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  • Questions on shallow femoral trochlea and also about weak joints/subluxatiobns

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    Old 02-02-2004, 09:25 PM   #1
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    Question Questions on shallow femoral trochlea and also about weak joints/subluxatiobns

    Hi everyone!
    Hopefully someone on this board can give me some information about this.
    Last October I fell really hard on my right knee during a bowling tournament. When I saw an Orthopaedic doc he thought that I had a torn meniscus and sent me to Physical Therapy. Well, the physical therapy made my knee worse, and actually caused more bruising. So it was immediately stopped. I went back to the Orthopeadic doc and he ordered an MRI of my knee. The results are as follows
    The femoral trochlea is shallow. There is no knee joint effusion. The joint surface is well preserved. The cruciate and collateral ligaments are intact as are the extensor tendons of the knee. The menisci are normal in configuration without signal abnormalities. There are no particular bone marrow signal alterations.
    1) No evidence of internal derangement.
    2) Femoral trochlea is shallow, which may predispose to patellar tracking.
    When he read the results he basically said that the grove that holds the patella in place and allows that nice tracking isn't really there in my knee, and since I fell, it caused the patella to be moreso out of place, and not really flat, like its at about a 45* slant. Tomorrow (well later today) I have to get a CT scan because he wants to see better how much of a grove I actually have. So he wrote on the CT script "CT eval trochlea groove for hypoplasia." He said something about surgery. One I found out by doing a little bit of research is basically a lateral release. He didnít seem too fond of that specific surgery saying that thereís a good chance that it wont help me any. He talked about another surgery where they actually go in and making the groove that the patella is supposed to track in deeper so that it can do so. And then tightening ligaments and whatever. But first heís sending me up to the Childrenís Hospital of Philadelphia, Iím a 16 year old female by the way.
    My momís more in favor of the second surgery mentioned. Partly because I have a bright future as a bowler. I have the highest youth female average in the state, a 191, and Iím right up there with the better guys in the state, even though now my average has gone down since I havnít bowled since the fall. Iím planning on bowling competitively in college, and also later on in life. But my knee also affects daily life. Like, it locks and gives out on me (especially when going up and down stairs) and it pops and sometimes feels as though its pinching something because Iíll get shooting pain through my lower leg on the right side just next to the bone, and I always have pain (about a 6 or 7 on a scale of 1-10), the pain doesnít go away either, its always there, in the middle of my knee towards the left. Also, I canít drive for more than 45 minutes without my knee totally locking up to the point where I have to pull over and stretch it out and walk some. Thatís a very dangerous situation for me and all of the other people out on the road.
    So my questions are --- Does anyone have similar experiences that they could tell me about? Can anyone tell me what the name of the surgery is where they make the groove bigger so I can do some research on it? Also, is there a possibility that my other knee could be the same way? What about support? I use a brace, but it doesnít seem to offer as much support as I need. Iíve heard about taping, can anyone tell me the proper way to do that? Any information would be great!
    On another note, I seem to be a little pre-disposed (for lack of a better word) to subluxations in my joints. I currently see a chiropracter who routinely puts everything back in place, and its not only my neck. My left wrist (Iím a lefty) has been coming out of place for about 2 years now. Every once in a while it will give me pain if it pops and it grinds hard, but itís not often and the pain isnít severe enough for me to really complain about it. Also, both of my shoulders come out of place. Both have been subluxated due to lifting my book bag, and now I have a note with school saying that I have to have an extra set of books at home. Not that it really helps now, since Iím homeschooled due to migraines, but thatís another story. Also, my right hip sometimes feels like it pops in and out of place, especially when I havenít been moving for a while. Is there some sort of I donít know, medical something that would cause such weakness in my joints? Iím also very hypermobile if that has anything to do with it. My momís an Occupational therapist and has always been amazed at how much I can hyperextend my joints, especially my knees and elbows. I also use orthotics in my shoes because I donít really have an arch in my foot, and the lower part ofmy leg, like below my knees are bowed.

    So any information on any part of my post would be so helpful!
    Thank you all so much!

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    Old 03-08-2004, 04:53 PM   #2
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    Re: Questions on shallow femoral trochlea and also about weak joints/subluxatiobns

    I have gone through a lateral ligament release about 10 years ago only after having my acl reconstructed but am not familiar with the other surgery you describe. I had no problems with the release and healed fast.
    I am however very familiar with the sublexing and dislocations of joints and was misdiagnosed for 30 years with a "rare form of arthrititis" as it actually turned out I have a genetic disorder called Ehlers Danlos Syndrome, somehwhat uncommon to many physicians it seems. There are actually a few syndromes/diseases that can cause frequent subluxation and dislocations and finding the actual diagnosis is the key to protecting yourself.
    Bracing can be helpful however it can also lead to long term problems as your joints become accustomed to using a brace your muscles can become weaker causing more problems than it is worth. Strengthening the muscles is what I have found to be the key.
    EDS is genetic so therefor it is an inherited disorder. You might want to have a look for more information on EDS to see if some of the symptoms seem similliar as well as does anyone else in your family have similar problems. I was able to track EDS back 4 generations on my mothers side.
    For more information about EDS visit their national foundation at [url][/url] there is alot of helpful information there.

    Good luck

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