The WAITING ROOM => GENERAL KNEE QUESTIONS and comments (good for new threads) => Topic started by: lightedge on July 01, 2005, 03:34:04 AM

Title: Tried EVERYTHING. Combo menisci, muscle nerve problem
Post by: lightedge on July 01, 2005, 03:34:04 AM
3.5 years ago my life was turned upside down. I was doing a light jog, felt a tinge of pain behind my knee and several days later my lower leg was badly swollen and would not move. Swelling was most notable immediately behind my knee. MRI indicated a stress frx on my tibia and various micro tears in my gastroc medial head and that was it. Nothing surgical was noted. Tried PT for several months with very little benefit. After about 9 months, I was able to walk with moderate pain and a limp. I've had continuous swelling at the head of my gastroc for 3.5 years. I eventually gained about 80% leg function and decided to live with this since every specialist in Dallas had no idea what to do. Small changes in the level of this swelling has substantial impact to lower leg function.

In 9/2004 leg worsened substantially again. Swelling behind knee worsened as well. Weakness in ankle flexion (all directions) are most impacted but weakness and reduced sensation in lower leg are most pervasive symptoms. Multiple MRI's, EMG's bone scans diagnostic nerve blocks in Dallas showed NOTHING wrong.

I went up to The Mayo in May. Their MRI shows muscle swelling behind knee (popliteal effusion), swelling of bilateral head of gastroc, discoid/degenerative posteromedial meniscus and secondary RSD.

I'm working with an OS with one of the professional sports teams. I've been in PT for about 6 weeks and can walk short distances with significant pain. Swelling behind knee is not benefited by PT.

A lot of information here.

My question is this:

What could be causing the chronic inflammation behind my knee? This seems to be the linchpin for everything IMO. I know that I've been seeing the best and the brightest, but I'm looking for a needle in a haystack and one of you might stumble on to the needle.

Thanks for reading my lengthy post.
Title: Re: Tried EVERYTHING. Combo menisci, muscle nerve problem
Post by: jillo on July 01, 2005, 05:16:28 AM
Scar tissue maybe?  Or a meniscus that's torn and deflecting inot or out of the joint.  I had a sort of similar problem with swelling, severe muscle wasting and cramping after a failed meniscal repair. COuldn't put any weight through the back of my leg, which evantually messed up my kneecap too.  MRI showed nothing at all except one tiny bright white spot on a couple of films.  When they went back in they found a good sized tear that was displacing into the joint and a bunch of scar tissue wrapped around the popliteal tendon and muscle.  Took most of it off and it's 80% better.
Title: Re: Tried EVERYTHING. Combo menisci, muscle nerve problem
Post by: Nettan on July 01, 2005, 07:20:59 AM
Haven't they done a scope on you to really see what's wrong ? It's the easiest way to really know what's going on as Mri not are 100% accurate.
Maybe you don't need a sports doc , maybe you need someone else just good at your issues.

Hugs Nettan  8)
Title: Re: Tried EVERYTHING. Combo menisci, muscle nerve problem
Post by: lightedge on July 02, 2005, 03:09:06 AM
Than you both for your thoughtful responses.


Any thoughts on who this "someone else" might be. I've seen 4 different highly respected OS's. 3 specialized in knees, 1 was an orthopedic oncologist as a mass was suspected at one point. I also saw an OS specializing in knees at Mayo. No one has been remotely interested in any type of invasive procedure. I've attempted to discuss the idea of arthroscopy numerous times to no avail. I think the existing neuropathic pain process is making everyone nervous about any type of surgery. I've worked at length with 3 different highly respected neurologists and possibly the top physiatrist in Dallas again to no avail.

All 4 doctors I saw at the Mayo felt that I should work with a top OS with one of the professional sports teams and undergo intensive PT so that's what I'm currently doing. I saw my Mayo MRI films and I must admit that they are MUCH more informative than any MRI's I've had here. However, the swelling is showing no sign of improvement. To your point, even the best MRI's aren't 100% though.


I will discuss your experience with the OS next week. Your story somewhat similar to mine.
Title: Re: Tried EVERYTHING. Combo menisci, muscle nerve problem
Post by: jillo on July 02, 2005, 09:59:04 AM
Yeah I had a really hard time explaining the problem with the back of my leg.  I could put weight on it fine if I stood on tip toes, but if my heel was flat the back of my leg wouldn't carry any weight, if that makes any sense.  Also the side and back of the knee felt tight and pinchy all the time where the scar tissue was preventing the joint from rotating normally as I walked: my calf didn't do that rotate to the outside thing it normally does.  I don't think the doctor ever really got it to be honest, but it sure as heck feels better than it did once he fixed the meniscus and freed the popliteal tendon!  It is taking ages to get the calf muscle and VMO back but before surgery I couldn't even really tense the hamstring or calf without getting a cramp.

I still have some scar tissue but he didn't want to go digging for it, probably because of all the nerves there so I have to do a year of strengthening and we'll reevaluate.  So far, so good.  I have some scar tissue at the entryways but it is loosening up by ripping off painfully in chunks at random intervals.  Way better than before though.
Title: Re: Tried EVERYTHING. Combo menisci, muscle nerve problem
Post by: Nettan on July 02, 2005, 03:09:28 PM
Just a quick question, have the docs worked together regarding your problems ?
I went to a specialistclinic with all specialists in one place working together to sort out my mainproblem as noone could help me. this gave positive results. I know what I have to deal with now, but unfortunately nothing I can be helped with. Instead they try to help me the best way the can to take care of it in best way, means that my treatment changes very often.
Sorry, wish I could help you better.

Hugs nettan  8)
Title: Re: Tried EVERYTHING. Combo menisci, muscle nerve problem
Post by: lightedge on July 02, 2005, 04:18:30 PM

The docs worked together at Mayo in order to make a diagnosis and set a direction. They don't know why I have swelling behind my knee. No one knows. I probably need to be scoped but the challenge is finding someone willing to do it. I'm hoping my current OS will be willing to get more aggressive if PT doesn't help and he gets more comfortable with my situation.

Thanks for everyone's input. I'll refer to your comments when I meet with the OS next week.