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Author Topic: Knee issue - Looking for other opinions  (Read 197 times)

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Offline cmurph1969

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Knee issue - Looking for other opinions
« on: December 07, 2017, 09:20:31 PM »
I've had minor knee pain most of my adult life. This was likely caused by being 500lbs for a good portion of that. I have lost 250lbs in the last 3 years but my knee pain over the last 6 months has been getting worse not better. My doctor says it's arthritis and we have run through a number of anti-inflammatory drugs, naproxen, celebrex, meloxicam and arthrotec. Arthrotec has bene the only one to calm the pain down, but at this point it is minimal.

6 months ago my left knee started giving my problems, constant burning in the front and the inside. Prior to this I was walking 60-90 minutes a day for the past year, there was always minor discomfort but manageable. At this point walking longer than 10 minutes requires me to stop and rest for a few minutes to relieve the pain. Once stopping the pain is manageable for another 10 minutes or so.

My doctor had me get an MRI. When she received the results her suggestion was for one of the following.

1. Do nothing
2. Receive a Synvisc injection
3. Receive a cortisone injection
4. Meet with a surgeon, but that would likely be a waste of time as they would suggest an injection.

I have suspicions about her motives, she is the one doing the injections. Her ratings online suggest that she wants you to keep coming back as often as possible to increase her bill backs to the government (Canada).

Anyways, TLDR. Looking for a 2nd opinion on my MRI results, documents below.


Age: 48
Sex: Male
Height: 5 11
Weight: 255lb

MRI Results

EXAMINATION FINDINGS: CLINICAL HISTORY: To rule out internal derangement and chondromalacia patella.

TECHNIQUE: Sagittal PD and coronal, sagittal and axial fat-saturated PD modified with BLAD through the LEFT knee.

There is tricompartmental degenerative arthropathy most advanced in the medial tibiofemoral compartment, showing sever joint space narrowing, extensive full-thickness cartilage loss, prominent marginal osteophytosis and patch subchondral edema.
Grade 3 chondromalacia patella is noted mostly along the lateral facet although a full-thickness cartilage flap is also evident along the medial facet.

The medial meniscus is partially macerated together with complex tears. The lateral meniscus also shows complex tear alon the anterior horn.
The medial collateral ligament shows bowing and mild sprain. The anterior cruciate ligament shows probable partial tear. No other ligamentous nor tendon tear is identified.

Mild joint fluid is present. No Baker's cyst is observed.

IMPRESSION: Advanced degenerative arthropathy in the medial tibiofemoral compartment followed by the lateral patellofemoral compartment. Complex medial and lateral meniscal tears with partial maceration of the of the former. Mild MCL sprain and partial ACL tear.

Offline Vickster

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Re: Knee issue - Looking for other opinions
« Reply #1 on: December 07, 2017, 09:43:27 PM »
I'd be inclined to meet with a specialist knee psurgeon to discuss keyhole to tidy up the torn meniscii and cartilage wear and flaps, which will likely be down to the arthrtis in the joint. Get the synvisc injected during the op and then start physio afterwards once recovered from the trauma of the op. Synvisc doesn't really help where the damage is extensive, but could reduce the surgical inflammation (worked for me after a scope in 2010)

Unfortunately doing this is probably just a band aid which will hopefully help with the what sounds like fairly severe arthrtis throughout the knee and meniscus pain. I expect you'll be looking at a replacement in a few years. You could see whether a brace in addition to the physio might help as well as losing more weight, getting down to 180 would probably make a decent difference. Easier said than done as I know myself! Well done on losing so much already

Good luck :)
« Last Edit: December 07, 2017, 09:57:26 PM by Vickster »
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
LK New MRI shows lat & medial meniscus tear & other stuff
RK MRI lat meniscus tear
8/1/15 RK Steroid jab,
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation