knee arthroscopy- 3 months later

[hb911]

I had arthroscopic surgery on my left knee almost 3 months ago. The medial and lateral meniscus were repaired along with scraping under patella for some arthritis.The medial was much more damaged than the lateral. Surgery seemed to go well. No pain at all. After some weeks with therapy the knee still feels unstable laterally. Front to back movement was very good, Pain developed on medial side of knee and the patella tendon when walking.  When I move the knee or walk I can feel it 'clicking" and 'shooting" pain from the patella tendon The Doctor says that there is still some swelling in  the knee. He has recommended synvisc treatments without ordering a new MRI.

Will the synvisc reduce the pain and swelling? Is synvisc a curative or a temporary relief of symtoms? Are  there any draw backs to synvisc?

Howard

[abhijeet v ghosh]

hello howard,
generally arthroscopic treatment are very popular now a days due to less post operative morbidity.But due to the learning curve , some problems may arise. In your case it seems like your ligaments have been not repaired properly (as your lateral side is still having instability). Also you have mentioned about shooting pain/clicking pain, which shows some loose body (cartilagenous, as in x-ray it's not seen) in your knee.
I need few more informations from you.
1) What was the initial episode of injury to your knee.
2) can you tell  me your previous MRI report as well as arthroscopic findings.
I can definitely help you on in this case.
hope i am clear to you,
take care,
abhijeet

[abhijeet v ghosh]

hi again Howard,
i forgot to mention the second part (regarding synvisc)
Synvisc is Hylan G-F20. It is a type of lubrication for the knee joint which is given when the natural lubrication of the joint has dried up (when patient has Osteoarthritis) . There is no harm in taking up this treatment but , what i feel , is that more this treatment, the doctor has to address the instability problem. MRI will definitely help you.
any query, you are free to ask me,
thanks
abhijeet

[hb911]

The injury to my knee occurred without much fanfare. I was walking up a flight of stairs, without any strain or weight on it, and the left knee just collapsed. There was tearing sound and some pain. The MRI showed that the medial meniscus was more seriously injured than the lateral. It also showed some arthritis under the knee cap. The surgery included a scraping and shaping under the knee cap. After surgery there was still sensitivity on the medial side of knee. Surgeon said it was because of the way the knee was held open during surgery and it would fade. It did for a time and now it is back. If I move my left leg from left to right and have some resistance against the foot there will be a sharp pain in the medial meniscus.

[abhijeet v ghosh]

hi hb911,
thanks for showing interest in my reply. You should go for a new MRI as if there is some cartilage loose piece in your knee, it will be easily picked up in that investigation. X-Ray will not reveal that part. And hence we will be able to prevent the further damage to the knee. Your instability can be due to -
1) Cruciate ligament weakness or tear.
2) Colateral ligament injury OR
3) Quadriceps weakness due to poor rehabilitation following the index surgery.

So tell me when are you doing th new MRI and tell me about the report also.
regards
abhijeet

[erijon]

I know what you're going through, I am 30 days out from a similar surgery in addition to a microfrature surgery, all to my left knee. I have severe OA in both knees, but we wanted to treat the meniscus tears in my left knee before we started on the right which has the worse OA. I have been taking synvisc in the right knee, and it is not a cure, at best it will make you more comfortable and buy you some time before you need a replacement procedure. That's my goal, get another few years as knee replacement is recommended at around 55 years of age.

I don't know that another MRI is necessary as I'm sure your Orthopedic took a close look at your ligaments, I know mine did. He checked the integrity of the ligaments and made sure they were not in need of repair. I also have instability in my left knee but my Ortho says it is due to the deterioration of the joint due to OA and it is affecting my gait. Give the synvisc a try, its pretty good stuff from my point of view!

Good luck.

Jon

[Allyson1]

I had surgery 10/5/14 to medial meniscus and patella scraped it shows my patella is at 3 range and was told that if it reaches 4 I may need full knee replacement.  The doctor said my MRI after my fall showed nothing.  Yet the pictures of my surgery showed a lot of loose frayed cartilage and fraying meniscus that was removed. I went back to work at two mouths post op and my knee is killing me. it pops, grinds, and sharp pains, and aching still have swelling. i walk and or stand 7 hours of my 8 hour day.  Could I be making my knee worse? I am 57 years old