I was hit by an out of control snowboarder yesterday, and wound up dislocating my patella (I actually felt it on the side of my leg), and according to the ER doc, likely tearing my retinaculum. Has anyone here had this type of injury? Did you need surgery, or did it heal on its own? How long before you are training again? Are my plans for my first IM in September screwed?
An yes, I am going to see an orthopod, I just can’t get in until Monday afternoon.
Sorry to hear that
There are no “Mouth Breathers” where I ski
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The ortho exam is critical in determining what in fact is going on in your knee. A full orthopedic examination should give you and the doc a better idea of what is going on and if not, an MRI may be in order. If in fact you only tore the retinaculum at the medial knee surgery will most likely not be a treatment. However, this does not just mean “let it heal.” meaning, healing will be sped up via manual therapies such as Graston Technique, perhaps Ultra-sound and EMS, and then working on proprioception exercises and then working toward hip and knee primary mover strengthening exercises and then finally plyometric exercises to ensure full return to your activities. Just remember that just because it does not hurt anymore that the healing is finished! Keep your chin up and your IM may not be out of the picture just yet… depends on the ortho and decisions made from here on in. Good luck! ERIK
Thank you Erik. That is somewhat encouraging.
be as pro-active as you can with therapy and self-treatment. Do everything the provider that you trust says and if that does not work, do not hesitate to go and get someone else’s ‘perspective.’ good luck and keep in touch as to what is going on with you. ERIK
A patello-femoral dislocation can be a serious thing, both for you and the orthopedist. When the patella dislocates, laterally (to the outside) in virtually all cases except those who’ve undergone previous patellar soft tissue surgery, the major damage is to the MPFL, the medial (inside) supporting ligamentous structure. Damage to the articular cartilage structure of the femur and/or patella are highly likely during the subsequent relocation of the patella. In some cases, the broken off piece or pieces can form a “loose body” leading to intermittent locking of the knee.
I’d suggest you nose around the net and learn as much as you can about the injury, potential methods of treatment and their complications so you can have an intelligent discussion with your orthopedist and plot the course that’s best for you both long and short term. Good luck!
A patello-femoral dislocation can be a serious thing, both for you and the orthopedist. When the patella dislocates, laterally (to the outside) in virtually all cases except those who’ve undergone previous patellar soft tissue surgery, the major damage is to the MPFL, the medial (inside) supporting ligamentous structure. Damage to the articular cartilage structure of the femur and/or patella are highly likely during the subsequent relocation of the patella. In some cases, the broken off piece or pieces can form a “loose body” leading to intermittent locking of the knee.
I’d suggest you nose around the net and learn as much as you can about the injury, potential methods of treatment and their complications so you can have an intelligent discussion with your orthopedist and plot the course that’s best for you both long and short term. Good luck!
Thank you John. I just checked out your blog, and can see that you are more than qualified to discuss this injury. If any pieces break off as you mentioned, will they generally be revealed by an MRI, which I can only assume my doc will want me to get? Also, most of the articles I saw on the net dealt with self inflicted injuries. Would a dislocation caused by an external trauma be treated any differently?
Thanks,
Adam
While i am not Johnpostmd I will give my .02:
Yes, an MRI will reveal if any of the fractured/avulsed bone is ‘free floating’ as well as what other structures are damaged. MRI’s are used mostly to determine soft tissue trauma/pathology but bone can be seen via MRI. Usually, after a thorough physical exam (HANDS ON) using orthopedic test etc. the doc (ortho in this case) may order an MRI to rule in/out tissue pathology/trauma etc. And finally, No trauma that you sustained will not be treated any differently… or atleast that is what I think you are asking?
ERIK
Adam-an MRI may/may not be helpful in someones first (and hopefully only) patello-femoral dislocation. If there are fragments, there’s usually some variablity in size making the smaller ones difficult to observe via scan. That said, it may not be required initially as you and your orthopedist would have to answer the question, “Will the information obtained by MRI make a difference in my treatment?” In other words, surgical vs non-surgical care.
Let me give you my most recent example: 17 year old HS wrestler suffers probable PF dislocation during middle of match. (Takes an injury time out, relocates patella, finishes match and wins-tough kid.) But, on initial eval it was unclear if this was really a dislocation or possible lateral meniscus tear so (after regular xrays) an MRI was obtained, positive for loose body and dislocation (among other things for which he underwent arthroscopy.) He was still symptomatic 1 year later and underwent formal ligament reconstruction (among other things.)
Whether the injury was “self inflicted or caused by external trauma” may not be overly significant.
Good Luck!- John Post, MD