The WAITING ROOM => GENERAL KNEE QUESTIONS and comments (good for new threads) => Topic started by: ChristianH on June 03, 2007, 02:01:32 PM

Title: Chronical knee problem(s)
Post by: ChristianH on June 03, 2007, 02:01:32 PM

I just found this forum and there really seems to be a lot of knowledge here! Hopefully there's advice for me as well here. :)

I'm a 22 year old male from Finland, currently in Germany, where I'll be working until end of August.


My story starts on 10th January 2006. It was like any other day; I was down at the gym (had been training for about 5 years, the last one quite determinately) working out my legs. I started with squats. I made a series of 5 repetitions on 90kg, followed by another one on 4 repetitions. I had trained using this weight for about a year. I felt some slight pain in my right leg, but I didn't think about it, and went on. On the next repetiotion I felt great pain and barely managed to get up with a lot of help of my left leg. I realized that I wasn't going to do anymore squatting that day. I tried to do some really light leg extensions, but only contracting the muscles was enough for the pain to be unbearable.

This was the last time I trained the legs heavily and also the last time I didn't feel any pain in my knee(/leg).

Every time I bend my leg more than ~90 degrees (eg. the squat movement) I feel pain, and sitting in (narrow) benches causes pain after a while. Often when I fully extends my leg, there's a popping sound and afterwards it feels better fo a while. The same thing goes for bending it fully backwards towards the bottom.

I've been seeing a lot of different doctors since that, and the knee has been examined by ultrasound as well as with MRI.


I've tried my best to translate the MRI results into English:



Axial T1, sagital T2FS, PD, Medec, DESS, coronal Medec.

Very mild hydropsis, no Baker's cyst. ACL, PCL, MCL and LCL normal. No meniscus rapture. At the patella and its upper edge where quadriceps tendon is attached a mild oedema, but the tendon looks intact. At the patella cartilage, at the center a mild signal change, but the find is very small, no clear chondromalacia. At the cartilage of the medial condyl of the femur a similar change, this one also rather mild.


Meniscuses intact. Mild cartilage changes, no clear chondromalacia.

Patella's and quadriceps insertion mild oedema."


After this, we decided to make an arthroscopy:


In Spin. anaesthesia is the right knee stable in both ap and side directions. Sotrz arthroscop provided with 30o optics is inserted anterolaterally. The outflow needle through the upper lateral recess and working portal antermedially. The joint fluid slightly muddy, no synovit, no foreign objects. A big medial plica exists that acctually is suprapatellar attached the upper edge of the patella and stretches towards the medial wall. This plica is very large and possibly explains the patient's problems and is therefore totally excised.

Somewhat chondromalci on the patella surface, nothing to revide. The tibiofemoral surfaces are both laterally and medially fine so as the ACL and PCL and both meniscusees are tested with hooks. The knee is rinsed well. On 3 portals tape. Knee bandage is attached.

DG: Syndroma plica medialis genu dx. M25.5"

However, I felt that didn't help. I lost a lot of muscles due to this and the problems remaines, so acctually things got worse.

It took me a long time, but finally I accepted that I would have to give up my passion, weight-lifting. The knee kept on bothering me, but the doctor told me that the knee looked good and that there was nothing more to do. I've gone to physiotherapists, tried to do rehab-training with weights, swimming and water gymnastics, but my problem remains.


Three weeks ago I played some relaxed soccer here (I should have realized that I'm not suited for that..) and felt some slight pain in my left leg! The day after the condition of it was basically the same as the right knee, only worse. It hurts really bad when I sit down and I have to either throw me down or assist with my arms.

The other thing that has been bothering me since I came here (I've walked a lot more here than at home) is an extreme feeling of exhaustion in my right leg. Most of the time it is in the back of the leg (hamstrings) , but sometimes also front (quadriceps) and behind the knee cap. I wouldn't call it pain, it just feels very powerless and for instance walking upstairs makes the leg feel really weak.

Last week I decided to go to the doctor here (an orthoped). He had me lie down and pressed above the knee caps, which made me bend my back in pain. He said it was clearly problems with the patella. He recommended me to train my adductors, which should help. I don't know, I've (earlier) been training really hard and look where it has got me.. I must admit that the adductors haven't been in focus, but I still find hard to believe that this would cure me. I told him this as well, and he said that when I want to he can a minor surgery called "lateral release", which he said helps about 75% of the patients. If it still didn't help another surgery could be made, "from the other side" (I didn't really understand).

I should still add, that here in Germany I've an insurance from work and an additional Finnish travel insurance, so surgery would be free. In end of August I return to Finland and will no longer have the possibilty of free surgery.

Title: Re: Chronical knee problem(s)
Post by: ChristianH on June 03, 2007, 02:20:54 PM
I forgot something very important: the German doctor told me, that if this problem isn't dealt with, the cartilage will wear out and then I really, really have problems..
Title: Re: Chronical knee problem(s)
Post by: Nettan on June 03, 2007, 04:28:52 PM
Christian, I would go ahead with a second opinion if that is possible before going into the route of new surgeries.
Once you have started doing surgeries there's no regrets.
Is there really a problem with patella not tracking propertly..if not a LR won't help.
Working on the muscles around the knee can take a long time to build up.
Even if he consider LR to be a minor surgery you should really go ahead and look around and read here on the board about the surgery and the rehab after.
Wish you good luck with descisions.
Title: Re: Chronical knee problem(s)
Post by: ChristianH on June 04, 2007, 06:44:19 AM
Thank you for your answer,

okey, I thougt about a second opinion myself too, so I'll do that.

What do you mean? That it will take a long time of training before I'll notice if the adductor training works, or that it will take a long time to recover from the lateral release?

I will do that as well!

Tack ska du ha än en gång!
Title: Re: Chronical knee problem(s)
Post by: ChristianH on June 04, 2007, 08:44:23 AM
Any thoughts about Hyaluron acid? On another forum (for weight training) a guy had exactly the same problems as I, and he couldn't squat (without weights that is) at all. After one injection, he said he could "jump like a frog". I've requested it several times in Finland, but all the doctors have refused to give to me, claiming that it's for old patients with wear downs. Should I try to get it here? Are the risks that something goes wrong severe? It must at least no be as comprehensive/risky as a lateral release?
Title: Re: Chronical knee problem(s)
Post by: Nettan on June 04, 2007, 01:53:58 PM
I mean that working on adductors could take a long time before you notice any differences.
About lateral release, many here around have done them, some with success and some with failure.
Though the surgery might be minor, the rehab after is tough.
Hyaluron is not only for elderly persons. But though maybe your damages isn't enough to go through that. But agree though that injections is minor compared to surgery.
Have you asked the doc in Germany about that ?

Varsågod, även om jag inte kan vara till någon större hjälp. ;D
Title: Re: Chronical knee problem(s)
Post by: DeborahinNC on June 04, 2007, 04:34:22 PM
Hi Christian,

I don't know much about LR except what I've read here.  My OS had mentioned it before the last surgery and it was not done since my problem is not patellar tracking.  I'm not sure if you read some of the posts that this is really a "minor" surgery. 

I did try the injections.  I had Orthovisc which is essentially the same thing just a different brand name.  The injections were not bad, they are supposed to help "lubricate" the knee.  These did not work for me but there are people I know and people on this forum who have had great success with them.  I don't really think there is much of a downside to the injections.  Yes there is always the risk of infection or anverse reaction but barring that I don't think the injections are too bad. 

I agree with Nettan, I would and have tried everything before surgery - free or not - so if you have the time to try alternatives do that.  If you end up with surgery you will know you did everything possible before. 

I wish you great luck.  Let us know how you are doing.

Take care,

Title: Re: Chronical knee problem(s)
Post by: ChristianH on June 05, 2007, 09:20:56 AM

Thanks a lot for your answer as well!

I'm getting that feeling as well, so I think I will at least postpone any surgery. There are two things putting preassure on me though; the first one being the fact that I now have the possibility to get free surgery, and the other one the threat that I'm constantly wearing down my cartilage.. The doctor told me that the tracking problems could increase the pressure in the knee threefold and I've been walking (and not only that..) around like this for 1,5 years now.

But it sounds like I'll definitely have a go with the injections, provided that he'll give them..

Take care as well, both of you,
Title: Re: Chronical knee problem(s)
Post by: ChristianH on June 05, 2007, 11:02:08 AM
Do you have any suggestions what I can do / should not do to improve my condition?

I as already told, I'm training my adductors, quite hard, varying, the seated machine and using a cable (tied round my wrist, lifting the legs sideways, both in front of and behind myself).

In addition, I try to train my quads, which is not very easy. I've skipped squats, leg kicks and lunges and only do extremely light leg presses, which are almost on the borderline to causing pain as well.

My hamstrings I train by machine curling. Maybe I could take upp "straight legged deadlifts" (but not with acctually straight legs!) again?

On top of this I do stretching. And quite a lot of walking, which doesn't feel bad for the left knee and mainly cause the earlier desrcribed exhaustion on the right one.