Second Daughter Experiences Patellar Subluxation, MPFL Surgery

I still can’t believe it happened. It was the last basketball game of the season at the end of March, and she fell to the floor grabbing her knee.

Those of you who have followed my blog are probably thinking my oldest daughter Sports Girl – Callie – hurt her knee again. But it wasn’t Callie this time; it was my middle daughter, Tessa.

It took us a while to accept the fact that Tessa has just experienced patellar subluxation in her left knee just as Callie had at about the same age.  We even encouraged Tessa to go back into the game to keep playing. She tried, but she promptly came back out explaining that her knee started to give out again. She was in pain, and she was scared.

We continued with our denial. Since it was the end of the basketball season, we thought perhaps Tessa could recuperate and do some exercises and light weight training on her own to get past it. But her knee slid out two more times during physical education classes during April and May.

Then Tessa attended a week long basketball camp in early June. While the knee didn’t actually sublux during the camp, it did swell considerably. And so we dug out her sister’s old pre-surgery knee brace for her to use and scheduled an appointment with the orthopedic surgeon later that month.

Handsome Hubby was ready to schedule surgery right away. But even with her sister’s history, the surgeon approached Tessa’s issue conservatively.

Unfortunately, it was a familiar routine with a familiar ending. Tessa completed six weeks of physical therapy, and she performed the exercises faithfully. But when we went back to the doctor late in July, he wasn’t satisfied with the results. When he started to wiggle her kneecap with her leg extended straight, Tessa experienced extreme apprehension. To be honest, she about came up off the table.

So today I am sitting at the hospital waiting for Tessa to come out of surgery  – the same surgery Callie had done almost three years ago. Tessa is having a cadaver ligament inserted in place of her MPFL to stabilize her knee. She will also most likely have a lateral release performed and any other maintenance necessary to allow her knee to track better.

Callie hasn’t been completely without issues. She has had some discomfort and mild swelling around the ligament when she resumes a new strenuous activity, such as when soccer practices started twice a day in early August. There’s also the scars which will always be present on her young skin around her knee. Callie has some general tightness in her knee, as well, and cannot always easily bend her knee far enough to touch the back of her foot to the inside of her thigh. But I can’t do that either!

But we do know from Callie’s experience that the surgery works; it leaves the patient in better shape than before. And so we are going through it again with our second daughter at an even slightly younger age. Callie had surgery shortly after she turned 14; Tessa just turned 13 in May. Both girls had the surgery as eighth graders in school. The goal is to save precious cartilage that is damaged with each subluxation.

I always thought that Callie’s initial injury was primarily due to some sort of unusual blow to the knee she received during physical education class. But after Tessa has had the same injury, it’s hard to deny that the issue might be due in part to genetics.

Rylie is only five, and we know that this surgery cannot be performed until the patient has finished growing. But we have joked that perhaps if we get Rylie’s knee fixed now, we might be given a buy two, get one free offer. But we are only kidding. We are hopeful Rylie can somehow avoid the same fate. Besides, we know the health care industry doesn’t offer any such discounts anyway!

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Knee holds up through basketball season

Sports Girl (35) grabs for the ball from an opponent. The poor girl holding the ball had broke her nose in a previous game. Playing sports can sure be dangerous!

Sports Girl’s first high school basketball season has gone fairly well. She hasn’t set any freshman scoring records or anything, but she has been consistently able to play at up to the junior varsity level.

And while the season hasn’t been completely without incident or injury, remarkably, nothing has involved her knee. And it’s not like she hasn’t taken more than one or two nasty spills onto her knee or knees on the hardwood or tile basketball courts across South Dakota.

The surgery she endured over a year ago where a cadaver ligament was attached to her left femur and patella to replace her MPFL has so far proven successful in stabilizing her knee. She has had no further subluxation or dislocation issues, and she has had very little discomfort in her knee.

She did, however, sprain her left ankle about a month ago, and she has had some pain from shin splints. The ankle sprain has continued to plague her, requiring constant taping during all practices and games to keep her ankle from rolling again, and continued icing afterwards. Now she has developed an allergic rash and a friction blister on her left heel from all of the taping.

These injuries are really incidental. At least I think they are. I say that because I find it odd that all of her weaknesses appear to be on her left side. She had the most trouble with the Achilles tendon pain during soccer on her left leg. And now her left ankle has given out, as well.

Sports Girl has been diligently strength training in the weight room, so I don’t think her left side can really be that much weaker than her right. Can it? Or could it all somehow be related to her knee surgery?

Either way, I still declare the knee surgery a success. At least so far. Sports Girl is gradually regaining her confidence, and she doesn’t seem to worry about her knee any more. The reward is seeing that competitive spark return to her eye … and when she grits her teeth, watch out!