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knee replacement? kneecaps do not align with my tibia....

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I have been diagnosed with femoral patella pain. However, having an auto-immune disorder that makes me frequently use a walker hardly makes me a runner. But the x-rays showed both kneecaps on the outer side of each knee. I went to PT to build strength in my quads,leg muscles that would hopefully bring everything into alignment but I guess there are a couple of ligaments that hold the kneecap in place that are difficult to isolate & strengthen. Upon returning to my orthopedist he said he hoped PT would help but in essence, my kneecaps do not align with my tibia and femur, that it was an anatomical disorder I was born with and is only now presenting a lot of pain. I was wondering if anyone has experienced this problem, their resolution and prognosis. Thanks in advance ...Peg
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replied December 20th, 2011
Especially eHealthy
Lloyd51,

Lloyd you do not say how old you are or what you body habitus is. Reason being, that as men start getting older their knees tend to go in to a varus type of deformity. Some people called this being bowlegged. This can cause the patella to shift and rub in the wrong places. Likewise, if the knees move together, it also shifts the patella and they can rub.

But, even in knee that have straight mechanical axises, the patella can tilt in the trochler groove of the femur. This is usually to the retinacullum on the sides of the patellar being out of synch. If the medial one is too tight, then the patella will rub on the medial side.

These can usually be easily corrected by releasing the tight side retinaculum and plicating the loose one on the other side. Placing the patella back where it is supposed to be.



So what if this is the way you where born. If it is bothering you significantly, you have undergone the recommended therapy, and yet you still are not able to do what you need/want to do, they seek out another surgeon. One who will listen to you and understand what will be necessary for you to get back to where you want to be.

Don't give up.

Good luck.
Lloyd51,

Lloyd you do not say how old you are or what you body habitus is. Reason being, that as men start getting older their knees tend to go in to a varus type of deformity. Some people called this being bowlegged. This can cause the patella to shift and rub in the wrong places. Likewise, if the knees move together, it also shifts the patella and they can rub.

But, even in knee that have straight mechanical axises, the patella can tilt in the trochler groove of the femur. This is usually to the retinacullum on the sides of the patellar being out of synch. If the medial one is too tight, then the patella will rub on the medial side.

These can usually be easily corrected by releasing the tight side retinaculum and plicating the loose one on the other side. Placing the patella back where it is supposed to be.



So what if this is the way you where born. If it is bothering you significantly, you have undergone the recommended therapy, and yet you still are not able to do what you need/want to do, they seek out another surgeon. One who will listen to you and understand what will be necessary for you to get back to where you want to be.

Don't give up.

Good luck.
Lloyd51,

Lloyd you do not say how old you are or what you body habitus is. Reason being, that as men start getting older their knees tend to go in to a varus type of deformity. Some people called this being bowlegged. This can cause the patella to shift and rub in the wrong places. Likewise, if the knees move together, it also shifts the patella and they can rub.

But, even in knee that have straight mechanical axises, the patella can tilt in the trochler groove of the femur. This is usually to the retinacullum on the sides of the patellar being out of synch. If the medial one is too tight, then the patella will rub on the medial side.

These can usually be easily corrected by releasing the tight side retinaculum and plicating the loose one on the other side. Placing the patella back where it is supposed to be.



So what if this is the way you where born. If it is bothering you significantly, you have undergone the recommended therapy, and yet you still are not able to do what you need/want to do, they seek out another surgeon. One who will listen to you and understand what will be necessary for you to get back to where you want to be.

Don't give up.

Good luck.
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replied March 5th, 2012
Hi there. I'm 18 years old and since I was 5 I developed a condition where my kneecaps are also permanently on the side of my legs. I too have just started going to the physio therapist to try and strengthen up what muscles I can. Fortunately I have been able to walk all my life but tend to fall over on random occasions. I have been to the doctors frequently but are yet to find a explanation as to why my knees are like this. My condition is a hereditary condition, that my nana, uncle, mother and I all suffer from.
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replied March 6th, 2012
Especially eHealthy
Kels_0015,

Many people have patellas that are tilted or that sit a little to the outside of the knee. But, if your kneecaps are totally dislocated from the femoral groove, sitting on the lateral aspect of the knee, and cannot be moved into the femoral groove (reduced), then you may have a condition known as congenital dislocation of the patella.


The following is taken from the POSNA (Pediatric Orthopedic Surgeons of North America) website.

Congenital dislocation of the patella is an unusual condition that may occur in isolation or with syndromes such as nail-patella syndrome or Down syndrome. There are two groups of patients, one with a fixed dislocation at birth, and the other in whom the patella is normally located at birth, but progressively subluxates until it is in a fixed dislocated position. Diagnosis is generally not made until after walking age. There is a fixed flexion contracture of the knee, the patella is laterally displaced with genu valgum, and the tibia is externally rotated. The trochlear groove is hypoplastic. The preponderance of reports of natural history seems to be that of increasing disability with age, although some authors report the knee being painless.

This condition does not respond the physical therapy. If the patient is significantly hampered by the condition, surgery is usually the only option.



As noted, this is only for the patients whose patella cannot be reduced (or put back where it is supposed to it, even if it doesn’t stay there). If the patella can be moved over manually, then the patient does not have this condition, though they do have some sort of patellar subluxation.



You should speak with a pediatric orthopedist or an orthopedic surgeon well versed in congenital orthopedic problems. This is a rare condition, but not unheard of.

Good luck.
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replied March 9th, 2013
My son has congenital dislocation of the patella, he has Larsen's syndrome.

Kels_0015 - do you have intoeing of one or both feet?
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