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Author Topic: Nick's 3in1 Diary FatPadTrim, Medial plica/Distal patella excision, AIR x2, LMR  (Read 278882 times)

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Offline Clarkey

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Had my MRI scan results this morning and only found a problem with the fat pad there too much fluid around the fat pad and I think the fat pad is inflamed as well. I saw the very nice PT again who suggested two options having Physio on the fat pad ultrasound and massage or a cortisone injection around the fat pad fluid area. I will have to wait a couple of weeks for PT and it might not help and the PT I saw today was reluctant for me to have an injection by a very good OS that good giving injections.

I still not satisfied with the outcome for many reasons since my fall back in October 2007 I have not been able to walk well and can no longer run. I get regular knee pain around the fat pad and can feel it catching at times that is not a nice feeling. I have been doing PT to build up the quads and it has helped to go to the Gym 3 times a week and go on the cross trainer and exercise bike but after about 10 minutes I get knee pain in my right knee where I have the fat pad problem. I cant work to my full potential on the Golf Course as if I overdo it knee begins to hurt.

All I want is to finally see an OS as its I am now starting to become annoyed about my whole knee issue I can't see any harm in trying the injection as my knee cant get any worse. I don't like to wait another few more months to see if the PT helps or not as it most likely might not and will end up with the Injection.

My left knee, not 100%, as well as I, have maltracking problems and it also hurts if I use my knees too much and sometimes the pain very bad but does not happen too often. The PT hopes the insoles will help with my knee pain which will be fitted on the 19th August.

I like to know if anyone else has had fat pad problems and how it was treated, how bad do I have to be till I see an OS rather then a PT who very good at his job but only the OS can really find out the real knee problems and what action is needed. Will the injection solve my right knee problems as my PT thinks I don't need a scope but could it come to this if PT and injection do not help me run again with less or no knee pain? The Injection might work but will it fix the fat pad problem.

I kind of happy that I know what it is but disappointed that I not been sent to see an OS which I knew was going to happen.

Nick ??? {2008} :)
« Last Edit: January 27, 2018, 10:00:00 AM by Clarkey, Reason: Title change for 3rd scope »
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline suehaem

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Re: Fluid around the Fat Pad!
« Reply #1 on: July 23, 2008, 07:24:06 PM »
Hi Nick,

I reinjured my knee running and my fat pad has swollen and is being pinched by my knee.  I have been having PT and they suggested acupuncture which I did try but it was not for me.  They also suggested injections which I have tried and it was very good, it lasted for about three months.  Okay it does not take away the problem but it made walking easier.  I was due to go and see the OS just before I was due to have another but I did not want it masking the pain before I saw him.  I have been listed for further surgery as he thinks I have torn something else or there is something loose.

My fat pad is still very fat!! and I would love to have another injection but I have decided it would be best to wait for the surgery and at least I will know where the pain is. 

If you feel you are not getting any further along with the PT and are still having problems go to your GP and ask to be referred to an OS to be checked out.  My original MRI came back as normal and he found problems when he got in there.

Good luck with it.

Sue
 ;D
North Wales
Fall from horse 04/04
Arthroscopy 27/07/07 -Grade III debridement
Re-injured knee running 1/03/08
Arthroscopy 11/10/08 - Grade II debridement
09/03/16 Fracture fib sking damage to knees
31/05/16 Grade 4 Chondromalacia and patella tilt (R)
17/11/16 Need new knee cap (L)knee
Awaiting Arthroscopy 2018

Offline Nettan

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Re: Fluid around the Fat Pad!
« Reply #2 on: July 23, 2008, 07:42:15 PM »
Sue, could be that your fatpad is so big that interfers between the joint surfaces. I have had that and had my fat pad shaved.
Could be what you also need later Nick, if nothing helps.
When you have an inflammation, patience is the key. Can take long time to get rid of.
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 suehaem

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Re: Fluid around the Fat Pad!
« Reply #3 on: July 23, 2008, 09:50:14 PM »
Hi Nettan,

Its possible that could be the case.  It had been good before I reinjured my knee but now it is swollen and feels a little numb.  I did find the injection good and also taping the patella up helps for a short while as well.  Like you say with inflammation patience is the key.

Hopefully Nick will get some answers soon

Sue
 ;D
North Wales
Fall from horse 04/04
Arthroscopy 27/07/07 -Grade III debridement
Re-injured knee running 1/03/08
Arthroscopy 11/10/08 - Grade II debridement
09/03/16 Fracture fib sking damage to knees
31/05/16 Grade 4 Chondromalacia and patella tilt (R)
17/11/16 Need new knee cap (L)knee
Awaiting Arthroscopy 2018

Offline Clarkey

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Re: Fluid around the Fat Pad!
« Reply #4 on: July 24, 2008, 04:36:34 PM »
Thanks Sue and Nettan for some good advise might be right to wait longer but I personally feel that I should be allowed to see a OS at the Hospital I went to yesterday.

I get pain in other parts of the knee if I been using the knee a lot and not only in the fat pad area and no matter how hard I try to run I end up fallling onto both knees. I lucky I dont have to be able to run for a living ie Police, Army are just a few examples but do use my knees a lot in my job as a greenkeeper.

What I know will happen like it did last year, this coming winter will get more regular and intense knee pain as we will be doing lots of contruction work on the golf course. shifting soil and clay by hand with shovels digging by hand for drainage. I dont fancy another winter like the last one with the knee pain.

Is it to cheeky for me to go phone the PT I saw at the Hospital and ask him to book me in to see a OS as I just have a feeling it needs looking further and the unltra sound might ease the pain a little but might not help me run again.

All I would like is a 1 to 1 with a OS its not too much to ask for to discuss variouse options if the ultra sound and injction is not a success.

Might see how ultra sound goes for a while but if I am still the same after thiis treatment will ask to see a OS but might be waiting 6 weeks for 1st appointment.

Its like a meniscus tear this fat pad problem as it hurts after activities and when I strimming on a slope at work and when I cycle at the gym. The catching inside the knee feels as if its a tear but the MRI came up normal apart from the fat pad.

My main question is should I push to see a OS as it will be soon a year since fall and not seen the top person yet.

Nick :) {2008} :)
« Last Edit: January 19, 2009, 03:36:54 PM by Clarkey »
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline Sailor

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Re: Fluid around the Fat Pad!
« Reply #5 on: July 24, 2008, 05:20:30 PM »
I say "Go for it".  It is time to see the OS, and you just have to be persistent, as you are the best advocate for your health.  Good luck,  Sailor

Offline Clarkey

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Re: Fluid around the Fat Pad!
« Reply #6 on: July 24, 2008, 05:42:14 PM »
Thanks for the advise Sailer,

I might be over reacting a little but not convinced ultra sound will solve the fat pad problem and the Injection is the next stage. I am the last person that would want a scope and will only go for it as the last resort. PT thinks surgery is 3 out of 10 possible but I work in % I would say surgery right now only 45% but if injection not a success then 50% plus that a scope the only way to get rid of the problem such as shaving the fat pad so it no longer catches.

I hope I proved wrong with my feeling and the ultra sound works? we shall see!

Nick :) {2008} :)
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline TwoBadKneesUSA

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Re: Fluid around the Fat Pad!
« Reply #7 on: July 24, 2008, 05:50:18 PM »
Hi Nick,

Ultra sound really does work nicely on inflammation and helps soft tissue healing.  It seems kind of silly to have the PT put some goop on your knee and run a funny looking wand around it.  It may not look like it's doing much, but it really does.  I should not hurt, so it is worth a try.  It did lots of good for me when I had bleeding into my knee after a LR many years ago.  It looked like someone beat the back of my leg with a stick!  In 2-3 weeks the brusing had really faded.  So give it a shot and keep pushing to see an OS.  Pain is no fun and being unable to do things you like just stinks.  Best of luck.

Milly
'83 lt knee scope
'88 lt knee LR
'89 rt knee LR (6 mos. after left)
'05 rt knee scope (clean up)
7/5/07 - scope, LR left, right clean
3/19/08 - LR failed, Supartz failed
http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=47974.0
8/21/08 - new OS apt
8/5/09 - TTT, LR, PFJR sched.

Offline Clarkey

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Re: Fluid around the Fat Pad!
« Reply #8 on: July 25, 2008, 04:26:30 PM »
Hi Milly you are so right and should give ultra sound a go, I admit I was in a bad mood yesterday about the whole knee issue as Its be managed badly.

I had to wait over 12 weeks till I saw a PT as they never recieved a referal letter from my GP. I finally see a PT twice 1st time he gives me some leg excercise's to build up my quads, 2nd time said I have excessive bone in the knee and will send me for a xray. I told him I can feel loosness and pain in a cetain area of the knee but he seemed not bothered about it. If he did bother to inspect it could have found out it was the fat pad that could be inflammed and done some untra sound in April when I 1st saw him and if it did not work send me to see a OS for an injection.

When I see the PT in the Hopsital the 1st time never mentions the excessive bone and dont have an xray but have a MRI scan instead as he thinks my fat pad inflammed and is right when results come back.

I did ring up the PT at the hospital secretary so speed up the PT at the 1st centre I went to as they delayed me to start off with and would like to see the same PT again who knows me and my history so will wait and see if they hurry my ultra sound which I like to get done ASAP incase it fails and need a injection.

I say I want to see a OS but did not want surgery unless its the only option left so should be happy to try the other 2 options. If I still cant run after a few ultra sound appointments and still get pain will ask for a OS to see me ASAP and not in a few weeks time.

The PT never said what the next stage is if ultra sound and injection fails, would I be right I predicting a scope of the knee? would be great if it never comes to this stage but there always a possibilty so cant rule it out just yet.

I have a dead line would like the knee back to normal by Christmas with what ever treatment it takes, treated by then what form cant say would be nice if ultra sound works but not afriad if a injection was needed.

Nick :) {2008} :)
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline TwoBadKneesUSA

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Re: Fluid around the Fat Pad!
« Reply #9 on: July 25, 2008, 09:29:49 PM »
Hey Nick glad you are at least more up today.  It's easy to get discouraged and disgusted when you are in pain and it seems no one is listening to you.  I have found there are good PTs and some not so good.  I think you are right about a scope if all the conservitive treatments fail.  Sometimes they just need to get in and see what is going on.  If all they do is have a look around the recovery should not be too bad or too long.  I had work done every time they scoped my knee so it took a while to get back to normal.  A scope is not so bad, but any surgery is scary.  I've been through several for different reasons (not just the knees), and I still get scared stiff and don't want to go through with it.  It's normal. 

I think surgery should be the option of last resort myself.  So try everything else first.  Can you take anti-inflamitories?  Like naproxen or ibuprofen?  Some folks can't becase they can be hard on your stomach.  I do know you need to take them for a few days at regular intervals to get the best result.  It's nice to have a nurse in the family so I can learn these things.

Take care.

Milly
'83 lt knee scope
'88 lt knee LR
'89 rt knee LR (6 mos. after left)
'05 rt knee scope (clean up)
7/5/07 - scope, LR left, right clean
3/19/08 - LR failed, Supartz failed
http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=47974.0
8/21/08 - new OS apt
8/5/09 - TTT, LR, PFJR sched.

Offline Clarkey

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Re: Fluid around the Fat Pad!
« Reply #10 on: July 26, 2008, 04:04:17 PM »
Hi Millly,

My Mum says she will pay for a private PT and ultra sound if the NHS one takes too long because I have Asperger Syndrome I get anxieties easily and my mum starting to notice I getting a little down about the whole knee issue and wants it sorted out sooner rather then lator. On Monday morning she kindly going to the PT centre to explain my AS and ask them to hurrry my appointment or shewill go private. Thats what Mums are for at times to help thier children when they having a problem.

I will give it another 2 more weeks and if I dont get a appointment within this time will have to pay private which is not right but has to happen if the NHS dont pull thier weight. The PT secretary at hospital said he has not sent my refferal letter yet until Monday. Saw him Wednesday morning should have the letter on the way by now so wont get refferal letter from him till Wednesday should have been Friday or Monday morning the letter arrives at PT Centre.

I agree surgery as the last option as I scarred about being put to sleep not so much during and after surgery just the build up to it before going into theatre but hope I dont have to face this and ultra sound works.

Nick :) {2008} :)



RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline Clarkey

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Re: Fluid around the Fat Pad!
« Reply #11 on: July 27, 2008, 04:04:08 PM »
My mind changes like the weather I have now decided to wait on the NHS for the ultra sound as I find it unfair that my Mum would have to pay when you can get it free. My 3 Sisters out of 6 had a chat about my knee problem amd may have been a bit selfish as thier are people with far worse knee conditions then me who need to see a PT before me. I can still manage to work ok and can manage the pain the last 9 months so a few weeks longer wont be long to wait.

Ther PT did say should get a appointment within 6 weeks but should get one sooner then that if I not heard from PT centre after 4 weeks phone him so he can chase up appointment. I am a little sceptical about of the ultra sound will really fix the problem and will need a injection but as I said before it does not hurt trying the least drastic option 1st.

Nick :) {2008} :)
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline suehaem

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Re: Fluid around the Fat Pad!
« Reply #12 on: July 27, 2008, 07:01:26 PM »
Hi Nick,

I will have to agree with Milly about the ultrasound.  I had ultrasound when I first injured my knee and it did wonders.  It made my knee painfree with no other trouble at all until it went again three years later.

Definately give it a go and if things don't seem to be working out then press to see the OS.  I also benefited from the injection as well.

Unfortunately knees have a mind of there own and will soon let you know if things aren't working.

Good luck

Sue
 ;D
North Wales

Fall from horse 04/04
Arthroscopy 27/07/07 -Grade III debridement
Re-injured knee running 1/03/08
Arthroscopy 11/10/08 - Grade II debridement
09/03/16 Fracture fib sking damage to knees
31/05/16 Grade 4 Chondromalacia and patella tilt (R)
17/11/16 Need new knee cap (L)knee
Awaiting Arthroscopy 2018

Offline TwoBadKneesUSA

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Re: Fluid around the Fat Pad!
« Reply #13 on: July 28, 2008, 01:37:01 PM »
Hi Nick,

It's easy to get anxious no matter what.  I get so nervous before any surgery.  I asked if I could change the date on my way to the operating room once.  Thankfully no one said sure.  It's never as bad as our imagination would make it out to be.  I hope you get your PT appointment soon.  While it is true there are others with worse problems that need PT, everyone deserves their appointment.  It is good to know your mom will pay if necessary.  At least there is a relief in knowing that if the NHS doesn't get it together, you can still get the treatment you need.  Hang in there.

Milly
'83 lt knee scope
'88 lt knee LR
'89 rt knee LR (6 mos. after left)
'05 rt knee scope (clean up)
7/5/07 - scope, LR left, right clean
3/19/08 - LR failed, Supartz failed
http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=47974.0
8/21/08 - new OS apt
8/5/09 - TTT, LR, PFJR sched.

Offline Clarkey

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Re: Fluid around the Fat Pad!
« Reply #14 on: August 11, 2008, 08:16:15 PM »
I have a date for my 1st ultra sound its this coming Wednesday 13th August unlucky for some but not always and will give it a try. I still think there more to it then just ultra sound and hope I proved wrong and ultra sound fixes the knee problem.

Knee swollen and feels unstable and as you all know cant run and walk at a reasonable pace and can feel the fat pad catching so rather be seeing a OS as I am in a bad enough condition to be able to see one.

My goal is to run with my mate at the London marathon 2012 the year the olympics games is held in the UK and would like to practice soon as it takes a while to train up, but handicapped due to knee injury.

I want the knee sorted out before Christmas if ultra sound fails wether its an injection or surgery if it needed.

Nick :) {2008} :)
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming















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