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Author Topic: Mysterious paiin after kneeling  (Read 1760 times)

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Offline riverbluff

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Mysterious paiin after kneeling
« on: March 21, 2006, 03:05:11 PM »
   Thanks to anyone who can shed light on this knee event:
   I am female, 55, and very active, playing racquetball 2 or 3 times per week.
   For 25 years, my knees have been problematic with stiffness and aching, with two brief episodes of extreme and lasting pain brought on by merely turning over in bed.  The last of those episodes was 4 years ago when I was 50 pounds heavier.  Xrays showed deterioration of cartilage, arthritis, but nothing else, and eventually that pain went away without treatment.  Also for years, I have not tried to kneel or squat because these actions always made my knees feel as though they might explode, like a water balloon with pressure applied.  Two years ago, I lost 50 pounds and became much more active, taking up racquetball, treadmill, and eliptical.
   Several weeks ago, I fell on the racquetball court flat onto both my knees with my full weight.  I rolled off my knees immediately and thought it was a minor miracle that I was not hurt.  I got up and finished that game and played for another 10 minutes or so to finish out our hour.  I had no pain or any discomfort of any kind from the fall.  The next day the only thing hurting was my left arm tricep where I had apparently tried to stop my fall against the wall.  A week later I had no symptoms whatsoever and continued to play and exercise.  I don't even know if this event contributed to the eventual event.
   Then I had to clean the floor of an apartment I own.  I knew kneeling was a bad idea, had been for years, so I avoided it as long as I could, but eventually I ended up trying it.  I was on my knees for no more than 3 minutes before realizing that I just couldn't do it (experiencing no pain, but the feeling of things trying to explode in my knee), and I got up.  Instantly, I had a sharp searing pain in my right knee and could not straighten my leg from the kneeling position or put any weight on it.  I hopped down the stairs and to my car, where it was pure hell to extend my right leg to operate the accelerator and brake.  I managed to get myself home, where I sat in a chair for about half an hour.  I had no pain when my leg was bent, only when I tried to straighten it.  Then suddenly, about 1.5 hours after the onset, I was suddenly able to straighten the leg, walk on it normally, and had absolutey no pain and no aftereffects--it was exaclty as if nothing had ever happened.  I thought, ok, something was out of place and it's back in now.
   Three days went by, I played racquetball with no problem at all, and did normal activities.  Then suddenly in bed one night, my knee would not extend and I got that same horrible searing pain again.  After 1.5 hours, it miraculously disappeared with no aftereffects and was fine for a couple of days.  Then suddenly the same thing happened again, and again, and again for a week until finally the knee "went out" and would not return to normal even after 24 hours.  I was able to get in to an OS on an emergency basis 24 hours after the knee locked up for good.
   The OS xrayed and did an mri, but since I could not get my leg extended, the mri picture was not good.  He wanted to do a second mri by numbing my knee and getting it extended for the procedure.  The numbing agent did not do its job and they ended up forcing my leg straight while I could feel everything and was screaming and crying on the table.  This led me to believe that the doctor did not believe that I was having the level of pain that I was demonstrating; otherwise, why would any doctor continue to forcibly inflict that kind of misery?  I endured it and was able to lie still for the second mri, but after that experience, the knee hurt in all positions when before it had hurt only when trying to extend it.
   The second mri showed nothing wrong other than osteoarthritis, which I'd had since my early 30's.  There were bone spurs and he told me that the interior wall of the patella was worn, but otherwise nothing.  None of that explaiined the mysterious "going in and out" I'd experienced.  He gave me the option of (1) anthroscopy to diagnose anything unseen on the films or (2) a cortisone shot.  Since I felt something mechanical had to be causing the "in and out", I opted for surgery, but at the very last minute (I was on the gurney with i.d. bracelets on my wrist), I changed my mind and had a cortisone shot instead.  I made this decision mostlyy because I had developed some mistrust for this OS.
   The cortisone shot helped and three days later, I am able to extend the leg almost fully, not quite fully, and can put most of my weight on it.  I've gone from hopping with a walker to limping with a cane.  But this does not explain to me what happened, and that's why I'm posting.  Why would my knee experience one miraculous recovery after another with not the least aftereffect if the only problem was osteoarthritis?  That makes no sense to me.
   I will appreciate responses from anyone who has had a similar experience.  Thanks!

Offline blackbeltgirl

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Re: Mysterious paiin after kneeling
« Reply #1 on: March 21, 2006, 08:57:02 PM »
It sounds like there's a loose body in your knee.  If you've had degenerative changes in the knee for years, there are probably loose bits of cartilage that have broken away over time.  Sometimes, in some people, they get caught in the joint, affecting the actual mechanics.  This could explain why it didn't hurt when the knee was bent, but it did when you straightened it.  A piece of cartilage could have been caught up, and prevented part of the joint from working properly.  On top of that, when you forced it straight, the loose budy may have been pressed into a sensitive area, such as exposed bone.

Another explanation is a flap tear to the meniscus, which would work the same as a loose body.  The difference is that the flap of the meniscus will always get caught in the same general area, while a loose body can move around the joint, and get caught in different areas.  In either case, once the loose body or tear moves again, your pain goes away.

The cortisone shot helped by reducing the swelling.  Reducing the swelling in the knee could have created enough space in the joint for the loose body to move again, no longer impacting the basic function of the knee, or pressing on a sensitive area.

It's worth a discussion with your OS.  And of course, if you don't trust the current OS, see someone else.  On the one hand, arthoscopy is "relatively simple", and they could just wash out any loose bodies, and trim away any loose edges.  On the other hand, once they start on even the simplest of surgeries, you don't know how your body will respond.  In addition to the normal surgical risks (infection, anesthesia, etc.) it's possible that you've lived with relatively manageable pain for so long because you're used to the current state of your knee.  Surgically changing that, even a little, could result in more awareness of pain.

Of course, I'm not a doctor.  And I haven't had this particular problem.  But I've done a lot of research in the last few years, and it's at least an idea to explore.  Best of luck in finding appropriate medical care,

ACI was supposed to be 2/21/06.  On 6/29/06 Insurance co said have another scope, and if it still looks good, they'll ok the ACI.
Microfracture Dec 7, 2004
   3cm x 6cm lesion, LFC; 3cm x 1cm lesion, trochlear groove; lateral tibial plateau lesion
2nd degree black belt, tae kwon do (had to stop)