Stumping Doctors Once Again

Annie had her appointment today with a different orthopedic surgeon to discuss how to treat her dislocating knee caps.  Once again, she has stumped the doctors.  Three orthopedists in the group had discussed her case together before we went in for our appointment.  But our doctor today still didn't have a good solution.

He mentioned a very involved rotation surgery to cut away the knee joint from the upper and lower leg and rotate the entire joint, but that is a huge surgery and wouldn't give good results in Annie with her hip and muscle tone issues.  He took a lot of time just sitting and thinking about all the options, and finally decided that the best option might be to just work to manage her pain long-term.

There was then a long pause in the conversation as I was thinking that option is not acceptable.  Then I mentioned the possibility of a patellectomy--completely removing her knee caps.  The doctor looked rather surprised, thought about it, and then actually agreed that that might very well be the best option for Annie.

The catch is, he has no experience with patellectomies, and it's such an uncommon procedure that it might be difficult finding someone who does have a lot of experience.

He went ahead and x-rayed Annie's knees and pelvis (her dislocated hip and pelvis rotation can apparently have a big effect on the knees).  The x-rays were just as we expected--she has no groove at all for her knee caps to slide in.  Her ligaments are also extremely loose, so her knee caps can pretty much float around however they please.

This is Annie's x-ray of her bent knees.  You can clearly see each knee cap dislocated, and the lack of a nice, deep groove where they should slide.

Our doctor is going to meet again with the other orthopedists in his group to further discuss the best options for Annie, particularly the patellectomy.  He said they need to do some research about the procedure and look up more information about it in the literature they have.   Hopefully they will have some answers for us soon, or at least more information that will help us move forward in finding Annie some relief soon.