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Author Topic: Bone Bruise (Knee)  (Read 10264 times)

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Offline Ihave3kids

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Bone Bruise (Knee)
« on: March 15, 2005, 04:39:54 AM »
Hi Everyone....

Finally got my daughter into a OS that specializes in Sports Medicine. Good News and Bad News. Glad she does not require surgery but the diagnosis is not good.
A little history:

13 year old active daughter
Injury occurred on November 27, 2004
Softball injury while at practice, sliding into home. Twisted knee full force and landed on knee HARD!

Emergency room doctor said no breaks, should be Ok in 3 days. To this day 3+ months later she can not play sports, can not run, can barely walk and can not go up or down stairs.

Jacked around by insurance company. Finally changed IPA's.

Saw an OS who said "Hmmm, don't know what's wrong with it. No PT, it's bad for it. Went a second time and he decided it might be a dislocated patella but it's "ok now, just wait for it to heal"

Got insurance to OK a second opinion. Doctor didn't even LOOK at her knee or MRI pics, just looked at the MRI report and said "It's a sprain, go to PT and come back in 6 weeks."

So.....went to this doctor today. Paid cash price *gulp* $250.00. This doctor was very professional did not pawn me off to an "assistant"..looked at the MRI and X-Rays..had her take new X-rays, looked again. Says he didn't see a significant bone bruise area in the x-ray. He then proceeded to explain "everything" to me.

He eliminated things by telling me his findings. He finally deduced it was more than likely a bone bruise and that the "locking" sensation she must be having is the outer protective cartilage that got damaged when she fell on it. He said there is DEFINATELY something going on in there but it's not his recommendation to open her up for surgery when it's likely that it's a bone bruise.

Said bone bruises take 6 months to 1 year to heal. Recommended taking Glucosamine Sulfate everyday. Ride a stationery bike 2 hours per day to try to "sandpaper" and smooth the cartilage back up. Have to go to a special concocting pharmacy for a special cream that will help numb it.

He did say go ahead and keep going to the physical therapy to help get the muscles back up in the leg.

PT now wants her back on the crutches....her limp is getting bad...I DON'T want my 13 year old limping sideways for 1 year!!!!
PT says yes, her backaches and sideaches are from her limping and keeping pressure off the injured leg. She said normally they want you off the walking aides but in her case she wants her on to help her use the leg. She hates the crutches and is fighting it.

She seems to be OK with the fact that she will not play this season and possibly next. I know she was hopeful that she would be playing by September so it's breaking my heart. She talks about softball everyday. Her softball friends call everyday and tell her they miss her and when can she come play.

We have some friends that have a team of younger girls, I'm thinking of talking to him about her "coaching" the little girls(tips and talking to them ONLY). Not sure if it's a good idea or not.

 Her coach was upset and sad when I told him. Her Dad is still in denial and thinks she'll be back to normal in 3 months. I can ONLY hope!

Anyone have any thoughts or ideas? Anyone heard of and/or experienced bone bruising?

kneesknees

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Re: Bone Bruise (Knee)
« Reply #1 on: March 15, 2005, 02:34:20 PM »
Wow - u nearly described my situation!

After being passed around for ages, I had an mri which showed a bone bruise, swelling and fluid....OS said my kneecap is maltracking (duh! Its like off the side of my leg, but neway...).  I'm now waiting for an arthroscopy and just getting more and more p****d off wiv the situation.

I can't play sports or anything either, I limp when I walk and struggle on stairs etc.  It sucks BIG TIME!  Also used crutches for ages, then one crutch for even longer and basically never use it now, I hate crutches so much!

I have been like this since last February (2004) and things are just getting worse not better!

I'm really sorry that I don't really have advice (I never do really) - I can just say that I totally relate to your daughter's situation.  I used to play loads of sport and now can't do any and life is really crappy right now.  I know that sometimes it helps just to know that others are in the same kind of situation and it sounds like I really am.

If you or your daughter ever want to talk, just message me...there'll definately be someone who can offer you more scientific advice on here...but I just wanted to offer some support.

I hope your daughter's situation improves soon

Katy :)

Offline Ihave3kids

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Re: Bone Bruise (Knee)
« Reply #2 on: March 15, 2005, 03:42:42 PM »
Hi Katy,

Thanks for posting! Sometimes this board is good for just for the theraputic "bawling session." I don't think I've ever been so frusrated in my life and I'm 45 years old. When it comes to my kids, Don't Mess Around With Mom!!!!!

I'm so sorry to hear you're going through the same thing...I WOULD NOT wish this on my worst enemy. You've been at it a long time. Yes, my daughter and I can relate since she's very sports oriented. On the off season she plays volleyball and basketball. Her favorite is softball and her dreams were to join the high school team in 2 years. She's also a pitcher---can't even pitch now.

Are you seeing an HMO doctor? If you are and could afford it, go see a good (PPO) doctor that specializes in sports medicine. When I told the other 2 doctors how she injured it, they looked at me like I smoking crack...this PPO doctor knew exactly what I was talking about and gave more insight on what happens in that situation. HMO doctors just shove you out the door as fast as they can.

Unfortunately, I was up all night researching bone bruises and NOTHING sounded good. I actually found a post that went on for days and......everyone was in month 11, month 13, 1 year etc., I think one person said it started feeling better about 9 months later!!!!!!!!

Katy, I also researched Glucosamine. Found out you don't want the KCI after it because of the salts that's added. They say if you find a bottle with the KCI after it then you're not getting "pure" Glucosamine..about 30% less. Did you find a brand that was Glucosamine Sulfate with no KCI? I live in Southern California.
Did your doctor tell you only Glucosamine Sulfate and Cholond(SP?)? I read that it takes about 2 months before it even shows some effects.

Crutches do suck! But...walking with a limp is even suckier. Her PT told her about a guy that walked with a limp 6 months after the fact just because it was a habit. I let her get away with it today but when I watch her walk across the grass and to the car...Ahhh, that's the test. Smooth ground and around the house she feels comfortable trying to use the leg but at school she's afraid of falling (and has 3 times) so.........

Katy, I sure hope you find some relief and someone who will take good care of you. My daughter and I will keep in touch.

Offline ProfLiebstrom

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Re: Bone Bruise (Knee)
« Reply #3 on: March 15, 2005, 05:14:29 PM »

Did your doctor tell you only Glucosamine Sulfate and Cholond(SP?)?


Glucosamine and Chondroitin. It's best to take both of them as the combined effects of them is much much greater than either of them individually with cartilage damage. And yes it can take time for them to show any effect.

Even if your daughter is insistant on doing sports trust me when I say don't let her. I injured my knee somewhere between 5 and 10 years ago so younger than your daughter (7 - 12). Saw doctor when I was 12 and they bumped me off with growing pains crap because my parents wouldn't take me. Anyway let me get back on track. I carried on with sports. Football (soccer), Rugby, Cricket, Martial arts were my main 4. And then all the things we did at school.

Now im 17, both my knees are going. I spent new years day crying in pain on the floor. I can barely walk now because of the pain and because I feel like im going to topple and fall all the time. All because 1) I had a crap doctor and 2) I wouldn't stop my sports. So try and keep her off the sports and on the crutches. When I see my OS for the first time (I finally got a decent GP and has had almost everyone at the practise send a referral now to get me seen quickly) im going to try and get crutches. I stole a friends for a bit one day and its amazing how much they do help so try and keep her on them whenever you can.

Scott

Offline ranger

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Re: Bone Bruise (Knee)
« Reply #4 on: March 15, 2005, 07:07:43 PM »
I've got every sympathy with your daughter :( My main source of pain is from a bone bruise seven months after the fall and I was told it could be up to a year to heal. Using a knee brace has made a huge difference to the pain levels as that stops the bruised surface getting knocked when I move around- it does get less painful if you can stop irritating it- but I've never got off crutches completely in all that time. Lifting weight off the knee by using crutches is the only way to reduce the pain and to make sure the knee is still being used in a good walking pattern. Limping long term isn't good and may cause secondary problems.

If your daughter can be really committed to being nice to the knee for a couple of weeks and religiously using the crutches to keep weight off it, she may find that the pain levels will go down and that will give her a little more lee way and freedom.

Best wishes to you both, hope she's more comfortable soon

Ranger
Sept 04 fallá
Dec 04 arthroscopy, medial femoral coblation, ACL reportedly 'stretched';
Jan 05 cortisone;
Feb 05 new OS, MRI, ACL 75% tear, articular cartilige damage, MCL partial tear, femoral bone bruise, knee severely unstable.
MacIntosh ACL repair 8/4/05

Offline Ihave3kids

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Re: Bone Bruise (Knee)
« Reply #5 on: March 16, 2005, 04:11:46 PM »
Ranger,

You say "seven" months...arrggghhh! How did you fall and exactly where did you injure? My daughter was in a slide position with the knee straight, slightly bent but when the cleat dug into the ground it put her at a dead stop..while the knee twisted...then fell forward on the knee with a loud thud in the bend position.
He said the thin shiny cartilage that is at the end of the bones had to be damaged in order to make the bone bruise and thinks that's the locking up feeling she's getting. The bruise is on the femoral condyle(sp), right knee...he suspects right on the inside tip area where it meets the meniscus.

Problem with the crutches is...she was on them for 5 weeks. OK at first but after walking to 7 classes all day for 5 weeks she was SOOOOooo very happy to put them in the closet. Now she's fighting me to use just one!!!!!!

I am going to "rat her out" to the PT tomorrow. You know kids, they don't listen to the parents but always to someone else.

God give me strength to do this for a year!!!!

Thanks so much for the tips and taking the time to post!

Offline Ihave3kids

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Re: Bone Bruise (Knee)
« Reply #6 on: March 16, 2005, 04:35:32 PM »
Hi Scott,

Wow, I'm so sorry you're going through that. You should be trying to reach the top of your sports career right now. I can't imagine being 17 years old and going through the pain you're in now.

Unfortunately in the wheel of life there's.......insurance companies!
I can certainly relate. I didn't know dealing with them has been so frustrating. I feeling like screaming "there's a live, 13 year old child here that's not some number."

Hmmm, I researched the Glucosamine and said there was no studeis to prove that the added Chondroitin help BUT...there's no evidence that it doesn't exactly work either. I did find a bottle at the pharmacy that didn't have any sodium in it. It was expensive but if it works, it's well worth it. I believe the added Chondroitin will certainly not hurt so next bottle, I think I'll buy that.

I think if she COULD play sports....between her and her Dad....she WOULD! She's not a big crybaby (she didn't even cry when this happened) and doesn't mind "working throught the pain." That's why at the point that she couldn't get up..damn, I KNEW it was something serious.

Fortunately...she just flat CAN'T...too much pain. Thank goodness for that huh, Scott..because I hear what you're saying.

I THINK she's getting it now--it's finally hitting her. I just know how her little mind works..... I believe that's why she's fighting the crutches. She figures she won't be playing for up to a year anyways so there's no need to inconvenience herself (by using crutches, etc.) since that was her goal to get better. Does that make sense?

I will surely show her your post and thanks so much Scott for you input. I certainly hope this new doctors gets you straightened out soon. Coming from a sports family I know how much it means to you!

Offline smiley196

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Re: Bone Bruise (Knee)
« Reply #7 on: March 16, 2005, 04:57:02 PM »
3kids-
Im sorry to hear of your struggles trying to get a proper diagnosis on your daughters knee.I'm sure we can all relate to how frusterating it is when we know there is something wrong with our knee's but the OS doesn't care. All I can say is I hope you daughter gets well soon. I too am unable to play soccer this year, and my old coach switched from coaching us to coaching 11 year old girls and asked if I would like to help out. This is alot like your idea. I personally think its a great idea, because then I am still involved in the game somehow even though I cannot play. I hope your daughter gets well soon!!! Lotsa hugs x0x
Krista
*16 years old*
Left Knee:
Torn:PCL, ACL, MCL
SEVERAL dislocations
Grade 3 Chondromalacia
Medial & Lateral Meniscus tears
Plica Syndrome
Sept 14th 2005-(LK)ACL recon, TTT, menisectomy,plica removal

May 26th/06-Torn ACL(RK)

June 14th/06-(LK)ACL graft recon, screw removal, menisectomy

Offline ranger

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Re: Bone Bruise (Knee)
« Reply #8 on: March 16, 2005, 06:55:08 PM »
I had a fall and injury from the sounds of it very similar to your daughter- I stepped out of my back door, my foot slipped straight forwards and I landed in a hurdler's position with my left leg bent up and behind me, and jammed my knee into the doorstep. I bruised the right femoral condyle, and tore the articular cartilige badly- the knee was jammed and wouldn't straighten until I had it scoped. All the pain is on the joint line, it looked like a meniscus tear. I also damaged the MCL and my ACL, and the main reason I haven't got back to full mobility has been the ACL damage- the knee is very loose and unstable which aggravates the bone bruising. After several months of walking around on it and trying to get it going again I've now done all but tear the ACL right out, and it needs reconstructing, but the pain is still focused on the bone bruise.

The brace and keeping weight off it really have reduced the pain hugely, from a 7-8 down to a 2 most days. If your daughter can just be patient for a couple of weeks she should be a lot more comfortable and that ought to give her a little more freedom. I so understand where she's coming from - I'd love to be able to ditch the crutches!!!

Best wishes

Ranger
Sept 04 fallá
Dec 04 arthroscopy, medial femoral coblation, ACL reportedly 'stretched';
Jan 05 cortisone;
Feb 05 new OS, MRI, ACL 75% tear, articular cartilige damage, MCL partial tear, femoral bone bruise, knee severely unstable.
MacIntosh ACL repair 8/4/05

Offline Ihave3kids

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Re: Bone Bruise (Knee)
« Reply #9 on: March 17, 2005, 03:43:40 PM »
Hi Ranger,

Wow, sound exactly what my daughter did but just a different pose. Of course the extent of your damage is worse. She shows no signs of ACL, MCL tears. With the type of fall you did, I'm surprised you didn't break something.

I was up late last night and found a really good website on sports knee injuries and the wording below shows my daughters(and yours) injuries to the T. I also found another site from a sports medicine clinic and it does not sound promising.

They all say that the Articular cartilage does not have it's own blood supply (thus the need for Glucosamine to speed up the healing process) and is hard to repair once it's damaged. It even went on to explain that in some cases where the articular cartilage is damaged it my rub on the bone bruise (kind of what he was telling me) aggravating it over and over and over. Sound familiar????

If that's the case then just her walking....will be detrimental to her recovery. I tried to explain it this morning and she still refused to use the crutch. I'm going to have to get mean about it, I can tell. Today I'm ratting her out to the PT and hope this helps.

This article goes on and on but very informative. I would post it, but don't know if it's allowed. Then  it went on to list how you can repair the articular cartilage with different surgeries. It's amazing what they CAN do nowadays. However, you need to find a doctor willing to do it!!!!!!!!!!!!!

"The main problem with articular cartilage is that it lacks an arterial blood supply, venous and lymphatic drainage and derives its nutrition primarily from the synovial fluid and to some extent from the adjacent bone. This has implications with regard to healing since superficial lesions rely solely on very slow and unsatisfactory cell mitosis and regeneration for repair. Deeper lesions which, together with the articular cartilage involve the underlying bone, heal better because there is direct access of the repair cells in the bone to the cartilage defect."

"The presenting features of articular cartilage damage are non-specific. These include intermittent pain and swelling. The patient may also present with locking or giving way if the fragment has separated into the joint. On examination, there is usually muscle wasting /inhibition, a reduced range of movement and tenderness over the site of the damage which is most commonly the medial femoral condyle or the patella;the other main causes are an anterior cruciate ligament tear, a peripheral meniscal injury and a severe bone bruise"

Offline ranger

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Re: Bone Bruise (Knee)
« Reply #10 on: March 17, 2005, 08:58:30 PM »
That sounds like a very acute article. I went for a second opinion due to problems with the first OS who did the smoothing off with the cartilige- using coblation which the second OS was a bit doubtful about to start with. He said that he tries not to operate on articular cartilige unless it's absolutely imperative, as in the end it inevitably means less cartilige where it should be and helps the cartilige to break down quicker, increasing the likelihood of arthritus and other problems. During the coming surgery one of the things he wants to do is check the extent of the cartilige damage I have, less for what he can do about it now as to what he needs to expect in the future to help me manage it effectively. The glaucosamine sounds like a really good idea. Plenty of calcium is another piece of advice I've had- apparently early adulthood is an important time to lay down good amounts of calcium to ward off bone problems in later life.

I'll be thinking of you reading the riot act to your daughter re the crutches- and hope she's a lot more comfortable and mobile soon. Take care.

Ranger
 
Sept 04 fallá
Dec 04 arthroscopy, medial femoral coblation, ACL reportedly 'stretched';
Jan 05 cortisone;
Feb 05 new OS, MRI, ACL 75% tear, articular cartilige damage, MCL partial tear, femoral bone bruise, knee severely unstable.
MacIntosh ACL repair 8/4/05

Offline KarenS

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Re: Bone Bruise (Knee)
« Reply #11 on: March 20, 2005, 07:04:35 PM »
I'm so sorry your daughter is dealing with a bone bruise. I've been dealing with the same situation in both knees for the past 5.5 months. I have sensitive knees to begin with, as I had a lateral release on both knees 13 years ago. The surgeries were extremely successful, but my knees will never be "good." Oddly enough, I ended up with bone bruises from using the leg press and squat machines at the gym. Apparently those are two things my knees cannot handle. I ignored the fact that my knees felt irritated after using those machines, thinking that they just had to "get used to it." Unfortunately, one day I could barely stand up anymore -- the pain even radiates into my ankles. The bone bruise was confirmed in my right knee on MRI, but the MRI of my left knee didn't show bruising. My doctor said it could be that it just didn't show up (it's milder on that side -- that's always been my "better" knee, anyway).

The first three months were particularly miserable. Thank goodness I'm a SAHM, or else I would've had to quit work. But it was extremely hard to care for my two small children during those months. Thank goodness for my mom and dad who live closeby, and my husband who did a LOT during that time. The only way I could function at all around the house was to ice them both down. I spent most of my days in a chair with my legs up.

Things seemed to "turn a corner" at the three-month point. I would actually get short periods of time when I wouldn't feel discomfort in my knees and could stand/walk for longer periods of time as long as I kept sitting to rest (I'm still talking about within my own house, though -- I would never elect to "go for a walk" or even walk around a store!).

Now, at 5.5 months, I'm getting impatient because, although I've been able to do more and more around the house (I can do laundry and clean the kitchen again -- yay!)...I "poop out" by the end of the day (meaning I have to sit in a chair and ice them down in order to cook dinner for my husband and kids, etc.). Out of sheer frustration from how long this is taking to go away, I've been pushing myself a LOT in the past couple of weeks -- going up and down stairs, grocery shopping, house cleaning, etc. -- sort of like I was rebelling against the situation because I'd had it! But now I think my knees are "rebelling." I'm trying to take it easy for a couple of days now. When I do too much, it definitely catches up to me.

This is definitely a slow process. I know you're dismayed to see people talking about 7-12 months or more until the pain completely subsides, but I think it's a fact that you might have to accept. If she gets better sooner -- great! But she needs to take care of herself. I was told by my doctor to do "what I can" in my day to day life, but don't do anything I feel my knees can't handle. Basically, use common sense. On good days, I feel like it will only be another month or so before I can get back to the gym to at least use the weight equipment...but days like today remind me that I still have a long way to go before that happens. I have a husband and two little boys (3 and 4 years old) to look after, and I've told myself that until I can do what needs to be done in my everyday life without discomfort in my knees for a solid month, I'm not fooling around with getting back to "extracurricular activities." It's depressing, but it's a fact. I still have a long way to go, but I'm extremely thankful to no longer be stuck in chair for 80% of the day -- THAT was horrible. At least now I can function somewhat normally and just put up with relatively mild discomfort. Frozen peas are my friend! Every time I sit to rest, I put my legs up and put a bag of frozen peas on each knee for a good 10-15 minutes -- ahhhhh! It really, really helps!

It must be very difficult to watch your child struggle like that, especially at that young age when she should be running and playing with her friends. But there will be a light at the end of the tunnel. If all she has is, in fact, bone bruising, be thankful it's just that. My doctor is the "knee guru" in my local area -- he's been an orthopedic surgeon for over 40 years. And he told me he has never seen anyone with a bone bruise that doesn't heal eventually. Some people take longer than others, however. I hope your daughter recovers sooner rather than later! *hug*
« Last Edit: March 20, 2005, 07:15:23 PM by KarenS »

Offline Ihave3kids

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Re: Bone Bruise (Knee)
« Reply #12 on: March 24, 2005, 01:55:58 AM »
Gosh Karen, sorry to hear that....I can almost feel your pain when you talked about your small children. I remember having my 3rd child (being older and not healing as fast as the last two) and feeling down, not able to take care of my 2 year old child....It was really frustrating!!!!!

I know what you mean about the "get used to it." My husband is very impatient and tried to get her to go on a bicycle ride. He thinks our kids need to work, work, work on their muscles, we argue constantly about this. He kept telling her "a little further" and she kept telling him it hurt. He just said "Oh, you're just not use to using it"........her knee ended up hurting worse for 2 days because of it. :'(

I sure hope you get to feeling better soon! I know it's hard having kids and then people say "rest, rest"...don't you want to just choke the living snot out of them? Teeeheee!

Offline Ihave3kids

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Re: Bone Bruise (Knee)
« Reply #13 on: March 24, 2005, 02:12:30 AM »
UPDATE...UPDATE...UPDATE.....

Took my daughter to the original (my HMO) doctor today. I saw the "real" doctor and he said he was very surprised when she walked in with the crutch (I got her to use it today, yahoo!). He said she shouldn't be this sore for this long and something is definately going on in there more than a sprain-----give me a big DUH!!!!!

I did NOT tell him about paying to see the other doctor and him mentioning the bone bruise. He said he wants to have an MRI done and see what it looks like. Told him been there, done that. He finally looked at the report that was in her file. He said MRI's sometimes don't show everything.

He said he wants to try a shot first. He did mention Arthroscopic (sp?) surgery and that way he can have a look at the cartilage & meniscus because he suspects that's where the problem lies. He says everything else seems good. He said the MRI would tell him about the ACL too.

He said let's try the shot. If the shot works then he knows it's something in the knee joint (DUH, again!)...he said if it doesn't work then it might be the ACL, which will definately have to be looked at. He says the shot will hurt (which it's hurting her bad right now, she's back on the crutches) tonight but then she should be able to walk on it tomorrow and the next day normally----OOokay!

I tried to tell him she passed out when they take blood the last time. He said OK, he can lay her down but it was probably from her looking at the blood. She said she felt fine, sat up---we walked to the appointment desk, she said she still felt fine then as I'm standing for the appointment she squeaks out "I don't feel good" and I barely caught her. He said "Oh, you were right"...Hell, Mom is always right--teeeheee!

I see him again in 2 weeks and if the shot didn't help then he's talking the arthropscopy. Anyone think it's a good or bad idea for a 13 year old with knee pain for 4 months?

Thanks for everyone for the tremendous support on this thread...you all know how upset I am and you all have been life savers for me!!

Offline Teresa_S

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Re: Bone Bruise (Knee)
« Reply #14 on: March 24, 2005, 02:50:50 AM »
IT sounds like a difference of opinion and not really knowing for sure, that is where the scope does add something, but not for a 13 year old if avoidable, in my opinion. There are too many young ones on here that are not coping well with the coninuing saga of knee surgery. I had a injury, when I was 21 where I opened the car door to step up on the drivers side, and there was a ice storm going on and my foot slipped out of the car and landed on my left knee twisted underneath me and left one heck of a bone bruise. IT took over 10 months for it to really feel much better. NOBODY offered me crutches, but from many experiences I can say that her gait will be altered to spare herself pain. IT is natural and she is not consciously controlling it. I have literally wore out my hip and the other knee sparing the bad one. OUR bodies take over to spare pain when they can. I hope she can be spared surgery, and just try some anti inflammatories for the pain, in addition to the glucosamine and maybe use the crutches for awhile. THe shot was prbobably a combination of a steroid and analgesic. GOOD luck, Teresa I have 5 kids and would glady take their pain, as I know you would ANYTHING for them.
On going instrumentation failure, chronic infection,
Arthroscopes Left 11 Right 2, MRSA, L TKRá ,á Revision, LR x5, Medial and lateral meniscus repair, Broken prosthesis
Osteochondral Fracture,untreated 6 mths. Revision new tkr 01-07 awaiting new hip and right knee
R TKR pending