Torsional problem with patellar instability

Six years ago I fell when climbing on benches in school. After several weeks of pain following the incident, I had an MRI done during which a growth was found in my knee. This was consequently removed and I had a further operation 6 months later to remove remaining cells that had formed another growth.

Up to this point I had been a keen sports person and even competed at a national level for girls rugby. After this operation I continually had unexplained bruising around my leg with extreme heat radiating from the area. Without much progress to resolve this issue my parents decided to get a second opinion, which resulted in an arteriovenous malformation (AVM) being diagnosed and removed by my previous consultant, Mr Duncan Whitwell.

Subsequent pain & patellar instability

My knee continued to be painful when walking and my kneecaps began dislocating on activity. After several months of dislocations and being told by the NHS I didn’t need an operation, I went back to Mr Whitwell who referred me to Professor Wilson who then completed an MPFL reconstruction (March 2017) which successfully stopped the dislocations.

Femoral Osteotomy (Dec 2017)

Prior to this operation I was hoping for the majority of my pain to go away, be able to resume normal activities (such as walking up stairs properly, be able to cycle/run) and for my leg to look straighter. I was nervous about the op because I appreciated the risks involved. However I was pleasantly surprised when I came back from theatre - the pain was well managed by a variety of pain reliefs and a spinal block.

I was discharged from hospital a few days later and started physiotherapy at home. Within 6 weeks of physio I was off my crutches and a further 6 weeks I could walk up/down the stairs normally. The pain had significantly reduced and by 5 months I was able to resume cycling and all every day activities. I do still have pain in my knee but it is significantly better than before I had the operation.

My advice to others would be to make sure you persevere to get the medical treatment that you need and don’t be too scared of the operation you may have to have as ultimately you should be left pain free and able to participate in activities that you previously wouldn’t have been able to do and that is worth a little bit of pain and discomfort for a short while after an operation.

My life has definitely improved for the better by having this op, without Seeing Professor Wilson I wouldn’t have been offered this opportunity and would probably still be in significant daily pain and unable to do the normal activities teenagers do without even giving it any thought. I’m grateful we were able to find out about Professor Wilson’s work, and experience first hand the beneficial results of such treatment. 

Adrian Wilson

Adrian Wilson

Mollie has done really well with her femoral osteotomy. We plan to follow with a derotation osteotomy of her left distal tibia for external torsion.

She has difficult issues, with terrible knee pain her whole life.

She presented initially to Southampton hospital and was noted to have a benign bone tumour and was referred on to. Oxford as this was felt to be locally aggressive and also causing her pain. Removing the tumour didn’t help her knee pain.

She came to me with knee pain and an unstable patella. I hoped that a simple MPFL reconstruction would help to settle the pain by making the patella stable, but sadly this didn’t help the pain.

We did her torsional profile and found her to have abnormal torsion in the femur. And to be honest this was the primary problem from the start. De-rotating the femur has helped enormously. Her knee pain is now significantly improved but it has left her with an externally rotated foot. So the final procedure will be to bring her foot back into appropriate rotation and we plan to do this at the end of the year.

A complex problem but the torsional issues always are...

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