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What Causes Tight Ligament When Diagnosed With Patellar Clunk Syndrome?

Posted on Mon, 7 Aug 2017

Question: Hi.
I am xxx xxxxxxxxxxxx and searching for a doctor who can give my life back to me due to an unsuccessful knee replacement. I am allergic to nickel and since my replacement am mildly reactive to vanadium and molybian sp? I have a XXXXXXX and Nephew Oxnium knee but it has been faulty since the very beginning and my doctor told me that I have patellar clunk syndrome as when I attempt to bend my knee the knee seems to jump up as if it is dislocating. I can hardly bend my knee now after four years, I can't drive my care because of pain in the knee when moving my leg to go from the accelerator to the brake and my ROM is about 50 at best. It is so difficult to walk and stand and my back hurts me because I am walking funny. I have spent the last year mostly in a wheelchair, or in bed or lying on the couch. This is no way to live. I understand that my doctor isn't rated well at all so I am looking for another doctor and I am wondering if there is an implant out there that doesn't have nickel, vanadium, and molybian sp?I was hoping that Dr Seigel would answer this question as I noted he is online and an orthopedic doctor. Thank you. Pxxxxxxxxxx

Answered by Dr. Aashish Raghu (57 minutes later)

Brief Answer:
Gold and ceramic knees

Detailed Answer:
Hi Pam

Thanks for the query

I have read your query and understood your problem.

Most of the Orthopaedic implants used in knee replacement are chromium and molybdenum.

Gold and ceramic coated knees have also entered the market with quoted lesser wear and tear.

It would be helpful if you could send me your knee Xray because the patellar clunk could be due to tight lateral retinacular ligament which can be treated with surgery. Other possibility could be loosening of implant, infection, malaligned implant which may be failing.

I can read the knee Xray and guide you to taking the next step in alleviating your problem.

I hope I have answered your query.

I will be available to answer your follow up queries.

Regards,

Dr.Aashish Raghu

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Aashish Raghu (46 minutes later)

I will have to get a copy of the X-ray. How would I send it to you? Where are you located? I forgot to mention that I fell very hard on the asphalt on my knee and that only exascerbated my problems with the knee. I have an MRI and now it says I have a tumor as well. I forgot to mention that. I didn't have that on the previous MRI before I had the replacement surgery. Are you saying that the reason I can't bend my knee may be because a ligament is too tight?I do have a copy of the MRI report if that might help.

Answered by Dr. Aashish Raghu (5 minutes later)

Brief Answer:
Oedema, Loosening of implant, infection and right ligament

Detailed Answer:
Tight ligament can be a cause for the patellar clunk among other reasons like traumatic loosening of implant, infection.

You can upload the photo of the Xray films, MRI and concerned reports to the Healthcare Magic team and they will upload it for my reference.

Please do upload the Xray and MRI films and reports.

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Aashish Raghu (32 minutes later)

I won't be able to upload the xray as I don't have it and won't be able to obtain it until next week. I have the MRI report but I don't know how to upload it. My son can help me but it is 2 AM in California so he is sleeping now. I will have to send it later this morning when he can show me how. I am not technilogically savvy. Thank you for your assistance. I truly appreciate it.I think I may be able to figure out how to send it. I am going to scan it into my computer and then try to attach it. I hope that it works. If not, I will ask my son in the morning. It should be there in a few minutes if it works.

Answered by Dr. Aashish Raghu (18 minutes later)

Brief Answer:
Infection?

Detailed Answer:
Thank you for uploading the MRI report.

I have read your MRI report.

It is positive news that there isn't any drastic complication.

The 'tumour' is a non-aggressive lesion so you don't have to worry about it. Incidentally benign or harmless bone tumors do occur without the need to intervene.

However there is a email collection of fluid which may need to be aspirated and tested for infection.

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Aashish Raghu (11 minutes later)

Ok thank you. The surgeon recommended that he just replace the spacer and put in a longer stem. I don't see how this will correct my inability to bend my knee or help with the severe pain under the kneecap. I found out that he is at the bottom of the ratings so I question whether his idea of what to do to get me functional again is appropriate. Does it sound good to you?

Answered by Dr. Aashish Raghu (3 hours later)

Brief Answer:
Sounds good

Detailed Answer:
Your left knee requires a knee replacement as well due to complex tear of the meniscus with severe arthritic changes.

Sometimes the polyethylene insert can degrade quicker and cause reactions and pain in the knee which is why your Surgeon wants to replace it. Long stem will be needed because it is a revision surgery and a normal stem won't be able to anchor the implant into the bone as well as a longer stem.

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Nagamani Ng