MRI results

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hi all

I got my results back from my MRI scan today the doctor didn't tell me everything that was on his screen so when he went out the room I had a look myself. It says the patella is minimally medically displaced and there is thickening and irregularity of the lateral patrlofermoral ligament suggest at least a partial tear and the medial ligament is lax by 7mm? Can anyone explain this please as ally he doctor has told em is that they want to take blood from me on a machine and then put it into My knee and if it doesn't work then will require key hole surgery to see what's going on ? Any help will be much appreciated

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  • Posted

    I'm not a doctor but this is what I think they mean:

    Your kneecap is not in quite the right position (are you sure it was "medically" and not "medially"wink? One of the ligaments (the lateral patellofemoral)  that attaches the kneecap to the thigh bone is thickened and does not have the smooth appearance it should have. This suggests it has been torn at some point. I think they mean that the medial collateral ligament is also stretched - that is the ligament that stabilises the knee down the side.

    The treatment he is suggesting is probably a technique called Platelet-Rich Plasma therapy. This is an extract from an article about it:

    "The process of making P.R.P. is relatively simple. A doctor draws between half an ounce and an ounce of the patient’s blood and spins it in a centrifuge to separate the platelets, the disc-shaped cells best known for their crucial role in clotting, from most of the red and white blood cells. The spinning concentrates the platelets in the plasma, the liquid part of blood. When the process is finished, the number of platelets in the plasma increases by a factor of between two and twenty, depending on the spinning method. The substance is then injected into the site of the injury, whether it’s a ligament, a tendon, or an arthritic joint.

    The treatment was first used about thirty years ago by dental surgeons, to repair jaws and other facial bones that often don’t heal well. Researchers knew that these areas have fewer blood vessels than many other parts of the body, and wondered if the healing problem was related to a lack of blood. They found that P.R.P. could improve results in these situations, as well as for wounds that were slow to heal. The side effects were generally minimal—soreness, stiffness, and swelling from the injection—so doctors were willing to try it. In the mid-nineties, veterinarians began using it to treat tendon, ligament, and cartilage injuries in horses; like bone, these tissues tend to have a relatively limited blood supply. About a decade ago, P.R.P. moved back to human orthopedics and sports medicine. Practitioners estimate that P.R.P. is now used by a few hundred doctors around the country, mostly orthopedists and sports-medicine specialists. There are no statistics on how many people have been treated, but Ibrahim and others who use P.R.P. put the number in the tens of thousands, including hundreds of élite athletes like Waddell.

    At the same time, P.R.P. remains controversial. One of the leading skeptics is Stephen Weber, an orthopedic surgeon in Sacramento. Six years ago, he became interested in P.R.P. and set up a study to see if it could help patients recover from shoulder surgery more quickly. He operated on the rotator cuffs of sixty people, half of whom received a P.R.P. injection afterward. His study, which was published last year, found that P.R.P. made no difference in patients’ recovery speeds. “We need to be very cautious,” he said. “Just because a Los Angeles Laker gets it doesn’t mean that it works.”

    If you use your search engine to search for a section out of it you should be able to get the original. And there are probably a lot of other articles about PRP too - there is a good explanation on the Arthritis-health site for example. It is relatively new and there seem to be mixed opinions. It is said to speed up the healing of soft-tissue injuries in joints. It is also used for osteoarthritis. I couldn't find any studies to read in a quick search - but I think I might want to get some more information about the numbers of cases they have treated and their results. And I think I would get a second opinion. The surgeon from Sacramento (above) is of the opinion it doesn't speed things up - in fact, if they do it and it doesn't work, then it slows recovery down doesn't it because you will have to wait for the other procedure to be done.

    The only good medical source I can find is from the British Medical Journal, written in February 2016, so it is pretty up to date. They say in their "important points to take away" bit:

    "What you need to know

    - Autologous platelet-rich plasma (PRP) is increasingly used to treat musculoskeletal soft tissue injuries, either on its own or as an adjunct to surgery

    - Routine use is not recommended as there is insufficient evidence of clinical efficacy; instead, its use should be restricted to research settings

    - Ensure patients receiving PRP are aware of the limited evidence of efficacy, so that they can make an informed decision about their care

    - Clinicians should be aware of the concentration of PRP, and yield of bioactive proteins, produced by their selected preparation device"

    and in the article itself say "As an autologous preparation, PRP has been introduced into clinical practice without being subject to the stringent development required of new drugs." - this means it has not been subjected to clinical trials to show whether it really does do what they say it does. You have only their word for it. 

    So basically - I wonder if your doctor is adding to his personal clinical study experience? Are you in the USA? Will YOU have to pay for any part of it? And if it fails - who pays for that?

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    • Posted

      haha yes it was meant to say medially I blame the dictionary.  Wow you know a lot I'm from the uk all he told me is that it's a machine that takes my blood and takes all the heeling out of it and the injects it into my leg e said it will be very painful and if that doesn't work it will be keyhole surgery to see what's going on. I previously had 4 operations on this leg one was to remove the screws but they are constantly asking me who did the operations in the past, so I asked them if my operations was done wrongly all he said was not necessarily as before my knee cap was to the left they but now it's moved to the right but I did have these operations almost about 10 years ago 

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    • Posted

      I know how to look for medical "stuff" and can understand it.

      Is this to be done on the NHS then? Or do you go privately? There are NHS hospitals that offer it - but I'd really want some evidence, wouldn't you?

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