patella dislocation

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On Sunday, I dislocated my left patella to the exterior of the knee while in a semi-split. I've had a number of injuries in the past (4x on right knee, 1x on left prior to this for more serious damage), so I am somewhat familiar with the process. I have regained up to 90 degrees in range of motion and do short extensions/bends, but no strength/power at this point, a moderate to significant of swelling, and an issue at around 30 to 45 degrees of bend (about the angle when it dislocated). The end of my femur is smooth instead of grooved, so I will remain susceptible to this sort of injury for life or they replace my knee(s). I had lost over 90lbs, but have regained about 25 since the wedding. Any advice on treating the immediate damage as well as ways to prevent future issues would be appreciated; I know the weight is a factor, so I would ask that respondants not beat the proverbial deceased equine on that piece of the puzzle (presently 265 @ 6'4" with 'football'/Viking build/structure). Thanks in advance - am back to short leg extensions and lifts with occassional ice atm.


M.

I don't have any advice except giving yourself time to heal but as you've said that you've experience of this before you probably know far better what you need to do than me.

Hope you feel better soon and heal well.

As a teenager my knees always twisted and dislocated. Ever since infancy if someone or something touched my knees (or elbows or knuckles and sometimes my upper back) when they were unbent I felt like I was going to pass out. I was always told it was just a sensory thing from the autism. Joint compression and brushing didn't help and simply made it worse and I eventualy fought my parents and the therepists about doing it so they gave up. I used to actualy hope I would get into somekind of accident and need my legs amputated above the knee. My chiropracter thinks it's something to do with my spine ( I have scolosis as well) and I think he may be right.

If you're still overweight, try to lose as many excess pounds as you can to take the pressure off your joints. Unfortunately, as long as you are still overweight, it is worth mentioning again, because your doctors certainly will.

You can get surgery to remove cartilage, but again, they may not want to operate if you are too heavy, due to the risk of complications.

In the meantime, you can also take over the counter anti-inflammatories to decrease the swelling (paracetamol etc)

Get physiotherapy to help you keep the joint mobile, and try to keep as active as possible to stop muscle wasting (swimming is good; lots of movement without any pressure).

Personally, my advice would be to stay away from chiropractors (they are not a recognised medical profession, or at least not in the UK) and contact a doctor; he or she may be able to prescribe you more potent painkillers/anti-inflammatories.

It's been this way since I was an infant and I was never a fat baby. Chiropractors have been more helpful than MDs who blame everything on the autism and basicaly just want to hand out pills. Ever since I started going to one for my scolosis, the pain has gotten so much better. Sometimes a good back crack is all one needs. MDs just want to throw medication at the problem. They are nothing more than legal drug dealers. A man could come in with an arrow in his head and they would keep giving him medication to deal with the pain instead of removing the arrow itself.

Get a good physio. Dislocations aren't just to do with the bones.

I'm sorry to hear you had a bad experience with a physician, but contrary to popular fiction, doctors are not always focused on 'fixing the symptoms'. Yes, if there is pain, we will give painkillers. Doctors also give things like radiotherapy, chemotherapy, anti-inflammatories, surgery etc etc. to fix the underlying problem, but funny enough, when people come in to the practice, the first thing they usually want is pain relief.

If a man came in with an arrow in his head, then yes I would give him pain medication. I would also send him immediately to A&E. There, they would examine him to see if they could remove the arrow or whether it was too close to any vital structures to be removed. If it wasn't, a specialist surgeon would remove it. If it was too close, then yes, they would leave it in, and good reason; taking it out would kill him.

(sorry Makuranososhi for going off topic)

It's OK, Lene - I appreciate your perspective. I am torn personally as there are some medications that are incredibly helpful but also went through a stage where I felt more like a chemistry set than a person, with bad bad side effects. I had lost most of the weight I had wanted to (goal 220, reached 232, back to 260 now) and have been working to shed what I have gained back. Today, the swelling doubled but have more movement. No insurance, so I have to self-evaluate before pursuing a doctor's opinion.


M.

I'll ask around, but I think the fact that you have more movement is a good sign. I'm no expert though. The insurance thing is a problem. Unfortunately, if you leave this too long, you may end up shelling out more in the long run, so if you can afford it at all, I'd get it checked out. Research online first though and see if there is anyone in your area who specialises in joint diseases; they'll be more use than a general physician.

This link's quite good; http://en.wikipedia.org/wiki/Osteoarthritis

Seeing my GP tomorrow (if I can drive) for his opinion, and referral for tests if necessary. I can bear weight if straight, now can bend and do straight raises, but have no "push" in it at this point. I do have joint issues, which is probably why I told the EMS to go once I was upright (that and I freak out @ hospitals) and am less concerned than some might given the situation. Just a lot of latent swelling that I don't understand.


M.

i agree 100% physio is essential and the best way to recover.

How'd the visit go?

Time difference; leaving shortly. Luckily there is a physio/rehab across the street from my store, so at least it is accessible. Regained a little 'push' but can't get it to 'catch' going down. Will keep thread informed, thank you for interest/concern.


M.

Ive dislocated my knee twice playing football, and recently did some medial ligament damage while in goal.

Like somebody said it might not just be the bones, but it could also be your quads, tendons, other muscles and ligaments which may be causing problems.

Also id go and see a physio and DO the exercises they give you. I didn't do them much the second time around i dislocated my knee cap and thats probably what at least partly caused my recent knee injury.

Apart from the obvious like taking anti inflammatories and putting ice on it to reduce swelling and resting and keeping it in the air (above heart level) some exercises they gave me included straightening the leg, lying on the bed and trying to press your knee down into the bed as much as poss.

Also ive just started doing some little squats where i put my weight on the injured leg and bend down, and then straighten it as much as possible.

Also just out of interest which way did it pop out, and did you manage to pop it back in by yourself (i've been told it hurts a hell of a lot and was just wondering; as both times i wasn't able to do it without some gas (which put me into hysterics); first time i had no idea what i did and was a little out of it; and the second i was running and took a few steps on it so i thought i may have done something worse)

Oh, and by the way, the physio might not give you any exercises yet as you may have to wait until its a little less sore, or more stable. Also REST UP AS MUCH AS POSSIBLE (which isn't what ive been doing lately lol - as it helps reduce swelling big time) and if necessary just use crutches if they allow you to.

GP feels it is torn cartlidge with a likely partial ligament tear. 6-8 weeks recovery. Patellla dislocated to the outside of my knee; they've never gone inward when it has happened before. I have no groove in my femur to keep things in line, so this is a susceptibilty for me. Went mostly back on its own (again, no groove) and seemed to 'pop' back two days ago. This is the sixth time an injury related to this has happened (exception was the first, where a fulback bent my right knee the wrong way and chipped that patella in addition to two ligament and a tendon tear) so basics I am familiar with. Looking more for unique or targeted advice, ways to build quad strength (need TENS unit), etc.


M.

I would have thought if there was no groove then there would be just as much chance of it going inwards as opposed to outwards (though i could be very wrong as i dont know a great deal about the subject), everything else being normal though of course.

That sounds quite a bad dislocation. My friends girlfriend did something similar with her ligaments and cartlidge (but no dislocation) and she ended up having to have key hole surgery on it.

About strengthening though, as well as the physio of course ive found a rowing machine helped me a lot to build up my quad strength. It would also help if you're looking to lose weight too and you can usually buy them on their own without having to go to a gym to use one.

Also in most gyms (at least around where i live) they usually have a special machine where you sit down in a chair, and push your legs up so they become straight which causes weights to lift up which i'd imagine would be helpful (though id imagine if you didn't want to go to a gym that this sort of thing would be expensive).

Also i'd imagine cycling would help with the quads (but it may end up having an adverse affect with the bone problems which i dont have a great deal of knowledge about).

Most of that advice is quite simple and id imagine youve heard it before though.

Best of luck with your recovery and hope you get well soon!

Gassy