confused - any advice?

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?I've posted a few times about the ongoing problems with my left knee. I now feel more confused than ever after yesterday's consultation. This a brief chronology:

2012                         Went to GP re. knee pain – referred to musculo-skeletal clinic.

2012 – 2013            Steroid injections (no difference) + physio

November 2013       Arthroscopy & microfracture of left knee (4months off work, pain, unable to bend or kneel or drive) Physio felt kneecap out of alignment – not discussed with consultant

2014                        Arthroscopy & microfracture of right knee – success – no problem since

2014-2015               Ongoing appointments & steroid injections left knee, hyaluronic acid injection

2015                        Arthroscopy & microfracture of left knee – some improvement

2016                        deterioration of left knee again – back to pain levels of 2013. Gradual deterioration ongoing

2016                        To musculoskeletal clinic. To physiotherapy.

2017                        MRI, stated pes anserinus inflammation, not arthritis, steroid injection given (no difference made)

2017                        Physiotherapy, ultrasound given and strapping – no difference.

2018                        Saw consultant, Mr R, stated leg/knee out of alignment, talked about osteotomy. MRI + x rays

2018                        Telephone consultation with Mr R, no mention of alignment. Stated arthritis and recommend talk to Mr C re. pros and cons of knee cap replacement

2018   Mr C stated knee not showing excessive wear, not suitable for replacement. Said would do arthroscopy to see problem.

?I fell I have two types of pain - one the bone grinding ache that is constantly there. Then also  a "hot" pain - like my knee is on fire - this is more on the inside of the knee. I cannot bear for it to be touched. At times when I use pain relief gel to try to get some relief then I have to brace myself to put it on. Consultant felt this was strange as the pain I feel should be inside the knee.

?Now I just don't know. I've agreed to the arthroscopy as can't see there is another option. I felt it was offered as a sop to me. Consultant felt there was not really enough wear and tear to offer a knee cap replacement but this is at odds with the pain I gt on sitting with my knee at right angles. Problems as follows:

Cannot drive more than 30 miles

Driving is an issue – depressing clutch

Struggle when getting up off floor (not elegant!)

Constant aching pain

“Hot” pain at times

Pain impacting on daily life.

Pain killers not have much effect – but try not to take them

Sometimes will take cocodamol, ibuprofen and voltarol gel in order to sleep

Pain will wake at night

Find it difficult to sit with leg at right angles

Will always sit with feet up at home

Impact on working life – do not take time of sick as have decent work ethic – but in constant pain

Cannot bear touch on knee – seems ultra-sensitive

Will stiffen up when sat – find it difficult to get out of chair or car. Will swivel round in car to put both feet down to get out.

?The last two days have been bad. I could cry with the pain and there seems to be no relief and no way out. 

?I don't understand how I can have so many differing opinions and no clear answers. I'm not hopeful of this arthroscopy doing anything. How many can you have? If he chops more bits away, surely in the end there'll be nothing left. He did point out the 'fat pad' (?) and said that looked good. Well I do know that bits of that was chopped off in the second procedure so don't understand how it can look good. 

?I have booked an appointment with the GP. I am wondering whether to try to talk to the consultant again and go through this chronology. I just don't know. Sat here in pain with no answers. 

Does anybody have any advice?

?My mobility is good. I have no back or hip problems. I have no swelling.

?I'm not sure I should be here or in the arthroscopy page - it's more a problem than just arthroscopy I think!

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11 Replies

  • Posted

    Have you had a MRI?
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  • Posted

    Yes I've had MRIs - one before each operation  - well before to decide whether or not to operate. Then one a little while ago before seeing Mr R and Mr C. Also one before the musculo skeletal clinic where the doc said it was just pes anserinus inflammation- this was his conclusion from the MRI. Mr R felt the MRI showed wear of the knee cap and recommended I saw Mr C who then showed me the xrays and MRI - not much point really as I can't read them - and said no it doesn't show wear - or not enough to be thinking of replacement. I feel a bit pushed pillar to post. really. I have a feeling he agreed to this next arthroscopy to keep me quiet and as the degree of pain seems to be not in line with the wear I have got. Though that maybe unfair as the nhs doesn't now agree to things they don't feel worthy.

    ?I don't think I'm a Moaning Minnie but one of his other suggestions was that I've got a low pain threshold! Hmmm..............

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    • Posted

      Hi Trizwizz - Unfortunately I have no advice to offer, but was amused by your 'low pain threshold' comment. Around 5 - 6 months post-TKR my knee was still incredibly painful. Obviously my surgeon had done a fantastic job, so my pain was put down to 'mild chronic pain syndrome'. I suppose I should be grateful that I only had the 'mild' version !

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    • Posted

      yes, having a sense of humour is compulsory! I've always thought myself as pretty tough. I can understand what he meant when he said the pain should be internal so don't know why it's so sensitive externally. So maybe my body has gone into overdrive but there must be a root problem?

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  • Posted

    Any thoughts of getting a Bone Scan? My reason for the suggestion I to have had swelling pain etc x-rays nothing labs nothing mri same had a bone scan done then the Dr. saw the problem.
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    • Posted

      I have an appointment with my GP next week and will ask him. I'm not overly happy about having the next arthroscopy - the first was such a disaster and things have never been right since really that i'm concerned about having it. But can't see any other option at the moment

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  • Posted

    That I do not know I am in the US. You would have to ask your DR. it has to do with nuclear meds, its similar to an MRI but when you go in they inject some radioactive fluid in you and it collects in any bad spots. On the image it will look like the bad part is glowing.Here is more detail:

    What you are going thru sounds like me to an extant my last TKR was 2 yrs ago the dr. Retired and referred me to another DR. after a year had gone by I noticed the pain in my knee was getting worse so I e-mailed the Dr. numerous times thru out the following 6 months his reply always the same x-rays look good lab is fine nothing I can do.In the mean time constant pain and swelling. Finally had enough and found different Dr.and he wanted me to have one.Glad he did but the results were more then I expected. To determine exactly what was wrong to rule out infection they did more labs it was perfect however the scan was pretty bad the implant is failing and the Dr. then looked at my x-rays again and said your implant was not aligned properly its way off at first I did not understand but now its pretty clear. Now I know why I have lots of increased pain and swelling now I have to see a specialist this next surgery is not going to be fun.

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    • Posted

      Thank you  - that's interesting especially as I have had two consultants plus other doctors give me differing ideas and they all looked at the same xrays and mris! I have an appointment to see the GP and will ask him. If necessary I will think about paying privately.

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  • Posted

    I am no Dr. but I thinks its pretty stupid you have swelling in your knee along with pain tenderness and yet the experts ( as we programmed to think of them ? ) Tell us your x-rays and MRI's are fine. I think its BS how can you have pain and swelling for no reason?? Granted after surgery and for months afterwards but come on we live with our knees they do not. If I would have followed the Dr. advice I was referred to by the surgeon that did my last TKR I would be getting constantly worse but according to that Dr. I was fine. I am glad I dound the present Surgeon he listened and wanted to check to make sure. I am glad he had the bone scan done I have a definite problem and it also means the surgeons prior were not looking at my x-rays correctly. I hope you find a surgeon that will listen and help pain is no fun.

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