Worse than before arthroscopic

[anthon1]

6 months ago I had arthroscopic surgery.  I went into surgery with pain in my right knee that would occur if I ran or jumped and on long walks.  I had an MRI done and it showed a tear on the latera and medial meniscus.  I also showed signs of degenerative arthritis (mostly medial side).  The pain was thought to be from either the tear or arthritis. 

I had partial meniscotemy for both tears and a large plica removed.  I have not seen any improvement. In fact now i have pain during all activities instead of a occasionally.  Could the surgery actually have made things worse?  Did those torn meniscus actually have been helping instead of hurting my arthritis? 

I am now looking to see another doctor, but in the meantime i am scheduled to get Synvisc shots.  Any advice?

[Nettan]

Have you been doing any phys in between to get muscles back ?
Are you on any antiinflammatories ? What does the OS say ?

[anthon1]

I have gone to phys therapy and it did help.  I need to be more religious about it.

My doctor thinks its the arthritis getting worse.  He says I didn't have much meniscus on the
medial side to begin with so that the portion he took out shouldn't be a big factor.

But i find it is definitely different than before surgery and this sudden decline and the surgery go hand in hand. 

[jathib]

....  Could the surgery actually have made things worse?  Did those torn meniscus actually have been helping instead of hurting my arthritis? 

A torn meniscus does not help arthritis. The inflammation they cause more often makes it worse. Unfortunately, some people just don't get better after surgery. There's no cure for arthritis and if your knee was degenerating before surgery then that process is going to continue with or without surgery. The hope is that if you remove the torn bits of a meniscus you'll reduce the inflammation and slow down the degenerative process. The downside is you've had some of the cushion in your knee removed. Some people end up with knee replacements within a couple of years of having a meniscus removed.

But it's not all doom and gloom. If the physical therapy helped then you need to be religious about it for the rest of your life. The doctor can only do so much, now you have to do your part. The best thing you can do is get yourself a bike, either a real one or a stationary if you don't mind being bored to death. I was able to prolong the life of my knee for 34 years after a meniscus tear by biking and swimming. You need to keep your knee strong. PT is not something you can do for a month and then quit. You have to keep at it forever. If you do need a knee replacement later on you'll be a lot better off if your knee is strong.

I wouldn't bother with Synvisc. I found the shots to be useless. I also don't think another doctor is going to tell you anything different but second, third, fourth opinions never hurt.

[darlp]

I definitely hear you on this and can agree.  My problem, which I have in both knees, actually did get worse after the arthroscope.  Could be coincidence but in any case it definitly got worse.  There can be many reasons for it though- after mine, my activity decreased enormously.  If you go from one extreme to another, it makes sense that things will get worse.  Of course the athritis can get worse, the degeneration can increase - there's many reason "why".  No amount of therapy helped, my exercise was severely limited by pain and if you overdo it, you can cause more harm than good.  No easy explanation.  I've tried everything - I even have braces for both legs.  I use the Unloader 1.  My knees are bone on bone but only on the inside of each knee, I still have space on the outer sides.  I've tried coritsone, and every pill out there - nothing worked.  My last chance before 2 tkr's is the Synvisc.  Don't let anyone tell you not to try it - it works differently on everyone.  Some people go years, some months, with the Synvisc.  In my opinion, anything that delays tkr is worth a try.  Tkr does not always work either and the younger you are, and depending on the severity of the arthritis, the more times you'll have to replace the knees.
I had my first Synvisc injections yesterday, both knees.  I can tell you that I already know there's a difference, not a lot, but noticable.  I have 2 more injections in each knee, next week and the following week.  And as long as your doctor numbs the area first you won't feel anything or maybe just a slight bit of pressure.
I'm looking forward to next week, and I'm very hopeful.  Try it, you've got nothing to lose.

[jathib]

... And as long as your doctor numbs the area first you won't feel anything or maybe just a slight bit of pressure.

That is not necessarily true. My doctor sprayed my knee with numbing stuff and injected lidocaine beforehand. It still hurt like hell. The lidocaine itself is a very painful shot. I had three shots and three different experiences. The first one was not too bad, the second hurt a little more, but the third was the most painful shot I have ever felt. Had the first one felt like that I never would have gone back and I have a very high tolerance for pain.

[darlp]

Sounds like your doctor was hitting bone - but you shouldn't tell people not to do it.  Obviously it's different for everyone.  I had the spray and a doctor that was very careful with the lidocaine - mine went well, yours didn't.  Doesn't mean it doesn't work.  A TKR doesn't always work either, depends on the doctor, the patient, and the severity of the problem.  Very poor advice to tell someone not to try.  There are many many many people on this board and others that disagree with what you say - there are pros and cons for everything and everyone.

[darlp]

Here's my advice - do what's best for you. 
Synvisc works for some, not for others.  Many people who talk about it haven't had the recent Synvisc but rather the older one or a version of it.  Keep in mind a TKR doesn't work for everyone either and if you can avoid it, especially if you have arthritis, then I would say take a chance.  It certainly doesn't hurt to try. 
My first ones were painless - I had both knees done - but my doctor was very careful and only went through the open space (only one side of my knee has any open space, the interior side is closed).  If your doctor goes through a closed space the pain can be excruciating.  Talk to your doctor, tell him your concerns, talk to him about he pain.
I don't know how old you are but keep in mind the younger you are the more times you'll have to replace the knees.  If you try it and you don't like it, you've lost nothing but a little time - you can still do the knee replacement.
Good luck to you and remember, everyone is different - only you should make the decision based on YOU, not on what someone tells you.  Talk to your doctor.

[digginit]

Sounds like your doctor was hitting bone - but you shouldn't tell people not to do it.  Obviously it's different for everyone.

Those shots can hurt immensely.  Doesn't mean anybody "hit bone."  The material is really thick, and my first injection (both rounds) has hurt incredibly and left me limping for hours after each injection.  It's not from the needle--I don't use any topical anesthetic because I think I've become numb to a needle...lol--and it's not from hitting bone.  It's the orthovisc (in my case) that is painful for a while until I get used to the extra load in my joint.  I've never had a steroid shot hurt the way hyaluronic acid shot hurts.  The 2nd and 3rd shots of the series aren't nearly so bad.  Maybe that's just me, but people are all different. 

~dig

[jathib]

Sounds like your doctor was hitting bone - but you shouldn't tell people not to do it. 

My doctor didn't hit a bone. My quads went into a spasm and he couldn't get the needle out. Your first shot might have gone well, your second one might not. My first one went well, too. As far as telling someone not to do it, the poster asked for advice, I gave it. You shouldn't tell people it won't hurt, because for everyone who says they don't hurt there is another that suffers excruciating pain. People need to be prepared for that.

[darlp]

You apparently aren't reading what is being written.  I said it's different for everyone. I said some people have trouble with it some don't.  I said to talk to their doctor about it more - none of us can say what to do.  I gave good advice, not irresponsible.

[tensailswim]

anthon and others.....

your post is almost a year old and i'm wondering how you are doing now?  what treatments have you done over the past year?  what worked?  what didn't?  i am exactly in the same place you were, anthon.  8 months post-op for medial/lateral meniscus removal.  i have more pain now that before the surgery. 

look forward to your responses.

thanks.

[ladystail01]

I had arthroscopic surgery in 2001 for a torn meniscus.  The doctor told me that I would get arthritis.  Boy DID I.  The pain from the surgery was worse than the pain I was trying to cure.  I've been told I need a knee replacement.  I am NOT running to have that done.

In 2004 I had synvisc injections. They seemed to work.  In 2007 I got Euflexxa injections which worked somewhat.  In 2008 I tried Orthovisc and didn't get too much help.  I just got the Synvisc One on Tuesday and am experiencing very bad adverse reactions (as I posted earlier).  First my leg got very stiff and painful.  Then the leg became swollen from ankle to hip.  And the pain in the knee is worse than before.  Before it was sporadic and now it is constant. 

Will be going to see the doctor tomorrow and see what he tells me.  The expression "damned if you do and damned if you don't" certainly applies.  Might as well just toss a coin in the air!!!!

[tensailswim]

ladystail01,
thanks for your response. i can identify with your "damned if you do, damned if you don't" quote.  that's how i feel about the arthroscopic surgery i had.  i would be damned if i didn't do it and suffer the meniscus pain/damage, and now i'm damned because i had the surgery.  i agree that the meniscus pain was not bad compared to the arthritis.  my doctor did not tell me to expect arthritis pain after surgery, this is a total surprise and disappointment.  had i known ahead of time, i would have postponed my surgery and stuck out the pain of the meniscus tear.  would have been worth delaying arthritis pain. 

thanks for your feedback.  it really helped.

tensailswim

[ladystail01]

Hi tensailswim

Sorry you're in the same boat.  But even if your doctor had told you that you would get arthritis, unless he specifically said it would be excruciating pain, you probably would have gone ahead with it.  My doctor told me I'd get arthritis, but didn't say anything about its severity.

When I kept going back to him because I was in so much pain, the bottom line was he told me to lose weight (I was overweight).  Well, I just lost 23 pounds (and I hope to lose more) I do feel better physically, but I am still having knee problems.

I just posted today that I had low intensity laser therapy and will see if I get any help.  Have to take 12 treatments to get full results.  I can only hope that this works because the synvisc just did a number on me.  My leg is still swollen and the doctor (a new one) says it can take a couple of weeks to get better.

Be well.   Marcia