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Old 07-07-2012, 12:01 PM   #1
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Unhappy Sharp and dull knee pain

I had arthroscopic surgery about 4 years ago, knee has never been the same,last week at work i slipped on wet floor tried to catch myself but twisted my right knee and slammed it on the concrete. No bruising very minor swelling but severe sharp pain by the medial miniscus while walking and Dull pain around the knee while relaxed the knee also pops loudly and feels like it is grinding knee also very unstable. acl and mcl are good had 3 xrays that showed nothing but minor arthritis. orthopedic wants me to wait a week he thinks maybe a severe strain but if it still hurts then MRI. they also arggrivated the daylights out of my knee checking it it hurts wosre after there tests.
What is the difference between medail miniscus tear and strained medail miniscus?

 
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Old 07-07-2012, 12:15 PM   #2
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Re: Sharp and dull knee pain

I don't believe there is such a thing as a meniscus strain. A knee strain is damage to the tendons and muscles around the knee, and it can produce pain. A meniscus tear is different, although there are many different types and degrees of tear.

 
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Old 07-07-2012, 12:23 PM   #3
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Re: Sharp and dull knee pain

Thanks Jane
It sounded strange to me, He also said something about not all meniscus tears show up on a MRI since i have already had surgery on that meniscus previously.

 
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Old 07-27-2012, 08:03 AM   #4
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Re: Sharp and dull knee pain

Had a MRI done on knee on Friday July 20 2012
still awaiting results from MRI still hurts like #$#$ between the bones on the inside of the knee, when knee is babie it hurts inside.
Got a copy of the results but dont know how to read them. its sweet what an MRI shows.
On sunday i lost my knee gave way when walking down some stairs. I took anouther shot on the knee with road rash.
question is how long does it take to for docter to get back with MRI results?
I recall him saying with previos surgery MRI might not show whats wrong and may have to scope knee, anyone ever hear of this?

 
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Old 07-27-2012, 08:44 AM   #5
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Re: Sharp and dull knee pain

Yes, I have heard that. In fact, for me, my knee MRI's didn't show any damage before I had my knee surgeries. When my surgeon saw inside my knee, he saw a lot of torn cartilage under my kneecap. Previous surgeries or not, MRI's may not show all the damage in a joint.

 
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Old 07-27-2012, 09:07 AM   #6
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Re: Sharp and dull knee pain

Ozfan79:
What kind of of issues where you having with you're knees?
I'm thinking of calling the docter, tired of waiting for the results, Knee has been hurting and bothering me for about a month and the docter prefers to wait and see if pain goes away.

Last edited by WALLEYE; 07-27-2012 at 09:08 AM.

 
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Old 07-27-2012, 09:53 AM   #7
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Re: Sharp and dull knee pain

None of my knee surgeries were needed because of high impact injuries. My problems just happened during everyday activities. For my first two knee surgeries, I had kneecap tracking issues. My kneecaps were popping out of their groove slightly. This caused tearing of the cartilage under the kneecap. My third knee surgery (the MRI before this one did show a problem) was for a medial meniscus tear. I haven't had any knee surgeries since March 2010. My knees are holding up well at the moment.

I hope you find out what is wrong and can get it fixed soon.

 
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Old 07-29-2012, 02:47 PM   #8
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Re: Sharp and dull knee pain

According to docter, MRI results show nothing wrong with miniscus mcl or acl,If its bothering me the said try physical Therapy, or wait and see.

 
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Old 07-30-2012, 07:55 PM   #9
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Re: Sharp and dull knee pain

Hi WALLEYE,

I too, have never heard of a meniscal strain. Don't think there is such a thing, but I am seeing both my physical therapist and Ortho surgeon later this week so I can ask both if there is such a thing. (I personally doubt it!)

Since your knee has subsequently buckled and given way on you (Which is how all MY knee problems started in Sept. of 2005), I am pretty sure that you now have a fairly sizable meniscal tear in that knee. If the knee feels like it is "grinding" at this point and you were told previously that you have some osteoarthritis in there, it sounds like your cartilage has worn away almost completely and it is bone on bone which IS EXTREMELY PAINFUL! (Been through that, done that, with both knees which is why I needed TKRs in each knee within a year of each other!) That's the "grinding" you are feeling.

As for whether meniscal tears do or don't show up on MRI, I believe they do and it has EVERYTHING TO DO WITH THE SKILL OF THE ORTHOPEDIC SURGEON IN READING THE MRI!!! (And/or X-ray for that matter.) I'll give you a short example - when I tore the medial meniscus in my right knee in the fall of 2005, my previous surgeon did an arthroscopic repair that December. Only problem was - he cleaned out WAY TOO MUCH CARTILAGE and the rest wore away completely from Osteoarthritis over the next 4 1/2 years! In June of 2010, I went back to this moron because the knee was hurting badly again and starting to "grind" and "buckle" on me. I asked him for a new handicap parking permit and he said he had to take x-rays to justify it. Well, he took those x-rays and told me my knee was STABLE so no new permit! Feeling that something was drastically wrong with the knee and unhappy with this guy's care (or lack of it, I should say!), I switched back to my original Orthopedic Surgeon in October of 2010. (Don't ask me why I didn't follow him when he left the other guy's practice in '95 to form his own - I still don't know to this day!) Anyhow, better late than never, as it turned out. When I went for my first appt. back with my original surgeon, he took ONE LOOK AT THE SAME X-RAYS the other jerk had taken four months earlier, and turned to me in abject horror and said, "Carol, you need a TOTAL KNEE REPLACEMENT ASAP! - YOU HAVE NO CARTILAGE LEFT IN YOUR RIGHT KNEE AND IT'S BONE ON BONE!! THAT'S WHY YOU'RE IN SUCH PAIN!!!" Knowing he used to be in the same group as the other guy while he was establishing his own awesome reputation, I could see the wheels spinning in my current surgeon's mind, like, "How the HECK could Magill MISS THIS ONE!!!?" Oh yeah, just to be sure, my surgeon sent me for a confirming MRI that November, and sure enough, when he read it in December of 2010, it confirmed his suspicions from the x-rays. My point on this - MY CURRENT SURGEON KNOWS HOW TO PROPERLY READ MRIs AND X-RAYS, which, obviously, THE OTHER GUY MISSED on a SIMPLE X-RAY!! So it DOES DEPEND ON THE SKILL OF THE SURGEON READING THE MRI!

Anyhow, we scheduled the TKR for the following April (4/5/11) and I had to go for pre-surgery physical therapy to build the muscles surrounding the knee so I would have a really good outcome. About a month or so before that surgery, I developed pain in my left knee from compensating with that leg. I didn't want my surgeon doing both TKRs within the same hospital admission, but did agree to let him do an arthroscopic repair of the left knee during the right TKR surgery. When he opened the left knee during that surgery to scope it, he discovered that not only had I torn the meniscus, but also the ACL (anterior cruciate ligament) which may or may not have shown up on the MRI of the left knee that I had just before surgery. (I suspect my surgeon saw that on the MRI but didn't want to upset me so may have chosen not to tell me at the time, since he was going to repair it anyhow.) Unfortunately, through no fault of my surgeon, the left knee went bad again 8 months later (last Dec.) and I was back in his office telling him that I was now in pain with the left knee. He took a new x-ray and saw that the cartilage was almost gone and that the knee was verging on bone on bone! He tried two cortisone shots in the knee six weeks apart to give me some more time before needing the left TKR. But the shots didn't help, and since I could not take the liquid cartilage injections of Synvisc because of a severe allergy to one of its main components, I got my surgeon to agree that it was now time to schedule the left TKR ASAP. Went in 3/23/12 and had it done. This time, my surgeon told me later in Recovery, that when he opened the left knee to start the TKR surgery, the knee was a LOT WORSE than he expected to find. The osteoarthritis had completely worn away, not only all the cartilage, but also the previously torn ACL!! He said he had to clean all of that out before he could even start cutting the bones to fit the prosthetic knee!!! So, thankfully, he caught this one in time. I recovered a LOT faster from the left TKR because I had the stable right prosthetic knee to work with this time in rehab. Matter of fact, I was SO MOTIVATED going in to this second TKR surgery, that I told my surgeon, that since mine was the first case of the day on 3/23, that if I got to my Ortho Unit room from Recovery early enough in the afternoon, I was going to get up on the walker the SAME DAY OF SURGERY! He said it was fine with him. (They usually make you wait till the next morning.) I walked 200 FEET on the walker THAT AFTERNOON THE SAME DAY OF SURGERY!! No one had the chance to tell my surgeon this that day, because he was in the O.R. all day with other joint replacement surgeries. When he came on rounds two days later, I asked him if anyone had told him how far I had walked the day of surgery and he said no. So, with a huge grin on my face, I told him it was 200 FEET, and he was absolutely astounded and thrilled! He nicknamed me "Rascal" after that, because I was always up on my walker the entire hospital stay! (When I wasn't sleeping, that is!). I'm all healed up from both TKRs now and it's such a pleasure to be able to walk PAIN FREE FOR THE FIRST TIME IN SEVEN YEARS!! (I do have back pain issues that had been brewing before the knee problems which I am getting treated for. Once those back issues are resolved, the new prosthetic knees, and the fact that I'm now walking normally and well balanced, should help take future pressure off my hips and back.) My surgeon is the most kindhearted surgeon I've ever had in my entire life (and I've had many surgeries for other medical problems). He did the most amazing job giving me my new knees and I did the rest. I did EVERYTHING THAT HE AND MY PHYSICAL THERAPIST ASKED OF ME POST SURGERY, and thus have two excellent outcomes because of my willingness to be a full partner in my own care. My Ortho surgeon is my Medical Hero!

Back to your knee issues. I get the feeling, based on what you said you are feeling in your knee as far as pain and "buckling' and "grinding", that you may be headed for a total knee replacement at this point. That arthritis you were told you had previously, sounds like it's progressed to full blown osteoarthritis which is wreaking havoc on your knee!

(When I got the surgical reports for both TKRs in June, it showed that I had "end-stage" osteoarthritis in BOTH KNEES so the TKR surgeries really were MY ONLY OPTION! And boy, am I glad I had them done!!)

Let me know what your surgeon says about the results of the MRI and whether he thinks you need a TKR. If so, please don't hesitate to keep posting here and ask ALL THE QUESTIONS you need to in order to prepare yourself for TKR surgery.

As noted above, been there, done that twice and I'm happy to answer your questions on what to expect during the surgery and post surgery rehab.

In the meantime, to alleviate the pain, there are several things you can do to help yourself.

1. Get a sturdy adjustable knee brace and wear it when you have to do a lot of walking. It will help stabilize the knee a lot better in the interim until you have surgery. (Ask your pharmacist for the best one.)

2. Ask the surgeon for a strong painkiller for the meantime until he determines you need a TKR. (If you can take any of the NSAIDS like Aleve, take that if he won't give you a stronger med via prescription.) If he's willing to give you a script, ask for either Tylenol #3/Codeine OR Oxycodone/Acetaminophen at the lowest dose so it doesn't cause you nausea. (If he gives you the Oxy Rx, MAKE SURE YOU EAT AROUND THE SAME TIME YOU TAKE EACH DOSE and that will help your stomach from being upset by it - IT IS STRONG STUFF!)

3. At your pharmacy (again, ask the pharmacist for help), get one of those hot/cold packs and get two of them to cover the entire knee. Put the packs in the freezer as soon as you get home and allow them to get cold for at least a couple of hours before use. The packs come with a cover so you don't get "freezer burn". Put the ice packs in the covers which each have an adjustable belt that you wrap around the knee and hold in place with velcro. Use the ice packs for 20 minutes at a time at least 4 to 5 times a day and keep the leg of the bad knee elevated, both while icing it, and when you sleep or lie on your couch watching TV. That will help bring the swelling and internal inflammation down to a "bearable" level! I would hold off on any intense sports activities for now, or even prescribed Physical Therapy, until your surgeon tells you what the plan of treatment will be - another scope at best or a TKR surgery at worst.

Hope all this helps.

Keep me posted as to what your surgeon decides to do to fix your knee. (If I were you, given what you describe here, I would ask him if he's willing to do the TKR surgery. Sounds like you really DO need it.)

Regards,
Carol

Last edited by ldy12; 07-30-2012 at 08:07 PM. Reason: grammar correction

 
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Old 08-10-2012, 09:17 AM   #10
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Re: Sharp and dull knee pain

Background~
Severe pain in right knee for the past 5 weeks.
Went to my Ortho Dr. who is local in my area.
He said to use crutches for three weeks and stay off the leg.
I had a MRI which states I have Horn Medial Meniscus degeneration/contusion, thickening of the MCL with a mild MCL SPRAIN, and osseous edema.

I've been icing, wrapping, using anti-inflammatory drugs, resting with a wedged pillow... Nothing is helping to relieve the pain.
I'm not happy...

Second appt with Doctor
He was shocked when I told him I can't walk and still in so much pain.
He said the MRI might have missed something.... (Hmmm) and wants me to have a second one done... (not sure if this will be covered under my insurance or what a second mri will tell)

Not sure if I should see my Ortho surgeon who isn't local.... (he did my THP few years back) Just a pain traveling to and from his office.

I just don't know what to do.
I am in soooo much pain... I want to get a wheelchair. Don't want to walk anymore.

 
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Old 08-10-2012, 09:48 AM   #11
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Re: Sharp and dull knee pain

CPCruizer,

If I were you, I would get a second opinion from your other ortho doctor. Surgery usually isn't done for mcl sprains (unless it is a complete tear), but the medial meniscus degeneration may be a more serious issue. I had an mcl sprain and medial meniscus issue at the same time a few years ago. My surgeon treated the mcl sprain conservatively, and he said the medial meniscus issue wasn't anything to worry about at the time (he said it was damaged but not torn (he said it looked like jello)). After six weeks, my knee felt better. A few months later when I was standing from a kneeling position, I felt a sharp pain on the inside part of my knee and it kept giving out on me. When my ortho surgeon examined my knee a few days later, he diagnosed a meniscus tear and sent me for an MRI. The MRI confirmed the diagnosis. Because of the area of the tear, surgery was required within several weeks. It has been 2 years since that surgery, and my knee is holding up well. Since you are unable to walk, I would definitely seek out a second opinion. I hope this helped.

Last edited by ozfan79; 08-10-2012 at 09:51 AM.

 
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Old 08-10-2012, 10:13 PM   #12
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Re: Sharp and dull knee pain

Hi CPCruizer,

Hold on there! You're not ready to just give up and sit in a wheelchair the rest of your life. You really need to go back to the Ortho surgeon who did your hip replacement. Sounds like he knows what he's doing instead of the Ortho guy who is more local for you. I can almost guarantee that if you go back to your THR Ortho surgeon, he will be able to read your latest MRI correctly and recommend either an arthroscopic repair of the medial meniscus OR a total knee replacement.

That's absolute garbage that the local Ortho guy said the MRI "missed" something. My previous Ortho surgeon who did my original right knee arthroscopy in 2005, told me four and a half years later, when I went back to him in June of 2010 (and this was a simple X-RAY) that he did that June, that my knee was stable even though I told him it was hurting like heck! Unhappy with his incompetence, I switched back to my original Orthopedic Surgeon in October of 2010, and after looking at the exact same x-rays the other guy did four months earlier, he looked at me and said, "Carol, you need a total knee replacement ASAP! You have no cartilage left and it's bone on bone!" And just to confirm his diagnosis, he sent me for an MRI and it showed everything that was wrong! Point being - it really does depend on the skill of the surgeon in knowing how to read x-rays and MRIs!

So, don't give up on walking! Just go back to your original surgeon and let him do either the arthroscopic repair or a total knee replacement, whichever he feels is appropriate.

I will warn you though, that if you do need the TKR, be prepared to do everything your surgeon and physical therapist ask of you post surgery, and I promise you will be up and around within 3 months without pain! Been there, done that twice in the last year and I now have two new stable prosthetic knees and am walking normally without pain for the first time in seven years!!!

Let me know what you decide to do and I hope you take my suggestion of going back to your original surgeon!

If you don't want to go to that original ortho surgeon, you should still get a second opinion. I see you live on Long Island. I would call North Shore LIJ Univ. Medical Center and ask them for at least two names of Orthopedic surgeons who specialize in arthritis treatment of the knees and joint replacement surgery. Whomever you end up going to, make sure that surgeon has at least ten years experience with TKR surgery and does at least 200 of them per year! (That's apparently the benchmark of an experienced joint replacement surgeon you can trust, from what I have found out.) Just more advice for you.


Best regards,
Carol

Last edited by ldy12; 08-10-2012 at 10:23 PM. Reason: grammar correction; more advice

 
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Old 08-11-2012, 09:05 AM   #13
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Re: Sharp and dull knee pain

Thank you ozfan79 and Carol
for your replies.

Yesterday, I was in so much pain, I finally broke down and called my Surgeon who did my THP. Bad news is the earliest appt is in late Sept.
He wants me to bring the x-rays and MRI disc. Hope my local Dr won't give me a hard time providing me with them.

Had my THP done in the city at the Hospital for Special Surgery. Best in the world for Orth surgery... My dr performs over 200 a year.

~My local Dr only does 12. Hmmm!

For years I complained about my knees... 4 ortho doctors told me "I was too young to have TKP".... then suddenly I fractured my hip... Thats when they said I could have my knees replaced...
When I went to the Surgeon who preformed my THP he said what quacks are you going to....you definitely need your knee replaced....
Only reason why I kept it off is because after my THP I ended up with blood clots and lymphedema.

But now it's definitely time and will take the risks involved.
The pain is too much.

If I need both done... wonder if they will both at one time... if that would be too much.

 
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Old 08-11-2012, 10:34 PM   #14
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Re: Sharp and dull knee pain

Hi CPCruizer,

Actually, late September is not all that bad to wait. You're lucky he can see you that soon. Most of the really good Ortho surgeons who do TKRs book two months in advance! I know mine does. Now you know you did the right thing by calling your original surgeon at HSS since you note here that he does the recommended 200 minimum per year as opposed to the 12 the local guy does. Hmmm is right! The local guy sounds like a real quack!

As long as you sign a release form at the local Ortho guy's office, he HAS to give you your MRI CD and copies of x-rays and reports. If he refuses, that is grounds to report him to the NY Office of Professional Medical Conduct for impeding proper treatment of your knees by failing to provide your original surgeon with necessary medical information on your case! (The same thing happened to me in 2010. I had gone back to the surgeon who originally did my right knee arthroscopy in 2005, and was back in his office 4 and 1/2 years later in June of 2010 because the knee was getting painful again, and I wanted him to also renew my handicap parking permit. He took x-rays and said my knee was stable so no new permit.) Unhappy with his total incompetence, I switched back to MY original Orthopedic surgeon that October. He looked at the same x-rays from June and said I needed a total knee replacement ASAP as I had no cartilage left and it was bone on bone in the right knee! I went back to the other jerk's office the same day I got my diagnosis and signed a medical records release form with his staff. Which they apparently "conveniently" promptly "lost"!! It took 2 1/2 months and a call from my current surgeon's physician assistant to the other idiot's office to get my records sent over! (I simply signed a release form with my current surgeon for HIM to request my records from the previous Ortho guy.) So, if the local Ortho doctor starts giving you a hard time about handing over the MRI CD, just tell him that if he doesn't give it to you, which you're entitled to have, that you will report him to OPMC! I guarantee you that you'll see how fast he hands it over!

As for having both knees done in the same hospital admission (they usually do each three days apart), it depends on how bad both knees are for one thing. If one knee is way worse than the other (meaning it's bone on bone with NO cartilage left), but the other knee still has a little bit of cartilage, I would have only the really bad one done first, rehab that for at least 3 months or more. Try to wait a minimum of six months between the two. If the other knee is not as painful and still has some cartilage left, ask the surgeon if he can delay the second TKR by giving you cortisone shots in the "good" knee in the interim. It may give you the six months respite between surgeries that, ideally, you should have.

When I had my right knee done on 4/5/11, my surgeon also had to scope my left knee during the same surgery because I had developed a compensating meniscal tear AND torn ACL (anterior cruciate ligament), and it took about four months to rehab because I literally didn't have a stable leg to stand on! That's why I didn't want him to do both replacements during the same admission. Plus, the left knee was not that bad just yet, so the scope bought me an extra year. (just about). This past December, though, the left knee started to really hurt again and was buckling on me with some regularity. So I went back to my surgeon, he took x-rays and said that it was time to do the left knee this past spring. Apparently the osteoarthritis in the left knee progressed a LOT faster than both my surgeon and I anticipated it would, and by the time he got me on the O.R. table and opened the left knee to do the TKR, he found it was a lot worse than he expected to find! The good news though, was, that he said he felt I would recover much faster this time because I already had the stable right TKR to work with that was completely healed by the time I went in for the left one in March. He was right. I was almost totally healed within about a month after surgery!

So, ask your HSS surgeon if you can afford to wait between replacements and let him do the one that is in worse shape first. That way, you'll have an easier rehab the second time around, like I did.

Let me know what the ultimate game plan is for doing your TKRs. And if you have any questions on what to expect post surgery, feel free to ask away. Obviously, I've been there, done that, twice, and am very happy my surgeon was willing to do the surgeries on MY schedule, not his. But then, I have the most kindhearted Ortho surgeon and I feel he is the nicest surgeon I've had in my entire life! (And I've had quite a few surgeries for other issues over the past 23 years! My other surgeons for those problems were okay as far as bedside manner, except, of course, my previous Ortho surgeon who had NO bedside manner at all). But my current Ortho surgeon has really been there for me every step of the way, with compassion and encouragement, and I continue to have an excellent rapport with him to this day. (Which is great because I've developed bad osteoarthritis in both shoulders and may eventually need an arthroscopy in the left one within the next two years (or possible shoulder replacement.)

Keep me posted.

Best regards,
Carol

Last edited by ldy12; 08-11-2012 at 10:43 PM. Reason: more advice

 
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