About 10 years ago I had an ACL repair. Everything's been just fine and now all of a sudden, I'm having painful grinding behind my kneecap and in the joint. What's happening?
Researchers at the Steadman-Hawkins Research Foundation in Vail, Colorado have been researching this very problem. They noticed some of their ACL patients were just fine for 10 years -- a perfect outcome. Then all of a sudden, they developed arthritis.
They think the problem may be a lack of mobility between the patellar tendon and the tibia (lower leg bone). A condition referred to as patella infera may be part of the problem. With patella infera, there is a permanent shortening of the patellar ligament. The kneecap sits too low in relation to femur (thighbone). The result can be a severely limited range of motion of the knee joint.
Patella infera is a common complication of injury or surgery to the knee joint. It usually doesn't show up until much time has passed after injury and/or surgical repair.
Treatment options include physical therapy to manually release the kneecap and/or surgery to revise the soft tissues around the knee. If the joint degeneration has gone too far for conservative care to be successful, then total knee replacement may be needed.
Gina Brockenbrough. Focusing on Mobility in ACL Rehab May Boost Patients' Postoperative Outcomes. In Orthopedics Today. April 2006. Vol. 26. No. 4. Pp. 60-61.
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