KNEEtalk

The WAITING ROOM => GENERAL KNEE QUESTIONS and comments (good for new threads) => Topic started by: Kris on March 09, 2006, 05:39:47 AM

Title: ???'s--PKR or other option
Post by: Kris on March 09, 2006, 05:39:47 AM
I'm heading to the new OS tomorrow.  I thought I was prepared, but I'm nervous that I'm going to not ask something or not get all my options.  I don't even know exactly what this doctor will be able to do for me.  I know he studied or something at the Steadman-Hawkins which I think is a pretty good indication that I may be heading to someone that can help me with my knees.  I also read on his biography or whatever it was that he does partials and total knee replacements plus high osteotomies (sp) and cartilage repair.  All may be options for me.  I have no clue though. 

My question is that when preparing for this visit I finally got all the doctor reports and MRI reports from my original OS and I was browsing through them, I was wondering if after reading all the information, I am still a candidate for each procedure. 

Here's what I now know from reading all the reports.  The last doctor I visited with (just because he had to administer my final shot) said that I had degenerative joint disease in the left, so I'm sure that goes for the right as well since the left leg is the best.  Both the second and third doctor stated that I have significant crepitus, which is basically from the Chrondomalacia and also a positive patellar trap test.  What is a patellar trap test?  The MRI reports that both the lateral and medial part of my right knee  are "fairly preserved."  My ligaments and the meniscus are fine.  It says that I have significant chrondomalacia and subcortical changes with loss of articular cartilage and thinning in the patellofemoral joint as well as in the trochlea.  I'm not sure what options there are for me because the reports don't sound all that bad.  I know from the operative reports I have Grade 3 Chronodomalacia in spots and Grade 4 in most other spots.   All doctors say my tracking and allignment are normal now after my reallignment surgery, however it definitely doesn't feel that way.

I know I'll find out the options tomorrow, but I was wondering if I still have many options or if the partial is the only way to correct my right knee.  This was the suggestion of the 2nd doctor who is a coworker of my original.  They both suggested looking into it.  Since I'm 27 years old and a teacher I also want to know what would most benefit me in the long run.  I do a lot of knealing with my 2nd graders which I can adapt if I have to and I'm always on the go at school.  I know this is a lot of rambling, but if anyone could offer some advice I'd surely appreciate it.

Thanks,
Kris
Title: Re: ???'s--PKR or other option
Post by: Natalie.D on March 09, 2006, 12:48:15 PM
Hi Kris,

Obviously I am not a doctor so I'm only guessing going by my own situation, but if your report says that the lateral and medial parts are "fairly preserved" then I would think that gives you hope at being a candidate for either cartilage repair/transplant - depending on how badly deteriorated the patella is there may be a few options open to you, even a partial may be the best option with just having the kneecap replaced.  Is your report fairly recent?  I ask because I went to see a new OS with the hope of being given some options like cartilage transplant or PKR only to find that all three compartments of both my knees were so badly damaged with OA that the only option left for me is a TKR, I hadn't realised that my knees had become SO bad SO quickly.  Your report seems to indicate that you are still at the stage where there is hope of being able to have something done and if your chondro is at grade 3 in parts then that means its not totally destroyed all over even if it is at grade 4 in other parts, I suppose it depends on the percentage of grades 4 versus 3  ???  Good luck, I hope you get some encouraging news at your appointment.  Let us know how you get on.

Natalie.
Title: Re: ???'s--PKR or other option
Post by: Kris on March 09, 2006, 01:47:59 PM
Thanks Natalie for your reply.  My MRI was done in December.  This is the first time I've seen the report.  I've been going on what my doc says and of course that's not much regarding the report.  I do not know if I have more Grade 3 or Grade 4.  I think from remembering the surgical report in May said that a lot of the Grade 4 is located on the femur.  I think that's right.  I don't have the report right in front of me since I have packed the car to go to my appointment.  It'll take 3 hours to get there give the fact I only know to point my car in the the East direction.  I'm really worried about what to do next with the knees.  I know I don't have much hope of living a "normal" life pain free, but every procedure I have had has not lived up to the expectations and in some cases have given more pain.  I'm afraid to make another bad choice in trying to save the knees.

Thanks again,
Kris