Victoria perseveres: Knee surgery brings new possibilities

patellar femoral dislocation“Last can be better than first.  It can be bigger than anything when getting there wasn’t supposed to happen,” says Chris Voye, a few hours after his 12-year-old daughter Victoria’s first cross-country meet.

Victoria fell in love with running six years earlier during a summer track program. She had hoped to participate the following summer, but began experiencing problems with her knees.

“It started when I was in second grade,” recalls Victoria. She’d be running or jumping, and one of her kneecaps would slide to the side. She’d stumble and fall. The condition affected both knees.

When she was 8, Victoria was diagnosed with patellar instability; her kneecaps regularly dislocated.

After three knee surgeries between the ages of 9 and 11, doctors cautioned Victoria she might never run again.

And for two years after that warning, Victoria didn’t run.

Then on Sept. 12, 2016, Victoria laced up her running shoes. She felt a little nervous about testing her knees, but she wanted to get a one-mile run under her belt before the start of cross-country season.

How was her first mile in two years? “It felt good. I was a little slower than I wanted,” she admits.

Victoria continues, “I know how to persevere. I don’t give up.”

Victoria’s knee surgeries

When Victoria’s knee problems started, Chris took his daughter to her pediatrician, who referred her to an orthopedic surgeon. The next stop was a pediatric orthopedic specialist, who inserted metal plates to improve her leg alignment and stabilize her kneecaps.

“Each time I had to have surgery, I’d get really upset, but I understood it was the right decision,” says Victoria. The goal of each operation was to stabilize Victoria’s knees.

Unfortunately, she continued to struggle with patellar instability. It wasn’t possible for Victoria to run or participate in sports.

When she was 11, Victoria’s surgeon referred her to Dr. Benton Heyworth, a pediatric orthopedic surgeon in the Boston Children’s Hospital Orthopedic Center, suggesting that a specialist trained in both pediatric orthopedic surgery and sports medicine might approach Victoria’s condition from a different perspective.

“Patellar instability is rare enough that there’s no established treatment for children under 12,” explains Heyworth.

Victoria recalls, “Dr. Heyworth had a different idea about how to take on the surgery. He explained it to my Dad and to me, and he asked me what I thought. “

Her medial patellofemoral ligament, which keeps the kneecap centered and helps track the knee, had stretched too much, so Heyworth planned to reconstruct the ligament in each knee.

After meeting Heyworth, Victoria discovered there was an added incentive to additional knee surgeries. “If I had these operations, I could do sports. That was my main goal with the surgeries.”

Protecting Victoria’s growth plates

“The tricky thing about ligament reconstruction in children is protecting the growth plate (the area at the end of the bone responsible for bone growth) during surgery. Orthopedic and sports medicine surgeons who care for adults also reconstruct the ligament, but they don’t have to work around open growth plates. If surgery interferes with the growth plate, the child’s leg may stop growing or develop a deformity. We operate on kids’ knees enough that we’ve learned how to avoid growth plates,” says Heyworth.

Heyworth performed the growth-plate-sparing technique first on Victoria’s left knee on Aug. 5, 2015, and then on her right knee on Jan. 11, 2016. He prescribed a stringent physical therapy protocol to help Victoria rebuild strength. Victoria stuck with it.

Nine months after Heyworth operated on her second knee, Victoria is up and running and thrilled with her knees.

Her first cross-country meet was Sept. 22.

Victoria’s adrenaline kicked in as soon as the gun sounded. “She wasn’t pacing herself,” recalls Christopher. After a few minutes, she faded back but continued to run.

knee surgery
Victoria and a very proud Chris after cross-country practice

On the second lap of the 1.5-mile course, as Victoria whizzed by her Dad, she shouted, “I got this!”

Christopher watched as his daughter ran the final 100 meters the same way she started the race — in a full-on sprint.

After the race, Victoria walked over to her family. “I was hot and sweaty and upset about my time,” she says. With tears in his eyes, Chris hugged his daughter.

“We both let out five years of emotion: difficulties, nay sayers, disappointments. Her time, not being first — none of it mattered. Victoria overcame it all. I often wonder if her reason for choosing cross country was about proving all of the nay sayers wrong,” Chris says. Victoria persevered.

At Victoria’s second cross-country meet, her teammates gathered around and congratulated her. She beat her time in the first meet by three minutes.

“I wanted to show people I could do it. I made it!” Victoria says.

She’s looking forward to her next race and participating in other sports, particularly basketball.

Meanwhile, Heyworth and his colleagues at Boston Children’s are studying the growth-plate-sparing procedure to understand long-term outcomes. “Early results are promising. We’re able to get kids back to sports, there’s no effect on growth plates, and we’re cautiously optimistic that the long-term knee stability will be good.”

Learn more about Boston Children’s Sports Medicine.