Dislocated Kneecap Advice?

what are the reasons you wouldn't do the surgery? time off work, money..? what's the insurance situation and is it likely to get better or worse in the future?

you're presumably pretty young and you like doing shit like skiing. if 100% back is an attainable option i think you should do it. idk shit about knees, mine are made of titanium alloy, but when i pretend i'm in your shoes right now i find myself saying yeah let's get the op done unless it's a money problem

sorry to hear. sending good vibes your way, if all goes well you might be able to get back out by spring!

just looking for a bit more details, what procedures is the orthopedist suggesting? how bad is the fracture? what grade is the tear? what sort of diagnostics have you had done? MRI?

youre gonna have to do some serious knee-habilition regardless of which route you go. the surgery might get you back on snow quicker if the severity of the injury is high. if had to choose getting metal anchors, screws or plates in my leg or not, i would go with not.

SofaKingSickwhat are the reasons you wouldn't do the surgery? time off work, money..? what's the insurance situation and is it likely to get better or worse in the future?

you're presumably pretty young and you like doing shit like skiing. if 100% back is an attainable option i think you should do it. idk shit about knees, mine are made of titanium alloy, but when i pretend i'm in your shoes right now i find myself saying yeah let's get the op done unless it's a money problem

No I'm very financially stable, have good insurance, and am WFH right now anyways so that wouldn't be a problem.

I've just never really had a major surgery before (other than getting my tonsils out lol) and they way the doc was talking made it seem like if I stay on top of PT and take care of myself, I shouldn't really have any issues with it in the future. Plus, if it gets to be like further down the road, I can always opt in for the surgery then, so I was sorta thinking like "might as well try the less invasive/burdensome route first, and then cross the surgery bridge when it comes to it."

You make great points tho, and I guess what my biggest aversion is, is just not being able to do shit for like 4-months if I do the surgery.

ajbskisorry to hear. sending good vibes your way, if all goes well you might be able to get back out by spring!

just looking for a bit more details, what procedures is the orthopedist suggesting? how bad is the fracture? what grade is the tear? what sort of diagnostics have you had done? MRI?

youre gonna have to do some serious knee-habilition regardless of which route you go. the surgery might get you back on snow quicker if the severity of the injury is high. if had to choose getting metal anchors, screws or plates in my leg or not, i would go with not.

Thanks bru - (and it's not lost on me the irony of this happening right after you were telling us not to inflate our egos lol. I swear it was just a freak accident haha. Just caught an edge and got all twisted up cruising a groomer)

I did the x-ray day of, which diagnosed the fracture (avulsion fracture?) but the doc said that actually wasn't that bad and did my MRI yesterday. They told me the MPFL is fully torn, but I can't find anything about a "grade" on my paperwork.

Also tagging @SkierPT - any advice friend?

GrandThingsThanks bru - (and it's not lost on me the irony of this happening right after you were telling us not to inflate our egos lol. I swear it was just a freak accident haha. Just caught an edge and got all twisted up cruising a groomer)

I did the x-ray day of, which diagnosed the fracture (avulsion fracture?) but the doc said that actually wasn't that bad and did my MRI yesterday. They told me the MPFL is fully torn, but I can't find anything about a "grade" on my paperwork.

its ok, just be glad it didnt happen several clicks away from civilization.

so the procedure is not on reconstruction of the fracture.

grade 1 is fibre disruption but no tears
grade 2 is partial tear
grade 3 is full tear

its likely the surgery will be taking a part of a healthy donor ligament and transplanting it in place of the mpfl using a screw and some anchors.

i think i would do the surgery. it will make the rehab go a lot smoother. you can always get the metal removed later if its bothering you. not 5 years later but maybe one season. my mother is still rocking titanium plates in her leg and will likely not take them out. she bitches about it only when getting in a hottub.

once again, stay positive. i think a knee injury is kind of a right of passage as a skier. so now youre more legit than ever!

GrandThingsNo I'm very financially stable, have good insurance, and am WFH right now anyways so that wouldn't be a problem.

I've just never really had a major surgery before (other than getting my tonsils out lol) and they way the doc was talking made it seem like if I stay on top of PT and take care of myself, I shouldn't really have any issues with it in the future. Plus, if it gets to be like further down the road, I can always opt in for the surgery then, so I was sorta thinking like "might as well try the less invasive/burdensome route first, and then cross the surgery bridge when it comes to it."

You make great points tho, and I guess what my biggest aversion is, is just not being able to do shit for like 4-months if I do the surgery.

won't healing up through PT and exercise take a while anyway?

idk, i'm not pushing you to do it, just being a sounding board and thinking what i'd do. not being 100% and a higher chance of redoing the injury seem shitty to me as a person who doesn't want to stop being active and doing stupid shit for a long time

SofaKingSickwon't healing up through PT and exercise take a while anyway?

idk, i'm not pushing you to do it, just being a sounding board and thinking what i'd do. not being 100% and a higher chance of redoing the injury seem shitty to me as a person who doesn't want to stop being active and doing stupid shit for a long time

The other factors that are making me want to go the PT route are that the timeline for me walking and getting my life slightly back to normal with PT is like 2-3 weeks and the surgery route is 4-5 months. I guess this feels kinda short-sighted now as I type it... I'm also not super worried about re-injury. I don't do super crazy stuff on skis (started skiing in college, 28 now) and mostly just like cruising and maybe hitting a few small jumps in the park. Plus the doc said if I do re-dislocate it won't be as bad/painful as the first time.

I totally appreciate the counter-thoughts tho. Like I said, this is really my first big injury so just looking for other perspectives and advice

ajbskiits ok, just be glad it didnt happen several clicks away from civilization.

so the procedure is not on reconstruction of the fracture.

grade 1 is fibre disruption but no tears
grade 2 is partial tear
grade 3 is full tear

its likely the surgery will be taking a part of a healthy donor ligament and transplanting it in place of the mpfl using a screw and some anchors.

once again, stay positive. i think a knee injury is kind of a right of passage as a skier. so now youre more legit than ever!

Yeah exactly, it would be a cadaver replacement of the ligament. (Which I think is dope haha)

Deff staying positive! I think this is key for recovery. I was cracking jokes about it with the nurses and X-ray techs and they were like "you're surprisingly chipper for someone who just smashed their knee to bits" haha. Super thankful its not my ACL/MCL or like a broken femur. Could have been so much worse.

GrandThingsThe other factors that are making me want to go the PT route are that the timeline for me walking and getting my life slightly back to normal with PT is like 2-3 weeks and the surgery route is 4-5 months. I guess this feels kinda short-sighted now as I type it... I'm also not super worried about re-injury. I don't do super crazy stuff on skis (started skiing in college, 28 now) and mostly just like cruising and maybe hitting a few small jumps in the park. Plus the doc said if I do re-dislocate it won't be as bad/painful as the first time.

I totally appreciate the counter-thoughts tho. Like I said, this is really my first big injury so just looking for other perspectives and advice

gotcha gotcha. yeah i ain't no expert, just being a sounding board. sleep on the decision and keep the positive attitude. either way you're all good man

@GrandThings

i see your points. and youre right. skipping the reconstruction will bring back independence quicker (which for most normal people is the biggest objective)

as a skier, albeit a laxed one, the surgery gives you a piece of mind. it might be less painful the second time the injury happens, but its still as debilitating and the potential for damaging other ligaments is higher. theres nothing worse then feeling everything is good then 2 years later, you make a small mistake and youre back at square 1.

my gf had a partial tear in her mcl and left it alone. we did a good year of physio together, everything was looking great. she even took a couple of slams on the wakeboard in the summer and everything was fine. on our first trip back west, we hit a patch of some deceptive crusty snow and boom, full tear now.

even doing everything right in physio doesnt guarentee that the ligament will grow back properly. surgery almost guarentees.

like i said, im against people doing reconstructive procedures if its a partial tear or even full tears of less important ligaments, but the fracture makes me think you might have complications further down the road without it.

im not a doctor, im not qualified to give you medical advice. ive just been through my fair share of sprains and even surgeries (in my back), and i want to give you what ive taken from my experiences so you can make the decision that best applies to you.

once again, i wish you a speedy recovery.

ajbskionce again, i wish you a speedy recovery.

Thanks friend, really appreciate all the thoughts and goodwill!

Feel free to PM me on here or my IG @skiingphysicaltherapy , I’d love to express my opinion

Hey man,
This really blows for you and I know how much it sucks. Got major deja vu reading this, because it is exactly what happened to me. 4 years ago, dislocated kneecap, tore MPFL and tore a chunk of bone off the kneecap. They gave me the same options. I was 16 at the time and completely went with the PT option. Worked great for 3 years and then started flaring up again, dislocated it 3 times in a few months. Went back to the doctor, and now I have to get that surgery that they proposed in the beginning. What they explained to me the second time around is that PT is a temporary fix and I would've had to get surgery eventually no matter what. Further, because of the multiple dislocations, I scarred some of the cartilage under the kneecap and this is gonna lead to more issues down the road. So honestly if I could go back and do it all over again I would get the surgery the first time. I am gonna miss another season, and now that I am in college its much more of a hassle to get the surgery. It is a really shitty situation all around and I feel for you. Definitely PM me and I can go into more detail.
-Cam

Yo! Interested to see what route you decided to take in the end. I’ve subluxated my kneecap 3 times in the last ~6ish years and have a bit of cartilage damage under the kneecap as a result.

I don’t have any pain currently and knee stability feels fine. Just trying to be proactive and considering surgery at some point in the future when it’s convenient.


Was interested to hear your story and how you’re doing now.

GetshiftyYo! Interested to see what route you decided to take in the end. I’ve subluxated my kneecap 3 times in the last ~6ish years and have a bit of cartilage damage under the kneecap as a result.

I don’t have any pain currently and knee stability feels fine. Just trying to be proactive and considering surgery at some point in the future when it’s convenient.


Was interested to hear your story and how you’re doing now.

Ayo!

Thanks for the bump, this actually turned into quite the funny story. TL;DR - I opted not to get surgery, did all my PT and then like a month after I got back to full-health I fractured both of my elbows skating (requiring surgery). Lol the universe really just wanted me to go under-the-knife in 2022.

Regarding the knee specifically tho, I am quite happy with my decision to not get the surgery. I was super dedicated to my PT and things are feeling really good. It does get sore if I exercise heavily, (especially after a long run) but it's just general soreness, and usually goes away with some ice and tylenol. I do still ski with my knee-brace.

I don't want to say I'm "in the clear" but my knee feels quite stable, so barring another traumatic fall, hopefully I'll be good! (Also sounds like you've done way more than me, so that gives me hope!) I remember them telling me, "now that you've dislocated it once, it'll come out more easily, but shouldn't hurt as much as it did the first time". Hoping to not experience that tho!