Frequent right knee dislocations: Triathlon Forum: Slowtwitch Forums

Frequent right knee dislocations

Apr 24, 12 0:40

Post #1 of 4 (3064 views)

Brief history: dislocated right knee at 12 yrs old gymnastics, dislocated right knee again at 27 from a slip and a smash into a steel door and finally Nov 2011 doing a rear lunge where my foot caught a very slippery mat that made me slip so I turned and the knee popped out for the 3rd time in my life. 3 weeks before my Ironman back on November 2nd.

I still went full speed ahead with Ironman Cozumel and actually PR'ed my swim and run (and overall time). Came out of it with a mind-numbing LEFT shin pain from compensation during the run/walk of the marathon. I spent Dec - present in PT twice a week. Shin healed through Graston (god bless Graston!!!!!!!!) but the knee has just gotten worse. When I squat I know have a tendon or some tissue that pops out on the medial side of the knee. I am almost at equal size on left and right knee but the pain is unbearable. I haven't been able to run in 6 months. I gave up.

Saw an ortho surgeon today on recommendation from my sports med doc, PT, chiro. He wants to perform a Medial Patella Femoral Ligament Reconstruction. Basically they take all the stretched crap out of the knee and put in a cadaver which should fix me right up. Well with another 3 months of rehab. Has anyone had this surgery done before? Would love some feedback.

Have to give up IM Lake Placid and another Half Ironman this year. Kinda sad but more focused on just getting better. Damn my flexible ligaments. I'm seeing the races starting and it's starting to sink in that I'm going to miss a season. I've missed months in the last 3 years with 5 stress fractures in my hip (3 times), tibia (1) and pubic remus (1). Now this horrible freak accident. Doc says the MPFL tore at 12 yrs old most likely (94% of people tear it in the first dislocation).

Any advice great appreciated.

Thanks!
D

Last edited by: deee650: Apr 24, 12 0:41

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Re: Frequent right knee dislocations [deee650] [ In reply to ]

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noodlecat77

May 4, 12 2:41

Post #2 of 4 (2949 views)

Hi There,
What has your physio been doing so far with your knee? although the decision to have surgery should be based on informed choice and looking at all of your options, in my experience treating patellofemoral dysfunction with and without surgery, there is a lot to consider - including that slicing through all the lateral ligaments of the knee to "release" the patella means that this will develop scar tissue and can tighten up again anyway. it's messy surgery and quite painful from all accounts of my patients. But of course if you need to give it a try then you should really get your surgeon to detail exactly what he/she plans to do - you need to be fully informed - ask lots of questions!
In the meantime, I would probably suggest doing loads and loads of ITB releasing with elongating ITB massage and rolling (this hurts - like it's gotta break a sweat /make you cry type painful, but it works). you need to release your ITB as much as humanly possible (even if you are going ahead with surgery) and then get onto really specific VMO (vastus medialis oblique) training - start off with open chain exercises and progress to loaded body weight strengthening. also look at the position of your cleats on the bike - you may want to toe in just slightly on the bike to increase the medial loading and reduce the lateral quads loading.. just a teensy bit.
Let us know what you decide to do and how it goes.
cheers,
:)

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Re: Frequent right knee dislocations [noodlecat77] [ In reply to ]

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deee650

May 6, 12 1:27

Post #3 of 4 (2899 views)

Thanks so much for your reply. The dislocation happened in November and I've been rehabbing for over 5 months. It got to the point where I just wasn't getting better and then had something popping out of my leg on the inside. Doctor said it was probably a torn retinaculum. So After 5 months of INTENSE PT, I decided to go for the surgery. The MRI I finally got a few weeks ago showed not only the torn retinaculum but a completely torn mpfl. Little cartridge damage thank god... But there is basically nothing hold my kneecap in place anymore.

It kills me to have to get surgery but it's the only way that I can return to the sport in 6 months and race again in a year. It's something I need to do now. Unfortunate since it was a freak accident slip in a gym doing a backwards lunge. UGH, if I could go back in time...

I have a good surgeon lined up and the positive thing is that it's not a weight bearing ligament so I'll be able to walk without crutches about a week after surgery. He's very aggressive about rehabbing it right away without an immobilizer. He's a marathoner himself so he gets it.

I've been attacking my ITB more than ever - and it's actually ok now. I asked a ton of questions and a cadaver is going in there to replace the torn mpfl so my knee won't dislocate again. I want to be able to go back to triathlon and not worry. PLUS do things like soccer and tennis. This will allow me to do that again. Last night I was walking in the city (SF) and it almost shifted out of place. I can't take it anymore... I've reached the end. But I"m still scared... :(

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AWARE

May 7, 12 15:11

Post #4 of 4 (2851 views)

Friend of mine had that surgery combined with a meniscus repair/some other reconstruct in her knee. Basically, her knee was a bit of a train wreck. I don't think hers ever dislocated, but sometimes she could run with no issues & then sometimes it would "pop" within about 3-4 miles & our run was near done. The surgery was, of course, a difficult process for her but I think the majority of that pain & the long healing has come from the rest of the reconstruction. Her actual knee cap now stays where it should & that part of it hasn't really bothered her at all. What's taken the longest with her is the "guts" of her knee.

Not sure if that helps at all but if you can get it fixed so that life is more comfortable again & you're more functional, you should. We need to remember sometimes that there's life after/around our beloved sport. She took the time to get it fixed & endure the long healing so that she could get back to some running & some activity again.

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