT scan to check for femoral anteversion and tibial torsion. If your knees point inwards it could be that your femurs are twisted inwards too much - this can cause all sorts of problems with your knees.
CaliGirl86
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Re: Severe pain from Miserable Malalignment

Post by CaliGirl86 »

I am currently on government insurance so my options right now are limited...but I may change insurance in the next few months.

I believe it's an overuse injury and not anatomical...I started having this problem as a teen and the pain got worse over time. So it is possible to fix it without surgery?
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vickster
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Re: Severe pain from Miserable Malalignment

Post by vickster »

A book called Saving My Knees has been mentioned many times on here in relation to PFS, maybe worth seeking out

Also look for posts by SuspectDevice, he has posted a lot on dealing with his own PFS

Have you tried PRP injections for example to try to reduce inflammation, along with proper rest (i.e. doing nothing / very little, other than keeping the joint moving, maybe gentle swimming / hydrotherapy?)

Have you had MRI and ultrasound to check for damage, tendinitis etc, blood tests for auto immune and other diseases, there's likely a reason why it's chronic/refractory to treatment if you've tried resting for prolonged periods (months) to allow to heal
Last edited by vickster on Fri Sep 09, 2016 4:02 pm, edited 1 time in total.
Came off bike onto concrete 9/9/09 (lat meniscus, lat condyle defect)
LK scopes 8/2/10 & 16/12/10
RK scope 5/2/15 (menisectomy, Hoffa’s fat pad trim)
LK scope 10.1.19 medial meniscectomy, trochlea MFX
LK scope 19.4.21 MFX to both condyles & trochlea, patella cartilage shaved, viscoseal, depo-medrone
CaliGirl86
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Re: Severe pain from Miserable Malalignment

Post by CaliGirl86 »

I think I will check out the book...
To be honest, resting doesn't help at all and makes the pain worse. The more active I am, the less the pain is. But I can't be active all the time though, for instance at night, or if I'm somewhere where I have to sit for a period of time, the pain gets really bad.

I went to the doctor and she said there is nothing I can do but to take ibuprofen and ice it. I was somewhat disappointed but just waiting until I can change insurance providers.
CaliGirl86
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Re: Severe pain from Miserable Malalignment

Post by CaliGirl86 »

I also have this big bump under my knee...I've had it for years now. I am not sure if it is cartilage or bone but it's painful when I sit on my knees because of it.
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vickster
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Re: Severe pain from Miserable Malalignment

Post by vickster »

Do you mean Hoffas fat pad?
Came off bike onto concrete 9/9/09 (lat meniscus, lat condyle defect)
LK scopes 8/2/10 & 16/12/10
RK scope 5/2/15 (menisectomy, Hoffa’s fat pad trim)
LK scope 10.1.19 medial meniscectomy, trochlea MFX
LK scope 19.4.21 MFX to both condyles & trochlea, patella cartilage shaved, viscoseal, depo-medrone
CaliGirl86
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Re: Severe pain from Miserable Malalignment

Post by CaliGirl86 »

No it's not fat...it's more like a hard lump...
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vickster
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Re: Severe pain from Miserable Malalignment

Post by vickster »

Have you had it checked?
Came off bike onto concrete 9/9/09 (lat meniscus, lat condyle defect)
LK scopes 8/2/10 & 16/12/10
RK scope 5/2/15 (menisectomy, Hoffa’s fat pad trim)
LK scope 10.1.19 medial meniscectomy, trochlea MFX
LK scope 19.4.21 MFX to both condyles & trochlea, patella cartilage shaved, viscoseal, depo-medrone
CaliGirl86
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Re: Severe pain from Miserable Malalignment

Post by CaliGirl86 »

Well I have been to a few doctors for my knee problems and they looked at my knees and said there is nothing wrong with me and I should just take painkillers for any pain I have. It's so hard to find a doctor that will take me seriously that I have kind of given up
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vickster
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Re: Severe pain from Miserable Malalignment

Post by vickster »

Have you seen a knee specialist with interest in patellofemoral problems, maybe a sports physician or musculoskeletal rheumatologist as well as an orthopaedic surgeon?
Are you very restricted by your healthcare insurance, can you pay to see someone and get imaging done privately instead at least to get a firm diagnosis?
Came off bike onto concrete 9/9/09 (lat meniscus, lat condyle defect)
LK scopes 8/2/10 & 16/12/10
RK scope 5/2/15 (menisectomy, Hoffa’s fat pad trim)
LK scope 10.1.19 medial meniscectomy, trochlea MFX
LK scope 19.4.21 MFX to both condyles & trochlea, patella cartilage shaved, viscoseal, depo-medrone
CaliGirl86
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Re: Severe pain from Miserable Malalignment

Post by CaliGirl86 »

No I haven't yet, I am not able to with my current insurance. I will be switching insurance companies in a couple months and hopefully I should be able to see a specialist by next year
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