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Author Topic: Your experiences of arthrofibrosis  (Read 3181 times)

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Offline Clarkey

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Re: Your experiences of arthrofibrosis
« Reply #15 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, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline DogfacedGirl

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Re: Your experiences of arthrofibrosis
« Reply #16 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 #17 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, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline DogfacedGirl

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Re: Your experiences of arthrofibrosis
« Reply #18 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 #19 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, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline DogfacedGirl

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Re: Your experiences of arthrofibrosis
« Reply #20 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

Offline Betematty

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Re: Your experiences of arthrofibrosis
« Reply #21 on: November 26, 2017, 10:10:37 AM »
Hi Clarkey
I saw you are in the uk and as Iím not a million miles away I wondered if u could give me some advice.  I ruptured my ACL in 2014, had the broken acl removed in Jan 2015 and rehabbed we left with a stiff knee then had my ACL reconstructed in Feb 2016 but again have been left with a stiff knee.  I canít get full extension and still walk with a limp.  I have had X-ray & MRI which shows nothing.  My knee gets really cold and other times really hot and it is effecting my hips and lower back as my hips ache and I keep putting my back out.  My consultant wants to go for an extension brace although 21 months post op, do you have any thoughts or ideas ??

Also I suffer from IBS and have had a very stressful period over the last few years.
Thanks in advance

Offline Clarkey

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Re: Your experiences of arthrofibrosis
« Reply #22 on: November 30, 2017, 09:34:27 PM »
Hi Betematty,

I have never sustained a ACL tear with my ongoing right knee injury problems without any reconstruction surgery as all my ligament were intact. The only thing that springs to my mind is knee bursitis fluid build up of the bursa maybe from scar tissue building up. Nerve problems with the cold and hot variations in temperature is another possibility. Scar tissue build up can occur from numerous amounts of surgery putting extra strain onto the other joints and from limping. Have you had a gait analysis done by a experienced physiotherapist. Tightness in the muscles can restrict extension of the knee. My ROM and stiffness improved after 3 sessions of dry needling needling, intramuscular stimulation (IMS) sessions after my first scope in my right knee. Someone might be able to advise you further that has also been through ACL reconstruction surgery.

[email protected]
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline lilbit

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Re: Your experiences of arthrofibrosis
« Reply #23 on: January 08, 2018, 02:00:06 AM »
Hi there Dogface Girl,
Thank you for taking on this summary of experiences.  I have copied the questions into my email, and will work on answering them - have to run to take care of an elderly mother.  The last part of the journey is the hardest!
I too have a "bad knee" experience - 80 degrees flexion and full of arthrofibrosis.  The surgeon's response when I asked about amputation was, "It shouldn't hurt that much."
I have been following your posts about resolvins and inflammation - had been using Advil - no more! 
I have lost that thread but will look for it again.
Your posts are giving me lots of information, and even some hope!!   I live in Canada, and am considering Anakinra.
In the meantime, I'm trying out Castor Oil at night.  LOL!!  Aren't we desperate? 
All the best to you, and thank you again.  I am on a steep learning curve here.
Lilbit

Offline DogfacedGirl

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Re: Your experiences of arthrofibrosis
« Reply #24 on: January 08, 2018, 01:36:56 PM »
Hi Lilbit,
Thanks so much for your post, its nice to know that I'm giving helpful information! Have a look at my recent posts on "Observations on arthrofibrosis", if you haven't already.

It sounds like you have had a tough time of it, and yes, we do get desperate. Surgeons that don't understand make things even more difficult. I look forward to your response to my questions, but there is no rush. It's great that your are taking care of your elderly mother  :)

All the best,
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 DogfacedGirl

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Re: Your experiences of arthrofibrosis
« Reply #25 on: February 08, 2018, 10:59:57 PM »
All the very best Clarkey!!

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 #26 on: February 10, 2018, 12:06:12 PM »
All the very best Clarkey!!

Kay

Thanks Kay for checking in to see how I am getting on after my 3rd scope last month. I am sure you have seen my post op diary already since my surgery. Had my 2nd AIR and patella decompression surgery that no big surprise with all the scar tissue accumulation. My suspicions of having a meniscus tear was also right that might have been why I had an increase of effusion that was the deciding factor to go in again or would have been told nothing more can be done. Glad I took the risk and gamble, always knew there was more to it than just chronic patella tendonitis.

How is your knee problems going any changes or have it remained the same as it was towards the back end of 2017? Is your research into arthrofibrosis still going strong after your pet bereavement that is hard to accept, pets are very much part of the family. Hopefully, 2018 will be more promising and happier year for you happy late New Year, better late than never.

[email protected]
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline Betematty

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Re: Your experiences of arthrofibrosis
« Reply #27 on: February 20, 2018, 10:25:13 AM »
Hi

Was wondering how people got the diagnosis of Arthrofibrosis was it through MRI or with them going in and seeing it ?

Thanks


Offline DogfacedGirl

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Re: Your experiences of arthrofibrosis
« Reply #28 on: February 20, 2018, 01:35:52 PM »
Hi Betemmatty,
My diagnosis was based on symptoms (poor ROM and pain), because I have artificial knees and MRIs don't work all that well with metal. I think that for many people the diagnosis is based on symptoms, but may be confirmed with either an MRI or by arthroscopy to lyse the scar tissue.

By the way, for others reading this, if you would like to contribute your responses to my earlier questions about your experiences, then soon would be good  :) The first draft of the paper is close to being ready.

I'm very pleased to hear that you're going well Clarkey!!

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 #29 on: February 22, 2018, 09:00:20 PM »
Hi Betemmatty,

My ROM was not that bad felt pain anterior knee pain and pressure, my MRI scans did not show the arthrofibrosis with effusion spotted in my MRI pre-op to scope #3. Mine was discovered when I had my last 2 surgeries for other procedures ended up having anterior release surgery where scar tissue had built up from overusing the knee too much in the early stages of recovery to scope#1 and 2.

Kay, going well so far just cannot tell yet how the right knee is until I have my knee brace taken off on Tuesday and no longer using the crutches.

[email protected]
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming