Torn Meniscus

[jenkermpad]

I had arthroscopic surgery on my knee for a miniscus tear January 9th.  Pieces of the miniscus were removed and the ends of the big bones smoothed.  I had expected to be better by week three.  It is now week 8 and I have pain and swelling for the entire time since surgery.
A week ago the doctor drew aprox. 20cc of fluid off of the knee and sent it to a lab, it was clean, no bugs and no indications of gout.
The knee is not as swollen, but it is still swollen and some pain.  I had another MRI last Thursday; the doctor read it during an appt. Monday.  He said it showed a small fracture in the subcondrieal (sp?) and changes in the bone marrow in the ends of the large bones.  He said it appeared the marrow was not getting sufficient blood supply.  (Swelling contributed to that?).  He put me on crutches for the next two weeks said to stay off that leg and made an appointment two weeks out.  My question is if the bone marrow is changing due to lack of blood supply it seem insufficient to not review it for two weeks.  Is my concern valid?  Suggestions?

[jenkermpad]

I fear you may be correct.    The more I read about it the more it seems to fit.  I am going for a second opinion today.  Unfortunately I was told yesterday that the Medical Records will not be ready until tomorrow afternoon.  So I don;t know may have to go just  to reschedule.

Thank you.  My doctor may be thinking  of spontaneous osteonecrosis of the knee but he does such a poor job of communication with the patient you fee like he is just setting appointment after appointment hopping it gets better.  Which I gather is a valid treatment of osteonecrosis.  But he  needs to communicate more.   He may not be thinking anything and is just hoping things will get better.

Sorry venting.   Thank you for your response   It may be correct or not but it is very useful information.

Thank you.

Jennie

[Michael L Gross, MD]

It sounds like your surgeon is describing osteonecrosis.  There is an entity known as "spontaneous onsteonecrosis of the knee." or "SPONK" This occurs rarely after knee after knee arthroscopy and can resolve after a period of rest and non-weight bearing.  I t is not usually a reult of swelling.  If anything, two weeks may be to soon to expect any change, either positive or negative, and often 6 weeks is used before re-evaluation.