Knock Knees, Patella Femoral Syndrome and Bilateral Release Surgery!!

by Dana
(Roseville, CA USA)

I am a 36 y/o female. I am knock kneed and 4 years ago was told I have patella-femoral syndrome. I have never injured my knees, and I have never been in tremendous pain from my knees, just suffer from occasional discomfort due to persistent grinding and popping. Several times my knee has locked up on me.

At that time, I was sent to physical therapy and shown some exercises to do at home to help relieve discomfort by strengthening the muscles around my knees. The most relief I received was when they wrapped my knee (McConnell wrap?).

I just returned home from my first visit with a new orthopaedist. He is recommending p/t, steroidal injections (although I don't have any swelling, so I'm not sure if these will help), and possible bi-lateral knee release. How will this surgery help, why would it be bi-lateral (both knees, I presume?), would the steroid injections help or be a waste of time, how long is the recovery from injections and surgery?

I have a 17 month old son, we live in a 2-story home and are considering getting pregnant again soon...would surgery be better if done now or after baby #2? Any information or help you can provide is appreciated.

Thanks!

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Aug 23, 2008
Therapy could help...
by: Bart - SII

Therapy for patella femoral syndrome is usually beneficial, if it is treating the underlying cause of your patella femoral pain. Unfortunately, there are usually multiple factors in the manifestation of PFS. In my opinion the most important part of any PFS rehab program is the focus that is paid to strengthening the lateral hip muscles - the abductors and the external rotators. These muscles, not the quadriceps, have the most influence on the position of the patella femoral joint. So, physical therapy that focuses on the hips and core and places less emphasis on the quadriceps has the best chance of being successful.

You also need to make sure that any biomechanical issues at the foot and ankle are addressed - over pronation is the most common thing seen with mechanics, and orthotic intervention can be helpful with this as well.

I am not a proponent for steroid injections for patella femoral syndrome, as this problem is almost always caused by mechanical irritation and abnormal stresses on the joint rather than chronic inflammation. Steroid injections can also be harmful to articular surfaces and tendon/ligament structures, and I believe should be a last resort.

Lateral release procedures can be effective in treating Patella femoral syndrome, and are most beneficial if the problem is due to lateral patellar tilt. However, this procedure is sometimes used as a catch all treatment for PFS that is unresponsive to conservative treatment. If you have lateral patellar tilt diagnosed with an X-ray, and you have gone through a conservative treatment program that addressed all of the areas I talked about above, then lateral release could help. They are probably suggesting bilateral because you have pain in both knees, however, I would recommend one knee at a time, as the recovery can take some time.

With conservative treatment as described above, you should start to see results in 3-4 weeks. Most of the patients I have treated successfully for PFS are in treatment for 4-6 weeks and enjoy a full recovery in that time period.

Recovery after a lateral release will likely be 3-5 months total, with 6-8 weeks in therapy. This procedure progresses slowly at first, and swelling can be a major factor in the recovery process.

Bart

Mar 10, 2009
I too have knock knees
by: Anonymous

I am a 30 year old female with knock knees. I had a medium meniscus tear on my left knee about 6 yrs. ago. I had surgery for the tear but while under he did a lateral release and have suffered every since. My leg is now a inch longer on that side...which in turn my pelvis is now out of alignment...just bad all around!

Apr 29, 2009
bi-latteral knee release
by: Anonymous

I had bi-latteral release on both knee's at the same time, plus cleaned out under my knee caps, and few other things. it's very painful. my knees feels like rubber bands are strected real tight around them most of the time. My knee's want to buckel out from under me and its been almost 4 wks. I would never recommend both knee's at the same time. very depressing thought i'd be recovered by now but it looks like this is going to be a long recovery, not what i was told. best of luck to anyone who goes thru it.

Jul 22, 2009
Both Knees!!
by: Leanne Mais

I had a bi lateral release on 15th July and i can honestly say that it felt better straight away. Obviously the pain of being operated on was there but i could tell the difference straight away when i was able to stand. I was given a sick note for 6 weeks and the surgeon told me that 6 weeks was pushing it to go back to work. We shall see.. i think its very important to do the exercises given by the physio team to make sure you have the best result. I will not be expecting to much to soon.. plenty of rest in order to heal is what im doing, it will be well worth it in the long run.. will keep you posted.

Jul 01, 2010
bi lateral release/ torn mins. L knee
by: jo ann

Feb 3 2010 Went in for surgury fpr a torn mins. doctor did a bi lateral release. Awful . pain my knee still feels tight. Hard to get out of car climb stairs. wevt to the doctor yesterday. checking for rsd. my knee doesnt go sraight when iam standing it kinds of bends. this doctor screwed me up really bad. becareful out there. leave your knees alone.

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