Left Knee Dislocation with Patellar Fracture: Treatment Options - Orthopedics

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Dealing with a left knee dislocation accompanied by a patellar fracture can be a complex and challenging situation. Your experience since the injury in December 2015, including the use of PRP (Platelet-Rich Plasma) injections and the advice to avoid certain activities, indicates that you are on a long road to recovery. Let's explore the treatment options and considerations for your condition.


Understanding Your Condition
A knee dislocation, particularly with a patellar fracture, can lead to significant instability and functional limitations. The knee joint is crucial for mobility, and any injury can impact your quality of life. The swelling and deformity you are experiencing are common after such injuries, and they may persist for an extended period due to the trauma to the joint and surrounding tissues.


Treatment Options
1. Conservative Management:
- Physical Therapy: While your doctor advised against rehabilitation initially, physical therapy is often essential in the later stages of recovery. A physical therapist can help you regain strength, flexibility, and stability in your knee. They can design a program tailored to your specific needs, focusing on low-impact exercises that do not exacerbate your condition.

- Bracing: A knee brace may provide additional support and stability, especially during activities. However, if you experience discomfort or a feeling of pressure when wearing a brace, it may be worth discussing alternative options with your healthcare provider.

2. Surgical Options:
- Arthroscopy: If conservative measures do not yield satisfactory results, arthroscopic surgery may be considered. This minimally invasive procedure allows the surgeon to visualize the joint and address any loose bodies, repair damaged ligaments, or smooth out irregularities in the joint surface.

- Reconstructive Surgery: In cases where there is significant instability or damage to the ligaments, reconstructive surgery may be necessary. This could involve repairing or reconstructing the medial patellofemoral ligament (MPFL) or other stabilizing structures around the knee.

- Patellar Realignment: If the patella is not tracking properly due to the dislocation, realignment procedures may be indicated to restore normal mechanics and reduce pain.

3. Pain Management:
- Since you mentioned discomfort and tightness, pain management strategies are crucial. Non-steroidal anti-inflammatory drugs (NSAIDs) can help reduce inflammation and pain, but if you have allergies to these medications, alternatives such as acetaminophen or topical analgesics may be beneficial. Always consult your physician before starting any new medication.


Lifestyle Modifications
- Activity Modification: As advised by your doctor, avoiding high-impact activities such as running and climbing stairs is wise. Instead, consider low-impact exercises like swimming or cycling, which can help maintain fitness without stressing the knee.

- Weight Management: Maintaining a healthy weight can reduce stress on the knee joint, potentially alleviating some discomfort.


Prognosis and Future Considerations
The prognosis for recovery from a knee dislocation with a patellar fracture can vary significantly based on the severity of the injury, the effectiveness of the rehabilitation program, and adherence to medical advice. It is not uncommon for individuals to experience lingering symptoms such as swelling, stiffness, or a feeling of instability even years after the initial injury.


Conclusion
In summary, while your current treatment plan has included conservative measures, there may be additional options available to you, including physical therapy, bracing, and possibly surgical interventions if conservative management fails. It is essential to maintain open communication with your healthcare provider about your symptoms and concerns, as they can guide you in making informed decisions about your treatment options. If you feel that your current treatment is not addressing your needs, seeking a second opinion from an orthopedic specialist who focuses on knee injuries may provide further insights and options for your recovery.