DR. Vinod, Thank you again for the answer to my ACL questions you answerd on Sept. 8th, and 9th, or about there. I have a couple of other questions and will try to shorten things. Once again I am a 56 year old woman who hurt my left knee sometime over or within the last year. I was recovering from a joint salvage of Right foot which failed, ( Hallux Varus returned) then after a MI incident, had more surgery, Foot Fusion 10 months later same foot.
Because of all this plus a long standing back injury ( since 1999) I compensated for pain on this foot ( right side back and foot) and put more weight on left foot. This is when my knee became injured. Here is my question.
The MRI shows I have bone contusions that are healing, bone marrow signal increase in medial femoral condyle and medial tibial plateau, , globular signal in posterior horn of medial meniscus, articular cartilage thinning along medial patellar facet , and some suprapatellar bursal fluid.The finding indicated that I likely had a tear from femoral attachment and anterior cruciate ligament tear that has re-adhered. I have constant pain, and can not move knee certain directions are impossible. I never even iced my knee and it is still swollen.
My regular dr. saw me last week and said based on my MRI report I definitly have some abnormalities and will see an orthopedic dr. and likely get arthoscopic evaluation. You told me previously you thouoght I needed ligament repair. My question is this:
I dont know if my tear is complete or partial, but because it says. " has re-adhered" does that mean the ACL has repaired itself back on to the femoral condyle, or something else?Also the MRI stated that," The Proximal femoral attachment is not well seen." does that mean it may be still damaged and they are just guessing what it looks like?Also what determines STRICT MRI CRITERIA FOR A TEAR". I know these are a lot of questions, I just would like to know if I am going to benifit from seeing the Orthopedic dr. or if my MRI says I have no injury, things are repaired, even though my dr. sent a referral and you said you thought I need a ligament repair. CAn you explain a little more to me please. ? I won't ask any further questions after this, I will wait for my appt to see the Orthopedic Dr. I really do appreciate your time and energy spent answering these questions for me.THANK YOU VERY MUCH!! fluffypurrcat
MRI is read in signal sequences.
There are T1, T2 signal sequences which show that the healing is taking place and fatty deposition has taken place. This is a good sequence for healing.
There is STIR sequence which is Short tau inversion recovery. Active bone oedema present. There is another PD sequence which is for proton density for knowing cartilage
Please ask your radiologist what sequence it is and the radiologist or your orthopedician can interpret it very clearly.
If required you would need a ligament repair as the tear is an old one.
Thank you dr. for the information. I don't understand a lot of it, but some has given me a little more information. I know the MRI says Decreased T1 signal, and says, " suggests healing bone contusions." So I would think on what you stated this is the first step, before T, Correct?There are no T2 signals listed.
I did get a call from the Orthopedic DR.s office and they got my referral. I am now waiting while someone in the office goes over my MRI to see if they can help me or not. I do have one other question.
If the Orthopedic DR.s office feels they can't help me. What would my next step be in relation to the pain I am having? It hurts to bend my knee outward, and I can't sit with my knee in a certain position which I used to do with no trouble.Would physical therapy be of any value, or will my knee just be not the way it was before this uinury?
Thank you again for your time and all your advice I is much appreciated.
good morning Fluffy, i've had an ACL repair of my right knee oh about 8 years ago and it was not healing on its own, i did have a little less pain but my knee was not stable and required the use a "quality knee support" which a script was written by the doctor and the insurance paid for it. i used it for almost anything i did after the ACL surgery only because i was afraid of injurying it again. and your right, the doc. that replied to your comment is enough to make anyone confused. he's not a knee doctor and he's located in india. when i had my ACL surgery, a machine was brought over to my house that automatically bent my knee for about a week. the purpose of it was to keep scar tissue from building up and getting good range of motion quickly. i do have to say if you get the ACL surgery don't go light on the therapy because scar tissue build up can be more painful the that the origional injury was. just ask the doctor. OH and DON'T let the doctor use a PAIN PUMP on your knee after the surgery, do your research. Take Care Phill
Hi, thanks for the response. I have sent you a private mesage so mayby we can talk that way in more detail and you can tell me a little more about your surgery, etc. I finally get to see the Orthopedic Dr. tommorow, Wed, so mayby then I will get some good news, which in my case is hopefully some answers to why my knee has been hurting so long. I was told by the receptionist that the dr. would offer me some " options" so I am not sure what they may be.
I do know unless they thought they could help me, they would not have even given me an appt. It requires a referral to be able to see them, and they also looked at my MRI report and also I would assume the actuall MRI itself.I am more afraid of nothing happening, as opposed to surgery,etc. The main thing is getting an answer. AFter over a year of pain, it is a relief to know that this was not all in my head. Thanks for the reply. Any last minute advice as to what to ask the dr. tommorow?
Hi. I injured my knee about 5-6 weeks ago. I have been waiting to get in from my ORTHO consult -- so much for speed. I've been NICE and the pain has gotten less, but I still have it and crunching pain when I rise from sitting too long or walking too far (not sure how far that is, but for a short distance). My ORTHO is in about 12 days. Part of me says cancel this appt cause they are going to tell me it's on the mend and of course there will always be some pain as you get older, but should I cancel the appt or not? Can a possible ACL injury heal itself and I won't or shouldn't have to go in for the ORTHO appt?
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