knee arthritis; how to proceed?

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Hi: so my patella is very worn and there is some area of bone contact. I 'may have spurs, etc. I have not had an MRI because my doctors don't think that it will reveal anything. I do pass all of the office tests well--i.e. they flex and twist my knee without my having pain. But steroid shots have stopped working. At the moment I can't bear weight for long (walking) without pain increasing significantly. I am about to begin taking a strong ibuprofen to attempt to help the so called arthritis, which I just discovered is a catch all term that covers just about everything. Doctors advise against any surgery, even arthoscopic, saying they aren't effective. The cynic in me wonders if this isn't a cost decision but I doubt that. I finally wrested a promise of getting an mri if after a month my pain doesn't subside. I'm in the states with Kaiser; which seem to have a hands off approach to things like a torn miniscus (sp,) which I think I experienced over a year ago when my troubles began. Just let it heal.

I've done physical therapy and will continue, but I'm very discouraged. I'm not overweight. I can't go for walks right now however. 

I'm venting but also asking for any direction. I'm hoping the ibuprofen will help and I will at least be able to walk for forty minutes as a minimum.

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  • Posted

    p.s. sorry I meant that "my meniscus is very worn" in the first sentence of my post. I'm in a hurry; sorry! --is there an edit function on this site?

    --Jeff

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  • Posted

    Ask the doc about SynVisc injections.  It's a lubricant for bone-on-bone conditions to delay surgeries.  I used it for 5-6 years and it worked great for me...may be different for you.  The 1-shot version lasts for up to six months; the 3-shot treatment (days 1, 8 and 15) lasts up to a year.  I got between 10-12 months out of mine.

    For a topical anti-inflammatory, try some Voltaren Gel (RX in the US)...second best topical on the planet.  Great at bedtime.

    MRIs are many times inconclusive.  I had four...two each knee.  All showed nothing.  But my four scopes repaired two torn menisci and two ripped femoral condyle cartilages that never appeared on the imaging.  Sometimes, they just gotta go in to find and fix the problem(s).  All were very successful for me. 

    A few years later, it got worse again (45+ years of playing hockey) and that's when I started the SynVisc for the arthritis and b-o-b situation.  Moved to a MUCH warmer climate and needed NOTHING for the next six years.  Once I hit 68, it was time for the first TKR.  I'm 19 months post-op...putting off the second for another year.   

    I have had great success with all of my scopes and TKR.

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  • Posted

    Try to go to Mayo Clinic in Rochester, Minnesota.

    It is excellent. I trust the physicians there.

    I had total knee replacement and that took care of

    The severe case of arthritis in both knees.

    I wish you the best!

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  • Posted

    Are you able to get some physiotherapy? Doesn't always improve things but worth a try.

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  • Posted

    Thanks all for your replies. As I mentioned, Kaiser has taken a hands-off approach so far which may well be appropriate. But they've also said, well, there's nothing to be done. Chico's comments about a surgeon going in and fixing a torn meniscus and other stuff and having it work out is interesting. I've spoken with lots of people who've had meniscus repairs, etc. Which is why my inability to even get an MRI done after I most likely tore my own meniscus has been frustrating. It's hard to know what the best way to proceed should be. Is Kaiser being cheap or practicing good medicine? 

    the truth is I'm conservative myself and would like to avoid surgery if possible. I also understand there may be real limits to what can be done.

    In any case thanks Chico for mentioning Synvisc and Voltaren gel; I'll mention these to the Ortho doc. Mary Kay, the Mayo isn't covered in my plan, so it's not in the cards right now. I'll continue with PT, especially if the industrial strength ibuprofen I just took starts to calm this flare up. I may start in the pool, which is sort of sad because I was an avid lap swimmer for decades and here I'll have become one of the old guys doing old guy group exercises like I used to see at times. Ah life!

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