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Author Topic: caritilage or patelar femoral pain? (something else?)  (Read 1214 times)

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Offline bthizle1

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caritilage or patelar femoral pain? (something else?)
« on: November 23, 2008, 03:23:25 AM »
The doc said Patellar femoral pain, but I don't feel he really did much to actually determine what is causing my knees trouble. I've had two ACLr on my left leg, first was hamstring autograft, second was patellar tendon allograft (6 months ago). Both my knees are bad now, supposidly it's PFP? I'm afraid I may have cartilage damage as well, because of the symptoms I'm observing.

http://i2.photobucket.com/albums/y42/bthizle1/LeftKnee.jpg

That's basically what's going on most of the time. Lots of pain just under/bellow the end of the knee cap (where it looks as though my meniscus is). Both of my knees are experiencing this too.

My doctor tells me I don't have bad cartilage, but he's basing that off an X-ray I took around 6 months ago, just after my surgery....how can I be sure. (I don't have health insurance, so MRIs etc..are sorta out of the question).

Offline kateplate

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Re: caritilage or patelar femoral pain? (something else?)
« Reply #1 on: November 24, 2008, 01:50:33 PM »
Although knee pain can be very confusing, as a general rule cartilage pain is  quite characteristic. There is locking, clicking, grating, sudden onset pain if a 'piece' of rough cartilage gets snagged. You can also have difficulty with specific tasks such as going upstairs, or holding the knee at a certain angle.  A constant ache in the knee joint wouldn't necessarily mean cartilage problems, but can be a long term effect. Classically you get a dull ache across the back of the knee joint. Sometimes its the inner surface of the patella that needs smoothing - could this be more likely??

I agree with you about MRI scans. I get them on the NHS and they are still pretty useless!! My latest OS told me that cartilage pain is pretty individual, and the extent of damage is hard to see until you take a look inside. What could be a hideous tear for 1 person may be symptomless, but another person may be in agony from a tiny tear.

I suggest you persist if you are concerned....but also bear in mind these docs are very experienced as a general rule, and I wouldn't disregard his opinion. How about a 2nd opinion, though??
Dec '05 RK plm; Dec '06 RK plm&pmm; Sept '07 LK pmm. Jan '09 LK pmm and synovial joint repair / removal of fat pad.
March '09 insertion of spinal cord stimulator for permanent nerve damage in L leg.

Offline bthizle1

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Re: caritilage or patelar femoral pain? (something else?)
« Reply #2 on: November 24, 2008, 06:23:43 PM »
I'd love to get a second opinion....it's just that I have no health insurance and am already having a hard time trying to pay for my current doctor visits. Gotta love living in the States...a place where we claim everyone is equal, yet health care is sooooo circumstantial.

Offline TwoBadKneesUSA

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Re: caritilage or patelar femoral pain? (something else?)
« Reply #3 on: November 24, 2008, 07:39:05 PM »
Just going to throw a couple of things out there.  I personally think PFP is a cop out diagnosis.  You already know it hurts somewhere between your kneecap and the thigh for goodness sake.  It's why you went to the doc in the first place.  That being said, it is quite possible that you have degeneration of the cartilage behind the kneecap.  For me personally this pain has been outrageous!  The doc may be thinking that the joint space looks good on the x-ray and that's a good thing.  It does not mean that the meniscus has not been damaged.  I had symptoms that were exactly what you find in textbooks for meniscus, but it turned out to be some huge gouges from the cartilage behind my kneecap.  Knee pain is tricky.  MRI's are not always accruate and in your situation I would not want one either.  Usually they are done to placate the insruance company into paying for a scope.  They can have some good info in them, but not always terribly accurate when trying to find the source of knee pain.

Just wondering if you qualify for some form of Medicaid?  I know it's hard to ask for it sometimes, but something is better than nothing.  I know there are a lot of hard working folks out there that don't have insurance supplied through work, or if so it's too expensive, or worse yet have none through work and can't afford a personal policy or qualify for a Medicaid type.  It's not fair at all. 

Hope you can figure something out and your knee feels better.
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http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=47974.0
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