Any Advise For Knee Treatments?????

lthomas

I had a scope in 1998 and again 2004. When I had mircofracture surgery in 2006 it was aborted because I didn't have enough cartilage for it to be successful. I would say the scope delayed TKA for about 8 years. I highly recommend scopes if you OS thinks it is appropriate. For me it was out-patient surgery on Friday and back to work on Monday. And it gave me total pain relief. I was able to return to normal activity almost immediately. I do know that there are lots of people that have not had successful arthoroscopy, but not me.

I am now having hip problems and I have an appointment with an OS that specializes in hip arthroscopy. I know that the knee arthroscopies have been so successful that I am not worried about the hip replacement I will need in the future. I know that I will need TKA on the other knee and a total hip replacement in the future but arthoscopy will be my choice until they say "You've have enough!" Oh. by the way..all of this began in 1968 with a sports injury.

__________________
L.Knee: Arthroscopy: '98, '04, '06; ACLrecon: '02; TKA:'06
R.Knee: Arthroscopy: '06; TKA indicated
R Hip: Arthroscopy '08;

Gymnastics is fun at 18 but not at 40.

debbie363636

Thomas. Thanks for the reply. I really haven't talked to the OS much since I only had one appt. with him. He said it was something to consider when as you said "I have had enough" I didn't realize the recovery was so quick. I thought I might be laid up for a while. That makes my decision much easier. My problem probably stems from years of abuse, running, aerobics, etc. My pain is like a knife jabbing in my knees and a alot of crunching noises from them. Does that sound familiar? I had put my knees on the back burner untill after my spinal fusion which was a way bigger deal. I am 51 years old and as my mother-in-law says "Getting old isn't for sissys". Thanks again for the info..............Debbie

lthomas

Yes. That is the way it starts. I had the depridements when I started waking up at night with pain. I learned that keeping my self occupied during the day kept me from feeling the pain.

It is totally a matter of quality of life. I really haven't heard any bad outcomes from this surgery but I would sure check with your OS. It may make a difference in recovery or return to your quality of life if you wait too long. Don't really want any surprises. If my OS gave me the go ahead I would do it the next day because mine have been so successful.

After the first I didn't worry about trying to be the "tough gal" and stick it out to the bitter end. I did that with TKA too. I toughed it out to the bitter end and the OS told me I had exhausted all my options. I could keep getting cortisone injections every 3-4 months and call when I was ready to schedule the TKA. I will take his advice with my next knee. I won't wait 2 years after he has given the OK on the other knee.

If you wait you will probably have that lightbulb moment when you say "this is it".

I had my first debridement when I was 48. I had TKA when I was 56.

__________________
L.Knee: Arthroscopy: '98, '04, '06; ACLrecon: '02; TKA:'06
R.Knee: Arthroscopy: '06; TKA indicated
R Hip: Arthroscopy '08;

Gymnastics is fun at 18 but not at 40.

debbie363636

lthomas, This is new to me and may be a dumb question but what is a debridement? TKA I am assuming is a total knee replacement. Thanks......Debbie

janewhite1

Debridement is a general term for a cleaning-out surgery. Basically, they remove anything that shouldn't be there, neaten up anything that's torn and jagged, etc.

kyma3

I am wondering the same thing. I see a rheumatologist and he told me last year that both my knees have the cartilage GONE. He had me on Methotrexate for a few months but I had a bad reaction and I was also due to have back surgery so he took me off of it. When I went to see him the first of May he acts like he doesn't want to put me back on anything else. He did take some more x-rays and said yes the cartilage is gone but he didn't want to put me on anything at this time???? I finally had to call his nurse and I told her I had to have something because the pain is so bad so he prescribed Mobic. I went to see my GP today because the rheumatologist is on vacation and asked her if she would do a MRI or CT scan because something has to be wrong because the pain is terrible especially in the left knee. She is going to get my reports from the rheumatologist and make sure they can do an MRI on me because of the hardware used in my back surgery but she said something definitely needs to be done. I have had really bad swelling in my legs and feet and she said Mobic probably causing that and also my blood pressure has been up. I take Percocet for my back pain and it doesn't touch the pain I have in my knee. I can't bend my knee and it feels like someone is stabbing me with a knife right into my knee cap. The knee is swollen on the inside of the knee cap. I am having a hard time sleeping also because if I have the leg straight out it just throbs against the mattress. I was told 3 years ago that I had a small tear in the meniscus. If the tear has gotten worse would it cause this kind of pain? Can everyone please explain to me how their pain feels?

Thanks for any information you can give me.

Linda

debbie363636

Kyma, Your case sounds a lot more serious than mine. I do not have any pain at all when I am not active. My pain is mainly when I squat and when I go up and down steps. It is knifelike with a lot of crunching in both knees. I use an elliptical machine daily and it seems to help them. I guess I am building muscle which must take the stress off of them. I need to loose some of the extra weight that I put on prior to and after my back surgery in January due to inactivity. That will probably help. I haven't had an MRI on them for a few years but am assuming it is still arthritis, bonespurs and cysts. I would say you definitely need an MRI to be sure of whats going on. What type of back surgery did you have and when? I think I recognize your name from the back board. I haven't been on it for a while.......Debbie

PS I noticed you are up very late I hope you get some pain relief soon.

lthomas

No question is a dumb question. There are so many terms when it comes to knees I don't think anyone can keep up with them. CT will show bone and blood. A MIR shows soft tissue.

Minescus has blood but the catilage doesn't. Meniscus reapir can be painful but removing floating cartilage isn't. My meniscus removed/wore away years ago. You can go for painfree for years without a minescus. Many times a torn meniscus cannot be repaired so they just remove it entirely. This will cause the joint to wear more quickly. The debridements last a long time for some people. They even think they can keep some poeple from needing a knee replacement. Mine last about 3 years and then I need it again.

I evidently have a high pain threshold. My OS told me anytime I said it hurts he knew it was bad. During the second surgery he just shook his head in srugery and said, "Geesh this is bad."

I asked," Why do you always say that, Is there a reason?"
Then he told me that he had people in all the time moaning and limping around and he does everything and can't find anything wrong. "Then", he said, "You come in walking a little slow, never ask for pain med and say that you knee hurts...Yes it always is worse than I expect!"


I don't know what you OS does but you can tell within 3 minutes if it is a joint problem. All you have to do is let the OS do an injection of marcaine (like novacaine) in the joint. If the pain goes away within 10minutes it is the joint.

Cortisone injections might help but you can only have one every 3 months. When I have one it is great for about a month. But if you are in pain even a month feels good.

Ice is my best friend

Strengthen you quad muscles. You can find tons of exercises that will help you. They are the most important muscles to develop when recovering from knee surgeries.

I have a cryotherapy unit that is fantastic. My insurance covered the cost. It is sort of like a heating pad but it is for ice. It is a little ice cooler that has a pump inside which is attached to a hose. The hose is attached to a pad that fills with ice cold water form the cooler and circualtes through the pad.


I wouldn't do without it. I know some people like heat but that never helped me.

__________________
L.Knee: Arthroscopy: '98, '04, '06; ACLrecon: '02; TKA:'06
R.Knee: Arthroscopy: '06; TKA indicated
R Hip: Arthroscopy '08;

Gymnastics is fun at 18 but not at 40.

kyma3

Hey Debbie I had the first part of my back surgery a 360 fusion on 1/29/08 where they went through the abdomen and put in the spacer. I got an infection so there was a 3 week delay on finishing it with going through the back L5/S1 to put in the rods and screws which was done on March 5th. I am still having a lot of weakness when I try and get up and do much walking. Now with my knees hurting and being swollen it is really making walking hard to do. I was in tears last night with the sharp pain in my knee cap that I almost got my husband up and take me to the ER but I feel like such a wimp when I do that. I think I am going to have to get my walker back out because the cane isn't working well anymore.

I did talk to my pharmacist today and she said that the Mobic that I was put on is probably causing the swelling in my legs and feet. I was hoping to hear something from my doctor's office today in regards to an appt. for my MRI but nothing so far.

I have an recumbent bike but it hurts my knees too bad so I can't use that for my exercise. I talked to my GP yesterday about my weight and she said it is not the time to worry about that because it will hurt my knees and back more at this time if I try and exercise.

Thanks to all for your responses and I hope everyone can have a good pain free weekend.

Yes Debbie I have a terrible time getting to sleep and the pain wakes me up all night long.

Linda

lthomas

Swimming, recmbant biking, and walking on an eliptical are the most low impact exercising you can do. Straight leg lifts will strengthen your quad muscles. If you think you may need knee surgery I highly suggest you start doing straight legs immediately. They will help take some of the pressure off your knees now but more importantly they will speed your recovery after knee surgery.

__________________
L.Knee: Arthroscopy: '98, '04, '06; ACLrecon: '02; TKA:'06
R.Knee: Arthroscopy: '06; TKA indicated
R Hip: Arthroscopy '08;

Gymnastics is fun at 18 but not at 40.

debbie363636

Linda, Bless your heart, I see you were up again last night. You are getting a double whammy right know with your back and kneees. Does it help to ice your knees? My fusion of L5-S1 was on January 15th this year. He was able to do it all through my abdomen. I would say my turning point where I really started to feel normal again was at 4 months. I feel great now. Don't panic about your back yet because you have to start over with your second surgery date. Are you taking pain meds at night? You really need to get that under control so you can get some sleep. It will be hard to recover if your exhausted all the time. I hope you get the relief you so desperately need.

lthomas, I have been using my elliptical about 4 times a week and doing about 2 miles on it. It has the least amount of impact on my knees and back. I have also been doing the leg lifts. I am hoping to delay debridement for a little while longer.

Hope you two have a great day and Linda try to get some sleep.........Debbie

lthomas

Well I just got my MIR and CT reports to take to the OS that specializes in hip arthroscopy. I know nothing about the terms but I know where it hurts. One finding said I had partial facet joint arthropathy at L4-5 and L5-S1. I saw on you post something that sounds like you may know something about what this might be. I go back to my TKA OS the last part of this month but I am suppose to be scheduled with the hip arthr. OS before then.

The hip OS is the OS that the Nashville Ballet and the Tennessee Titians use for soft tissue and arthroscopy, so I am pretty sure he is up to speed. He has written a number of books, some of which are used as medical text books. He also developed the coding system that the insurance companies use for hip arthroscopy addition to developing instruments used in hip arthroscopy.

The report list a bunch of things so I don't think my pain is in my head. It also recommends that I be "followed with clinical correlation"..so maybe it Isn't all in my head.

__________________
L.Knee: Arthroscopy: '98, '04, '06; ACLrecon: '02; TKA:'06
R.Knee: Arthroscopy: '06; TKA indicated
R Hip: Arthroscopy '08;

Gymnastics is fun at 18 but not at 40.

debbie363636

lthomas, I didn't realize that you were having back problems also. My disc at L5-S1 had completely degenerated away and I was bone on bone. I had a microdicectomy two years prior to my fusion to clean it up when it was bulging and that work for a while. I do know that prior to my fusion I had a lot of hip pain that was generated from my back. Since the fusion it is gone. Maybe yours is related to your back somewhat. You need to log in on the back board. There is a lot of good info there along with alot of knowledge from veterans with back problems. Well I am off to the eliptical to try to delay the inevetable....................Debbie

lthomas

Me neither. The MRI and CT show multiple problems. It reads like most of it is related to getting old (old Arthur creeping in everywhere)

Thanks
I didn't even think of the back board (I guess I was thinking basketball)

__________________
L.Knee: Arthroscopy: '98, '04, '06; ACLrecon: '02; TKA:'06
R.Knee: Arthroscopy: '06; TKA indicated
R Hip: Arthroscopy '08;

Gymnastics is fun at 18 but not at 40.