He presented my case to the hip team Thursday morning. They went over every option for my right hip and my PAO surgeon could not believe my hip is this unstable. Options for the right hip include another PAO for more anterior coverage, a femoral osteotomy to decrease anteversion, and re-doing the graft I had placed in December 2017. Everyone agreed that the graft should only be repaired/replaced if everything else is addressed too as it is likely to fail again if there are other factors contributing to my instability. That would be one massive hip surgery.
I explained that I feel like the kneecap is the worse of the two and that I think that we should focus on the knee and readdress the hip if/when something were to change. We talked about the risks of leaving the hip as is. Risks include dislocation that requires ER reduction (either closed or open), avascular necrosis, worsening pain, and arthritis from wear and tear from instability.
He agrees that we can focus on knee and discuss the hip if the pain becomes unbearable or there are signs of avascular necrosis. We both believe it is possible that relying on the right hip during recovery for left knee could push it over the edge.
The plan for the knee will be to replace the MPFL graft (original MPFL reconstruction was in 2010) which is completely ruptured, do a tibial tubercle transfer osteotomy, and provide lateral support as well to protect the kneecap from dislocating medially His goal is to get the kneecap to sit in the center of my knee (it does not do that at the moment) while stabilizing it from both sides. He said it will require at least 3 surgeons so it will be a full house! The surgery will be in early December.
While in Boston for the week I was able to spend some time with one of my friends that my surgeon introduced me to 2 years ago! We went mini golfing!
0 comments:
Post a Comment