Should I get arthroscopy for knee ?

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I am 47 years old. I used to do a lot of outdoor jogging and running in treadmill. I had pain in my left knee 2 years back. I saw a sports medicine doctor who's a surgeon. MRI scan indicated degenerative patello-femoral chondro malacia. Surgeon rules out osteo arthritis and he did arthroscopy of my left knee for chondroplasty in April 2015 followed by PT and rehab. I was pain free after surgery. After surgery he adviced me to stop running and go for walks instead. I've been following his advice and gave up running.

In January this year I I had severe pain of left knee and swelling above knee cap. I went back to the surgeon. He asked me to take over the counter NSAID and sent me to 5 sessions of PT. Swelling reduced and I had some pain relief. I have been having pain on and off. I had a follow up visit in May. The surgeon ordered MRI scan which showed full-thickness cartilage fissuring along the patella has progressed. Surgeon said I don't have osteo arthritis and is recomending arthroscopy again. He said I'll be in crutches for about a week and then normal weight bearing.

I saw another sports medicine doctor for a 2nd opinion. Doctor2 said I have osteo arthritis and did not recommend surgery. He took an XRAY which he said shows bone spurs formed in my left knee. He said arthroscopy to smooth out torn cartilage may or may not help. He sent me to 8 sessions of PT. He said I can try injection of OrthoVisc every 6 months for pain relief. 

I am quite confused which advice to follow.  Has anyone had similar experience  ? 

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5 Replies

  • Posted

    Oh my. You do have yourself in a quandry. I have not been in that situation but if I put myself in your shoes I would get yet a 3rd opinion. Right now you have 2 opposing views. At some point opinions are going to gel between 2 docs and that's why I would recommend getting another opinion before making any decision. I would also do a lot of research into your docs - - their background, how long they've been in practice; you should be able to get permission to talk to some of his patients who have had surgery. You might also want to make sure you're not seeing docs from the same facility. They have a network in every clinic between the staff who work there so it would serve you well to check in with another clinic. Good luck to you. I hope you find clarity. 

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    • Posted

      @MNLynne  Thanks a lot for replying, much appreciated. I am at a decision point and it is tough.

      I started having pain in my left knee in late 2014. Since then I've gone to 4 sports medicine doctors so far. Surgeon1 recommended arthroscopy for chondroplasty and I went with his advice in April 2015. I saw surgeon2 with a different practice before the surgery. He said I had Osteo arthritis and said I could go for OrthoVisc injections at that time. 

      This January after the swelling and pain reduced I saw surgeon3 who is in the same group practice as surgeon2. He ruled out surgery and said I had Osteo arthritis and sent me to PT.  He said I can take OrthoVisc injections late this year.

      About 3 weeks back I saw surgeon4 with a different practive from other doctors. He said my condition is Osteo arthritis and said arthroscopy may or may not help. He said I can try OrthoVisc injections any time. 

      Level of pain and stiffness in my left knee varies day to day. Some days I feel just fine while other days it is painful. It is aggravated by squatting or kneeling. 

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    • Posted

      After re-reading it looks like the concensus is osteo arthritis. That is what I have in my knees. And I did do the injections with some relief for several years. I did all I could do non-surgically until those options were no longer working. That is when I decided on the tkr with surgery 4 weeks ago. My surgeon really encouraged me to do all that I could before having surgery. And he was right. My recovery is going great and I'm happy with my decision. You have a really tough decision. I hope you're able to come a conclusion that works for you. 

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    • Posted

      @MNLynne Thanks a lot for sharing your experience !

       I tend to think  for my knee condition catrillage fibrillation and patello-femoral chondro malacia non-surgical like PT, injections, etc are not likely to make it worse. So I want to give those a try. I want to mention couple of things: 

      1. My sister who is 2 years older than me has been having pain and swelling of her knees. Her right knee is more aggravated than left. I tend to think Osteo arthritis could be in our family. i.e due to genes, not due to injuries or trauma of knees as widely believed in the U.S. 

      2. I had arthroscopy in April 2015 and about 6 months later I started having pain in my left thigh. I had not done anything straining my thigh. In  January this year I first had sever pain in my thigh before my knee pain started and swelling occurred.  Do you know if chonroplasty would cause issues with thigh muscle ? 

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    • Posted

      That's really interesting although I have no idea if chonroplasty could cause your thigh issues. However, your quad is very involved with knee replacement (aka thigh); it's all connected so you have a plausible question. 

      I'd definitely inquire with your doc or his nurse. 

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