Miserable Malalignment Syndrome

Last week was very stressful and exhausting (mentally and physically). I had another appointment with my surgeon on Thursday and a MRI of my right ankle on Wednesday. We discussed my knees, RPAO post-op status, back, and a little about my ankle.

Ankle/MRI-
My surgeon briefly looked over my ankle MRI (my ankle surgeon did the full evaluation and later confirmed) and said that it did not look good at all. The ATFL ligament (a lateral/outside ligament that supports your ankle from rolling out) is "shot." There was evidence of tears that tried to heal but didn't heal correctly. At some point the ligament was ruptured and it's likely I re-tore it many times! Regardless, the ligament is beyond useless (not that many of my ligaments are really useful) and needs to be removed and replaced with a cadaver tendon. My ankle surgeon will perform the Chrisman Snook procedure--which is an open procedure that involves screws and a cadaver tendon. I will spend approximately 10 weeks in a cast.

*My RPAO screws will be removed during my ankle surgery!

Knees-
My left knee looks great! I finally have functioning ROM/flexion and no longer wear the post-op brace. My hip surgeon was VERY happy to finally see me without the brace after 8 months. I still need to build up strength in my quad and continue controlling my RSD but otherwise the left leg is doing well. My right side is a little more complicated. The right knee is still very loose but hanging on. Unfortunately I have Miserable Malalignment Syndrome in my right leg. In simple terms, my right leg is "crooked." The bones in my leg don't form the proper angles. It can stem from the hip joint, knee, or ankle! This malalignment causes a chain reaction to the upper body (likely a contributing factor to my back pain and SI joint instability). Because of MMS, if my right knee were to dislocate (and it warranted surgery) I would need both the MPFL reconstruction and TTT Osteotomy (Tibial Tubercle Transfer). A TTT Osteotomy is a realignment procedure with an extensive recovery process. It involves realigning the Tibial Tubercle (just below the patella/kneecap) to create the proper Q-Angle (see picture below for a visual of the Q-Angle and surgical fix). Fingers crossed I can get away without needing my right knee reconstructed! I have a renewed script for more PT with Cam to strengthen the muscles and relearn how to walk properly--using the correct muscles..in the right order!

Miserable Malalignment Syndrome (lower body can send a chain reaction of alignment abnormalities to upper body)

Surgical fix (TTT Osteotomy)

Q-Angle Diagram

  

Hip-
I saw my primary surgeon for my post-RPAO appointment because my PAO surgeon wasn't available. I had an x-ray which showed that the bones are 99% healed! Great news! I will continue therapy with Cam to regain function in the hip joint! Some of my exercises cause groin pain but so far nothing like my left hip! I hope I continue to make forward progress with my hips--I don't need any set backs!

Back-
We spoke briefly about my SI joint instability and pain. EDS is obviously the main reason my SI joints don't stay in place but it's possible Miserable Malalignment Syndrom plays a role as well. I was told I need to wear an SI belt and hopefully that will help a bit. He said it may be beneficial to see one of the back specialists at Children's during my next trip in August.

It was also great to be in the best city in the world when the Boston Bruins WON the STANLEY CUP! GO BRUINS! (I still believe that wearing Patrice Bergeron's shirt on the day of Game 7 had something to do with it...I mean he did score the winning goal)

Yesterday I went to the Kenny Chesney concert! It was AMAZING! I can't wait for next years concert..I seriously recommend seeing him perform. He puts on a great show!

I start therapy tomorrow with Cam for my shoulder! Hopefully the evaluation goes well...