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Author Topic: Tendinosis/fat pad fibrosis questions  (Read 2519 times)

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Offline Skinnycatz

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Tendinosis/fat pad fibrosis questions
« on: July 19, 2008, 04:55:31 AM »
I hope I am putting this in the right place!

My latest MRI showed tendinosis and fat pad fibrosis.  This is my third surgery...you can read all of my history on the patella board and some on the meniscus board.  I have had three lateral meniscus tears plus I have grade III/IV chondromalacia under the patella.  I have been getting chronic heat in this knee since a few weeks before this last surgery (April 18).  I am still getting heat everyday...am on Lodine now (might actually be working more than Mobic at least). 

I don't really know how I got the tendinosis, I didn't even know I had tendonitis!  My fat pad has been causing chronic tightness when I try and stretch the quad.  I can get full range of motion by massaging the area though.  PT does ultrasound and massaging too.  The patella tendon area feels like a block of weird tissue to me.  After my last surgery there was numbness there but now that is worse.  Could a build up of scar tissue under the lateral portal incision cause the tendinosis?  Can I get better without more surgery?  I don't think any of these tendinosis/fibrosis issues are causing the heat in my knee...because it was happening before this last surgery.  I can only assume that the kneecap being bare along the lateral facet is causing heat from friction with the femur but the PTs and the OSs I have seen don't think my arthritis is bad enough to be causing this much heat.  I am also getting tests done with a rhematologist.

I am just sick of this whole thing and want to get better...at least I don't have another TEAR in my meniscus!! One positive thing from the last MRI!

Any thoughts/insights?  Please!!  (Getting desperate here in skinnycat land! LOL My kitties don't care about my knee but they DO provide a LOT of comfort for me...)

Francine
Diagnosis: CMP, torn lateral meniscus.
Meniscus trimming, chrondroplasty 2/14/03.
Meniscus trimming (lateral again) chrondoplasty 8/3/07
Grade III/IV Chrondomalacia kneecap
Meniscus trimming (tear in front of lateral) 4/18/08
Left TKR 7/15/10

Offline Janet

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Re: Tendinosis/fat pad fibrosis questions
« Reply #1 on: July 20, 2008, 03:42:12 PM »
I recently had a "tendon needling" procedure which cured my tendonosis. This was after about 12 months of just trying to let it heal on its own, different cortisone injections, a brace, PT, etc. After the needling, the pain was gone in 10 days. For the needling, first they identified through ultrasound the area on the tendon that was the tendonosis. Then, guided by the ultrasound, the OS used a needle (no medicine except a local anesthetic) to rough up and scrape that area. This promoted bleeding, which brings healing. I was very sore for a couple of days, then it gradually got better until all the pain was gone in 10 days. Miraculous!

As for your tightness around the patella tendon area and fat pad, I had that same problem in 2003. There was a huge ball of scar tissue around the patella tendon and into the fat pad area (not shown on MRI). I had it removed arthroscopically and had quite an improvement, although a chondral defect behind my patella eventually led me to a TKR three years later. MRIs are a very good tool, but they don't show everything (especially scar tissue). In fact, when they did my TKR they found a large meniscal tear that hadn't shown at all.

Janet
Torn quad tendon repair & VMO advancement 4/99, MUA with LOA 10/99, Patella baja and arthrofibrosis, LR & medial release & LOA 5/01, LOA & chondroplasty 6/03,TKR on 11/06, MUA 12/06. From perfect knees to a TKR in 7 years, all from a fall on a wet floor...and early undiagnosed scar tissue.

Offline Skinnycatz

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Re: Tendinosis/fat pad fibrosis questions
« Reply #2 on: July 20, 2008, 05:56:08 PM »
Thanks Janet...I think that after my surgery in 2007 (August) I might have had some minor scar tissue in the tendon area...there was always a numbness there.  But now it is soreness as well as a block of weird tissue.  I am going to the OS this Thursday with the new MRI (was ordered by the physical med. doctor) so he can look at it and hopefully suggest something.  I don't feel like it is getting much better from the PT.  Massaging the tendon only has a temporary effect.  I haven't had any cortisone injections...I have heard that those weaken the tendon.  Cortisone has never helped me with anything....but then again I have never had this much consistent inflammation in my knee either. 

I will definitely ask him about the needling procedure.  I DON'T want another arthroscopic procedure right now...I think the last one only made things worse for me.  I know I had to get the lateral tear taken care of but now my fat pad is messed up and I think more surgery will only make it worse. 

Did you have heat in your knee everyday with your patella defect?  I am still getting the heat even with the anti-inflammatories but with this latest one (Lodine) the heat happens much later in the evening...actually right before bed, timing is better since I always ice right then!  I think the pain I get during the day is more related to the tendon but who knows since my defect is in the lateral facet of the patella.

I tried a new brace recently...it didn't work (don joy tru pull lite) like the taping.  I have taped the knee for a long time...since after my first surgery in 2003.  I have tried on and off to get "off" taping but haven't found a brace (besides the one that uses tape! This was an on-track knee brace) that does the same thing.

Thanks again for the reply and I will post here what the OS has to say! 

Francine
Diagnosis: CMP, torn lateral meniscus.
Meniscus trimming, chrondroplasty 2/14/03.
Meniscus trimming (lateral again) chrondoplasty 8/3/07
Grade III/IV Chrondomalacia kneecap
Meniscus trimming (tear in front of lateral) 4/18/08
Left TKR 7/15/10

Offline Louisamith

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Re: Tendinosis/fat pad fibrosis questions
« Reply #3 on: November 11, 2021, 01:01:55 AM »
Hi, I am a 21 year old female runner who was wondering if you could help me out with a question about my knees as my symptoms are EXACTLY the same as yours.

I recovered from anorexia about 1 year ago now, however at that time I had a bad exercise (running) addiction, probably averaging about 20km daily. I am running much much less now, but I have lately been feeling like there is some sort of damage within my knees.

Originally I just got an extremely weird sensation, hard to describe, but it is a ‘creakiness’ - the same sound you would expect from an old floorboard, or a rusty hinge. I don’t have any major pains in my knees after running, just a constant dull ache thats worse when squatting and going up and down stairs - but when I place my hand on my kneecap and straighten it out I can feel the vibrations.

However, my main concern is the constant warmth, redness and inflammation around my knee, I was wondering if the sounds and the redness were connected?

I am concerned this is the beginning of osteoarthritis or chondromalacia. I have had X-Rays (which did not show any joint deterioration), negative blood tests for Rheumatoid arthritis, and have been to the doctor however I did not get much information on what this could be, them just putting it down to ‘overuse’.

Thanks so much for taking your time to read this, I look forward to hearing back from you.

Offline DogfacedGirl

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Re: Tendinosis/fat pad fibrosis questions
« Reply #4 on: November 11, 2021, 10:36:37 PM »
Hi Louise,
The pain, warmth, and redness do indicate you have inflammation in your knee. It's best to have an MRI (X-rays are useless for soft tissue damage) and hope that the reporting radiologist will report on the condition of the fat pad as well as the usual tendons and cartilage. The more that the requesting doctor puts on the referral the better.

In the meantime, the safest thing is to back off anything that makes your knee worse, since inflammation is damaging it. This will probably include running. Try to find a different way to exercise that doesn't hurt your knee.

All the best,

Kay
1999 Osteoarthritis both knees, chondroplasty
2004 MACI graft L knee
2005 MACI graft both knees
2007 MACI graft R knee
2007 Patella baja
2011 TKR both knees
2011 arthrofibrosis