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Author Topic: Fat Pad, Arthritis and Tendonitis, Help!  (Read 2273 times)

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Offline LeeC

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Fat Pad, Arthritis and Tendonitis, Help!
« on: December 04, 2008, 09:13:09 PM »
Been to see my OS for the last time since having my anthroscopy. Basically after a long depth conversation with him he said due to having the acl reconstruction 2 years back and one or two other things i have developed a few problems. My Fat Pad is inflamed at the moment and when i pull my heel up you can see the fat pad push out the both sides of my knee. My patellar tendon has tendonitis,  i had it after the acl op as my graft was taken from there, but now its got a lot worse and is quite sore. I also have some athritis on the lateral side of my knee. All this at 25, who says sport is good for you. So basically i am after some help on the above. How can i reduce the fat pad inflamation (steroid injectons? Ultrasound?) How can i help with the reducing the pain from the tendonitis? How can i help reduce the pain from arthritis? One other thing, does anyone know of a really really good physio in the kent/sussex/surrey or south london area?
Thanks for your help

Offline Clarkey

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Re: Fat Pad, Arthritis and Tendonitis, Help!
« Reply #1 on: December 04, 2008, 11:32:56 PM »
Hi Lee,

Sorry you are also having problems with your fat pad and mighjt have read about my fat pad issues and fianallly will see an OS for a steroid injection right into the fat pad and if that does not help will need a scope but its up to me if I want it or not. I tried ultrasound and it failed so hope the injection helps me or even cures my fat pad problems. Fat pad problems are hard to get right and the injection needs to be in the right place or could do damage if injection is in wrong place. Do you get sharp pain and catching on the lateral side of your knee as I do and can u walk ok, I cant run or walk fast since October 07. Hows your mobiltity is it limited?

Cant give you info on your other knee issues its best to take the advise from an OS.

Good luck with your outcome with your OS about your fat pad. If conservative treatmant fails then removal of the fat pad is the only option left.

Nick :) {2008} :)
« Last Edit: December 05, 2008, 09:19:54 AM 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 LeeC

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Re: Fat Pad, Arthritis and Tendonitis, Help!
« Reply #2 on: December 05, 2008, 10:31:02 PM »
Hi Nick, basically i had a scope about 5 weeks ago and that was when the arthritis on the lateral side was found. The tendonitis has also flared up since the scope which i thik is to be expected but i was just wondering if anyone had any tips on reducing the discomfort. As far as moility im quite good really. I can run jump etc and im playing football again. The fat pad just seems inflamed as when i pull my heel up like a quad stretch it feels tight either side of the joint and then u can see bulge out either side of the patellar tendon. Just wanted tips to help recovery of the the three problems.

Offline LeeC

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Re: Fat Pad, Arthritis and Tendonitis, Help!
« Reply #3 on: December 07, 2008, 11:26:55 AM »
Anyone? I am managing the tendonitis quite well now after doing some reading on the froum. Just wanting to get the swelling/inflamation out of the fat pad.

Offline JaneDown

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Re: Fat Pad, Arthritis and Tendonitis, Help!
« Reply #4 on: December 12, 2008, 02:05:11 PM »
Hi Lee
did you ever get anywhere with finding an effective way of reducing inflammation in your fatpad?? I'm awaiting results of MRIs on both knees following disasterous bilateral arthroscopies done back in October which seem to have left both knees totally trashed!! But I strongly suspect that the MRI of the left knee will reveal an inflamed/damaged fatpad as it  is very sore, puffed up and feels very squelchy inside the knee and as if the fatpad is huge, catching on things and very sensitive. If I walk for anything more than 5 minutes I also get bad pain in/behind the patella tendon so am wondering if the fatpad is so swollen it's pushing against that too.
Anyway, just wondered if you had got any further with finding out how to deal with your fatpad as everything we do presumably involves the patella rubing on it and the whole joint pushing on it so how can it ever stop getting inflamed when it's constantly being rubbed!!??
jane
Knee pain since 2002
2006 MRI shows lateral meniscal tears
Oct 2008 Bilateral partial lateral meniscectomies (long recovery!!)
Jan 2009 MRI shows surgery caused damage to medial meniscus!!!
June 2013 knee injury, agony!!!
August 2013 - left knee medial partial meniscectomy

Offline dm

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Re: Fat Pad, Arthritis and Tendonitis, Help!
« Reply #5 on: December 17, 2008, 06:23:19 AM »
Just thought I'd comment that I've just had my 2nd injection of dexamethasone/marcaine into the fat pad under the patellar tendon and that the shots have had a very significant positive effect for me. The way the shot was done was a straight in approach that penetrated through the patellar tendon at the edge of the kneecap and up under the kneecap and the first injection was approx 2cc ea dex and marcaine. Hurt like he** when my doc did it, and for near a week after, but it did help. Had to ice the knee immediately after the shot and a couple times more that evening, and on/off the next few days, then it started feeling better. I ice regularly for recurrent swelling anyway, due to the permanent damage i have, so I'm used to icing all the time anyhow.
Injection repeated monday was 1cc dex, 1cc marcaine and 1cc something else, I didn't catch what. Didn't hurt so bad as the first shot a month ago. Same injection approach.

I find that by modifiying how I walk so that I swing the leg more with the hip joint, flex the ankle more,  and only flex the knee enough so that the foot just clears the ground, minimizing the knee bend, the change in gait seems to give my knee a break. Flat shoes are a must, no heels or narrow soled shoes at all. If the sole of the shoe is not as wide as the width of your foot, you're putting more stress on the knees, making them work more to keep balance.  No one looks at their shoes when they think about the pain in their knees.
multiple arthroscopies 2/00,3/01,6/01,1/03, 12/07,10/10. chondromalacia, severe medial joint space narrowing following 3 partial menisectomies, chronic pain problems, kneecap problems, OCD lesion, failed mfx.

Offline Clarkey

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Re: Fat Pad, Arthritis and Tendonitis, Help!
« Reply #6 on: December 20, 2008, 11:12:27 AM »
Hi dm,

I read with interest your posting below about injections into the fat pad and how it has benefited you. Thanks for the warning about the pain you get when needle goes in the knee and kind of expected that as its got to hurt a needle going onto your knee. I got a date for my injection into the fat pad 19th January which is not long to wait and hope it works otherwise will be heading for a scope.

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 dm

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Re: Fat Pad, Arthritis and Tendonitis, Help!
« Reply #7 on: December 21, 2008, 05:40:22 AM »
Nick,
I've had over a dozen injections into my poor knee over the years, since 2001, and I'd have to say that the one I had just before Thanksgiving was one of the most painful. Going into that swolled fat pad through a pissed off tendon with that needle was not anything I'd recommend anyone have to feel. I'd rather be blatantly honest and tell you flat out that it did hurt, so you're not surprised. Just don't tense up when he does it, that'll make it worse. Doc's instructions to me were to go home and put ice on the knee. So, I did, and did some more.

The other injections have had a more lateral approach, where the needle was put in from the side, more along the medial or lateral "corner" of the kneecap at the bottom a bit past the scope hole on the side in question, and didn't hurt any more than any shot you've gotten in your rump.

The crappy thing about tendonitis - which is my "official" diagnosis of the moment with the tendon issue, is that it takes ages to heal, and with my work hours, 22 hours of overtime this week, it doesn't exactly speed healing. I wish I could work a bit less, but I gotta eat and I gotta pay bills, and I have a house that needs a sewer line, and can't put that much on credit at the interest rates they're charging these days! I wish I could get the interest rates the Fed hands out.... but the banks don't give us what they get.

Hunt up my recent posts via my username, I left one lady a post with some tips about dealing with these kinds of knee shots if you've not had them or had many of them, she was scared of the needle too. Unfortunately this fat pad shot needs the knee in the "prone hang" position to be given, where you're sitting there on the side of the table with your feet dangling in space, but the others I've had didn't, and those went easier if you put your leg up on the table when they did it. So, it doesn't hurt to ask if you can lay down for them to give you the shot, if possible. One, you don't see them do it, two, the knee's supported and to me that seemed to make them hurt less.

A Polar Care or similar ice machine is a wonderful thing, if the knee's hacked off and you're not planning on going anyplace for a few hours. Fill that up with ice and cold water, wrap the pad to the knee, plug it in, and let it freeze the heck out of my poor knee until I can't feel it much between that and the painkillers. Nothing like a good excuse to watch a couple movies from the library - mine loans them out free here, not necessarily the newest movies, but doesn't cost anything. Got mine off Ebay, as my ins wouldn't pay for one. Well worth the 30 bucks I spent.

I wish you the best with your shot, hope it gives you as much relief as mine has. I've also gotten some relief from the tendonitis and arthritis (have both) by applying Lidoderm local anesthetic patches to the knee. Knocks the pain level down a few notches. They're prescription though, so you'd have to ask the doc to try 'em.
multiple arthroscopies 2/00,3/01,6/01,1/03, 12/07,10/10. chondromalacia, severe medial joint space narrowing following 3 partial menisectomies, chronic pain problems, kneecap problems, OCD lesion, failed mfx.

Offline Clarkey

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Re: Fat Pad, Arthritis and Tendonitis, Help!
« Reply #8 on: December 21, 2008, 02:18:28 PM »
Hi dm,

See you have had a few injections and having problems with your tendons and 7 years of injections is a fairly long period. Thanks for the support with my injection I be having on 16th January not the 19th.

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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