Off-Track Kneecap

[spacemountain]

Wondering if anyone else has had this before, how long it took to heal? I had fallen hard on my knee back in April, and after a long time of waiting it out, trying different pain medications, a trip to WDW, and seeing two different orthopedists, I finally had an MRI and 3 months after the fall was diagnosed with an "off-track" patella and a small tear in the medial meniscus. I have had 3 weeks of physical therapy now, but there has still been no improvement and some days the pain is very bad, worse than it had ever been before PT. I have another doctor's appointment next week and my therapist has already said I'll need more PT. I know that those 3 months might have done more damage.

So my question is, for anyone who has had this, how long did it take to heal, and after 3 weeks of PT did you see any improvent? Thanks

 

[luvmarypoppins]

Sorry I dont know what an off track knee cap is, but my ds had a lateral release done on his knee since it didnt bend right etc. He also had some cartlidge taken out and did the pt, nothing helped still with the pain. He went back to the dr. again and that surgeon consulted with his partner, ds also in addition to the mri (which didnt even pick up the problem that was found in surgery), he had a cat scan done of the knee thus verifying they cant do much for him right now. I didnt ask him if he wants a 3rd opinion yet. Best of luck to you,

 

[spacemountain]

Thanks, and I hope your DS can get some relief from his pain too.

 

[mjkacmom]

I feel your pain. Turns out I was born with off track knee-caps, was doing some lunges/squats, and one of them "popped." It's a little better after a month of PT, but will never be in the right place. I'm supposed to exercise my legs daily, to prevent it popping again. I didn't get an MRI, because the ortho didn't read the note from my therapist, who thinks I have a tear (constant fluid behind my knee).

 

[Golf4food]

I'll let my DW (Tazicket) chime in more, but she had knee cap problems after dislocating it in high school and a few years ago had to have patellar realignment surgery done. It wasn't fun. At least she can walk now. It had gotten to the point where walking, squatting, stairs, etc. were all very painfull - we even had to have her in a wheelchair at WDW on year because the walking was causing so much pain - she got the surgery a couple of months later. Recovery was a bear. Hope yours turns out not as a bad.

 

[Tazicket]

I'll let my DW (Tazicket) chime in more, but she had knee cap problems after dislocating it in high school and a few years ago had to have patellar realignment surgery done. It wasn't fun. At least she can walk now. It had gotten to the point where walking, squatting, stairs, etc. were all very painfull - we even had to have her in a wheelchair at WDW on year because the walking was causing so much pain - she got the surgery a couple of months later. Recovery was a bear. Hope yours turns out not as a bad.

DW chiming in.

My problem evidently happened because my patellar tendons are anchored in the wrong place (they're too far towards the outside of my legs). After I dislocated my kneecap, things never really fully healed, but I didn't find this out until a few years later. Something to do with my Quad muscle in that leg never getting used because of the way everything was anchored.

I was having a lot of pain, clicking and popping, and the knee would just randomly give out. I was referred to an Orthopedic surgeon who looked at it and sent me home with crutches and a list of exersizes to try for 2 or 3 weeks. The knee didn't get any better and all the crutches really did was irritate me. I went back after the 2 or 3 weeks and, since nothing had improved, we opted for surgery a week later.

They moved the anchor point of my patellar tendon in my bad leg over to where it should have been anchored all along and screwed it in. I had a cast from my toes up to mid-thigh for about 6 weeks and then did PT for about 3 months (I think). After the cast came off, I had a wheelchair and a walker that I used to get around for a couple of months and then came off the walker and went to a cane for a month or two. (I'm super clutzy and always had a lot of trouble any time I tried to use crutches.)

Like DH said, my recovery was really tough. But, my knee was really screwed up to begin with. I still have clicking and popping and it will ache periodically, but it's nowhere near as bad as it was before my knee surgery. It just took a long time to get to this point. Then again, I'm a really huge wimp.

Hope your knee feels better soon! And, if you do need surgery, please take my experience with a grain of salt - everybody is different.

 

[Claudia1]

Sounds like my knee, too. If the PT is causing more pain..... STOP ASAP!

After my meniscus tear was repaired, I felt immediate relief. Not pain-free, but relief. I then had PT to strengthen the muscles that holds the patella in place and that has helped.

To deal with it daily, I no longer wear high heels and wear more sensible shoes to prevent balance issues. Even the slightest off-balances can move my patella, so I am more cautious. Also, I ice down my knee whenever it starts to swell. Swelling causes more issues for me that can lead to a patella shift.

After a while, you will "know your knee" and how to prevent complications. Sometimes it is unavoidable but most of the time, I can keep it limber and mobile so that I can move quickly as needed with young children in the house.

After my surgery, my orthopod said my knee was "very ugly". No cartlidge, weak, etc... He said I would need cortisone shots every 3 months to keep me at the level that I want to be. However, with all of my personal modifications, I have only needed one injection in 18 months, and that one was in preparation for 10 days at WDW. It was preventative. I take Relafen (high dose Ibuprofen) and don't need anything else.

Good luck!

 

[Aardvarks]

Yep me too.

6 months of physio made no difference, did resistance work to re build quads and patella kept on tracking out of line.

Had athroscopy with lateral release, chondrolysis and high pressure wash out followed by 3 months intensive physio........result at about 12 months was no pain meds needed.

That was 10 years ago

Occasionaly I can twist it or set it off again but after ice packs, a week of me doing my excercises and applying a topical NSAID (diclofenac jell) I am back to pain free.

I left my surgery so long that when they did go in I had joint changes indicative of osteoarthritis.

I occasionaly wear a patella tracking band used to treat joggers knee or Osgood-Schlatters disease. This is a v shaped wedged band which fits bellow the patella and raises the edge and guides the tracking.

 

[Lisa loves Pooh]

Meniscus tears don't really heal depending on their location. So if you aren't seeing success, it could be the tear interfering with progress.

I've never had tracking issues, but I had a tear for about 15 years. The moment I woke up from surgery, I noticed an immediate difference and 4 months of PT and a half-marathon later--my knee never felt better. The doc also removed some plica whatever that is. Evidently that can cause issues when I Am older so since he was in their already, he took it out.

Meniscus can only be repaired if it is in an area where there is blood flow. Mine was not, so they just shaved out the tear and voila--good as knew.

 

[spacemountain]

Thanks for all the input, everyone. It sounds like I might have to have surgery, which I was afraid of, but if it means relief of the pain, it's definitely worth it. I'll see what the doctor says on Thursday. Hopefully I won't have to have too much more PT with no change only to have surgery and more PT. But thanks again for all your personal stories, I don't know anyone who has had this but I knew I could count on the DIS

 

[heimlichfan]

Subluxing patella, medial meniscus tear, and an issue with plica were my issues too! I also have chondromalacia...

My issues started during high school... I had about 4 months of PT followed by a surgery to remove the plica and fix the tear.

I had a second surgery about 7 years later to help with some of the issues with the chondromalacia.

Strengthening exercises help a lot, but my surgeries were ultimately more beneficial. It's been about 10 years since the second surgery and I haven't had any major problems since. I've had a few minor ones, with only one warranting a doctor's visit. He put me on some strong anti-inflammatories and things were fine in no time.

 

[spacemountain]

Thanks again for all of the advice, I've been rereading it now. My knee is still no better, and keeps gradually getting worse over time, so I finally have an arthroscopy scheduled for Oct. 13. My doctor told me straight out that he has no idea if the surgery will fix my knee, but I am out of other options. I did a total of 6 weeks of PT, followed by 2 weeks of Tramadol, a strong pain med. which did nothing. I then tried a cortisone shot, and again nothing. The pain got worse for a couple days after the shot and then went back to it's normal level. I just got done trying 3 weeks at the chiropractor due to the urging of my mother, but that also did nothing and I would often leave his office in worse pain than I came in with.

So I know that the surgery may or may not help, but he is basing this off of the MRI that was taken in June. I know for sure the meniscus tear has gotten worse since then, because I have much worse pain than I had originally in that specific area, in addition to the pain througout my knee. I also know that MRIs don't always show everything, as in the case of my wrist surgery I had several years ago, which was a shot in the dark as to whether it would work, but they ended up finding a rare situation that didn't show up in the MRI and were able to fix it.

Hopefully this surgery will be the beginning of the end of my pain. Thanks for listening I'll let you know how the surgery goes.

 

[disneyvacationmom]

I had my kneecap removed when I was 21--no real problems since--aches with the weather now and then but nothing that a tylenol won't fix. I had had knee probelms since I was 16--3 surgeries later(cartledge removed, kneecap scraped etc) they decided to remove the kneecap--worked like a charm--I walk normally and can do most things without any trouble--kneeling isn't an issue. Generally I was very happy.

 

[spacemountain]

I had my kneecap removed when I was 21--no real problems since--aches with the weather now and then but nothing that a tylenol won't fix. I had had knee probelms since I was 16--3 surgeries later(cartledge removed, kneecap scraped etc) they decided to remove the kneecap--worked like a charm--I walk normally and can do most things without any trouble--kneeling isn't an issue. Generally I was very happy.

Glad to hear your knee is much better now, hopefully I won't have to go through all that you did though.