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FurryPaws2011 05-19-2011 09:23 AM

10 months after injury - dislocated patella/rutured soft tissue/bakers cyst
 
Hi,

Hoping someone can help either put my mind at rest or offer guidance.

In july last year I fell off a ladder into the corner wall from where the chimney breast wall juts out. The top of kneecap took the entire force of the fall.

At the time I lay on the floor in agony and eventually managed to get up on my good leg (left) and get help. I stayed with my parents that night as I couldn't straighten my leg fully or bend it much. The next day I went to hospital and had it x-rayed. The said it was just tissue damage and nothing broken. I was sent home with only a tubular bandage for company.

I got about 10 physio sessions afew weeks later when bruising and swelling had gone down alot. Then I had to stop the sessions as I changed jobs and no longer had private medical insurance. When I left physio my knee pain wasn't too bad so I didn't seek help on the NHS as I thought it would get stronger and better on it's own.

However, 10 months on after the injury I still can't do what might be classed as an everyday task like going down on my honkers or kneeling. I can't swim breaststroke because I can't kick my knee out in any kind of way. I stopped surfing and I can't walk far.

So, I paid to go to a recommended physio this week and they think what has happened was alot worse than initially thought in hospital. She thinks when the knee made impact with the wall the kneecap dislocated and caused the soft tissue around it to rupture. It feels loose and abit unstable all the time. The physio confirmed I have a 'tracking' issue where she said the patella isn't sitting in it's 'groove'.

Pain levels on a daily basis marking out of 10 (10 being the first few days after the fall) is around the 7 or 8 mark for entire knee and also sometimes the bone going down from the knee. I also have a Bakers cyst at the back of the knee which is causing me pain too.

My question I guess is, do you think surgery will be neccessary from the sound of things? Physio will see me again in a week. She has given me exercises to try and strengthen the muscle above my knee as it has basically disappeared compared with my left leg.

The physio thinks surgery looks likely but I'm wondering if physio alone would strengthen the muscles enough to not need it?

I really am desperate to get walking, swimming and surfing again. I was also advised by the physio to put a complaint in to the hospital and physio who saw me the first time as they should have referred me to a consultant but that's another issue entirely!

Many thanks,
Furry Paws

barb70 05-20-2011 04:09 AM

Re: 10 months after injury - dislocated patella/rutured soft tissue/bakers cyst
 
I would suggest seeing a good Ortho for your problem.

FurryPaws2011 05-20-2011 04:26 AM

Re: 10 months after injury - dislocated patella/rutured soft tissue/bakers cyst
 
Thanks barb70 :)

I went to GP this morning and they are referring me to an ortho consultant. Could be about 3 months wait as I no longer have private medical cover since changing jobs. The GP also suggested an MRI scan to see what's happened.

I guess I just need to be patient but it's already been 10 months and the pain on some days is almost as bad as when I first fell.

The doctor today actually questioned whether there was a cyst and even I can feel it! She said only an ultrasound can tell for sure but I had one on Monday and it was confirmed.

I feel like I'm fighting a battle with GPs just to get things done. This isn't the first time they haven't referred me quick enough or misdiagnosed me. In 2008 I had unrelated problems and they fired 8 rounds of antbiotics at me before I pushed to see a specialist. Turns out I had the start of hodgkins lymphoma!! I know GP's are only human.. but where I'm concerned they seem to constantly make mistakes.

barb70 05-20-2011 04:42 AM

Re: 10 months after injury - dislocated patella/rutured soft tissue/bakers cyst
 
Sorry you are having all of these problems and can't get into see a good Ortho. The UK seems to need to upgrade their medical profession as so many people complain about it.
I had a friend living in Sweden and finally they returned to the US after having a child when they realized how bad the medical area was there.
I guess we are lucky here in the US even with our complaints.
I have just found out that my second knee is going to need a TKR also and I still have pain from the first one from over a year and a half ago. I had a shot to help hold off some of the pain on the second one and hopes it helps. The thought of going through all of this again freaks me out. As is I spend half of my life now in some sort of therapy.

FurryPaws2011 05-20-2011 04:47 AM

Re: 10 months after injury - dislocated patella/rutured soft tissue/bakers cyst
 
Not good at all. Sorry to hear you've to have the other knee done as well.

Thanks for the reply, funny that you are in the US and even you know how dire our NHS is!

janewhite1 05-20-2011 01:50 PM

Re: 10 months after injury - dislocated patella/rutured soft tissue/bakers cyst
 
Yikes! Sounds like something that should have been treated much more aggressively in the beginning. Still, a surgeon can probably improve your life a lot.

Well, the cyst may or may not be an issue. The question is whether any of the ligaments or soft tissue are torn in there. If something tore badly and didn't heal on its own, you probably should have surgery to stitch it back together.

Sometimes strong muscles can compensate for damaged ligaments, but if a physiotherapist is saying "I can't help you, see a surgeon" it's likely you do need surgery.

A good surgeon may be able to identify the problem through a simple hands-on exam, or he may want an MRI.

The "Just a sprain, don't worry" is not just a British thing, by the way. After I hurt my knee, I went to the ER, they x-rayed it, said nothing was broken, wrapped it up and kicked me out. I was in such pain, I called every orthopedist in 3 counties until I got an appointment for the next week. And he did another x-ray. Cracked tibia, meniscus tear, swollen bursae. Six weeks on crutches in a hard brace. That was almost 4 months ago, and it's close to better, but not there yet.

james079 05-20-2011 02:09 PM

Re: 10 months after injury - dislocated patella/rutured soft tissue/bakers cyst
 
[QUOTE=barb70;4758743]Sorry you are having all of these problems and can't get into see a good Ortho. The UK seems to need to upgrade their medical profession as so many people complain about it.
I had a friend living in Sweden and finally they returned to the US after having a child when they realized how bad the medical area was there.
I guess we are lucky here in the US even with our complaints.
I have just found out that my second knee is going to need a TKR also and I still have pain from the first one from over a year and a half ago. I had a shot to help hold off some of the pain on the second one and hopes it helps. The thought of going through all of this again freaks me out. As is I spend half of my life now in some sort of therapy.[/QUOTE]

Your friend should think herself lucky to have had her child in Sweden. It ranks third in the world with 2.75 deaths per 1000 live births, America is 46th with 6.25. The UK is 32nd. Canada is worse than it should be at 36. If you like back surgery America is the place to be, as percent of population Americans have 5 for every 1 in Scotland or England. So are patients in the US of A over operated on or is that the Scots and English are not getting enough.
James

FurryPaws2011 05-23-2011 01:47 AM

Re: 10 months after injury - dislocated patella/rutured soft tissue/bakers cyst
 
Thanks Jane! Yeah the physio said the muscles are much weaker on the leg with the bad knee. Even I could see it when we were doing resistance exercises. Guess I'll just have to wait another few months to see the Ortho guy.

Sounds like you've had some healthcare issues too. In reality there are more people about with issues than there are which don't! You haven't had to have an operation then? Though I know our injuries are slightly different, I'm not comparing, just curious.

janewhite1 05-23-2011 06:01 AM

Re: 10 months after injury - dislocated patella/rutured soft tissue/bakers cyst
 
I did not have surgery on the leg with the fracture (left leg). I have had surgery on my RIGHT knee a few weeks ago, it's been bad for years and the strain of having my usually good left leg out of commission pushed me to a point I had to do something. Right knee surgery was outrageously easy and successful. If you are going to be repairing/tightening ligaments, though, that'll be harder.

FurryPaws2011 05-27-2011 04:01 AM

Re: 10 months after injury - dislocated patella/rutured soft tissue/bakers cyst
 
I see, that sounds very bad. I'm sorry you are in such pain. I never gave a second thought to my knees before I injured the right one. Though I have fibromyalgia and understand the importance of not taking health and mobility for granted.

Good luck with the left leg/knee!

Last night I was kept awake by knee spasms. When it first started happening I thought an alien was trapped underneath the patella trying to escape :D

The pain has ramped up today as a result and when I walk (which is a limping motion these days anyway) the pain spreads down the back of my calf. Some rest is on the cards for this weekend. Hopefully that should help abit.

LessStress38 06-04-2011 06:55 PM

Re: 10 months after injury - dislocated patella/rutured soft tissue/bakers cyst
 
F.Paws, I was wondering how far off the ladder was your fall?

I recently fell, lost my balance and all my weight landed on my right knee.(5days ago) My knee has been swollen twice it's size since. Getting up and down from sitting hurts and walking, I limp, stairs, of course are bad. I have been ice-ing and elevating my knee as often as possible. I can only use ibuprophen once or twice a week (not two days in a row because of headaches) I called the nurse once who said it could just be a bad bruise and could take two or more weeks to get better. Then she said to call in a few days if nothing improves. ?????

I'm so not about going in to waste my time or theirs, but....ouch!
I recently had trouble with my old primary doctor and haven't met "offically" my new one and it's going to be a weird first impression.

What if they tell ME it's nothing and I go on for ten months?
Or what if I don't go and I don't get better, but worse...
I guess..I go and see...Monday

Thanks for posting....hope your recovery continues to be speedy!:)

janewhite1 06-04-2011 07:02 PM

Re: 10 months after injury - dislocated patella/rutured soft tissue/bakers cyst
 
I have both bruised my knee in a fall and really injured my knee in another fall.

The bruise did indeed get in the way of activities for a couple weeks, but after a few days, it was clearly improving.

The real injury was a little painful the first couple days, but I was able to walk. Third day needed crutches, fourth day agony even when I wasn't moving (which was what clued me in that it wasn't a bruise!), and it took another week after that for the pain to start to fade. (At 4 months out, I'm close to normal.)

If it's been more than 3-4 days, you've been icing, elevating and not using the knee more than you can avoid, and it's still really bothering you, call your doctor Monday and make an appointment.

FurryPaws2011 06-06-2011 01:38 AM

Re: 10 months after injury - dislocated patella/rutured soft tissue/bakers cyst
 
Hi Stressless,

I only fell from 3 steps up. But I fell sideways and when the ladder started to slip the opposite way I stupidly made abit of a jump the other way forgetting about the chimney breat wall.. d'oh! Probably hit it with more gusto than if I'd not tried to leap from the ladder!

I knew I was in trouble from the minute it happened as I lay in agony for about 40 minutes before I got up on my good leg and hopped to open the front door (otherwise no one could get me!) Mine was swollen, bruise completely covered the kneecap area and I couldn't bend it past about 40 degress, nor could I straighten it. I couldn't drive for several weeks and relied on my lovely family to get me to work (luckily they were going the same direction). I stayed with my parents for acouple of weeks until the worst was over.

All you can do is go see someone and get their opinion. Hopefully they'll be able to offer reassurance or get you sorted quickly if you need treatment or physio. In this process what I have learnt is to listen to what your body is saying. I knew from the beginning after they xrayed it and told me to go home that it was more than just soft tissue damage. And even at that, soft tissue damage could mean a torn ACL or another similar ligament.

If you need extra reassurance why not see a recommended physio and see what they think. A one off consultation doesn't cost that much.

Hope you're doing well. I have an appointment next week, so luckily I haven't had to wait long as my physio has pushed the GP :)

LessStress38 06-06-2011 08:43 AM

Re: 10 months after injury - dislocated patella/rutured soft tissue/bakers cyst
 
yup, I went and had x-ray....bones look fine, swelling and pain still bad. I must say the swelling went down a very little. My right knee is still about two inches bigger than my left and it's a full week now. The pain is worse. Ice helps. The doc, who I trust, says to give it two more weeks and if I'm still having pain see an Ortho. So, it my be a sprain or tissue, cartilage damage? He said no MRI or anything yet, only if it don't get better in a couple more weeks. At least I get a comphy brace out of it.

F.Paws, Thanks for your reply!! Wow, what an experience! You did quite a number on that fall. That does sound real painful. It's good your family is there for you. I am glad you are seeminly, finally on the mend....:) These things take sooo long take care. :)

FurryPaws2011 06-16-2011 08:17 AM

Re: 10 months after injury - dislocated patella/rutured soft tissue/bakers cyst
 
Any better Stressless? At least you got a brace! I got a knee bandage.. may as well just cut a hole one end of a sock and put it on for all the use it was/is! :D

Update: Saw the consultant on Tuesday. He is quite non-commital on what could have happened and what's wrong. Understandable I guess. I've been refered for an MRI in the next few weeks.

He agreed with physio that there seems to be something out of kilter with the kneecap as he was bending it hearing it grind alot. He was poking his finger over the top of the kneecap and pressing (this is where I hit the corner wall so was very sore touching there!) My other knee you can't get to feel the top behind of the kneecap as the muscles prohibit this. Shows how wasted my muscles are..

He wouldn't say yes or no to surgery yet until he sees the MRI scans. I understand this completely however I have my concerns. He said if I 'fissured' (sp?) the cartilidge between the kneecap and leg bones then nothing would be done. I would have to make 'lifestyle choices' not to surf perhaps. This to me is ridiculous. I'm only 28 and I already have fibromyalgia and find swimming to be the only source of exercise I can do without getting too sore (within reason, not jumping in now for a 1 mile swim!)

So to me I have already had to make alot of 'lifestyle choices' to enable me to live a relatively normal life like work full time, have a social life and hobbies ie. swim, surf. I can't swim at all at the moment as I can't kick my knee, the thought of it makes me wince even...

He's given me a months worth of Celebrex anti-inflammatory to try and help with pain and swelling before the MRI.

See what happens.. the saga continues!


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