Curly Girl will have knee surgery consisting of two procedures.
Reasons and Procedures:
Your knee should have a groove which the patella slides in as it moves. The groove in Curly Girl’s left knee is minimal and should be 10 times deeper than it is. Because of this, Curly Girl’s patella is not tracking properly in the groove and has suffered recurrent full and partial dislocations. Since there is not a successful surgery to deepen the groove, the surgeon will perform a medial patellofemoral ligament (MPFL) reconstruction to correct this problem. In this procedure, the surgeon will reconstruct Curly Girl’s MPFL ligament, which will hold her patella in place, by grafting a donor ligament onto Curly Girl’s knee. The MPFL ligament must be reconstructed since it is now completely lax from the repeated dislocations. The donor ligament will be secured with absorbable screws. A brief explanation of this surgery is here: http://www.ziploop.net/video/Main_page_ziploop_website2.swf
Curly Girl’s knee also aligns incorrectly with her tibia, the lower leg bone, and is offset by several millimeters. To correct this issue, the surgeon will perform a Fulkerson osteotomy, also known as a tibial tubercle osteotomy. A brief animated explanation of this surgery is here: http://www.hopkinsorthogsh.com/tibial_tubercle_osteotomy.html. The osteotomy will be held in place with large screws which we may elect to have removed after 8-9 months.
The surgeon feels certain that Curly Girl’s knee issues are due to the structure of her knee, and no amount of physical therapy alone will stop the recurrent dislocations. The surgeon also feels strongly that Curly Girl needs both procedures to ensure a successful outcome.
Curly Girl will spend one night in the hospital. To allow the osteotomy to heal, her left leg may bear no weight for 4 weeks. Along with pain relief, this will be the largest obstacle for us at home since Curly Girl may not climb any stairs for 4 weeks. (Yes, our house is 2-story with her bedroom and both showers upstairs). From weeks 4-6, she can be 50% non-weight bearing and full weight bearing (but possibly with a brace) at 6 weeks. She will begin physical therapy at 3 days post-op and will continue PT for about 6 months. The surgeon said not to expect to play spring soccer (think of it as “gravy” and an outside possibility), but Curly Girl should be able to swim again next summer. The plan is for these procedures to completely stabilize her knee and prevent any future dislocations.