At the beginning of the new year I will be having a femoral rotational osteotomy on my left leg to counteract a femoral acetabular impediment which has cause a 30 degree retroversion and in turned caused a patellofemoral malalignment.
I am a 22 year old male student who has been dislocating my left patella since I was eight years old. I have not been able to ride a bicycle in years, swim, nor even have a vigorous workout at the gym; limping constantly limits my activity.
I have have had two previous arthroscopic surgeries on the left leg including a lateral release. In 2010 about 5 years after the first surgery, in which the doctor inserted a screw to hold the patellar tendon, I made a misstep on a sidewalk and ripped that tendon out of position. The second surgery I had in 2010 was to correct this problem, but unfortunately something, I'm not quite sure what, went wrong, and while, yes, my tendon is reattached, when I bend my knee my patella dislocates anteriorly and when I extend my knee my patella dislocates exteriorly.
I noticed this problem during my PT in 2010 and when I brought it up to my orthopedic surgeon, he handed me a knee brace and basically told me to deal with it.
I went out of town for college the next year and continually kept dislocating the patella. The initial dislocation would hurt, but then the pain would subside and my knee would become swollen the size of a grapefruit. I would dislocate it 4 or 5 times a semester, an increase from previous years, and had become increasingly frustrated.
I am now going to college a half hour drive from my house. Late last year I decides to bite the bullet and see someone else about my problem. If they could tell me something different, great. But instead of just going to one clinic, I would go to two because I knew that if I had done the same when I first saw the original orthopedic specialist, I might not have gone down that mud-ridden path.
The first doctor said I should have the femoral osteotomy. Both my mother, an LPN, and I were wary citing the previous doctor. So we got our second opinion at a Sports Medicine clinic. I definitely felt more sure about their diagnosis because 6 M.D's observed my leg and X-Rays and came to the same conclusion that the first Doctor did, except there was one caveat. Because of the long abnormal wearing of my patella against the femur and tibial bone behind it, I have early onset arthritis and I am going to have a second surgery to put left patella on a metal track so that it functions normally and pain free.
Dr. has sent me to another doctor who specializes in the femoral osteotomy (he will be performing the knee surgery at a later date; some time this spring). After a CT-scan, she and the Dr. concluded that the femur needs rotated 30 degrees to the anterior. Additionally, they concluded that I must be in a lot of pain with this constant dislocation. (1) My nerves were severed in the first two surgeries. Could that be hiding the pain or have the nerves grown back and am I just that stoic?
Much to my own agitation, I have decided to take spring semester from school off to focus on my health and get this together. I have learned some interesting things. First, I'll be in a cast for a month. Second, I will be in the hospital for two days.
(2) Do you know if I will be getting metal hardware inserted? It that a reasonable assumption?
(3) What kind of physical therapy will I need (technique, exercises, etc.)? I realize that I am fairly old for this surgery (usually done at 15 year old and younger) and that a femoral osteotomy on a patient with a retroversion is rare. When can I expect PT to begin?
Thank you for sticking with me on this long journey, and I really appreciate any answers.
Ask questions if you have them, and I will respond post haste.