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Knee sprain

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Few days ago my knee gave away and I twisted it and have since not been able to walk. I had an MRI of my right knee and it suggested that I have transient subluxation. I'm concerned because I've had instability of my knee for 3 years in which I have done;
- 1 year of rest and bracing
- 1 year of strengthening VMO and quadriceps
- 1 year of Physiotherapy and Hydrotherapy.

I have slightly bowed legs & Osgood Schlatters Disease in my right knee. I'm worried that surgery may be my only option, if so what type of surgery? How do I manage in the mean time?


Category: Orthopedic Surgeon

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Category: Spine Surgeon
Dr. Mukesh Tiwari is online now

Expert:  Dr. Mukesh Tiwari replied 4 Days.

Hello and thankyou for approaching DoctorSpring,

I have gone through your case. I will need to go through your MRI so that I can give you a better and an informed opinion.

Please can you upload your recent MRI report. Have you done an MRI earlier? If so please can you upload them, as this will help me evaluate your condition.

You can reply as a follow up, and I will advise accordingly.

Thankyou



Patient replied :

Thank you for getting back so quick. No I haven't had an any other MRI. I have attached the MRI report. The report states that the injury was sustained few days ago however that was when I was unable to walk. The instability problem has been going on for 3 years now, which is why i'm worried about what is next, especially considering all the treatments I've had in the past. I've been told by a another specialist that Patellafemoral Realignment Surgery may be required as my situation is quite bad or a lateral release surgery. However I was told with the lateral release surgery that I may need to have surgery again as due to the bowed nature of my legs this type of arthroscopic treatment may not be a longterm solution.


Expert:  Dr. Mukesh Tiwari replied 3 Days.

Hello,

Thank you for the additional information.

From your details, it appears that most probably you may be having patella subluxation disorder.Your details also show that you are alsohaving bow legs or in medical terms 'genu valgum'.

In this type of disorder you should not opt for arthroscopictreatment.The best treatment for this is to have an open procedure withsupracondylar osteotomy of femur.This procedure may be combined withother procedures like tibial tubercle advancement or others,which is best decided by your surgeon.

Hope this will help you. Would be glad to answer any follow-ups.

With best wishes.


Patient replied :

Hi thanks.

For this type of open surgery what is the post recovery situation. How is the recovery like. I'm am in uni and have heard this type of surgery like require several weeks immobilisation. If you could provide details on how post surgery will be that'd be great


Expert:  Dr. Mukesh Tiwari replied 2 Days.

Hello,

The supracondylar osteotomy with other procedures for your condition will take about 6-8 weeks after surgery.For this duration your limb may be kept in supportive plaster or other type of cast.After checking for bone union by x ray your doctor may decide for physiotherapy.This may also continue for next 3-4 weeks for your complete recovery.So for 2-3 months after surgery you have to do rest.

There are some procedures which may do good fixation of bone. If your surgeon is expert in this regard then duration of your post operative recovery period may be reduced by a month.You should discuss this from your surgeon.

Hope this will help you. Please feel free to discuss further.

With best wishes.


Patient replied :

Hi,

I went and saw my Orthopaedic Surgeon today and was told that I would need a Lateral Release Surgery + Arthroscopy.

He said that although my legs were bowed the groove of the bone wasn't completely flat, but it wasn't completely normal either so he said that having a big surgery wouldn't be required. He also said that my joints were quite loose throughout my body and that my MCL was to loose and LCL was too tight in my right knee. I'm little concerned as if this was the case why haven't I got any problems in my left knee and will I have problems similar in my right knee. My primary concern is if the Arthoscopic treatment does not work due to the bowed legs even if it isn't that bad, than what next, I don't want to have to keep waiting for surgery if something could've been done earlier to begin with.


Expert:  Dr. Mukesh Tiwari replied 1 Day.

Hello,

Firstly, my apologies for the delay with the reply due to personal reasons.

Ligament tightness or laxity is one of the associated factor in bow legs ,it is not a cause for bow legs.

If your diagnosis is bow legs then at your age osteotomy(corrective) is best answer.

Hope this helps, please feel free to get back.


Dr. Mukesh Tiwari
Category: Spine Surgeon
Experience: 
Fellowship - Khandaka Hospital, Jaipur
Residency - MS, Rabindranath Tagore Medical College, Udaipur, 2000
Medical School, Internship - MBBS, SMS Medical College, Jaipur, 1995
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