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Author Topic: Your experiences of arthrofibrosis  (Read 449 times)

Offline Clarkey

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Re: Your experiences of arthrofibrosis
« Reply #15 on: November 05, 2017, 07:12:58 PM »
Hi Kay,

It becomes frustrating when the letters came fairly quickly within 6 weeks after consultation. Since 2017 becoming longer and longer the waiting time to receive the a consultation letter. I always email rather than call as it is then in writing. Here is the paragraph that I sent and made it clear want my knee report and not my hip report letter posted.


Sorry to be trouble you once again after seeing Prof Snow on July 12th for a final consultation before my scheduled surgery. I appreciate the NHS is more overstretched taking longer to receive an outpatient letter. I am seeing Mr ***** for my right hip after seeing him on 16th June and got my outpatient letter mid September. Coming into November and still have not  had a letter in the post from Prof Snow consultation appointment which is why I making the enquiry as it has been over 3 months.


I was looking forward arriving back opening the letter and then saw it was the same letter I got in the post in September about my right hip. Was very frustrating as it was a Friday evening, hopefully will get a reply tomorrow. Made it clear in my email I want my report from my Prof Snow that was mentioned in an earlier email from the previous consultation before the 12th July that was also over 3 months wait, sent the correct report 1st time.

I can add more to my questions about arthrofibrosis that the ESWT sessions has helped with the anterior knee pain able now able to walk longer distances without too much pain. Just comes if I try to increase the pace or do larger strides or going up and down steep slopes. The pain is easy to pinpoint at the bottom of the tibia. There might be some wear and tear and a micofracture would not be a shock or surprise or cartilage tear a possibility which is why I happy to go for a diagnostic arthroscopy at this stage. This time round I will not have a physiotherapist pushing me too hard!

I am very lucky I have a physiotherapist specialised in arthrofibrosis a mile down the road and will book to see her even though Prof Snow says I wont need to see one post-op. Will feel more relaxed and at ease seeing her with his vast experience. Would like to walk quicker with less of a limp, running would be a bonus would be a good outcome post-op.

Only six arthrofibrosis physiotherapists in the UK, Lesley Hall who is based where I live in Droitwich Spa.

https://arthrofibrosis.com/practitioners/#1497656797544-15f6e098-e5b5

It's good to see someone that knows about arthrofibrosis even if it costs more it is worth paying the extra increase for expert post-op PT sessions.

[email protected]
« Last Edit: November 06, 2017, 08:57:58 PM by Clarkey »
RK: PFPS, Arthrofibrosis & Tendinopathy
Scope #3 scheduled January 2018
18/07/14 Anterior interval release  
16/11/09 Medial plica excision & fat pad trim
Cortisone injections: R-Hip - FAI 04/04/17  RK 23/12/15, 22/10/15, 13/05/15, 30/03/10, 23/04/09

Offline Clarkey

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Re: Your experiences of arthrofibrosis
« Reply #16 on: November 09, 2017, 09:42:39 PM »
Hi Kay,

With your broad knowledge in arthrofibrosis can the scar tissue if you have overworked the knee increase limping rather than feeling pain. Since doing a few gardening jobs locally my walking pace has slowed down even more with left ankle and heal aches as I am not walking properly impacting the good leg joints. Maybe the effusion in the knee increased doing physical manual work with more inflammation around the patella tendon.

I feel pain is as soon as I attempt to walk quicker pressure builds up around the bottom of the kneecap with intense anterior pain and discomfort as if I am pressing all my full weight onto my right kneecap. Something is not right, happy to risk and gamble a 3rd scope so my OS can do a full examination of the entire knee anatomy. A weight bearing pain, it is fine sitting down and sleeping with no pain or discomfort until I stand up feeling anterior knee pressure.

How is your knee behaving lately, improving, remaining the same or getting worse.

[email protected]
RK: PFPS, Arthrofibrosis & Tendinopathy
Scope #3 scheduled January 2018
18/07/14 Anterior interval release  
16/11/09 Medial plica excision & fat pad trim
Cortisone injections: R-Hip - FAI 04/04/17  RK 23/12/15, 22/10/15, 13/05/15, 30/03/10, 23/04/09

Offline DogfacedGirl

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Re: Your experiences of arthrofibrosis
« Reply #17 on: November 10, 2017, 01:59:28 AM »
Hi Clarkey,

I'm sorry to hear your knee is getting worse. It's very hard to say, but maybe the gardening work has upset the knee and more scar tissue has formed, which would make it difficult to have a normal range of motion while you're walking, and so you limp more. Do you have full extension, so your leg goes straight when walking?

More scar tissue could also increase the patella baja, pulling the kneecap in and down, and putting more pressure (= pain) on the Hoffas fat pad that sits there. The Hoffas fat pad might also be attached to the patella tendon with scar tissue, which will pull on the tendon as you walk. The fat pad can also attached to the tibia, but you know this because you've had AIR surgery before. If you haven't had an MRI in a while that might help understand what is going on, but then there is still the decision to be made about surgery, which is a difficult decision.

My knee is OK thanks, it's manageable so long as I do twice daily CPM and take the TNF-a antibody injections, which are prescribed for anther condition. I delayed my last injection because of a spider bite and infection, and the knee pain came back big time to remind me how much the injections are helping.
Kay
1999 Osteoarthritis both knees, chondroplasty
2004 MACI graft L knee
2005 MACI graft both knees
2007 MACI graft R knee
2007 Patella baja
2011 TKR both knees
2011 arthrofibrosis

Offline Clarkey

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Re: Your experiences of arthrofibrosis
« Reply #18 on: November 10, 2017, 06:00:35 PM »
Hi Kay,

As you know with the knee problems you endured over the years it becomes frustrating when you want to keep yourself occupied physically outside and restricted in how much you are able to do. I am able to do straight leg raises lying on my back with ease no limitations with my left knee. I am not able to do this with my right and will explain in my terms which I think makes it easy to picture. With leg flat on floor at 6 o'clock position fully raised reach 12 o'clock with leg raised straight up. My right knee when I reach 9 o'clock start to feel pressure and discomfort and can reach 10 o'clock with strain and pressure behind the hamstrings my limit cannot go any further passed 10 o'clock. Hope it makes sense just thought it up as a way to explain the angles of my leg raises. 

My fat pad has always been an issue since the start of my knee problems before my 1st scope that was trimmed rather then resection of the fat pad that might be a good idea as it was not done during scope #2 with a positive fat pad impingement test during my last consultation in July. Not sure if the fat pad can grow back that can happen after medial plica excision that was done during scope #1.

I am curious to know what going on inside the knee and would always play on the back of my mind if I did not opt for surgery. My walking pace cannot get any worse than it is right now, if the knee remains unchanged I will be satisfied and content knowing I did all I could to get it back to some normality. The key factor why I feel positive and optimistic post-op is how well my knee felt and was doing well recovering until the fateful aggressive physio session 6 week post-op that ruined the surgery with knee giving out several times with intense pain.

I waited for a while to get to this stage after doing all the safe conservative methods of treatment that all failed with surgery as the only option left. A diagnostic arthroscopy is a good diagnoses tool, I am not a big fan of MRI scan images when it comes to soft tissue problems in the knee clouding the images.

[email protected]
RK: PFPS, Arthrofibrosis & Tendinopathy
Scope #3 scheduled January 2018
18/07/14 Anterior interval release  
16/11/09 Medial plica excision & fat pad trim
Cortisone injections: R-Hip - FAI 04/04/17  RK 23/12/15, 22/10/15, 13/05/15, 30/03/10, 23/04/09

Offline DogfacedGirl

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Re: Your experiences of arthrofibrosis
« Reply #19 on: November 12, 2017, 11:36:39 AM »
Hi Clarkey,
Yes, the fat pad scar tissue can grow back, and it will hurt when it gets trapped in the joint or put under pressure because there are lots of nerves in it. Trimming is the best surgical option, as total removal of the fat pad is associated with poor outcomes.

The pressure and pain behind the hamstrings suggests that there are other problems in the knee as well.

MRIs are great for diagnosing soft tissue problems, but rely on a good radiologist to report what is shown accurately. And of course they are expensive, and don't fix the problem, which surgery has the potential to do.

Kay

1999 Osteoarthritis both knees, chondroplasty
2004 MACI graft L knee
2005 MACI graft both knees
2007 MACI graft R knee
2007 Patella baja
2011 TKR both knees
2011 arthrofibrosis

Offline Clarkey

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Re: Your experiences of arthrofibrosis
« Reply #20 on: November 13, 2017, 11:48:42 AM »
Hi Kay,

Thanks for the reply and advice, I have read up that having the fat pad removed totally can do more harm than good so close to the nerve endings. It's faster and easier to go for my scheduled scope #3 that hopefully will be in the 2nd week in January 2018. An MRI scan would have to wait 6 to 8 weeks then a further 6 weeks for the results that would go into the northern hemisphere spring equinox.

The pressure behind the knee came on recently that is a good sign that the right knee is not happy with a higher success that something else might be found during surgery that hopefully can be fixed or eased. It is make or break and happy to take a gamble and risk at this stage! Fully aware of the dangers and risks involved when signing the consent form that safeguards the OS if the knee becomes worse rather than better post-op.

Going to the book chapter writing workshop and conference next week Monday in Galway. Birmingham Airport is fairly large so will get overtaken several times. I can drive to close to the terminal where a chauffeur parks up your car and meets you again when you arrive back again. Less walking and use of public transport is always good if you going to be on your feet a lot while traveling. 

[email protected]

RK: PFPS, Arthrofibrosis & Tendinopathy
Scope #3 scheduled January 2018
18/07/14 Anterior interval release  
16/11/09 Medial plica excision & fat pad trim
Cortisone injections: R-Hip - FAI 04/04/17  RK 23/12/15, 22/10/15, 13/05/15, 30/03/10, 23/04/09

Offline DogfacedGirl

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Re: Your experiences of arthrofibrosis
« Reply #21 on: November 14, 2017, 01:41:54 PM »
Hi Clarkey,
That's good that you have a plan for the surgery, all the best with it. At least you're very well informed!

That's a long time to wait for an MRI result. I get my reports 2 days after the scan, but I have to go there to pick them up. The film takes a few more days to have in hand, but that's all.

Have fun with the writing workshop!
Kay
1999 Osteoarthritis both knees, chondroplasty
2004 MACI graft L knee
2005 MACI graft both knees
2007 MACI graft R knee
2007 Patella baja
2011 TKR both knees
2011 arthrofibrosis

 















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