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Tuesday, March 3, 2015
Bilateral patellar subluxation
My daughter was just diagnosed with bilateral patellar subluxation. She is 13 years old and is very active. She is a cheerleader and has been since kindergarten or first grade. She has been doing gymnastics since she was 7 years old. Her knee caps have totally turned in and the x-ray shows they are detached from the structure. She is taking time off from sports until after her evaluation with an orthopedic surgeon. But I was wondering about everyday activities like climbing the stairs at school and etc. Will this make her problems any worse? What should she do?
It is very unusual for the direction of patellar subluxation to be "inward" - which I'd presume means medial = towards the midline of the body... usually patellar subluxation occurs in a lateral ("outward") direction. It could be that you mean her hips have turned inward (femoral anteversion or medial femoral torsion) - which causes the patellae to "face" each other during standing - and the result of which can be patellar subluxation (in a lateral direction) during activity.
I don't know what is meant by "detached from the structure", but this sounds like a fairly significant problem which really needs to be evaluated and treated by her orthopedist.
In general, symptoms should guide activities, so if an activity is without pain, it's probably not going to make her problems worse. The degree to which her activities should be restricted should be based on her diagnosis, and needs to be discussed with and determined by her orthopedic surgeon.
Brian L Bowyer, MD
Clinical Associate Professor
Physical Medicine & Rehabilitation
College of Medicine
The Ohio State University