Pain and swelling and clicking in right knee for more than a year. PT no help. In Feb 2012, twisted bad knee and tore menicus through and through.
Mother of three children: age 47 / 5-11/ 193 lbs/ active/ healthy overall
MRI 1 March 2012 -- Horizontal tear of the posterior horn and mid zone of the medial meniscus, which extends to the inferior articular sufrace and free edge;
slight thickening of the medial collateral ligament with minimal periligamentous edema, compatible with mild sprain;
large joint effusion;
1.5 mm area of articular cartilage loss involving apex and medial facet of the patella.
Minimal subcond marrow edema and small (6mm) scleritic foci within medial and lateral femoral condyles. Spiring of the tibial spine.
Chiro and radiology tell me my knee is bad. Dr.'s PA says my knee is "shot." Dr. never reviewed MRI. Examines me and says, "I don't need to see the MRI. I can tell you have a torn meniscus." I ask before surgery if they will have a good look around. I am told they will.
March 23, 2012 Dr. fixes meniscal tear. No post op call. Surgery pics are reviewed with patient in first follow up. PA says arthritus and tear. Never mentions any additional problems.
Post op pain and swelling continue to get worse. Repeated visits to the doctor. Told things take time. Knee has to be drained (bloody fluid) twice. Dr. does 2 cort shots. No relief. Dr says he has no idea what the problem is. Says he is stumped. Tells patient to wait 2 more weeks (putting us at 9 weeks post op). Patient requests another MRI.
MRI #2 with contrast 5/14/12
Results: The medial meniscus is moderately diminitive in size through the midzone and to a lesser externt the posteriorly consistent with propr partial meniscal resection. There are horizontal signal alterations within the midzone extending from the truncated free edge which do not significantly enhance. These finding are therefore unlikely to represent meniscal tearing by MRI artho criteria and they are more likely to represent fibrovascular granulation tissue
There is partial thickness condral loss affecting the medial and to a lessor extent the lateral compartments of the knee. The lateral meniscus is in tack.
The fibular collateral and medial colleral ligaments are in tact. The quadriceps and patellar tendons are intact. There are moderate to advanced chondromalacic changes along the medial patellar ridge.
Dr. reviews MRI and says still no ideas what is causing pain and swelling and thinks problem could be ghost pain from my back.
5/16/12 sends me for MRI of the spine. The back shows a couple of bulges, but I have not had any problems with my back. Chiro who has worked on patient off and on through pregnancy and one elbow surgery says the problem is not my back. It's my knee.
Question: Is it possible that in his rush to fix the meniscus (obvious), the doctor missed the underlying degeneration issues. I have three young children (ages 4, 9 and 11) and a busy life. I just finished graduate school and started teaching college part time. I am scheduled to teach in August. However, the set backs post op have put my life on hold. I can barely walk or drive. Our family life is really in a tailspin. I have already met my $5,000 deductible with the first sugery and other medical expenses. So if I am going to have to have the knee replaced in a year or so, I would rather do it now and be upright to see my kids off to college. I have had several doctors tell me the knee will have to be replaced because of the cartilage loss and arthritis. So why is the surgeon who repaired the tear, who has done thousands of knee replacements, saying he does not know what is wrong? Getting so many mixed signals that I just don't know what to do.
Can someone give me some insight into what the MRI findings show? I would rather get the knee replaced and get back to life than keep suffering like this. Please help. Supposed to see doctor on Tuesday. But I am afraid and feel that something is off. ***@****
Well, the primary issue in the situation seems the meniscal injury with associated ACL sprain and patellar cartilage damage. Meniscal injuries/ tears do not heal and surgery largely involves resection of the damaged part. The injury/ surgery may be followed by inflammation and scar formation which could prolong symptoms/ healing. This can also be compounded by inadequate post operative management/ inadequate physiotherapy. I am not sure if a knee replacement would be a good idea at this time. I would suggest considering a second opinion from another orthopedician, preferably at a university/ teaching hospital to get a fair idea of the current situation, the expected prognosis and the appropriate management plan.
Hope this is helpful.
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