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Kevsgreat 05-06-2009 12:40 PM

Knee problems, can you shed any light?
Sorry if this goes on a bit, please bear with me!

Around three or four years ago I suffered a dislocated kneecap while playing football. It came out then went back in as I hit the floor. I saw someone at the hospital straight after but after the swelling went down I didn't follow it up.

My knee would hurt after exercise, but a few weeks rest would keep me going for up to four months before I needed another two weeks rest. I carried on like this until last year when I tweaked something lying in bed. I went to my GP and was referred to the specialst, who diagnosed Patellar Tendonitis and referred me to physiotherapy.

The physiotherapist then diagnosed Patellar Subluxation and I went through a few months of exercises to build up the supporting muscles around my knee. I injured the knee again during this time (playing football) and after building up the knee enough to limit the patellar subluxation I was still feeling pain. I had an xray on the knee which showed nothing and was referred back to the specialist after the physio said it was most likely to be cartilage damage.

The specialist sent me for a MRI scan, I went back to see him again today (thanks to the NHS this whole process has only taken 14 months!) and he said the MRI didn't show any serious damage to the cartilage, but the way I described my knee giving way as I change direction could indicate some damage to the ACL. I've been booked in for a knee arthroscopy so he can have a look around.

My concern is that he was completely uncommital to finding anything, and even said if he didn't find anything I had to accept that. I know for a fact there is something wrong in there, otherwise my mobilty wouldn't be limited, I wouldn't be in pain when I walk, I wouldn't have been referred there in the first place and the physio wouldn't have sent me back.

Does anyone here have any experience of an arthroscopy finding something a MRI scan didn't pick up? The last thing I want to do is make it worse by having a camera go in there when it might not pick anything up.

jennybyc 05-06-2009 01:10 PM

Re: Knee problems, can you shed any light?
Scoping your knee will at least enable the ortho to wash out the inside of your knee and get out any tidbits of cartilage that are floating around and that alone should make you more comfortable. And yes, MRI's aren't infallible. ACL's can tear horizontally and vertically and the vertical tears might not show. And hidden tears in the meniscus can evade an MRI too. They aren't magic!

Your doc must think something is wrong in there or he wouldn't be doing a scope. He just doesn't want to say what as he doesn't know and a lot of docs have trouble saying "I don't know what's wrong".

But before the new joint fluids became available, washing a joint via scoping was a standard treatment for symptoms like yours. You get to take a good look and clean it out. Originally scoping was only used to diagnose(had my first scope in 1974 when that's all they did). But at least if he does find anything, he can hopefully fix it while in there.

I'd say it's a good move.

good luck.............Jenny(8 scopes, 14 total knee surgeries and 2 far)

Kevsgreat 05-20-2009 03:01 AM

Re: Knee problems, can you shed any light?
Thanks Jenny,

A bit of an update, since then I was talking to someone about it and he said he had the same problem, went for the scope that found nothing and was in pain for months afterwards.

It turned out he had waited so long from the initial injury to having a scan and being treated that it had healed and the pain and instability he was getting came from muscle degeneration in the injured knee.

The last time I injured my knee was eight months ago, and it's been painful ever since. I have been keeping weight off it, and my injured leg has visibly less muscle mass than the other leg. It got me thinking that the pain I was feeling was a reoccurance of the original patellar subluxation. I dug out the resistance bands the physio had given me last year and after a week or so of exercise it does feel a lot stronger. Before I couldn't sit with my knee bent to 90 degress and straighten it out, now I can.

To complicate things I got a date for arthroscopy surgery, the end of next month. If I keep up these exercises and still feel an improvement do I still have the surgery to check over this longstanding problem? Or do I pull out? If I mentioned it to the surgeon would he just pull the plug on the whole thing?

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