should I have Arthoscopy?

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My knee has been hurting for years. Slowly getting worse. Saw Dr a few years ago given brace and steroid injection. Injection didn't help, brace somewhat but limited. So, last month I went to a new Dr. He said he thought it was patellofemoral syndrome and told me to go for PT and if it didn't help then an MRI. PT evaluator said he thought is was a tendon or meniscus problem. My knee only hurts on the inside curve. So did PT and went back to Dr. I asked about the MRI, he said no need as we already know there is a problem. Gave me another injection and said if that didn't help maybe an arthroscopy. So, after this long introduction, my question is should I go for the arthroscopy? The new injection was AWFUL the first day, still in pain day 2 but not as bad. I am 60 and if I get it done I want to do it this year as my deductible is paid and I'm in general good health. Any advice appreciated.

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  • Posted

    Victoria

    I had an unsuccessful arthroscopy 3 years ago when I was 56.

    It went well for a few weeks but on return to work where I'm stood up all shift, it deteriorated.

    I've got a limp but can still hill walk and cycle and (touch wood) it hasn't got to the stage were I need a knee replacement which definitely do not want.

    I think arthroscopies work on young knees but if there's any arthritis, forget it.

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    • Posted

      My xrays show no sign of arthritis. Does this alter your opinion? I have the most trouble when I sleep as there is no comfortable way to rest except on my back and I am NOT a back sleeper. The pressure of my knee on the mattress keeps me awake. Sometimes my knee locks, also.
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    • Posted

      Hiya, X-rays don't show up soft tissues I don't think? So cartilage issues wouldn't be able to be seen? With my knee an A&E x-ray initially showed nothing & they said I'd sprained my knee, but an MRI afterwards showed a big tear in my medial meniscus & I ended up with my op. I'm not a medical professional though, but think if it was me I'd rather an MRI first, but that's just me. Post-op I couldn't sleep without a pillow under my knee for a good 2 months when I was lying on my back, it felt horrid otherwise, but I had to eventually stop that to help my leg fully straighten, but again that's very different to what you're experiencing ashos was post-op. But a pillow may help in the mean time?  

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    • Posted

      I've not had any trouble with my knees locking but at night in bed if my top (bad one)leg drops it wakes me up and it's painful.

      If your knee locks then it may be the case that you need the op.

      MRI scan showed meniscus damage but x-ray didn't as was the case when I had my hip replaced.

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    • Posted

      You are right. X-ray does not show cartilage, but it did show a good amount of space between bones, so my bones are not rubbing on each other, I guess. That is why they said no arthritis. What I suspect is the Dr thinks that there must be soft tissue damage of some sort and only an operation will be able to fix it so why bother with an MRI. One less step and less cost.
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    • Posted

      Yes, my knee locks sporadically. Right now it's been 2 weeks since it last locked and that's part of the problem. You just never know when it will happen. It used to be a minor problem if it locked, I'd just stop and let it reset and be fine. Now if it locks, it hurts the rest of the day. The pain is not unbearable, but almost always there and now waking me up at night. Hard decision to make.

       

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    • Posted

      The first time I got that 'snap' in my knee it did it 3 times as I was walking and I didn't feel that again till after the op which was about a year later.

      Now it happens most often in bed and as you say it'll then hurt for the rest of the day.

      When I'm walking up hills it fine but coming down is sore.

      My thigh muscles in that leg are non-existent but hip flexors are fine

      The other leg where I had the hip replacement is the opposite.

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  • Posted

    I think it sounds a bit off-hand of him to say "no point having an MRI, we already know there's a problem?! Surely him/you want to find out what specifically it might be, for piece of mind & to know the best treatment? He can't tell just from your description whether it's meniscus issue/knee cap issue....etc etc! I get a lot of pain some days on the inner side of my knee, but I had a large chunk of the medial meniscus removed from there after it tore. So I have a lot less meniscus at that part of the knee acting as a bumper to my bones which I think is what causes the pain i get. What would the aim of the arthroscopy be? Just looking around (in which case surely pushing for a non-invasive MRI is a better starting point?) At least then you'd have a better idea whether there is something obvious mechanically & know one way or another which way to go regarding treatment? 

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    • Posted

      He actually said that there was no point in an MRI as it would show a problem and we know I have one, or it would not show a problem, and we know I have one. I suspect that he is more concerned that nothing will show up, thus giving insurance the ability to reject his request for the arthroscope. I will definitely ask what all he expects to accomplish, but I suspect he doesn't know exactly what he will find but plans to address whatever it may be?

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  • Posted

    I think it will help but MRI prior is also a good idea. MRI didn't show the intensity of my issue though. Sometimes it's better for them just to see what's going on in the knee.

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