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Offline Kathy_C

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Advice please
« on: August 08, 2007, 01:22:32 PM »
Hello! I'm a 52 year old female in the UK with a knee problem! Sorry if this is a bit long winded and I hope you can stay awake!
My right knee has been feeling a little unstable for about a month, a bit worrying as that is my "good" knee having had ACL reconstruction and meniscus trim on the left a few years ago. On 13th July (Friday 13th!) I felt a crunching/giving way sensation on dismounting my horse and similar but worse on mounting. It felt OK afterwards but the next day it was quite painful so applied RICE as much as possibe. By the following Friday it was feeling much better though a bit painful on the inside of the knee on occasions however that following evening while walking normally the knee gave way with a loud crack. After this I couldn't put weight on it, or bend it or straighten it without agonising pain and I had to shuffle around on my bum to get around. I took painkillers and left it overnight after which there was no improvement iso I went to A and E the next day. The nurse who examined me was at a loss to understand why it was so painful. There was minimal swelling, but severe pain originating from the medial aspect of the knee. I actually have a high pain threshold  in the past I've broken bones, ruptured ACL and damaged meniscus but nothing has been this painful. The nurse thought the pain was a result of muscle spasm and most likely problem was MCL injury and not likely to be meniscus as I could almost straighten the knee though it was agony to do so. She prescribed pain killers, put my knee in a brace which holds it almost straight and gave me crutches. The pain subsided over the weekend but it was huritng to put weight on it or if it got jolted. The following week I saw the orthopaedic consultant who diagnosed medial meniscus tear. He said it would probably need fixiing and the best bet was to skip the MRI scan as it woul hold things up and go straignt for an arthroscopy so it could be treated at the same time. He said it should happen in the next 2 weeks. I was quite pleasantly surprised by this as this is after all the UK, however after 2 weeks I called the hospital as I hadn't heard anything and was told the consultant should not have given that time scale as the waiting list for an urgent operation was 3 months. She then located my notes and said it had been marked very urgent and put me in touch the appointments department and the arthroscopy has been booked for 12th September or sooner there is a cancellation. The sick note I had been given by the consultant ran out last Friday so I made an appointment to see my GP as I need to know when I can go back to work for which I need to drive and if there was anything I could be doing in the meantime to improve mobility. She said it was unlikely I would be working for the next month and I should have been given a follow up appointment to discuss these things and possibly arrange physiotherapy etc. I got back to the hospital and tried to get another orthopediic appointment but was basically told by his secretary to get lost and  the advice I had been given was to use crutches and not weight bear and I should stick to it.
My problem is that after nearly 3 weeks although it is better that it was, it seems to have reached a plateau. In the absence of any advice to the contrary I'm still using the knee brace (except at night) which immobilises the knee, and crutches most of the time. My fear is that unless I start mobilising the knee and puting some weight on it I am going to get stiffness and muscle wastage which will contribute to instability slow down recovery after the op. I  still have some swelling above the knee and I can straighten it almost all the way but there is a resistance and dull aching if I hold it there for prolonged periods. I can bend and straighten it at will but very slowly. I can put weight on it with the brace but I get twinges sometimes. I can't put much weight on it without the brace and it is hard to maintain it as straight without the brace than with it.
Can anybody give any advice on anything I can do to improve mobility between now and the operation?
Should I ditch the brace/put weight on the knee as much as the pain and swelling allows?
 I am normally a very active person and I hate all this sitting around and it is very depressing to think that my activity is going to be this compromised for the next month or so which is certain if I stick to the advice and use crutches and keep the weight off it until the arthroscopy on 12th September.
Thanks for your patience!

Ruptured ACL 1973 hurdling, arthroscopy & meniscus trim November 2002. Recon 27th August 2003 (hamstring).