The WAITING ROOM => GENERAL KNEE QUESTIONS and comments (good for new threads) => Topic started by: Meerkat42 on April 19, 2016, 11:00:02 AM

Title: Help, not sure what to do.......
Post by: Meerkat42 on April 19, 2016, 11:00:02 AM
Hi, new to kneeguru and just wondering if anyone could offer any advice.  On the 31st March this year i had a skiing accident in Canada.  Initial x-ray showed no fracture but due to the pain and inability to bear weight was given crutches.  When i returned to the UK (4 days later) I saw my GP who referred me for an MRI.  Another 4 days later was told I had a minimal depressed fracture of the lateral tibial plateau with bone marrow oedema, joint effusion with lipohaemarthorosis and a medium size popliteal cyst.  The GP said i need an urgent referral with an orthopaedic consultant but almost 2 weeks on have not seen anyone.  I've had no real advice on what and what not to do.  I have a cold foot a lot of the time and the foot has a feeling of being wet underneath.  The knee itself is still swollen, although nowhere near as much, and is still on occasion hot to touch.  I don't have any real pain anymore and i'm now walking without crutches and almost without a limp!!  I still have problems with bending the knee, feels stiff and heavy and cannot straighten it completely. 

My questions are

#1  could the MRI be wrong?
#2  should i be weight bearing?
#3  is the cold and wet feeling in the foot normal?

Any other advice would be greatly appreciated  :)

Title: Re: Help, not sure what to do.......
Post by: The KNEEguru on April 19, 2016, 03:05:17 PM
Let's see if we can tease the issues out a bit.

1. Fracture of tibial plateau - this can be a nasty fracture if broken fragments are displaced or if a depression of the bone is marked. The principle is to try and get the bits into a good position before bony union takes place (3-4 weeks). If yours is minimally depressed, the surgeon might try to elevate the depression but might also choose to leave it alone.
2. You may or may not know that the meniscus (shock absorber) sits on the tibial plateau, so it will also be under stress, and that it one reason a surgeon might want to elevate it, but also to keep the bony alignment as good as possible to avoid any stress on the joint cartilage at the ends of the bone.
3. Lipohaemarthrosis means that there is blood and fat (probably marrow fat) in the joint cavity, and this can cause swelling, irritation and delay your rehabilitation.
4. A popliteal cyst is usually a consequence of there being fluid under increased pressure inside the joint, and it may resolve as things settle down.
5. The cold wetness is not right, and it may indicate some vascular issue, or even a pain syndrome such as CRPS.

You need to insist on seeing a surgeon - call the hospital patient advice and liaison officer (PALS) if you have such a person - and insist. And tell them at you have a cold foot (that may make them move). Get back to your GP and insist that he/she does something to facilitate this.

You need to get the knee moving soon, both flexion and extension, as well as keeping the patella mobile (you will get advice here) - but the first priority is to see an expert. I may even be worth paying to see someone privately and in a moment I will give you a link to a list of knee surgeons in the UK
Title: Re: Help, not sure what to do.......
Post by: The KNEEguru on April 19, 2016, 03:13:54 PM
Title: Re: Help, not sure what to do.......
Post by: Meerkat42 on April 19, 2016, 08:22:48 PM
Thanks KNEEguru, spoke to GP and been told I just need to wait!!  Referral team have said I may hear by Friday and that there's at least 200 people in front of me.  So much for an urgent referral  >:( :(