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Author Topic: Does scoping weaken the knee and increase the long term risk of arthritis?  (Read 1038 times)

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Offline willp

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Hi everyone,

I'm debating whether to have a diagnostic scope next week for mild/moderate long term patello-femoral pain brought on by marathon training.

My doctor has said that he'll shave any lose bits of cartilage he finds....I know this is a common procedure, but since I met with him I've read that some experts believe that any shaving of cartilage, and even the simple process of arthroscopy itself significantly increases†the risk of arthritis in the long term and permanently weakens the knee. These comments have mainly been made on websites that talk up the benefits of prolotherapy.

Does anyone have any insights into whether this is accurate, or is it simply unsubstantiated internet rumour-mongering?

Thanks,

Will
« Last Edit: April 07, 2006, 07:35:16 PM by willp »
Medial plica removal 4/12/06. Not referred to PT. Increasing pain and quad weakness. Diagnosed with scar tissue by Dr Steadman 10/12/06, LOA and AIR in Vail 12/15/06. Returned to high level activities 4 14 years.
2020 - flare up with medial joint line pain and occasional collapse. Currently baffled

Offline Nettan

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Re: Does scoping increase the long term risk of arthritis?
« Reply #1 on: April 07, 2006, 06:38:32 PM »
I would say like this...you can also have higher risk for arthritis if you're not taking care of damages like loose pieces.
So therefor you have to think how much your knee problems you have right now affects on you.
I know it's difficult when you hear different things but all depends on how severe problems you have and how that change your life. All procedures is always a risk, cause surgery is surgery but though if you have problems it is always better taking care of them then going around with them.
Wish you best of luck !!

HUGS NETTAN  8)
Surgery 6 times left knee torn meniscus, RSDS,chondromalacia, nervdamage cause constant nervpain,chronic inflamm.
Spinaldamage wheeler 100%.
Right knee damaged aug-06, use brace surgery 4/9-07.LCL tear.

Offline willp

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I'm replying to myself here. I'd forgotten I posted asking for advice on whether to go ahead with surgery. How I wish someone - anyone - had suggested holding off and pointed out that when a joint is violated, it's never, ever the same.

If you happen to be reading this after being suggested diagnostic arthroscopy, think very long and very hard. Everything I was promised was essentially a lie. I now know that an increased risk of arthritis is inevitable. I required a second surgery after not being referred to physio and developing arthrofibrosis - and being left unable to walk. I was in incredible pain, and my Dr washed his hands of me. I was incredibly naive about the financial pressures to operate in the US health care system. (I was a Brit living in NYC.)

While my arthrofibrosis op was a great success, and I returned to activity, it's never been the same, and I'm now having problems with the knee 14 years later.

Over those years I've spent thousands of dollars and an immense amount of time and emotional energy on trying to manage my knee. The operating surgeon would have taken 20 minutes inside me, collected a big payday, and probably operated on 4 other people that day. The last time I saw him three months post-op, with a leg fused with scar tissue, no quad to speak of, and in great distress he simply said 'I afraid I can't help you any more'.

I was deeply foolish to listen to him, and deeply foolish to be influenced by the reply to my earlier post, which I just re-discovered (though I don't blame that poster at all - they wrote what they believed and were giving advice in good faith.)

So, if you're thinking of having a 'diagnostic' scope....remember, YOU are the one that will have to live with it. There may be a tiny handful of cases where it's medically justifiable. Judging from my experience and many other posters on this board though, it often leads to a hellish cascade of long term consequences.

The surgeon just goes home from another day at work.
Medial plica removal 4/12/06. Not referred to PT. Increasing pain and quad weakness. Diagnosed with scar tissue by Dr Steadman 10/12/06, LOA and AIR in Vail 12/15/06. Returned to high level activities 4 14 years.
2020 - flare up with medial joint line pain and occasional collapse. Currently baffled

Offline kawi_girl

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Hi willp,

Thank you for your cautionary tale. Iím sorry for the experience you had. I have been wondering about a scope...if it would really tell me anything about my knees or not. Even before I read your post I was not convinced it would really do any good. My problem is very hard to treat yet does not strike me as being operable. I never have any obvious swelling or heat. Just pain with certain movement and if Iím in a flair up stage, at rest also. Then suddenly itís more manageable again for a while, and the cycle continues.

I sure hope you continue to manage as you are having issues now again, and that they donít get any worse.

Offline Lakeswim03

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Hi willp
I also would like to thank you for posting your very helpful update.
I am also considering a diagnostical scope (amongst other things) so was very interested to read your post.
I'm sorry to hear about the results of it and the other issues which you are experiencing.

Taking the decision to undergo any operation is difficult, and it is even more difficult to come to terms with if we are able to look back and wish we had taken a different route.

Thank you for helping others to fully consider the implications, and I hope you find the best possible way to manage your knee for the future.

Offline willp

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Re: Does scoping weaken the knee and increase the long term risk of arthritis?
« Reply #5 on: September 08, 2020, 12:37:26 PM »
Thank you both very much - I'm glad what I wrote is helpful. I'm just off for another visit to the orthopaedist for the results of a MRI. The direct consequence of what happened in 2006. I'm almost certainly going to have to give up running, which has been a passion of mine since childhood and how I spend much of my recreational time.

You're right - it's very, very hard mentally to deal with the regret that comes from making that one foolish decision. Please think hard about yours.

Medial plica removal 4/12/06. Not referred to PT. Increasing pain and quad weakness. Diagnosed with scar tissue by Dr Steadman 10/12/06, LOA and AIR in Vail 12/15/06. Returned to high level activities 4 14 years.
2020 - flare up with medial joint line pain and occasional collapse. Currently baffled

Offline Brandon123

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Re: Does scoping weaken the knee and increase the long term risk of arthritis?
« Reply #6 on: September 10, 2020, 08:45:13 AM »
Thanks for sharing your story, Will. Please keep us updated on how everything develops!
RK sharp pain while running, diagnosis chondromalacia patellae 6/09
RK arthroscopic chondroplasty 9/09
RK rehab, recovery, 90% normal, started running again -> back to square one 5/15
RK diagnosis patellofemoral arthritis + LK diagnosis chondromalacia patellae 8/15 -> conservative treatment

Offline mang0954

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Re: Does scoping weaken the knee and increase the long term risk of arthritis?
« Reply #7 on: September 11, 2020, 10:47:50 PM »
I don't have pain on my knee but it constatantly swells in past 6 months since I first notice swollen knee after running (have tried many conservative treatments and suppliments). Doctor told me that most likely I have floating cartiliage that causes swelling and that if I don't smooth it it will cause even more cartiliage loss with any movement. Is this true?

Offline Vickster

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Re: Does scoping weaken the knee and increase the long term risk of arthritis?
« Reply #8 on: September 12, 2020, 02:22:12 PM »
Yes, a loose body within the joint could potentially further damage the joint surfaces. A tidy up and wash out might be advisable
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline willp

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Re: Does scoping weaken the knee and increase the long term risk of arthritis?
« Reply #9 on: September 17, 2020, 12:09:10 PM »
I will do Brandon. The second opinion I saw now thinks that a 'quiescent' radial medial mensicus tear might have become 'active'.

I know that I've had this tear since at least 2016. I had a MRI then, and I was able to be active with it - it was clearly largely asymptomatic. However, the specialist says that I now have two choices - rest, but that probably won't help - or surgery.

Needless to say, I'm NOT leaping into surgery. I can still walk fine, even if occasionally I catch a step wrong and get sharp pain. Running isn't really possible any more - I don't have the confidence, and I get stabbing pain on  some corners. Night pain is probably the biggest issue....I've had very disrupted sleep over the past few months.

I'm reluctant to get into another cycle of Dr's visits, but it may be that I need a third opinion if this doesn't settle.

I hope you're doing well.....

Medial plica removal 4/12/06. Not referred to PT. Increasing pain and quad weakness. Diagnosed with scar tissue by Dr Steadman 10/12/06, LOA and AIR in Vail 12/15/06. Returned to high level activities 4 14 years.
2020 - flare up with medial joint line pain and occasional collapse. Currently baffled















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