Hi All-
It's been awhile but I check in frequently to see what you are all up to.  Unfortunately I find myself in another delima and would like to have your opinion on what I should do.  I have synovial chondromatosis in my knee and have had multiple surgeries thru the years ending in a TKR about 3 1/2 years ago.  Ever since I have been dx'd with SC it has been one thing after another.  Now I find myself again looking at a possible surgery.  So here is my dilema.  My knee has never felt good after all the work done on it and I had pretty much given up and was learning to live with it as best I could.  But I was always saying something is not right but could not put a finger on it.  Well finally my symptoms have progressed enough to get a dx I'm pretty confident is my problem.  I still have three sizable hunks of SC left in my knee but one in particular is sitting right next to my peroneal nerve.  My foot feels like it is going to sleep, tingling in my calf, ache around my ankle, tingling behind my knee and between my big toe and the next.  Started out these symptoms were on occassion but now it is getting so it is most of the time.  So went back to OS who did my first surgery.  I had gone back to him after my TKR thru the past 3 years complaining of my knee.  Tendon was snapping over something behind my knee and always painful so I would complain to him each year.  I needed a doctor who would oversee my case and who had been there from the 1st dx.  I like him and he knows me well.  So we agreed  it was time for an EMG to see what was happening now that my symptoms were more pronounced.  Thru the years I had had 3 EMG and it showed nothing.  Now it is saying that I have peroneal involvement.  Since it is now affecting my nerve we ran further tests.  Ultrasound showing multiple peices of SC, then onto a MRI showing the one hunk right next to peroneal nerve but no degeneration of my muscles.  Now I've started having a pain in my butt/piriformis so we followed up with a MRI of my back also to rule that out.  I have DDD and a moderate stenosis but OS and a spinal OS both agreed these nerve symptoms are not coming from the back.  So OS sent me on to my Ortho Oncologist who did my last synovectomy.  Both OS's feel I can not ignore it anymore and the piece should be removed.  OO says to not jump into any surgery.  He said it would be another open posterior and it would be very difficult and risky procedure.  OS feels if it is not taken care the nerve could shut down and I would have foot drop.  OO warns that surgery could also cause foot drop and the TKR complicates the procedure.  I asked my spinal OS how do I make this decision?  If I have surgery and it causes foot drop I would be so mad.  He said but how do we sit by and watch you degenerate and not do something.  At least I would have a fighting chance at recovering.  Finacially this could be devasting also to me.  I work full time.  Husband has been LO and I am on COBRA.  My job does not have any insurance nor disability.  I have to work but my time is limited also to have insurance cover this.  This decision has been eating me up inside.  I so do not want another surgery.  Each one I had I thought it would be the last.  It just keeps on going and going.  OO says there is no way to know if the nerve will shut down.  If it does I most likely will not recover from it.  So what would you do if you were me?
Sorry this so long.  I needed to tell my story and if you stuck thru this all God Bless you!
Martha

Hello Linda-
I do have COBRA until May 2013 so I do have some time.  But this whole process started last Aug and has dragged on thru tests and scans and multiple dr's appts.  This decision has been just dragging me down.  I am trying very hard to be very informed before another surgery.  I'm very afraid another surgery will do more harm than good.  I would go back to the OO for the procedure.  My OS said there is no way he would touch it.  He said it was time to go back to my OO and let him know what was going on.  I know I need a specialist now and he did my last surgery so he is familiar with me.

My next appt is with my internist to get his opinion.  I want to talk with someone who is not a surgeon  I have just spent a month at PT trying to work out some of the other problems and to see if I did have any impaired motor skills.  I do have some but minimal.  My therapist said it too sounds like I have run out of options.  He also suggested to go back to the neurologist who gave me the EMG and to get his opinion just like you suggest.  I think I will follow up with that.  After all their opinions it will come time to make this decision.

Thanks for the tips on the piriformis.  I have some stretches to do but they sometimes irritate my nerve.  Your suggestion of the hot rice pack is a good idea and I will try that too.

Thanks for talking with me.
Martha