Any thoughts? Going over 13 months now

Hi Peppe,

I replied but not directly so I want to ask what point in my post would have you believe in it being a meniscus issue? Could I have all these other problems as well with just a meniscus? My Mom just had surgery for it and did not have all the other pains and imbalances. Just curious since I am making my next ortho appt soon. Thanks

I should ask, are there any surefire ways to rule out a medial tear, or rule a tear "in?" 

These descriptions got me thinking of that:

"I cannot entend my leg fully when weight bearing.

I have a little weakness still in quads.

Pain normally sharp, esp after getting out of longer car ride

I limp most of the time, and cannot run"

These sound like my inlaw who was diagnosed with meniscus tear. It does not mean yours is torn, I could be sprained or something is pushing on it to cause you pain. I don't know if you tried any meds, but you should and minimize the workouts.

What makes me not totally certain is that your issue occurred after kneeling on tiles, but if you already had an injury that may have been the trigger.

Then again, knee is very delicate in a sense that it is held by tension of springs so any slight dislocation can trigger pain... But then you went to a chiropractor and nothing.

Just explaining my thought process here.

Very respectable thoughts there. Just to add:

I believe there may have been a few times after extended foam rolling that I could bend my knee back but not 100% sure- as if everything released and alignment was great. Next time I feel "better" I will try the weight bearing test.

Quad weakness is tough- I had to do leg extensions with weight- 10 lbs killed me at first but it was that or terminal pain. I got up to 80 lbs. with that one leg isolated (now it varies), and I am doing machine hack squats to target the inner quad. That has helped more than anything. All other exercises would absolutely not hit my inner quads, even though the left side would have no problem with getting hit. I think my alignment has/had a lot to do with that.

With the injury, my knee was 100% perfect, never a trouble or any soreness ever, sadly. My strength was excellent as well. The bottom of the patella hurt sharply a few times resetting the uneven tile (think prying up a stuck tile and pressuring the knee), and general pressure (besides the isolated tile strike that all the professionals I see dismiss.)

After that, it was a burning pain until the cracking 1 1/2 weeks later and I had to walk on the outside of my foot (not a good idea in hindsight) to avoid the cracking. Muscles must have wasted from pain?

My hip mobility is said to be fine too as a side note (is isolation anyway).

Thanks for the reply. I've done the rice thing many times and rubbed everything I could into it. Wouldn't x-ray or mri show bone damage? Wouldn't cartilage show damage if bone was damaged? I will keep everyone posted. Can muscular problems cause this much pain and debilitation? It is better than what it was but then there are so many down moments everyday. Everything just feels off. After I quit the PT route I have been at the gym for 4 months now. Thanks

hi O.F.G

 I saw you'd  mentioned Tiger Balm is that ok to rub on the leg after TKR? 5 months and 2 weeks post OP and I'm still having awful pain after ...activity such as doing shopping etc....

laid  here in awful pain at the moment and I know I have some Tiger Balm somewhere.

i could quite literally chop the leg off at the moment it's driving me mad,

Jean 

Sorry to hear that Jean, I know how you feel. Did your doctor say why you are having pain, or did you get proper rehab? Do your muscles feel strong and aligned? Sometimes if the mechanism of injury or wearing away is not addressed the pain could still happen, at least from my research. My Mom is at least three months removed from meniscus surgery and still has the sharp pain come and go.

I see my Surgeon on 25th this month ...he promised the last time I saw him Dec 31 St he would investigate further if my knee was still painful.

if I walk around ...just normal shopping etc... Then the knee swells and bruises in one particular spot .... I'm still having to ice etc... Even after all this time 

I ice as well sometimes but that does nothing for me, beside numb it maybe. I would expect to see progress in your case. Is the pain in the same area as before the TKR? I would not like the bruising myself.

I know of some people that got better weeks if not sooner after a TKR but many take up to a year as well, but you should make monthly progress.

I would stay away from the scar but any of the soft tissue should be o.k.Don't wrap or put heat on it. Vitimin e oil on the scar rubbed in real good. Bit E softens and heals the scar

I semi passed out 90 days ago and landed on both knees and my forehead (low blood pressure due to kidney caused the fall) didn't seem to hurt the knee at the time but 3 weeks later the tkr knee started to hurt and the pain escalated forcing me back to therapy. My ortho said that there is an area behind the kneecap that doesn't show in xrays and damage can only be determined by bone scan. I still have fluid on the knee and may have to have it drained with a needle. There are so many things with a joint that you can't over look anything. I have PVNS, a tumor that sat dormant for years and suddenly broke loose and started bleeding. That was in sept. 2002. I am now 9 surgeries, 30 rounds of radiation since and still have traces of the tumor that can't be removed. There are two types of PVNS and the type I have can only be detected by biopsy, so I've been told. I tell you this only to emphasize some the strange things that need looking into. Like PVNS, many of these things aren't known to many docs. I would continue to look for a doc that will search for answers. If you have a university medical school or teaching hospital close by, you might try there.

Interesting idea with the University Hospitals...I will look into that. I would have thought the MRI would detect bone but I will ask if there are any scans such as a bone scan that might help.

I should ask is having a weak or weak-firing VMO possibly cause the malignment and the pain? If I passively flex my leg, my vmo does not fire like my medial/outside quad. My hamstrings also contract when I try to contract my vmo. On my good side, my vmo fires first, or inline with my other quad muscles, and my hamstrings are mostly relaxed. I am hoping this would have a lot to do with it. Sometimes when I feel my vmo fire, my knee feels better. Otherwise God help me.

There are so many good, kind and helpful people that would give anything to be able to help but just aren't qualified even if the saw yest results.when my PVNS erupted I was going to an ortho practice of 8 surgeons with over 100 yrs experience. It is so rare none of them had ever seen a case. I was referred to an ortho/oncologist at the university hospital and she diagnosed it in 15 mins. Unfortunately it wasn't something she could jusy ake go away and 12 years later it is a bane to my very exisistence. The terminology is is non-malignent. The truth is its still there, still eroded tissue and can still hurt like hell when its doing its dirty work. So proper diagnosis 1sr, no matter where you have to go to get it, then treatment

In the meantime do whatever yo can to get some rest

what is PVSN? 

A very rare benign tumor of the joints. Comes in two forms, one like a large cyst and the other, the type I have, diffused. It adheres to the ligaments an tendons and spreads throughout the joint and suddenly, without warning breaks open and starts bleeding profusely. They had to put me under 3 times and drained 200cc each time. In between times the went in with a needle and pulled off 65-75cc each time. I had 30 rounds of radiation and a synovectomy to finally stop the bleeding but it cost me a knee. I still have a pocket of the tumor in the bone that they can't get to as it is in a nerve center and could cause me to lose the leg from the knee down. PVNS usually hits people in their 20's to 40's but there are known cases of small children being affected. I was 65 and then it resurfaced @ 75 when it caused the original tkr to come loose. They tell you its non cancerous but yet it eats away like cancer. I know of one case of a girl that had 12 surgeries before age 16 and it was going from joint to joint. It has also been found in the jaw.

You are right. My first and second Physical Therapist and Personal Trainer both said "chondromalacia" and "Arthritis." I thought to myself no way you go from having a perfect knee (no lie) to this. The thought behind that was the cracking I had when walking, though never painful but sometimes inflammatory afterward if it happened too much. Funny how it never had passive crepitus or pain with any testing, andhasn't happened since that day I had to beat the snot out of my glutes to do a job (because my quad was non-existant). That concludes it was the femur moving against the tibia which was stabilized enough to stop that action. 

I am trying to get rest, but I also have to keep my inner quad going so it does not waste in between sessions. Pain can quickly do that I learned.

I am now trying to get the inner quad active between sessions so I can rest before hitting the gym again.This used to be easy but when you are hurt and twisted/imbalanced, it becomes the most difficult thing ever.  I am going to give my orthotics another shot to see if that activates the vmo better when I walk. My last ortho was insistant on my problem being my vmo (only after I insisted on showing him my one-legged squat because I passed the other tests- he was ready to give me a shot or schedule a scope). I am hoping that is it and that the hamstrings will relax if th vmo can fire all day. I am guessing that maybe they tighten with weight bearing and cause the leg to resist full extension, which does not help.

Anyway, despite all the training doctors have, there are very few good ones. You are correct. Our family has seen its share of bad ones lately. makes you wonder what is being tought in schools.

Where are you located, Steve?

Outside the Chicago area

I'm about 1/2 hr S.W. of downtown K.C. If you cod get to mayo's in rochester I would bet on them for answers. I got my help @ Ku med

I'll keep them in mind just in case. I have to lay my bets on this being muscular at this point. The VMO is very difficult to hit in a situation like this, with malignment but it is getting better in terms of the exercise. I feel a little looser today so that is helping. I may take the day off from working out again and try it tomorrow. I may do low reps, low weight to activate and neuro train the muscle vs stressing it too much. If this is what it ends up being it would be stunning the crippling and painful effects an imbalance can have.  Some people seem to cope better but one day they end up with a meniscus or TKR. I am sure some of it is genetic structure too in people. I guess if I get out of this the lucky part would be it was so bad I could not damage it by running, jumping, etc.

thank you for explaining ...

My youngest son started on weight as a way to relieve stress when he was in grad school @ LSU. He continued after he got out in the world and starting traveling extensively, again for stress relief. He finally got so bulked up that he couldn't swing a golf club without pulling his lower back. Doc ordered him to knock off the squats completely and cut weights by half and drop 50% of the time spent in the gym. After a year his problems are about half and lower back pain nearly gone. Now if he would cut his beer intake in half ha would be in good shape. Some times, too much is just too much.

I hear you. I'm only doing weights to get my leg back up to par so I can walk normal. Strength is the right places is key. When I worked out before, I never had issue. Of course I never did bodybuilding either. I spent 30 minutes hitting legs and upper body with max weight every 7-9 days days. I keep getting stronger and stayed loose. Staying flexible is key. Adding strength helps too. I did this gradually over the last five years and was in the best shape of my life. My only way out is strength building which at this point is like trying to climb a down escalator. It is truely that difficult. The rest of my body is doing great now however since hitting the gym back in October full time again. 

From what I am seeing though it sounds like getting full weight bearing extension back is a huge key. Sometimes the muscles feel tight, and sometimes it feels tight around the patella or around there. I am hoping some backwards walking will help to loosen hamstrings as well. I'll ask my doctor this when I see him. I am calling to make another appt. tomorrow. I just do not know for sure if it muscle tightness due to weakness compensation/alignment, or tight muscles due to neuro habit, something from the knee, or pain/minor swelling from the knee causing the muscle tightness- as in a mean cycle of pain & tightness- one causing the other. Rediculous really.