Dislocated Patella - Leg Swelling and Bruising on Foot

[divsky]

About 10 days ago I slipped on the ice and, due to an unusual twisting of my leg trying to catch myself during the fall, dislocated my left patella.  I've been wearing a knee immobilizer ever since and trying to keep off my knee as much as possible.  About 6 days after the injury I noticed that my left leg was swelling from the knee down.  My left knee, my calf, and my foot all began to noticeably swell.  My lower leg feels somewhat "hard" to the touch.  Soon afterwards I started getting a large (about 1.5 inches across), blotchy purple bruise on top of my left foot, where the foot meets the leg about a couple of inches left of the ankle, which strangely is very noticeable, but not at all sore to the touch like a typical bruise (I haven't hit my foot on anything, btw).

Well today I finally saw an orthopedist (since this happened just before the holidays it was difficult to schedule an appointment).  I got x-rays, he said they looked typical for a dislocated patella.  Felt the position of my kneecap, bent my leg around a bit.  Said it was all typical for a dislocated patella.  But the swelling of my leg and the mysterious bruise he just said were "weird", and had no explanation for them.  In the end, he scheduled me for some physical therapy, and gave me some "TED hose" to wear on my left leg.

Now, as enthralled as I am to be wearing what's basically ugly men's pantyhose on my left leg I'm curious.. does anyone know what could be causing the swelling of my left leg and the mysterious bruise on top of my left foot?

[skirby09]

What ever happened with your calf Mike? I recently dislocated my knee (on Nov 18) and I'm currently experiencing the exact same thing - swollen calf, ankle that won't go away. I'd love to know what happened with your knee as it sounds very much like the same thing.

[dals]

What ever happend to the bruising?
You mentioned the swelling but left out the bruising.... did they go away? and did you find out what it was from?
i am keen to know because just last friday i dislocated my knee :(
I am in a knee immobiliser and the bruise on the side of my knee got larger and another one appeard. also just last night while putting cream on it i noticed i had a big bruise on the back of my knee which got me a bit worried..... i do have an appointment tomorrow with an orthopedist so hopefully they can put me at ease some what.....
see mine arent near the foot though... so anyway did yours go away? and if so how long did it take?
thanks :)

[JainMD]

Hi,
It's nice that you are recovering fast and your range of motion around joint has also increased.
I would suggest you to see your surgeon back and see if any explanation for swelling he has.
You also need to do imaging study to see how far is the swelling, is it limited by joint capsule or not.
If all causes are ruled out, then I feel you can go and meet hematologist for further evaluation.
Yes there could be collection of fluid due to inflammatory reaction in knee which can be drained.
Keep me informed if you have any queries.
Bye.

[divsky]

Just an update.  It's been another week and my physical therapy has been going well.  I have no problems with knee stability anymore.  I've regained a lot of range of motion in my knee.  I can now walk normally with just a slight limp and can walk up stairs two steps at a time (as opposed to just walking up one step, then bringing up my injured leg while keeping it straight).  Walking down stairs is still very difficult for me, but still, the strength and mobility of my knee gets better every day.

However, the swelling persists.  It's gotten better in my calf and foot, but it gets much worse if I stand for an extended period of time.  My knee remains very swollen all the time.  My physical therapist says she thinks it's getting better, but, I see it everyday, and honestly I don't think it is.  So tomorrow I'm going to follow your advice and try to see if I can schedule an appointment with a hematologist about the swelling.

I've heard of cases where this swelling can be caused by excess fluid in the knee, and can be fixed simply by draining the fluid.  Is this a possibility in what I'm experiencing?

[JainMD]

Hi Mike,
It is nice that your swelling has got better. It is necessary to get physical examination done to know the actual nature of disease.
Most of hematological cases are diagnosed incidentally, hence I had suspected one.
The swelling in your knee would also come down as Range Of Motion around Knee joint will improve.
All the best and take care.
Keep me informed if you have any queries to be answered.
Bye.

[divsky]

The physical therapist noticed the swelling and bruising and thought it was due to general disuse of my leg while it was healing, and said that as I started to exercise it more it would get better.  Since starting physical therapy the bruising has diminished drastically, and the swelling of the calf and foot has reduced somewhat.  My knee remains very swollen.

Btw, my name is Mike and I'm 25 years old.

[JainMD]

Hi,
What is your name? How old are you?
I think your Patellar dislocation is being taken care. Your doctor seems to be convinced about the diagnosis.
The treatment he has started is appropriate.
I think due to venous stasis and vascular compromise there is swelling.
Did you check your bleeding and clotting parameters? Have you done any investigations?
I think there could be a coagulation disorder. You should be consulting a hematologist and get concerned investigations done.
Keep me informed.
Bye.