Sports Girl's left knee is no longer swollen but shows some signs of scarring.
My posts about my 14-year-old daughter’s knee surgery where surgeons used a cadaver ligament to replace her MPFL and a lateral release have attracted lots of readers and several comments. I am happy to report that Sports Girl continues to have a quick and painless recovery.
She goes back to her orthopedic surgeon for a follow-up appointment on Monday, March 1, where the doctor plans to x-ray her knee and give her a post-operative evaluation. We should know more then about how well she is progressing, but by all indications, she seems to be healing as well or better than we could possibly have expected.
Sports Girl has regained almost complete range of motion in her left knee, and she continues with aggressive closed-chain physical therapy weekly with the therapist and daily on her own. This means she does weight-bearing exercises on her leg while her foot is planted on the floor, but no jumping or running or anything where she picks up her leg.
It is amazing to me how quickly her left quadriceps atrophied, and she still has work to do to get them built back up. But she is working hard at her therapy, and while hurdles and the long jump are out of the question, according to her physical therapist, running distance in spring track may be a possibility for Sports Girl at this point. We plan to discuss this with the doctor next week as track will start almost exactly 3 months after the surgery, and this was the short end of the 3- to 6-month recovery time frame we were given.
While she is doing very well now, the surgery wasn’t entirely easy. Sports Girl spent one week taking the narcotic pain reliever, Oxycodone. The little white pills made her queasy and light headed, but she needed them – especially at night when the busyness of the day didn’t keep her mind off the throbbing pain. She had many pills leftover at the end of that first week, but she gradually weaned herself solely to Tylenol. She found that she didn’t actually need the potent pain pills to be comfortable. She didn’t like the way they made her feel in her head and her stomach, and she didn’t like knowing that they are classified as habit-forming drugs.
Sports Girl’s knee swelled to at least twice its normal size, but we diligently kept it elevated and iced almost non-stop for at least the first week, maybe longer. As someone who normally sleeps curled up in a ball, I know Sports Girl didn’t adapt well to being forced to sleep lying flat on her back. There was just no other way for her keep her knee stable and elevated.
Sports Girl also struggled with the lingering numbness she felt in her leg, probably a prolonged effect of the nerve block she had for surgery and also a possible side effect of the long hours she had her leg elevated. But after a couple of weeks, she finally regained complete feeling in all of her left leg and foot.
I think some of Sports Girls struggles involved getting past her own fears. For example, my fashion-conscious teenage daughter wore the absolutely ugly white TED compression hose/leggings even longer than instructed. She also continued to bandage her incisions long after anything was draining, and she covered them with plastic wrap before taking a shower much longer than the doctor ordered. I believe she actually dreaded losing the pieces of tape that covered the incisions.
And while Sports Girl was quick to ditch her crutches, she wasn’t as eager to leave her large black leg brace behind. She wore the brace for a few days longer than necessary, but that was fine with Handsome Hubby and I. The roads, sidewalks and walkways around here have been covered in ice for much of this winter, and the brace served as a small insurance policy in case she fell.
The surgeon attached the cadaver ligament to Sports Girl’s femur with one dissolvable screw and to her patella with two screws that will not dissolve. According to the doctor, the dissolvable screws are too soft to be driven into the kneecap. The fact that the ligament will eventually be naturally attached to Sports Girl is reassuring and weird at the same time.
The surgeon could have used a piece of Sports Girl’s hamstring to replace the MPFL, but he wanted to leave the hamstring intact in case Sports Girl ever needed an ACL repair. Evidently the hamstring is the preferred tissue of choice for this type of repair. The surgeon assured us there was no risk of rejection using a cadaver ligament, and the recovery time is a bit less as the hamstring is not further weakened.
Sports Girl applies lotion with vitamin E on her incision sites daily as well as Mederma to reduce scaring. She will also need to wear sunscreen faithfully all summer as the surgeon said sun exposure in the first year makes scare appear more pronounced. I am picturing a tanned teenager with a white knee — similiar to how she looked last summer when she was wearing the black knee brace while playing sports.
The initial news of being sidelined from basketball and spring soccer was devastating for Sports Girl. But as she watches her former teammates wind down this basketball season, I think she has actually gotten a bit accustomed to her free time and has actually somewhat enjoyed this break from her sporting activities.
I believe Sports Girl’s biggest obstacles from this point forward could be overcoming her own internal fears as she regains trust in her knee – that and finding the strength and time to recommit to the sports she loves. So now we hope and pray that Sports Girl has the drive and dedication necessary to get ready this summer for high school sports in the fall. But first we need the surgeon to release her for full participation. I don’t think this will happen next Monday, but it might happen in March or April …
A Country Mom's Blog 
I found your blog when I was researching my son’s injury. He is a football player at a major D1 College but first had the same injury as Sports Girl in high school. Since then he has reinjuried his Knee twice and currently has done it again. He is presently getting treatment for it with the trainers and they have decided that he will go through spring practice with a brace and see how he does. Surgery is the next step for him if they can not rehab it this time. How is your girl doing and would you recommend this surgery. The School has been great but as a Dad I worry.
Thanks
Did your son have his MPFL replaced/stabilized with a cadaver ligament? And he’s reinjured the same knee multiple times since? Wow! Or did he have his own MPFL “repaired”?
So far the cadaver ligament surgery seems to have worked very well for my daughter, but she is just a little more than one year out and hasn’t tried anything any more competitive/strenuous than JV high school girls basketball and soccer. Although some of those games can get pretty rough and she has fallen on her knee more than once …
Good luck with your decisions here. It sounds like a minor injury, but from what the ortho surgeon told us, those who experience multiple dislocations/subluxations can have serious arthritis issues in the future. Our doctor actually mentioned the possibility of needing a total knee replacement at a young age. It’s not something that should be ignored, so your concern is certainly justified. I’m sure the school trainers know this, as well, and are doing whatever they can.
Hi~
I’m a 28 year old dancer scheduled to have the MPFL reconstruction w/ cadaver ligament this April. I am having a very hard time finding information about this surgery online. The only resource I have is the info the surgeon told me.
Can you tell me how long your daughter was on crutches? Also, did she get this done during the school year? If so, how long was she out of school? I am trying to gauge how long I will need to be off of work. Also, you mention the doctor attached the cadaver ligament with a screw. Do you know if this is the standard procedure?
Thanks for any extra advice!
Thanks for your inquiry. My memory is getting a bit fuzzy, but Sportsgirl wasn’t on the crutches for very long. I believe she was pretty much done using them indoors by 3 weeks post-op, and the doctor let her officially ditch them at about 4 weeks. I know she was putting weight on her left leg while wearing the brace much sooner than I expected.
As far as missing school, she had the surgery done on Thursday, Dec. 17, and I believe she would have been ready to go back to school by Wednesday or Thursday of the next week but school was on holiday break by then. She couldn’t bend her leg much at just one week, and she did still need to keep her leg elevated and ice it as much as possible as there was still some swelling. She took the prescription pain meds for a little over a week, and those upset her stomach and made her light headed. And you can’t drive when you are taking those.
As far as I know, attaching the donor ligament with a screw is pretty standard. It’s what was done in the sample information I found online. The doctor attached it with one screw in her femur, which we were told would dissolve in time. And he used two screw in her knee cap; those screws are not dissolvable, because the knee cap is too hard to drill those softer screws into it. The screws are evidently recessed into her knee cap, as we certainly haven’t been able to determine exactly where they are. But they did show up on the post-op xrays, which was a little strange to see!
I hope this is helpful information. Best of luck with your surgery!
My “sports daughter” is also 14 and tore her MPFL last November. The surgeons recommended we try the conservative approach first which we did. They released her at the end of February so that she would be able to participate in spring track (running events only). Well yesterday was the first day of spring track and she took 10 steps into her sprint and the Patella gave out and she’s back to where she was 5 months ago with a MCL strain and a MPFL tear. Like your daughter, mine is a huge athlete with soccer her number one sport. As a 6th grader she was the highest scorer for the High School JV team. So emotionally this seems to be a huge hit to her.
From your post it looks like lttle school was missed? How many days of PT did she attend per week. If we have the surgery now, will she be ok by the summer? How long did she wear the Patella guard? Really having a hard time on making the right decisions. There is so little information out there on this type of injury and surgery seems not to be recommended. Any help you could provide would be great.
My question
Hello Stacey,
I am so sorry to hear about your daughter’s situation. It does sound familiar. Sportsgirl didn’t miss a lot of school, but as I mentioned, we did the surgery right before the holiday break. I’m guessing she would have been out for about a week, though, had it not been vacation. She went to PT twice a week for the first 4 to 6 weeks and then we went down to once per week. Most of these were booked in advance and happened right after school. She did have to do her PT exercises at home daily.
From my experience, doctors aren’t eager to operate on young teenage girls. I actually found this comforting. It indicated to me that when the doctor did actually want to perform the surgery, that it must be our best option. Our doctor was not keen on trying to repair her own MPFL as the success rate isn’t as great. He obviously preferred the donor ligament option. But we know another girl in this area who had the same issue as Sportsgirl and saw the same doctor. He would not do the donor ligament procedure on her as her growth plates were still open and she was still growing. So that’s something to consider.
I would think that if your daughter has the surgery fairly soon, that she would be getting around pretty well by summer. I doubt, however, that she will be cleared for any physical activities involving jumping, twisting, or pounding until 5 to 6 months after the surgery. What does this mean for soccer — is her primary school season in the fall?
Sportsgirl didn’t miss a lot of soccer, but she missed LOTS of basketball. We looked at this way … at least she missed it as an eighth grader rather than as a junior or senior in high school. And we truly did the surgery so she could have a full, active life without a knee replacement surgery in her young life.
I hope this helps. Best of luck as you make your decision.
Country Mom
My daughter is 16 and is scheduled to have her MPFL surgery in two days. She also will have a cadaver ligament used. She was a borderline candidate for the tibia transfer, which would take a whole year to recover. We opted for the lesser of the two surgeries hoping this would be our best option overall. She will be a senior next year and is involved with volleyball, basketball, and track. We hope and pray we are making the right decision on the type of surgery. The doctor agreed with either option. She has a subsection speech meet two days after surgery. My question is, will this be something she will be able to do, or would it be best for her to stay off her feet and not attend school for a while?Thanks for the input and glad your daughter’s surgery went well.
Hello Small-Town Mom,
I certainly can’t speak for your daughter as everyone is different, but I really don’t think my daughter would have been ready for any speech event just two days after surgery. She experienced quite a bit of discomfort for several days, and it was best for her to just keep her leg elevated and her knee iced. We did attend a social event about four days post-op; even that was somewhat difficult, but she was happy to be out. My daughter was taking the prescription pain pills for about a week, and they sometimes made her nauseous and light-headed. It also took her a little while to master the crutches.
Also, your daughter won’t be able to bend her leg right away and probably won’t get a descent range of motion for a few weeks, so sitting in a vehicle and at other events can be tricky with the leg extended straight out. Another mom whose daughter had the same surgery posted a comment on my site about how difficult the first few post-op days were. And they were for us, too. But after that, things seemed to improve rapidly (maybe not fast enough for a teenager, but they seemed to move along quite nicely for me as the mom).
So I don’t mean to be negative, but it might be best to limit your daughter’s calendar for about the first week. After that, it should get a lot easier. And I do believe the surgery worked out very well for my daughter over the long term — at least so far. I always tell people that it’s not like having an ACL or MCL repaired; after this surgery the patient should actually be stronger than they were before. That’s how it’s been for us …
Best of Luck! ~ Country Mom
We just returned home from the surgeon, and need to make a decision on when to have it performed. Due to the swelling she can’t have the surgery done till the first week of May. My question to you is we have a cruise planned on June 25th. What kindo of shape will she be then…or do we wait until after the cruise for the surgery. I appreciate all the help you have provided above.
Stacey
As someone who had MPFL tightening, meniscus cleaning and a bone&cartilage chip removed, I would advise pushing it off until after the cruise because it is a slow recovery even though she will feel better than ever once healing is done. I personally had a longer time with crutches and the big black brace due to complications from the nerve block, but with slow progress the knee heals very nicely. One piece of caution is to make sure that she is doing as many hours as possible on the bending machine, the knee will feel very tight so keep it moving. If your daughter already had the surgery hopefully it went well and she is recovering quickly
Hi Country Mom,
My 14yo daughter is scheduled for an MPFL reconstruction and a TTT (Fulkerson ostetomy) next month. While I feel complete confidence in our surgeon and realize that my daughter has become practically disabled due to her knee issues, it’s still tough knowing what lies ahead of her after the surgery. My daughter was active, played soccer and swam year-round, before the knee issues and has had a hard time with not being able to do things. We’re looking forward to her having her life back after all the rehab, but I’m freaking out a bit about the surgery and rehab anyway. As a parent, how did you handle your own anxieties while reassuring your child? Please say something reassuring.
Curly Mom
Hello,
My daughter was so nervous, that I knew I had to stay positive and strong for her. She was truly a nervous wreck. I approached this surgery much like I handled the prospect of child birth — millions of others have endured this just fine, so we can, too. I also just focused on the end result, knowing that my daughter couldn’t continue on in the physical condition she was in. I don’t know if I fully understood everything that was ahead of us, but these kids really do heal quickly. It will all be over before you know. I think perhaps the hardest part was the time between when we scheduled the surgery and when it was done. After that, you just keep plodding forward.
I wish you and your daughter the best. Take Care!
Country Mom
for those who have gotten this surgery done before and kept playing the sports they were in, what kind of brace did you use? because i got one but they dont sell them anymore and me and my mom dont no where to go now because i personally dont feel comfortable. so if there is any chance that you could tell me where you got yours that would be great. im playing varsity basketball this year and dont want to take any chances.
Hi Everyone,
I have read these comments and can hear apprehension and confusion on this surgery. My daughter is a D1 soccer player and had this surgery October of last year. If anyone know hows tough soccer is at this level, you can imagine how difficult this can be. My daughter had ACL replacement when she was about 15 years old and this MPFL surgery is not only more difficult, but recoup time takes alot longer. The key to success is making sure the graph takes and you keep in stabilization brace. The leg will lose substantial size,, so get ready for that. The nice thing though, muscle has memory and it will return. I can assure you that it has been a long road for my daughter. She sat out most of last year as her patella slipped, sublexed, many, many times…once it happens hard, it continues to happen, regardless if you rehab. When I say hard, I mean snaps over the outside of your leg. I remember when it happened the first time and my D is tough, but she was screaming. I suppose I will give you a bit of good news…this surgery is very good, it certainly keeps the kneecap aligned…but it takes time for leg to strengthen and more than anything, between your ears, you must believe in it. She is back to playing, worked out as hard as i have ever seen anyone…what she does could kill a horse, honestly. She is not a starter, she is a red shirt Fresh…but she is rising to the top. She is becoming stronger and stronger and the knee and leg are getting much better. This is a year process…not 6-months or 8…it takes a year. And, it takes a year with work…not sitting and eating cupcakes. Brace yourself on this sugery…it is very uncomfortable for the person if you follow the crutch rules and brace rules post surgery. It is a long process…Once you are back around 5-6 months…keeping physically fit…I mean really fit, will get you there. At the end of the day,, when this happened to me 30 years ago, they had NO resolution…now they do, and trust me, it works…but it takes time.
SK
Hello SK,
Thanks so much for your input into this issue and surgery. I would agree with everything you wrote. My daughter experienced excruciating pain every time her kneecap popped out, even though it popped right back in on its own. And I know she has a high pain tolerance, as well.
It is wonderful that they now have a fix for this issue. Before my daughter had the surgery, I talked to a couple of women who continually experience patellar subluxation in middle age under the most basic of circumstances. Sports Girl does play high school sports, but she most likely will not play any official sports in college. She had the surgery so that she can live a full, active life without fear of this happening again sometime when she is simply out for a hike or just climbing a set of stairs.
And it truly did take a whole year before my daughter experienced the full benefits from this surgery, and it required a real commitment to physical therapy, strength training and physical fitness just as you said.
I hope your daughter has a great collegiate soccer experience!
Country Mom
SK, thank you for the experience shared and great advice. My question is did your daughter have an allograft or autograft in repairing the mpfl and did they perform a lateral release? My daughter is having the MPLF reconstruction done and we are undecided on which type of graft to use? Any thoughts would be greatly appreciated.
Hello Scott,
My daughter had the allograft using a ligament from a cadaver donor. Her ortho did want not want to use her hamstring; he indicated that he wanted to keep that in tact in case she ever needed an ACL repair at some point in the future. And she did have the lateral release performed, as well. We continue to have no complications from the procedure, and I believe her knee is stronger now than before her injury.
Best of luck to your daughter!
~ Country Mom
Hi, my daughter just had her MPFL surgery last Wednesday (March 14, 2012). She is experiencing very little pain (taking 1 1/2) pain meds every 4-5 hours and Tylenol about every 6 hours. But is experiencing the light headed/dizziness & stomach ache like you mentioned a lot:( how long did that last for your daughter? I think that right now is our biggest issue, it scares her so she will only get up to go to bathroom (which is only right out the bedroom door) , other then that it’s bed with leg up and ice. I’m hoping this is normal. AND what did your daughter do to pass the time while laying in bed?
Thank you,
Jessica
Hello Jessica,
We found that the light headed/dizziness and stomach discomfort were due mostly to the pain meds. As soon as my daughter quit taking the prescribed pain meds, those symptoms went away. But I think it was about a week before she was ready to go without the meds. Your daughter’s situation sounds very normal for the first week, at least based on our experience. I remember that tending to the bandages and taking a shower were major undertakings during that early time after surgery.
But things improve rapidly after this. I don’t recall my daughter doing much that first week other than watch TV and rest. She did start doing some puzzle books and even did a little cross stitch project during her second week post-op when she had relocated herself to the couch. By the end of the third week, she was motoring around pretty good — even without crutches around the house — and almost back to her old self! Of course that posed its own challenges, because she still had a long way to go before she would be fully recovered.
Best of luck with your daughter’s recover!
~ Country Mom
Hi Jessica,
This isn’t my blog, but my 14yo daughter had MPFL reconstruction and a Fulkerson osteotomy on her left knee in September and on her right knee at New Year’s. After the first surgery, she had a lot of dizziness and stomach issues due to the oxycodone (she was taking 2 every 4-6 hours). With the second surgery, we only gave her 1 oxycodone every 4-6 hours and 2 extra-strength Tylenol every 4 hours. Decreasing the oxycodone largely eliminated the dizziness and stomach issues. To remedy the bathroom situation, we kept a potty chair by her bed for the first week. After that, it was easier for her to get to the bathroom as her strength and confidence improved. Since she had to use the CPM machine for 8 hours/ day, she was mainly just in bed for the first few weeks. She mainly read, watched movies, worked on school work, etc.
Hang in there! It gets better. My daughter is now knee-brace free and walking for exercise about 30-45 minutes a day.
Best of luck!
Angela
Thank you 🙂 things have gotten a lot better since taking her off the oxycodones. Angela you mention the CPM machine, my daughter also is on that for 8 hours a day plus now will be starting PT 3 days a week, how did your daughter do it all and deal with school? We have school 4 days a week which makes our school days alittle longer. She was doing online school for this year but the public school was more willing to work with us and help ( seems crazy) but they’ve been on break and now she will be starting this week and I’m so nervous 😦
Thank you,
Jessica
I forgot to ask you Angela when did your daughter have her surgery?
Hi Jessica,
My daughter had an mpfl reconstruction and Fulkerson osteotomy on her left knee in mid-September and the same surgery on her right knee at the end of December. She is now doing great and says that both surgeries were completely worth it. She has regained full range of motion in both knees and walks or uses the elliptical for about 30 minutes each day without any knee braces. We are hopeful that she will be able to participate in summer swim team, and she plans to play high school soccer again next spring.
We homeschool, so we didn’t really have to deal with returning to school. My best advice would be to use a wheelchair at school and have someone help her with getting her books from her locker, getting through the cafeteria, etc. Our PT has mentioned that kids who are at school definitely need to take the brace off and bend their leg sporadically to mimic the motions of the CPM. To complete 8 hours on the CPM, she would probably just have to use in the evenings and while sleeping.
Best of luck!
Angela
Hi – my 13 year old son had knee surgery to replace broken cartalidge underneath his patella and tighten his MPFL on Feb 23rd, from a basketball injury where he dislocated his knee cap. He was on crutches and in the fully extended leg brace for 6 weeks after surgery, and started his PT last week.
He is doing well – off crutches and weaning off the knee brace – but today his Physical Therapist said that it could be a full 6 months post-op before he could return to sports.
With as well as he is doing – almost full range of motion and going up and down stairs without assistance – it is hard to believe that it will take 6 more months before he can even consider beginning sports type workouts. Maybe I don’t understand the underlying healing process. Can anyone shed light on what the realistic expectations might be? We have to make decisions about summer and fall sports, and off season workouts to prepare for next season (basketball and football).
Certainly don’t want to risk reinjury, but feel like their approach might be very conservative. Thoughts
Thank you,
FB Mom
Hello Julie,
It was almost six months before Sports Girl was approved for full-activity. She was allowed to do some distance running for track starting about April 1 which was only about 3 1/2 months post-op. But he did not clear her for all activities with jumping, twisting and potential impact until June 1, which was about 5 1/2 months after her mid-December surgery. And I don’t even know if he would have cleared her then, except most of her summer plans involved supervised strength training to prepare for soccer starting in August.
I am no expert, but I believe the reason the docs delay the full release is because it takes A LONG TIME to rebuild all of the muscle lost following the surgery. I was amazed at how much smaller Sports Girl’s left quad was than her right at just 3 weeks after surgery. And the muscles are what really protects the knee.
The most frustrating thing is the doctors refuse to tell you how to expect to be out of commission going into this process. But in my experience and based on what others have posted here on my blog, six months of recovery is about the best case scenario. Evidently this knee surgery is more invasive than some of the ACL and MCL repairs that are done.
I hope this helps!
~ Country Mom
Thanks so much for the validation. This has all started to synch in over the last few days, and from the great information on your blog and other research I have found, that seems to be the most common timeframe. Guess he will have to adjust and take the football season off. The positive side is that he will be able to focus on strength and conditioning during that time in prep for basketball…always a silver lining:)
Thanks again for your insight!
Julie
P.s. Hope Sports Girl is continuing to do well:)
Thank you for the post! My 16 year old daughter subluxed her patella twice during soccer and the surgeon is now wanting to do stabalization surgery. I have been trying to research recoery for this, bu have only found many negative posts….so it is great and reassuring to read your positive results!
Liz’s story:
My daughter (17) was a softball player as well. Original injury occured 4 years ago. She had repeated subluxes each season. Finally decided on surgery in June after numerous pt sessions. Liz had the allograft (cadaver) mpfl reconstruction on 8/21/12.
*Pain management: Femoral nerve block post op plus Norco (hydrocodone/acetaminophen) every 6 hours for 2 days, then 2 every 4 hours around the clock once the nerve block wore off for 4 more days with ibuprofen inbetween. On day 7 started cutting back the Norco. By day 10 only on ibu.
Had 10 day post op appt. on 8/31/12 and her inscisions were reappoximated and looked good! Dr. told her she could ditch the crutches when she felt comfortable, which was the next day! Brace locked at 90 degrees, but can go without at night and around the house. Saw PT on pod 15. Was already at 47 degree bend! It seems her quads were totally intact! (She had been doing straight leg raises since pod 7). Today, 9/10/12, pod 20, she is at a 68 degree bend and started doing stair stepping exercises at therapy. She is walking without any aid or brace.:) She says it feels “tight” when she bends it, but NO PAIN!!
Just a quick addendum to Liz’s story: (Tomorrow is her 18th birthday)
She was well past 90 degrees on Thursday 9/20 ( 4 weeks & 2 days post op)! If you’d see her walking toward you, you would never know she even had surgery….no limp at all! She sees the surgeon on Friday 9/28 and is hoping for clearance to drive again! (It was her right knee). 🙂
Hopefully the last installment on Liz’s story (right mpfl replacement w/ allograft):
She was cleared to drive on 9/28 as expected, and cleared to go back to work (McDonald’s) on 10/15! Her surgeon couldn’t have been more pleased w/ her recovery thus far! She is still going to PT 3x/ wk for another month or so and will see her dr. for hopefully her last check-up the end of November.
Hope this is inspiring 🙂
Hi my name is Joe im 26 Yrs Old. i went through the same surgery with a cadaver ligament on Sept. 4th. What they did with me was replaced my MPFL Ligament with a cadaver. What they did with mine was they drilled 2 holes in my knee and 2 holes in my femur. they inserted 4 screws which none of them are dissolvable they are all permenant screws. i applaud my doctor for his work. the surgery took about 3 hrs and i was right after i woke up. i didnt really use the crutches at all unless i went outside or went to the store with my wife. i slept on a air mattress on the first floor so i didnt use stairs. its been a month and can bend my knee 90 degrees already i still use the brace because if i bend my knee past 90 i can do harm to the ligament. but since the surgery i have had no pain at all in knee none what so ever. the only discomfort i feel is the tissue healing behind the cuts. i was driving after 2 weeks perfectly fine. bare in mind im saying the driving part because it is my right knee. its driving me nuts because i can not return back to work until around christmas because i do physical labor work being a electrician. they had to replace my ligament because i snapped it in half after the 3rd time i dislocated it. any questions feel free to ask ill respond back to any post. thank you for your time
I am 4 months post mpfl reconstruction and can say this is that hardest thing i have ever dealt with. I am a 24 yo highly athletic girl. After the first week, the pain wasn’t intollerable and it became more of mental struggle that a physical struggle–not being able to do anything i loved doing. Once I gained ROM back and was able get around, I became happy again and was able to have a positive attitude about the surgery. I lost 3 inches of mass off my quad and find it very difficult to gain that mass back. I am done with PT and go the the gym everyday for at least two hrs a day and still find my quad incredibilly weak. I still have a lot of pain and stiffness especially in the morning. It seems now that this has switched to a physical struggle again and is maddening when my mind is telling me leg to do certain things, and it just cant. My goal is to be skiing in december and am doing everything in my power to overcome this injury.
Hello Christina,
I think the most astonishing thing about this process is how quickly the quads atrophy. It was amazing to watch my daughters not even be able to mentally flex their quads during the first week to 10 days after the operation. And the next most astonishing and surprising thing is how long it takes to rebuild these muscles.
Hang in there as it does get better. I really think it takes about one full year before your body is fully recovered from the surgery, including the mental part. But you should be able to be skiing by December! My oldest daughter was released for full activity about 5.5 months post op.
Best of luck in your ongoing recovery,
Country Mom
the doctor told me full recovery is about roughly 1 year. but he said i will be able to go back to work and climb ladders daily at work around the week of Christmas which will be roughly 15 weeks after surgery. i am experiencing the same thing with my quad and calf muscles. it is a miracle how week your legs becomes just from being off of it for 3-4 weeks before i started P.T. i actually have to go back to the surgeon now because in P.T when i do my legs stretch to get my leg extension back my knee locks up and cant bend it back on my own i have to help it. when i had my ligament replaced he also did arthroscopic surgery on the right side of my knee to remove some meniscus that i tore up when i dislocated it. so now i have to go see him to see if my knee has tore up some more meniscus which is causing my knee to lock up and not bend after being fully extended or if it is getting caught up on the hard tissue at the bottom of my knee. i go to doctor on Oct 18th to find out. if its meniscus then they have to do arthroscopic again but if its just the hard tissue then my physical therapist can work that out for me. ill find out soon hopefully no surgery again!!!!!!!
I had MPFL surgery on 14 Dec 2012, 15 days ago. I am an active 38-yo female, and this was my second surgery on my right knee for dislocating patella. I’ve also had 2 on my left knee for the same issue. My prior surgeries were all over 20 years ago when I was a high school athlete. According to my surgeon, the MPFL procedure is much more successful and less traumautic than what I had done previously. The other surgeries improved my problem of dislocating patellas, but didn’t 100% fix it. I’ve had dislocations from time to time over the years, but had a humdinger a few months ago, which led up to the doctor visit and eventual MPFL surgery.
The first 2 days after surgery were great. The nerve block didn’t wear off until the middle of the 3rd day, and when it wore off, I went from perfectly comfortable to completely miserable in about 20 minutes. Needless to say, I couldn’t get those hydrocodone down fast enough. I took 2 every 4-6 hours for the next 3 or 4 days. This was a rough time for me because hydrocodone make me restless and unable to sleep (I didn’t know that until now). If I didn’t take them, my knee would hurt and I couldn’t sleep. Figured I’d be up all night anyway, so I might as well not hurt! 🙂 FYI – There’s not much on tv between 2 and 6 am. 🙂
I had surgery on Friday, and went to my first PT session on Monday. It was pretty minimal, really, but they sent me home with exercises to do on my own. I went back to PT on Thursday, and then on Friday traveled for 9 hours in the back seat of a truck to get to my parent’s house for Christmas. I have traveled all over the world, but I can honestly say that was the longest 9 hours of traveling I’ve ever done. I couldn’t sleep because of the hydrocodone, I couldn’t stretch out because the back seat wasn’t long enough, and I kept having muscle cramps in my thighs and hips. It was absolutley miserable.
I missed about a week of PT because of the holidays, but this week I started going to therapy 3x a week, and doing exercises at home at least 2x a day. I had stopped taking the hydrocodone and was doing ok with just Tylenol, but since starting back to PT this week, I’m taking it again from time to time. I mostly need it at night, but since it keeps me awake, I’m going to call the doctor on Monday and see if I can get something else.
I’m keeping my brace on all the time when I’m up and around, and I feel pretty good with just one crutch when the brace is locked. I was able to get 120 degrees of flexion at PT yesterday… Compared to my previous 3 surgeries, it is unbelievable to me how quickly my range of motion is coming back. I have high hopes that this surgery will fix a life-long problem!
Country Mom…I was so excited to find this blog! I have been researching knee surgeries diligently, and yours is the first story that is a “true life” story that I can relate to! I would really like to know what your daughter’s background history was that led to having the surgery. We are contemplating this surgery now, however our surgeon is telling us the success rate is lower than what I’m finding in research. You know, the “no guarantee” thing. I know they have to tell you that with surgery (i’m a nurse), but it’s scary. My daughter Savannah had her first dislocation at age seven, and she is now 14. She has had years where she had 11 or 12 dislocations, and some with only 2 or 3. She was never allowed to participate in sports, until just this past year. She has spent years in physical therapy, and they have always told us surgery wasn’t an option due to her still growing, that if we did the surgery, she would just have to have it redone at age 18. But she had a whopper of a dislocation this past month, that did alot of damage, and now he is saying we might need to think about the surgery. It’s just hard going into an “elective” surgery, when there is a chance that with aggressive physical therapy, we can limit her to very few dislocations. But I do know that even those few are too many, she already has arthritis type pain in her knees. Appreciate any input you have! Thanks!, Jamie
Hello Jamie,
So glad you found the site, and that you’ve found our experiences helpful! Two of my daughters have actually had the allograft surgery. My oldest had the surgery three years ago shortly after she turned 14, and then my middle daughter had it done in September at 13-1/2. Interestingly, the girls had different problems that led to the patella subluxation issues. My oldest had a patella tilt and very tight ligaments that actually pulled her knee outward. My middle daughter, on the other hand, evidently has really loose ligaments, leaving her with a “sloppy” knee. But hopefully both issues have been fixed by the same surgery — except that my oldest also had a lateral release performed to loosen the outside ligament and eliminate the pull.
In my research and talks with doctors, physicians used to perform the lateral release alone. And that only has about a 20% success rate. The allograft procedure has proven much more successful in solving dislocation/subluxation issues. However, the surgery has only been routinely for the last decade or so, but it is gaining in practice. I actually know of two other girls in our relatively small community (population 15,000) that have had the same procedure done in the last few years. One girl has had both knees fixed! And none have had any recurring problems.
I was told we needed to fix the issue before my daughters lost too much precious cartilage. But we did need to wait until their growth plates were closed. Thankfully for this purpose, I guess, my daughters grew early and were done by surgery time. And neither experienced their first incident until seventh grade — both during physical activity.
So hopefully your physician is looking at the allograft surgery for your daughter. It has worked very well for my oldest daughter, and we are optimistic for similar results for our middle daughter when she resumes track and basketball this spring and summer.
Best of luck!
Country Mom
Hi Jamie,
I saw your post on the Country Mom Blog. My daughter has had an MPFL reconstruction with a donor ligament and a Fulkerson osteotomy on both knees. She had surgery on her left knee in September 2011 and on her right knee in December 2011. In September 2012, she had the screws removed from both her knees and joined a rowing team two weeks after that. Two months to the day after the last surgery, she rowed 10K in the second largest regatta in the US.
Her left knee first dislocated in May 2009. When it began dislocating again in May 2011, it dislocated or subluxed more than 15 times before she had the surgery. She went from playing soccer and swimming year-round in May to being dependent on a wheelchair in crutches in August. Her right knee began dislocating/ subluxing about two weeks before the left knee surgery. We opted to go ahead and have surgery on the right knee so the PT time would overlap.
All of her surgeries were at Duke and were a great experience, as much as knee surgeries can be. Since the surgeries, she has had no more problems with her knees.
Angela in NC
Thanks so much for the input! My confusion is that I am seeing so much success with the people I am talking to, but her doctor seems so hesitant to do it, talking of a low success rate. We will continue to research and see what will be the best option for our daughter. She is very much wanting the surgery. She goes back to the orthopedic in four weeks. By the way, she is seen at the childrens specialty hospital here in Fort Worth. Hope to update soon, and get further answers from you “pros” also!
Thanks again!
jamie
Jamie,
Also, be very careful of the lateral release surgery which has a very poor success rate. You will most likely see some variation in doctor’s recommendations between a local ortho and a teaching hospital associated with a medical school; i. e. our local ortho office only does a lateral release, while our doctor at Duke who is the director of women’s sports medicine told us that surgery would only make the problem worse. Don’t hesitate to get a second opinion and search for the best solution for your daughter.
Hi I am almost 2 months out of the mpfl surgery and was wondering when was she able to do basic things and when was she able to do heavy activities.
Sportsgirl started doing some distance running just 3 months after surgery. Then she was fully released for basketball and all just over five months following surgery. But my other daughter is now seven months post-op, and while her early recovery was speedy, she is having a hard time easing back into activity. Her left thigh is still visibly smaller than her right, leaving her susceptible to ACL and other knee injuries. I really don’t want to have to take her back for more physical therapy, but I’m afraid I might have to. A 13-year-old girl just isn’t diligent enough with exercises on her own …
My daughter, a field hockey and softball player, had her MPFL reconstruction in February 2012. Her recovery and PT was tough, but she went off to college in August 2012 and played field hockey for her college team. She worked very hard and had a successful season. It required lots of running, lifting and working out. We were relieved that her season was so successful. Now, however, she is experiencing pain in this knee while running. Her quad is still visibly smaller and she has done everything to try to get it bigger. She is currently getting injections under her kneecap and is back in PT, but it doesn’t seem to be helping.
Any ideas?
I am sorry to hear that your daughter is experiencing problems with her recovery from the MPFL reconstruction. Honestly, my middle daughter has been struggling a bit to regain her quad muscles, as well. Her still knee hurts during physical activity at 8 months post-op as there isn’t enough muscle stability; her left leg is still visibly smaller than her right. Her interior muscle is the biggest concern. Her physical therapist has been working with her a lot on correcting how she generally overcompensates for her left leg without even thinking about it, and she evidently has an issue with flat feet which causes her knees to tip inward.
I don’t really have any suggestions other than hang in there and hopefully her current condition is better than her pre-surgery condition. The old way to fix this issue was to simply remove the patient from most forms of physical activity.
Best of luck and keep us posted!
~ Country Mom
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I’m also a 14 year old girl. I just got MPFL reconstruction surgery w/ lateral release and a Tibia Tubercle Transfer (distal realignment of the leg). I dislocated my knee 2 times so we thought it was best to get the surgery because there was a really high chance it would happen again, and even though there is still a chance of it reoccurring, i feel more confident that it won’t. I stayed in the hospital for 2 nights and now i’m almost 6 weeks post-op, and have stopped using the crutches and soon the brace! Now i have a 6 inch scar, and a 2 inch one on my knee, and I am going to have to continue pt for the rest of my summer… Im a swimmer, and my doctor told me I couldn’t swim breaststroke ever again. I didn’t really care because iv’e never been good at that stroke (probably because of my legs). But i start high school next year, so ill be trying out for the swim team- and i hope that it won’t affect it- I still have to be really careful though, because my doctor said my other knee/leg is the same way… hope she is feeling better by now, since its been 2 years since you posted this. Next year I’m getting the bolts out of my leg. But I think that was for the tibia tubercle transfer, though.
Dear Sports Girl~
Thanks to all for posting. I feel we are prepared for upcoming MPFL Reconstructive Surgery using the cadaver. My question is this, my son is 15, plays soccer, basketball and football at a 6A school, and sublexed his knee cap on both, and the initial over again all within a 3 month period. Never an episode or hint of this problem in the past. He is growing and they believe that has something to do with it. From his MRI he has “A LOT” more growing to do and the doctor wants to use cadavor ligament. I noticed in a previous post someone said they could not use a cadaver due to growth plates being open. I am concerned that my doctor is using this procedure on both knees 8 weeks apart after telling me his growth plates are still wide open, so growing another 4-6 possible inches of growth. How does this not effect the growth or plates? What was your doctors reasoning on not allowing the cadaver to be used, and how is everyone years after original post? Thanks a million for shared stories. I can’t imagine ever being 100 percent after this surgery. It sounds brutal.
Thank you for your comment. I don’t have any direct, personal knowledge regarding WHY the procedure wasn’t done by surgeons in my area when growth plates were still open. But I do know that this was a concern with both of my girls — the surgeon xrayed and checked growth plates prior to discussing surgery. And I do know of another girl from our area who could not have this procedure done as she was still growing, and she even used a different surgeon. I think I would question this.
I would say that Sports Girl, my oldest daughter, is back to 100% after the surgery she had done as a 14-year-old 8th grader in December of 2009. She is playing her senior season of high school girls soccer right now, and she has had no issues with her knee whatsoever. Now, I haven’t asked her recently if she can still “feel” anything with her knee, but she did speak of more tightness in that knee even a couple of years after surgery. Sports Girls has suffered some ankle sprains and some issues with her achilles tendon, but I don’t believe either have anything to do with her knee.
My middle daughter is just one year post-operation, and while it seemed to take her a little longer, I believe she is approaching 100%. She endured a second round of extensive physical therapy in March, April and May of this year, and she participated in her school’s summer athletic training camp to continue to strength train. She is now running in her freshman season of high school cross country. She has had other issues such as blisters, but her knee isn’t bothering her either, even after running several miles.
Actually, both of my girls are better than 100% as they could not be doing the activities they are doing now had they not had the surgery. And if they had continued to suffer dislocation issues, I am sure they would have eventually suffered significant loss of cartilage.
I hope this information is helpful. Best of luck to you and your son!
~ Country Mom
Hello. I am a 36 yr old non active female. I have been dislocating my patella every couple of years since high school. I never saw a dr because I was able to limp pretty quickly and all was better after a week so I just treated it like a spranged ankle. On Aug. 5, 2013 I did it again but this time was very different. I couldn’t put any pressure on that leg for three days. I was scheduled for MPFL surgery just a few weeks later. After the surgery I was told to stay off the leg and on the crutches for 6 weeks….no weight on the bad leg what so ever. I am wondering why there seems to be such a wide range of how quickly you can bare weight and wean off the crutches. I am 3 weeks post op and hating every second of this. I have some discomfort on the inside of the knee (where I got the new tendon) every so often. I haven’t been able to get a whole lot of information from my Dr. I just keep getting told “he’ll tell you everything you need to know at your next appointment” I don’t know how long I will be in the brace. All I have been told is that at my 6 week post of appointment I will start to get more flexion allowed and MIGHT be able to bare weight. I THINK physical therapy will start at that time but have only been told generalizations about how long and how often. I wonder if my age and lack of activity is what is causing my post op recovery to be so long.
Hello Dana,
I am certainly no medical expert, but starting physical therapy so very late in the process seems very odd to me. I will say, however, that the providers (doctor, physical therapist, etc.) didn’t ever tell either of my daughters how long to expect things to take as they kept saying that it varied between patients and situations. So I am guessing that’s why you aren’t getting a lot of answers up front. It truly is a wait-and-see type of deal.
The differences in approach could certainly be due to your age or it could just be a difference in medical providers. Either way, I hope the process starts to move more quickly for you. I have approved and posted your comment, so perhaps others might contribute their thoughts, as well.
Best of luck!
~ Country Mom
My daughter is 16 and is scheduled for MPFL surgery on Dec 17 (what a coincidence) using her hamstring and possibly LR as well as scoping her knee due to grade 3 chondromalacia. We have gone the PT route and it was not working. Fortunately, we are going to Wake Forest Baptist Hospital in Winston-Salem, NC for the surgery with a sports medicine surgeon. We feel very comfortable with this decision. My daughter is upset that she can’t play basketball this year but has been assured that she should have no problem playing in her Senior year. Her coach said she has something to strive for. This was one of the first sites I visited and I appreciate all the information. It is not an easy surgery to find out about as it is not very common. I have told my daughter about your daughters experiences (and have printed it out) so she can realize that everything she will be going through is normal. Thank you again for this posting.
Hi Robin,
You must live near us, as we are just 30 minutes from Winston-Salem. In September 2011, my daughter had a MPFL reconstruction and Fulkerson osteotomy of her left knee, and then had the same surgery on her right knee in December 2011. She had the screws removed from both knees in September 2012 and hasn’t slowed down since. She now rows competitively 6 days a week and hits the gym about 4 days a week. We also tried PT before the surgeries without any luck, but found that excellent, high-quality PT post-surgery made a huge difference in my daughter’s recovery. I cannot say enough great things about Wayne-Cannon PT in WS near Hanes Mall. We saw Hank, who is absolutely amazing. At Wayne-Cannon, you get one-to-one treatment without your PT bouncing back and forth between patients like at so many PT offices. My daughter’s surgeon was at Duke and the director of women’s sports medicine, and I can’t recommend her highly enough either. The combination of great medical care and excellent PT made a very challenging medical situation turn out to be as great an outcome as we could have hoped for. Feel free to reach out to me if you or your daughter have any questions. Angela
Hi I am just two weeks post-op of the MPFL and the fulkerson procedure. I didn’t realize that there was going to as much pain and that it is a very slow recovery process. I have had major trauma to my knee and multiple surgeries. This procedure is my last hope of returning to a “normal” life. I had one post-op visit and my surgeon is very pleased. I am still non weight bearing because my bone was cut already previously once and the surgeon advised that we need the bone to heal completely before weight bearing can begin. I am just feeling depressed still on pain meds, which is not me at all, and only at 30 degrees flexion in the cpm machine. I have been reading all the blogs on here and I have to say it has lifted my spirits.
Hi, i’m contemplating having the same surgery in the next couple months. Both MPFL and fulkerson procedure on my right knee. I’ve been dealing with patellar dislocations since I was a young child and now in my 30’s I feel like it might be the last resort. I’m extremely active and not quite ready to give up on my favorite sports.
It appears it’s been a little over 3 years since your post, can you tell me if the surgery has been successful? Have there been any long term issues you have had to deal with?
Any feedback would be helpful.
Thank you!
Hello Chandra,
Thank you for your message and for reading the blog. I hope it has been helpful. The MPFL procedure was quite effective for my oldest daughter; she has had no lingering issues other than perhaps some tight ligaments in her knee, especially during cold months or days of inactivity. But my middle daughter did require a second procedure which involved moving the point where her ligaments attach below her knee. Perhaps this is the Fulkerson procedure you reference – I’m not sure.
My daughter had this surgery 5 weeks ago. She still is in the long hinged brace, but was told she would be able to move to a patella stabilizer brace in 3-4 weeks. Did your daughter have to do this too? Which one did you buy?
I am thankful I came across this blog as it gives me so hope for my son who is scheduled to undergo the MPFL Reconstruction next month. He is 15 and he plays high-school football. He has subluxed his patella twice where it came out and popped back in but last week I got a call from his trainer that his knee cap had completely dislocated on the field and it was not going back in. An ambulance was called and they reduced his dislocation under IV sedation in the ER. His football season hasn’t even started and he is out for the year. I’m really hoping he recovers in time for Track this Spring as he throws discus and uses the same knee to pivot. We are using the cadaver graft as a surgical option to help with hamstring recovery as well. Now that it’s been several years since your daughters surgery, how has sports been for her since she had the surgery? I’m scared that he won’t be able to return to football which is the sport he truly loves. Thanks for sharing your story!
Hello
My daughter had an MPFL last year age 14 – it was amazing – completely changed her life and was able to join in on sports day 3 months after the operation. ShE plays cricket, rugby etc however nearly 1 year later – my daughter has grown and has completely lost all the muscle she built up around her knee – she is now in pain and it feels loose. She is back to exercising the knee area to build up the muscles. Has your daughter experienced the same issues when she has grown?
Hello Allison,
My oldest daughter did not seem to have any further issues as she grew. My younger daughter’s surgery, however, was not successful. I really need to add another post on my site as my second daughter actually had a second surgery to correct her subluxation issues. But I’m not sure that had anything to do with her growth but more about the first surgery just not working.
My 14 year old daughter had the mfpl reconstruction with the cadaver ligament. We are 4 weeks in. She is full weight bearing, locked brace and crutches, but is pretty much done with crutches. She really doesn’t use them around the house. When did your daughter’s Doctor discontinue the brace. She’s real small and honestly the brace even unlocked at PT is not allowing any degree of bending. The side pieces cover pretty much her whole knee. She hates it.
I apologize for my delayed reply. I am guessing your daughter is out of her brace by now. I remember the most frustrating thing was that the doctor(s) really wouldn’t give a timeline for anything. I think that was because they didn’t want a patient to be disappointed if it took longer than normal. I also need to post an update to my second daughter’s situation sometime. Her MPFL reconstruction was actually deemed a failure, and she had a second surgery/procedure to correct her subluxation issues. But my oldest daughter continues to be performing stellarly after her reconstruction.
I had both of those surgeries and wear a knee brace when I play soccer. Does sports girl wear a knee brace? I’m just wondering when I won’t have to wear it anymore
It has taken me way too long to approve this comment and reply — I’m sorry! Sports girl doesn’t wear a knee brace any longer; in fact, she really didn’t require the knee brace at all post-surgery. But her sister, who had the same procedure, didn’t have as much success. I really need to write a follow-up post about her as she did require a second surgery/procedure. So I guess the moral of the story is that everyone is different. I hope that you are continuing to recover nicely!
Just wanted to send my appreciation for your post and the many insightful comments. We are currently waiting to schedule my 14-y-o daughter’s MPFL reconstruction and the information on this page has been great. I am not eager to go through it, but at least know a lot more about what to expect.
Thank you for your feedback. I hope things are going well for your daughter!
Not sure if your blog is still active. My 14 year old daughter has had 3 dislocations over the years- she is a soccer player. Her dislocations are due to a shallow groove where the patella sits. The orthopedic doctor suggested tibial osteotomy when her growth plates close. We went for a second opinion and that doctor recommended the MPFL reconstruction, with cadaver ligament. Said the tibial osteotomy was too invasive as a first pass. Today we returned to the first doctor and X-rays confirm her growth plate is closed. I asked about the MPFL surgery and he said he wouldn’t recommend it- increases the chance of arthritis in the future. He felt the tibial osteotomy would be more successful. Now I don’t know what to do. Anyone face tha choice?
Hello Karyn,
I have not contributed to my blog for quite some time (life happens), but I am still replying to comments! I am not an expert on any of these procedures and I am not familiar with a tibial osteotomy, but I can tell you how things went for us. My oldest daughter recovered remarkably well from her MPFL reconstruction and returned to an active lifestyle within 6 months, including four seasons of varsity high school soccer, indoor soccer, club soccer, etc. Her primary issue was tightness of her ligament pulling her knee cap out of place, as well as a natural tilt. I don’t know about the risk for arthritis as she is only 21 years old now and hasn’t experienced this yet. She does experience some tightness in her ligaments, particularly following times of inactivity or during cold weather.
My middle daughter had the opposite issue causing her knee to pop out of place — her ligaments were very loose and weren’t holding her knee in place. She also had an MPFL reconstruction. I really need to write an update regarding my second daughter’s surgery, as her MPFL reconstruction was not successful. She continued to experience swelling in her knee after even mild activity and her knee dislocated again one year later. The only activity she was attempting was cross country running with no real physical contact. I believe that the MPFL reconstruction is more complicated when correcting ligamentous laxity (loose ligaments) and works better for my oldest daughter’s condition of tight ligaments.
My middle daughter’s surgeon wanted to perform another MPFL reconstruction on her, but I just didn’t feel good about it. So we consulted another orthopedic surgeon in Fort Collins, CO, which is many hours from where we live in western South Dakota, who recommended she have a tibial tubercle transfer surgery. Instead of working with the ligament that comes around the side of the knee (MPFL) this procedure involves relocating where the ligaments that run from top to bottom attach below the knee. As a result, the knee cap position is shifted.
My middle daughter had this second procedure done about 15 months after her MPFL reconstruction, and while she hasn’t tried returning to cross country (she felt behind after missing two years of sports), she feels much more stable on her knee. I should mention that for my middle daughter, it came to the point where we were wanting to get her better just for her long-term quality of life — not for any physical competitions.
I think it comes down to what procedure works best for your daughter’s particular issue. It probably seems excessive, but with two differing opinions, you might consider getting an additional opinion — perhaps even from a provider in a larger market than where you live (unless you live in a really large market already). As you can see, there are several options to correct the issue.
I hope that helps, and I wish the best for your daughter! I know that this all seems like “the end of the world” to a competitive, active 14-year-old girl. I’ve been there … twice.
Thank you for getting back to me so quickly! We live in the Boston area so there are many experienced doctors here. Will seek more opinions.
About six weeks ago now, my 14 year old daughter was in her bedroom. She stood up and turned around and then all hell broke loose. She dislocated her patella – although we didn’t know that was what had happened as she was down on the floor screaming. I had to call an ambulance etc. We all know the drill. Anyway it turns out that she has structural abnormalities – patella alta, femoral trochlear dysplasia Type A and a TT-TG measurement of 19.1mm. I think 15-20mm is borderline, anything over 20mm is bad. Ah, so close. So now we’ve seen 3 different orthopaedic surgeons and they all say something different. Surgeon 1 wanted to do an MPFL and TTT. Surgeon 2 wanted just the MPFL and Surgeon 3 told me … “Do nothing until she does it again. If she was my daughter I wouldn’t have it done.” After spending most of Christmas holidays Dr Googling, I’ve since read that without surgery she has a 70 percent chance of doing it again within 3-5 years. Each time increases the very high risk of cartilage damage and that’s the cause of osteoarthritis. I might add she forms hypertrophic scars. She’s very athletic and also hypermobile. How many more risk factors do we need? Her growth plates haven’t closed but the Surgeon 1 wants to do it anyway with her own tendon. Since reading all these posts (and others), I’m really very concerned about this operation and feel it’s probably just a band-aid for her – buying some time. I don’t know what to do and any advice would be appreciated. Might I also add that I am terrified for a whole host of other reasons….
PS This is her first dislocation. She has had some minor subluxations when she was 8 years old. There is no cartilage damage – so far.
Hello Kay,
Thank you for your comment. I’m not sure if I can give you any firm advice regarding your daughter’s situation. All I can do is let you know that the surgery was quite successful for my oldest daughter. She was even able to play high school basketball and soccer afterwards with no real issues. But my middle daughter wasn’t so lucky. She actually had a second procedure (different fix) done after repeated issues. She hasn’t had any problems since, but she hasn’t really pushed herself too much physically, either. But I do believe her knee should be good for general lifetime activities now.
Best of luck in whatever you decide.
Thank-you so much Karyn, Monica and Country Mom. I really, really appreciate you taking the time to write. I think I’m getting a very clear picture that my daughter will do it again and the reality is that she will need the MPFL reconstruction. The problem is her age … she’s 14yrs old which I think has a reputation of being the hardest teenage year of all. Alas – why couldn’t she be 16 years old? Heck – 18yrs and then make this decision for herself. Although obviously we’re not going to make this decision without her input. I just wonder sometimes, how much harder does it get being a parent? This is one hell of a tough decision. Like if the operation goes well and it’s successful, then it’s great. But what if it doesn’t …. what if she’s left with LESS movement … constant pain … and that is a possibility as I’ve read the statistics. It seems to have a very long recovery time and requires real commitment to the PT. Something I think my daughter is going to struggle like hell with…. (translate that to “us, the parents” as well). I’ve gone out and bought the Donjoy patella stabilization braces. Yes the maxi and mini versions – not cheap. My plan is to try and buy time. I’m going off to OS #1 in a few weeks…. to discuss a plan. We’re on his list at the moment for the operation in a few months. This is rather gut-wrenching…
My daughter also had MPFL Reconstruction with a donated cadaver graft. She dislocated her patella in February 2013 and did PT and opted for no surgery, even with the surgeon saying it was most likely going to happen again. She did fine until April 2014, when it happened again and we knew full well that if it happened again surgery would be required. She went to PT again after the MPFL reconstruction and almost 4 years now and so far so good. She does not play sports but does run and bike without any issues. It is such a hard decision and I am not sure if we would of done it any different knowing the outcome. I wish your daughter the best.
We faced a tough decision as well. My 15 year old daughter had 3 dislocation over a 3 year period. We were told after the second dislocation, surgery would be necessary. Our first doctor recommended the TT but only if her growth plate had closed. However knowing how invasive a TT is, I sought a second opinion. That doctor recommended the MPFL reconstruction with a cadaver ligament. We went back to the first doctor for the X-ray. I asked him if the MPFL would be an option- he said definitely not. He didn’t really have a good reason, and I didn’t really feel comfortable with him. We went back to the second doctor who really spent more time with us and explained explicitly why he felt MPFL was a better option: less invasive, faster recovery time, and based on the calculations he made for her knee, he felt it had a high success rate. He told us in the future if there was an issue the TT could be done later. Our daughter had the surgery in the spring. She is doing well. I have to add, she had been going to PT 2x week fir 9 months. I do believe it is due to her lack of exercising outside of PT. We just couldn’t motivate her. She has not returned to sports, yet but has no complaints and is walking and running well.
One last time thing. Our surgeon did not want to use our daughter’s own tendon in caseI she had another injury in the future- wanted to save it for that. Neither surgeon would do a tubular osteotomy if the growth plate did not close. Our surgeon also said he perfected the technique to avoid arthritis and cartilage damage. He also had a lot of experience performing surgery on girls knees and was a sport medicine doctor.