I don't have any experience in this area, but I wanted to say good luck and whatever you decide I hope it turns out well.

Thanks for your wishes:-)

I think that doctors trained in specific disciplines will help you in the way they are trained - an ortho surgeon will suggest surgery because that is what they know. I hope you can consider seeing other medical practicioners like maybe a physiatrist and compliment with someone who can do either Dorn Method or Active Release Technique.

Good luck.

I will look into the the physiatrist. Unfortunately, my chiropractor who does my active release and nuromuscular reeducation is the one that referred me to orthopedics. He has worked on my knees for 3 years and this is probably why I don't live with daily pain like most people with arthritis, but he couldn't solve the collapsing issue.

Thanks for the advice.

Not sure where you are located but I will sing praise for Boulder Center for Sports Medicine Andy Pruitt over and over. If you are close it may be worth a drive in or I know people fly in to see him as well. He is very well versed on all apsects of the knee and you may even want to see if you can send info his way and if they have a review system. May be a hassle but if he says you need it then I would believe. Boulder, CO is the mecca it seems for tris and he is the bomb up here. Let me know if you need more info!

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COtrimom

I live in Northern California, but what a great idea to send my records for someone to review. I will see if my insurance will cover that. Thanks for the advice. If I do have surgery it has to be done by the best, so I have the best chance of recovery.

I would call Boulder Center for Sports Medicine and ask what they can do in your situation. You may also want to see if Andy Travels at all to clinics. I am sure there are great docs out by you but maybe BCSM or Andy can refer you to someone in your area that they also work with. Having just had a surgery which so many normal orthos thought was pointless for ITB and it wouldn't work- they were wrong and it has been phenomenal. I would take your time research it and feel free to PM me if you need anything. Good luck to you- It will get better and if you are motivated enough you will get back to doing all of the things you hope to do!!!! Let us know what you are doing with it!!

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COtrimom

I have similar issues from a prior dislocation and a wide q-angle.. what do you mean by collapsing?

My knee gives away and I almost fall over. Normally it happens when I am walking versus when I am running.

I am not sure my response is the one that you want to hear, but I will give you my experience. Yes, been there and did that!
This was me 6 years ago. My knee would give way and I would nearly fall over. Same diagnosis as you. Patella was too far to the outside and was 'grinding' and not tracking properly. I did PT for a year with no results. I did not do ART at that time, but should have. I went ahead and did the surgery- had the lateral release done, repaired some plica issues and had the 'junk' scraped off the back of the patella. I did intensive rehab...and...well...my screen name is tri gone roadie. No more running for me. Way more pain now than I had before I had surgery. My knee gives way due to extreme pain when running now. So, I turned to road racing, cross and mountain biking. They don't always feel good, but better than running.

So, based on my experience, I am not an advocate of that kind of surgery. It didn't serve me well, but that is not to say it would not work for you. You are right to look at the recovery. It was tough for me, with no results. I didn't have kids to run around.

In my case, I do not believe the problem was lack of quad strength, as all the docs touted. I believe it was and is extreme inflexibility. I think my quads, calves and hamstrings are so inflexible that they don't allow the other muscles to let the patella sit where it is supposed to. I think if I were more proactive with ART of the quad, hamstring, calf muscles and spent more time doing yoga and pilates...I would be able to run.

I don't know if these things would help you, but I wish I had done them instead of surgery. I am in my early 30's now and have the knees of a 60 yr old it seems.

Best of luck with whatever you choose. I sincerely hope your outcome is better than mine, regardless!

Anne

:( Sorry about your knee! I also have this knee tracking problem. Was diagnosed with it several years ago and the specialist that I saw told me that surgery was an option, but recommended it for me as a last resort. His Rx was physical therapy which did help a little. My knee grinds and crackles and it's actually quite disgusting to hear when I straighten out my leg, buy I have very minimal knee pain in the long distances. I too wonder what is down the road for me. I am also in my 30's and hate the thought of having to have surgery.

Good luck to you :)

That is what I was afraid of. Will you still need a total knee? I am wondering if I should just keep running and doing triathlons knowing that I will still need a total knee in about 7 years; especially since I am not in any type of real pain. If this surgery is going to keep me from running than there seems little point in doing that since I was only considering it to gain full functionality of my knee. However I also am extremely inflexible in certain areas of my body. I guess I only have 2 degree Range of Motion in my ankles, most people have 10 degrees. I spent a long time in PT for that too, but no change. Perhaps adding Yoga to my routines will help. Thanks for your advice. It sounds like a lot of women might have this problem.

I am not sure if I will need a whole knee replacement, but my guess is yes at some point in my life, and I hope that is not soon! If you aren't having pain and you can run, I'd be hard pressed to encourage you to fix something that 'ain't broke'. I am not a physician, mind you. I can just tell you how discouraging it is to think that surgery is the answer and you will be right back in the game...only to find it didn't do what you thought it would.

The way it was explained to me is that this is a more common problem for women based on our build, and the way our hips set wider and so the muscles are pulled lateral or more to the outside because of the greater angle from the hips to the knees. Men have the problem, but less frequently due to the 'straight shot' of the muscles from the hips to the knee. Again, just what has been explained to me and it seemed to make sense.

Anne

I recently saw an article ons omething called McConnell Taping, form of taping which is supposed to "encourage" the muscles to realign the knee cap. Worth looking into?
Try this link http://www.optp.com/...20-%20May%202006.pdf

Hey I have emerged from lurkdom to sign up here because I had to respond to Ironmandie. I have been doing McConnell taping for years to deal with my PFSyndrome. First, had PT and got lots of homework (exercises) to do. I do stability and strengthening exercises routinely, and every time I run, I tape my patella into position. It is ridiculously low tech. It works! My knee is often somewhat swollen after a run, but never painful ... well, sometimes a twinge or two but I can live with it. BTW my doc is a sports doc, and a marathon runner. He is predisposed to PT whenever possible. Give it a try, and good luck.

Ineresting. I have never used it or seen it done. Just read about it. Who showed you how to do it - Physio?
Just curious - in case I ever need to know :-)

Physical therapist did. Though I am not sure I do it as well as he does (very sure) simply pulling it back and restraining it from sliding medially seems to do the trick!

I was diagnosed with PFS back in '93. At that point in time I was having MAJOR problems with collapsing and grinding. I had my left knee done (surgically repaired, NOT replaced), and did my own physio regimen (following guidelines by the doctor, and the physiotherapist) back in June of '96, and was playing sports, including soccer by December. Following year I had my right one done, around the same time frame. Was back playing squash by mid-November. For me I get the occasional pain in drastic weather changes, and it hurts like crazy to kneel down (I still have the pins, but that's mainly a function of me, not the Dr.); but would do it again in a heartbeat!

I went from a LOT of discomfort, and frustration. To being very active. I'm not the fastest runner out there (never was), but am able to play any sport that I like (squash, ultimate frisbee, running, soccer) and have no real issues.

The main thing I found with the whole surgery, is that there were a lot of rubrics for recovery that the physio people wanted me to follow. In checking with my Dr. it turned out that they weren't necessarily being as aggressive as they could have been. When I first took off the bandages, I spent a LOT of time in the pool and hot-tub at my YMCA, just working on range of motion and walking in the pool. I eventually made it to using weights, and was fairly happy with the result.

So in the end, over 10 years later for both knees, I would DEFINITELY do it again at the drop of the hat, and if anything would actually have done it sooner in retrospect. Mind you this is just my own personal good experience.....

Thats the kind of success I wanted to hear about. Who did your surgery? Do you know how I can find the best surgeon in my area? I live in the East bay of CA. I think that might have a lot to do with the outcome. I teach group exercise classes aqua and cycling. I am very familiar with rehabbing in the pool, so I am also glad to hear it played a role in your recovery.

I'm in Ontario, Canada; and had Dr. Athar Mirza do mine. My only complaint is that his accent was a little thick for the understanding portion of things, but really I cared more about the results, and heard that he was a good doctor, who better yet was actually in my area! :).

I wouldn't just say that rehabbing in the pool played a role in my recovery, I would say that it was the cornerstone. Between doing mundane things in there like walking and motion exercises, I would say that the hot tub played the next most important role for stretching.

I wish I could tell you more, but the big thing for me was that I felt like I was able to be active again, after having to tone things down due to the bum knees.

Hi IM,

Well, my experience is more from the medical side. I"m a practicing RN and have been involved with ortho, trauma, etc. For one, I would definitely research as many options as you can that are not surgery involved. Surgery should be the last step for anyone, specially at your young age. If it is Arthoscopic that would be different, but a Total Knee would probably not leave you much room for running in your future. Ortho has come a long ways in the last few yrs. Make sure you get 2nd, 3rd opinions, etc., even (unfortunately) if you have to pay out of pocket it might be worth it to you in the end. Also, definitely get an opinion from a Sport's oriented ortho doc. They aren't too numerous, but a consult with one would be worth your time.

N~

I have been to several Sports Orthos (infact I have seen 7 about this problem). They have all told me with out doing any thing that I will need a total knee in about 7 - 10 years. I am trying to avoid that. From the 7 orthos I have been given some type of variation of the knee reconstruction. Since I have had this from birth, the knee cap won't move back into the groove; although they and I have tried for a good part of my life. I have been doing nuromusclar reeducation and ART for the past 2 - 3 years. This has releived many symptoms but unfortunately it also been masking the deterioration of the the Patella. Clearly if I go no surgical I could end up with the total knee and I if I do surgery to reallign the knee, It might not work and I could end up in chronic pain. However, if it does work I won't need a knee and I might be able to run again. I just wish I could predict the future. Is there any way of finding out who the best surgeon is. Is there a ranking system? Can I find out how many surgeries of this type have done by a particular surgeon?

1st of all you need to find out what type of surgery (the actual name) this will require. Then you can go to the AMA website or just do a search on your surgeon's name or type of surgery you wll require. It should give you some feedback on the surgeons that are experienced with this. I would also talk with your primary MD. Sometimes they are a wealth of info, sometimes.

N~

Hi, did you end up having the surgery?