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Author Topic: mri misses, meniscus, arthroscopy, pain.  (Read 9867 times)

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Offline xhui

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mri misses, meniscus, arthroscopy, pain.
« on: March 05, 2010, 04:55:25 AM »
Hi everyone,

Found this forum while doing some reading up on my knee pain. I'm not local, but desperately need some advices from fellow gurus here.

To cut the long story short, i've injured my left knee while picking up some heavy equipments from the floor with my left knee down/bent. I vaguely remembered twisting my knee and hearing a pop sound. That was like about 4months ago.

Now, with every step, more so with weight bearing, sharp pain runs across from my inner knee across the joint line. My knee rotates and seems to have a full range of motion though pain worsens when i try to straighten my knee. No visible swelling but I feel tight around the injured area (swelling kind of feeling) and pain when pressed upon.  :-\

Have been seeing a Ortho doc who initially suspected a meniscus tear but did an MRI but came back normal with just traces of fluid in there. Was kindof lost as again, nothing conclusive!

Was given the option of doing an arthroscopy or follow up with physiotherapy to strengthen muscles around the knee in attempt to alleviate pain. Have actually started physiotherapy sessions but the pain seems more persistent now and my knee feels consistently tired and painful!

Help! should i go with the scope or try out few more weeks of PT first? Cost isn't a concern here but I guess the bigger disappointment would be to go for the scope and for the doctor to report a normal diagnosis again while the pain is real and really hampering my daily routines.

Thanks in advance for your advices and sharings!  :)
« Last Edit: May 02, 2010, 03:30:53 PM by xhui »
Nov 09 - injury: twisted left knee
Jan 10  - first appointment with Ortho doc
Feb 10  - MRI showed normal, nothing conclusive
Mar 10  - started PT for a month
15 Apr 10 - Arthroscopy, medial meniscus trim (frayings)

Offline tez27

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Hi xhui
Your case sounds similar to mine I also had an m.r.i that showed pockets of fluid but nothing else, I decided to have a scope because of constant pain and the fact like you it was affecting my daily life.
I came round from the anasthetic to be told I have a complete rupture to the a.c.l and a tear to the m.c.l at the moment the o.s is not sure what extent the m.c.l is torn because there was a lot of scar tissue.
My injury occured 19 months ago and I now wish I had had the scope a long time ago as the scar tissue is possibly where a lot of my pain is coming from and that would have been less extensive had somthing been done just after initial injury.
So please go for the scope its the only way to be sure what is going on in your knee I also tried physio thinking this would help with the pain but it did nothing to help at all so again please have the scope even if it's just to put your mind at rest that all is well with your knee
Take care Tez
















i
L K injured 25th June 2008
scope Jan 5th 10
diagnosis ACL rupture
fiberous band excised from acl
ACLr July 19th 2010  scope on 24th Sept 2011
ACL has failed incorrect tunnel placement
23rd July 2012 1st stage of a 2 stage ACL revision
10th May 2013 2nd stage ACL revision

Offline dm

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It's fairly common for an mri to be inconclusive, given several factors. One, the quality of the films, two, the experience of the radiologist reading them, and three, the mechanism of injury. So, you end up having to take the results you've got, combine it with the ortho's clinical opinion, your pain factors, and decide if it's worth the risks of an exploratory scope, or to just leave things be and wait and see. After 8 months of being told that my pain was in my head, I got another opinion, because the mri was inconclusive, and I was in pain, and my 1st doc didnt belive me, so I got another opinion, and he gave me the same options yours did... live with it or go see what's going on. You choose.
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 xhui

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Thanks so much tez and dm for the replies! Your sharing of experiences really just tip me towards the decision of doing the procedure. I guess after much procrastination, I realised I didn't really have much valid fears not to do it. Probably only the disappointment and frustrations if the scope would come back with NIL returns.

Thanks guys, the disabliting effects are getting to me hence shall make an appointment with my doc again to get this done. Will post back again on progress.

Any other replies are very much welcome still! (it sure is exasperating to be scourging the Internet for similiar experiences and what to do).
Nov 09 - injury: twisted left knee
Jan 10  - first appointment with Ortho doc
Feb 10  - MRI showed normal, nothing conclusive
Mar 10  - started PT for a month
15 Apr 10 - Arthroscopy, medial meniscus trim (frayings)

Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
Hi xhui,

I too had a normal MRI scan on my right knee with some fluid inside the knee but was told physio might solve the problem but it ddi not help. I fell hard onto the pavment onto my right knee in October 2007 and took over 2 years until they decided to scope my knee. I felt sharp pain and catching inside the knee and could no longer run since my fall.

When my OS looked inside my knee he had to remove the medial plica and fat pad as they where so large and inflammed that they were rubbing against my bone. I am now nearly 16 weeks post op and knee still not improved and knee worse off now then before the surgery.

Do not be put off having surgery just because mine is not working so far as surgery for most people helps or reduces knee pain and in your situation would have your knee scoped as I am sure your OS will find a problem and will be able to fix it.

Nick :) {2010} :)
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 xhui

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Hi xhui,

I too had a normal MRI scan on my right knee with some fluid inside the knee but was told physio might solve the problem but it ddi not help. I fell hard onto the pavment onto my right knee in October 2007 and took over 2 years until they decided to scope my knee. I felt sharp pain and catching inside the knee and could no longer run since my fall.

When my OS looked inside my knee he had to remove the medial plica and fat pad as they where so large and inflammed that they were rubbing against my bone. I am now nearly 16 weeks post op and knee still not improved and knee worse off now then before the surgery.

Do not be put off having surgery just because mine is not working so far as surgery for most people helps or reduces knee pain and in your situation would have your knee scoped as I am sure your OS will find a problem and will be able to fix it.

Nick :) {2010} :)

Thanks Clarkey for sharing your experience! Woah. that whole procedure sounds rather painful and complicated.. It must be pretty frustrating to have your knee feeling worse then before! But thanks for sharing, at least I can have balanced views of what a surgery can do and can't do.

Sincerely hope your knee will turn out better after some time of recovery and thanks for the encouragements! Don't give up on your knee too!
Nov 09 - injury: twisted left knee
Jan 10  - first appointment with Ortho doc
Feb 10  - MRI showed normal, nothing conclusive
Mar 10  - started PT for a month
15 Apr 10 - Arthroscopy, medial meniscus trim (frayings)

Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
Hi again,

As you have found out from members on this board MRI scans are not always accurate and the only person that knows there a problem in the individual that feeling pain inside the knee. The knee hurts for a reason and MRI scans do not always show up a knee problem and the best way to diagnose and fix a problem is to scope the knee.

Thanks for your concerns about my knee it not really improving at the moment and due to see my OS at the end of this month and hope he can sort out my knee problem finally.

Nick :) {2010} :)
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 xhui

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Thanks for all the kind help and replies so far.

Just some progress updates.

Have been undergoing physiotherapy to about a month now (since injury it has been 4months). I can feel my leg muscles are much stronger and seems to be supporting my weight better as I go about doing my daily routines. The pain seems to have subsided quite a bit from daily walking, but once any additional weight, twisting and up down stairs, the pain still comes on. Oh the reduced pain is more significant with some anti-inflammatory meds.

It was in this midst of waiting for my doctor appointment (1 month wait) that i underwent these physio exercises. I'm going to meet my ortho doc next week and I have to decide if I should consent to undergo the scope.

Now I'm starting to wonder if PT will really "fix" my problem and get me back to full exercise routine again?

Maybe I'm being procrastinating here, but the reduced pain seems to be wavering my initial decision to go ahead for the scope (that's the result for waiting too long!). Does PT actually solves say, a suspected meniscus issue? Or maybe my doc and therapist have been wrong all these while on the meniscus? A possible >4 months old knee sprain?

I've minimal or no swelling pretty much since injury, just some nasty sharp pain across jointline and medial side of my knee (tender to touch!) whenever i walk, put load on my knee.

My concerns for scope now is whether I'll be doing more damage to my knee then my current situation. Please advise and help!  :-\
Nov 09 - injury: twisted left knee
Jan 10  - first appointment with Ortho doc
Feb 10  - MRI showed normal, nothing conclusive
Mar 10  - started PT for a month
15 Apr 10 - Arthroscopy, medial meniscus trim (frayings)

Offline dm

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  • I hate my knee!! :(
"just some nasty sharp pain across jointline and medial side of my knee (tender to touch!) whenever i walk, put load on my knee" is indicative of meniscal issues IMHO, so keep the appointment and tell the doc exactly that. at this point, low swelling is good, I don't swell up much with meniscal tears either, have had 3 of them. Follow up with the knee, is my advice.
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 tez27

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Hi xhui
I realy wish I had had a scope when I first injured my knee because I now have a lot of scar tissue as well as the other injurys and I think that is where some of my pain is coming from. I also had a load of physio and it did help strenghthen the muscles round my knee which in turn helped the pain a bit but it has always been there and at least now that I have had the scope I know what is wrong with it and can start the process of getting it fixed. Dont wimp out now lol as far as I can tell you will not get a proper diagnosis without the scope.
I'm no expert but thats my experience.
Take care Tez 
L K injured 25th June 2008
scope Jan 5th 10
diagnosis ACL rupture
fiberous band excised from acl
ACLr July 19th 2010  scope on 24th Sept 2011
ACL has failed incorrect tunnel placement
23rd July 2012 1st stage of a 2 stage ACL revision
10th May 2013 2nd stage ACL revision

Offline Lou123

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Re: [Not local, need advices] New here, normal knee mri but persistent pain
« Reply #10 on: March 19, 2010, 08:27:38 PM »
Thats one thing that I'm finding annoying. When the dr and 2 different physios have done a physical exam of my knee, they have all been certain that there is cartilage damage, but as the MRI showed no tears, just fluid in the knee the os wants to keep on with conservative treatments.
Its been nearly 10 months since the injury, and they are not working. As much as i would like to avoid surgery, I think a scope is probably the best option now. I am worried that there will be scar tissue building up, which may be getting in the way.

Offline tez27

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Re: [Not local, need advices] New here, normal knee mri but persistent pain
« Reply #11 on: March 19, 2010, 10:14:41 PM »
Hi Lou
My advice would be to push and keep pushing your o.s to do a scope I really wish I had but because I am a total wimp I took what I was told and went on my merry way doing more damage as I went lol.
L K injured 25th June 2008
scope Jan 5th 10
diagnosis ACL rupture
fiberous band excised from acl
ACLr July 19th 2010  scope on 24th Sept 2011
ACL has failed incorrect tunnel placement
23rd July 2012 1st stage of a 2 stage ACL revision
10th May 2013 2nd stage ACL revision

Offline xhui

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Re: [Not local, need advices] New here, normal knee mri but persistent pain
« Reply #12 on: March 20, 2010, 02:05:08 AM »
Hi dm & tez,

thanks so much for your replies!

@dm
and I thought I was the 'weird' one by not having any swellings when doc kept saying meniscus issue. Was also ploughing the net for any other possible explainations to my pain and weakening knees. Thanks for sharing :)

@tez
oh my, can understand your regret for not doing that scope earlier! Scar tissues, this is something I've missed to consider! Thanks for the advices too, I'll try not to wimp out now till my doc visit. Lol. Am not even sure if I'm hoping for the os to find some 'problems' with my precious knee or to pray it is all well (huh again?!) oh well, this can get pretty frustrating!

@Lou
thanks for shaing your experience too. Seems like we are pretty much in the same boat. Everyone here have been really helpful so maybe you'll find their advices on follow up here. Take care :)
Nov 09 - injury: twisted left knee
Jan 10  - first appointment with Ortho doc
Feb 10  - MRI showed normal, nothing conclusive
Mar 10  - started PT for a month
15 Apr 10 - Arthroscopy, medial meniscus trim (frayings)

Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
Re: [Not local, need advices] New here, normal knee mri but persistent pain
« Reply #13 on: March 20, 2010, 10:24:39 AM »
I was in a similar situation you are in at the moment was told to keep on top of my PT and knee should be ok but after months of PT knee was still not improving. I went to the gym 3 times a week to build up on my quads and when I finally saw an OS he said my quads are very strong and gave me a cortisone injection which did not really help so had no option but to scope my knee.

I would go ahead and have your knee scoped as its not too bad as long as you keep on top of your PT after your surgery. I am over 4 months post op and knee not improving, but do not be put of by my situation as there are many succesful scopes done worldwide everyday. You only read up about the failed scopes on KG bulletin board because the members that surgery was successful no longer post on KG. Even the general anesthetic is not too bad as they have improved a lot over the years and the after affects are minimal. There are risks having a scope DVT and scar tissue but it does not happen all the time to patients so there always going to be risks with any type of surgery.

Nick :) {2010} :)

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 xhui

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Re: [Not local, need advices] New here, normal knee mri but persistent pain
« Reply #14 on: March 27, 2010, 05:00:59 AM »
Thanks Clarkey for your sharing again!

Just some updates, I've seen my OS and had scheduled for a diagnostic scope for the 15 Apr. They took some blood to test for any arthritis issues (hmm but I'm just 28yrs old!) I'll be going under general anesthesia(doc didn't give any other choice). Kindof scary, first time going under and sleeping..

What should I expect pre, during and post procedure? I've been informed to fast the night before and if nothing much has been found in my knee I'll probably be on 2weeks medical leave, while any other repair work might warrant a longer leave.

In the meantime, should I continue my PT sessions? I'll assume I'll continue PT after the scope too.

Saw on my checksheet doc wrote, surgery for diagnostic purposes, 'debridement/meniscectomy'. Does it mean she'll remove parts of meniscus if they are torn? Kind of worried about early oestheo or  arthritis problems!

After the surgery do I need crutches or can I literally limp off home (they mandate I have someone to fetch me). Hope my knee won't be too wrapped up or sorts, hate the feeling of being in need..

Thanks everyone for your advices!   
Nov 09 - injury: twisted left knee
Jan 10  - first appointment with Ortho doc
Feb 10  - MRI showed normal, nothing conclusive
Mar 10  - started PT for a month
15 Apr 10 - Arthroscopy, medial meniscus trim (frayings)

Offline Vickster

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Re: [Not local, need advices] New here, normal knee mri but persistent pain
« Reply #15 on: March 27, 2010, 08:22:42 AM »
I had a scope around 7 weeks ago to deal with a torn meniscus - wasn't repairable, but only 10-15% of the lateral one removed - as my OS pointed out, not too bad especially as we have two (I also had the back of my knee cap shaved and a wash out).  Day surgery with GA, in at midday, home by 10pm (I assume yours is a day op too). 

The operation isn't that long so you should get over the anaesthetic fairly quickly.  You'll be sleepy for a couple of days, but you won't want to do much anyhow.  I was told to use crutches for up to 3 weeks, had more or less ditched them after 2 weeks.  Stitches out after a week.  I had a couple of PT sessions afterwards, at a week and 2 weeks post (this probably varies by country and PT/OS).  Pain wise - I had a 5 day course of anti-inflammatories and had some other painkillers for a few days (more because the OS told me to take them, than having a lot of pain).  I was given bed exercises (SLRs, static quads, heel slides) to do regularly afterwards to get back ROM (was almost full after a week).

I have been back in the gym now for around 3 weeks, able to do a decent cardio workout at least every other day.  I have also been on my bicycle (had to get back in the saddle asap as it was falling off that did for my knee).  I cannot walk that far or fast or use a treadmill without pain, but I had extensive bone bruising from the fall and think that might still be an issue :(  All in all, feels pretty good, better than it was before the scope, albeit a bit niggly. 

I hope it all goes well for you - the recovery and rehab does depend on what is done, but if you are young and fit, it should all be good :)
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline xhui

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Re: [Not local, need advices] New here, normal knee mri but persistent pain
« Reply #16 on: April 12, 2010, 03:00:47 PM »
Thanks Vickster for posting and encouragements, really need them.

Some updates from the doc after they drew blood from me.. Had a turn of events, though i'm still proceeding with the arthroscopy, they found high amount of uric acid and suspects gout (which may cause joint pain??). Oh well, was caught off guard, didn't thought this could come up from the tests. Really kind of confused now, what is gout by the way? Did some googling and sort of points to the joint pain, but it seems to come in periods and with certain intensity especially at night? Is gout arthritis?

This (gout thing) doesn't seem to sit with my symptoms (I remembered the injury event, pain on the joint line and across knee when weight bearing, alot of clicking, now it is starting to catch a bit behind my knee when i go up and down the stairs (had to wriggle a bit to bend it), when i stand up from a sitting position, can feel/hear some grinding of the knee area, can't really hyper extend or straighten my knee anymore, pain in the medial knee area, weak knee as i've almost fell over a few times!) This has been a slow build on of symptoms and now it is coming to 5 months from injury.

Help! anyone can shed some light to what i'm doing and what else i should do?  :'( I'm pretty disturbed with the findings too, though this is something I've to face and seek treatment eventually.

Think i'm looking for more encouragements also.. My surgery is in 3 days time, this Thursday, I really really hope the OS finds something in this knee of mine. Some advices on what to expect and prepare for post op would really be helpful also! (The other thread on what to expect post surgery was really helpful too..)  :-\
Nov 09 - injury: twisted left knee
Jan 10  - first appointment with Ortho doc
Feb 10  - MRI showed normal, nothing conclusive
Mar 10  - started PT for a month
15 Apr 10 - Arthroscopy, medial meniscus trim (frayings)

Offline xhui

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Re: [Not local, need advices] New here, normal knee mri but persistent pain
« Reply #17 on: April 15, 2010, 11:52:13 AM »
For all that's worth, here's the findings from my arthroscopy I had today:

findings in short, medial meniscus frayings, trimmings were done. Didn't know even with minor tears could cause so much pain and discomfort. Now on painkillers and I woke from General Anesthesia without any side effects. The falling asleep feelings were rather pleasant even! The time taken from pre op prep to waking takes less then 2hrs!

Going back to the doctor tomorrow for a better understanding and change of dressing. Hope to start PT soon.

Thanks to everyone who's been real helpful and encouraging. Maybe if not for all you guys I just might still be suffering the pain with little courage to proceed with the scope. :)
Nov 09 - injury: twisted left knee
Jan 10  - first appointment with Ortho doc
Feb 10  - MRI showed normal, nothing conclusive
Mar 10  - started PT for a month
15 Apr 10 - Arthroscopy, medial meniscus trim (frayings)

Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
Re: [Not local, need advices] New here, normal knee mri but persistent pain
« Reply #18 on: April 15, 2010, 07:50:21 PM »
Sorry I did not wish you good luck for your surgery, I post on so many posts that I sometimes forget certain post. The GA is not too bad as it was my 1st GA with an injection, had gas as a kid at the dentist and was not at all nice, but the injection as you mentioned feels nice just before you fall asleep. The side affects are minimal all I had was a slight headache and sore throat but soon went away after a good nights sleep.

Hope your scope is more successful then mine as my knee worse off 5 months post op then it was before my scope but I sure your surgery will be more successful. The knee going to feel pretty sore for the next couple of days so keep on top of your pain meds.

Nick :) {2010} :)
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 xhui

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Re: [Not local, need advices] New here, normal knee mri but persistent pain
« Reply #19 on: April 16, 2010, 12:19:27 PM »
Thanks Nick for the thought, am really hoping my recovery goes smoothly..

Hope yours is in the midst of something helpful for you?

1st day after op, seen doctor and had a change of dressing, first time see what was done on my knee. Was kindof horrified by the amount of blood(dried up though), but was surprised how minimal or small the incision was! Just 2 stitches on each of the cut. Was told to keep the swelling down by icing it. Doc says I could remove the bandage and wear my knee guard to control the swelling? (there's still the gauze on e cuts).

Just a question, how fast should I get back to physiotherapy? Some miscommunication, not sure why the counter staff told me to give my PT a call to arrange an appointment instead of what my doc said she would put me back with my PT.  Anyway seeing my PT next Tuesday, guess it'll be quite different sets of exercise compared to my pre op? (pre op e meniscus tear wasn't even diagnosed).
Nov 09 - injury: twisted left knee
Jan 10  - first appointment with Ortho doc
Feb 10  - MRI showed normal, nothing conclusive
Mar 10  - started PT for a month
15 Apr 10 - Arthroscopy, medial meniscus trim (frayings)

Offline Clarkey

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  • Neil TheElephant knee packed up carrying his trunk
Re: [Not local, need advices] New here, normal knee mri but persistent pain
« Reply #20 on: April 17, 2010, 10:36:40 AM »
The incisions are small and after a couple of months are left with a tiny scar and hope you do not have problems with scar tissue as I am having 5 months after my scope. I changed my dressing every day after my scope, and ended up with a plaster over the incisions to protect the stiches and stopsping germs.

You need to keep on top of your physio as soon as you can, to work on your ROM and will be painful to start of with, but should improve over time.

Good luck with the PT and enjoy the weekend.

Nick :) {2010} :)
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 xhui

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Re: mri misses, meniscus, arthroscopy, pain.
« Reply #21 on: May 02, 2010, 03:44:43 PM »
Hi guys,

It's been about 2weeks+ after my scope for the meniscus trim ("irregularities over body & anterior horn of medial meniscus"). Been having some hits and misses (pain mostly), was wondering if anyone can shed some light on what's happening..

I've visited my PT 3 days after my scope and was taught some more exercises and stretches to build on the quads and help in straightening and flexing that knee. I've goto say my ROM is almost back fully (I could straighten and bend past 100 degrees). But, these aren't without pain. Especially when i straighten my knee and "extend" if using my quad (sorry, is the technical term called hyper extend?).. Stairs aren't that easy to do still especially the going down part. Oh, i was able to flex my knee pretty well prior the surgery though extending them does bring on more pain.

When i do stairs (mainly down) or just plain walking, the pain is a frustrating one across the knee cap (seems to be across the 2 incisions areas) and after a while of standing or walking around, it starts getting "tangled" on the left (it feels like something's obstructing the flexing of the knee), back of my knee! Lots of pain when i bend the knee and put weight on it.. I was thinking also, does scar tissue forms even for a simple arthroscopy procedure for the trim?

Oh, i also did checked with my doc on the numbness around the left incision, outer side of my knee.. kind of surprised she refuted my claims and said some stuffs to brush them off.. It was really "interesting" to experience more awkward and occasional PAIN (sharp) on the left side rather on my medial side too (though not enjoyable definitely!) Pins and needles feelings comes and go too.. left side, again. Incision wounds are still tender when accidentally brushed against. ouch.

I'm confused if this surgery has done me any good as my pain now seems rather similar to the ones i had before the surgery! Or am i being too impatient? I've still some swellings around the wound areas and above the knee cap.. am praying these are the ones giving me the pain.. yet i can't seem to differentiate them now.. help?  :-\
« Last Edit: May 02, 2010, 03:47:09 PM by xhui »
Nov 09 - injury: twisted left knee
Jan 10  - first appointment with Ortho doc
Feb 10  - MRI showed normal, nothing conclusive
Mar 10  - started PT for a month
15 Apr 10 - Arthroscopy, medial meniscus trim (frayings)

Offline xhui

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Re: mri misses, meniscus, arthroscopy, pain.
« Reply #22 on: May 11, 2010, 03:40:24 AM »
I'm now 4 weeks (1 month) from my scope. To be real honest, my knee is back to square one or even worse (I really didn't want to admit this!!)..  :-\

Everything's back with major sharp pain across the knee front with slight pain on the inner side. But i've 'acquired' some new pains as well. Now the nerve issues have been quite frustrating as the constant "tearing", "shooting" pain is really bad especially when i bend or stretch my knee.

knee gets "stuck" in a locked position when i stand too long (say 3mins?), have to forcefully (painfully) bend to start walking again Stairs are impossible. Really stiff and difficult to bend the knee made me wonder what have i made myself go through..

sigh, feeling rather helpless now. And my PT and OS have to keep telling me, I'm supposed to be back on my feet normally as of, say, last week?

Should i seek a 2nd opinion?  :(
Nov 09 - injury: twisted left knee
Jan 10  - first appointment with Ortho doc
Feb 10  - MRI showed normal, nothing conclusive
Mar 10  - started PT for a month
15 Apr 10 - Arthroscopy, medial meniscus trim (frayings)

Offline kris_83

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Re: mri misses, meniscus, arthroscopy, pain.
« Reply #23 on: May 11, 2010, 01:10:53 PM »
ugh! So sorry to hear this! What sort of feedback are you getting from your OS? I suspect they are unlikely to admit that anything he/she did is what's causing your new pain. My thoughts are with you today!
12/09 dx- patellar subluxation (not!)
1/10 mri- neg; PT rx failed
4/10 more PT
5/10 dx patellar hypertension
6/7/10 chrondroplasty, patellar decompression, synovectomy and plica excision
5/6/11 dx RA, sjogren's

Offline tez27

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Re: mri misses, meniscus, arthroscopy, pain.
« Reply #24 on: May 11, 2010, 02:01:49 PM »
Hi xhui
Sorry things are not working out for you the way you hoped. I feel extra sorry because I advised you to push for the scope in the first place, but what I think happens with some doc's [not all of them there are some really good ones out there] is that they go into the knee and the first problem they find they fix and leave everything else as is, hopeing that will be enough to sort the knee out unfortunatly in some cases there is more going on that still needs to be addressed.
When are you due back to see your o.s? I think you need to get back into see him asap and see what he thinks is going on now.
Take care Tez
L K injured 25th June 2008
scope Jan 5th 10
diagnosis ACL rupture
fiberous band excised from acl
ACLr July 19th 2010  scope on 24th Sept 2011
ACL has failed incorrect tunnel placement
23rd July 2012 1st stage of a 2 stage ACL revision
10th May 2013 2nd stage ACL revision

Offline xhui

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Re: mri misses, meniscus, arthroscopy, pain.
« Reply #25 on: May 11, 2010, 04:11:03 PM »
hi kris & tez,

your replies are enough to allow a restful sleep tonight for me.. thanks for the kind thoughts/words.

My OS met me (briefly) after 2 weeks to remove my sutures and mentioned (briefly again), "ok, the knee doesn't looked too bad, you should be back to normal pretty fast." When i enquired about the numbness and weird shooting feelings around the left incision, I could almost hear a pin drop while waiting for an answer. If i remembered correctly, she replied me with an "the numbness can't be from the surgery, its on the left side, how could it be if my cut is on the kneecap?!" I persisted and she brushed me aside saying she'll see me in 2 months time for a review..

Things started getting worse down the 3 and now, 4 weeks time. EVERYTHING is coming back with some extras onto it. Today while taking the public transport back (it gets really crowded here and seats are luxuries during peak hours), I could barely walk. I've terrible sharp cutting, stretching pains on my medial (almost to the back of the knee) and quite a bit of pain and knots on the outer-towards the back knee and of course, my favourite, constant major pain across the front of my knee.

Oh, I think my good knee is going to crash soon too. Let's see how long more it can last.

I really wonder what's wrong with this limb of mine.. I thought my OS fixed the "minor" meniscus problem (which she claimed it was sooo minor). sigh.

@kris
You're absolutely right on the not admitting part. I was just hopeful she could understand. I'm not trying to cast blame but I seriously want this knee to get better. Thanks for the thoughts.

@tez
hey there, don't at all feel bad, please ok? It was my decision to go ahead and I wouldn't know what else to do also. I kind of agree that (and was suspecting all the while) if she could have went in there and fixed the obvious problem (which she pre-diagnosed even before the MRI-which was useless also). I'm really beating myself now if she could have missed anything else..

This is impossible.. How could a "fix" continue to cause problems and pain!?

Back to see my OS on 23 June (yes, quite a long way), I really wouldn't imagine what she would say about my condition by then. She would definitely expected a really good and speedy recovery by then- especially when she kept emphasizing mine was a reeeal minor issue.

I'm contemplating seeking a second opinion but mostly I feel really stupid now. Everyone in the office is asking me if i've recovered and I had to smile and say either, "yeah, guess so" OR "well no, its getting worse"-and receive weird looks with periods of silence.

It's 11.05pm right here across the pacific now, i hope i get a restful sleep before i battle my journey to work again in the morning.  :'(
Nov 09 - injury: twisted left knee
Jan 10  - first appointment with Ortho doc
Feb 10  - MRI showed normal, nothing conclusive
Mar 10  - started PT for a month
15 Apr 10 - Arthroscopy, medial meniscus trim (frayings)

Offline tez27

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Re: mri misses, meniscus, arthroscopy, pain.
« Reply #26 on: May 11, 2010, 10:05:48 PM »
Hi Xhui
maybe it's time to get a second opinion, it sound to me like your o.s is brushing off your problems and that is not going to help you at all. I know how you feel when you decide to have surgery you think it will to fix all your knee problems but that is not always the case, at least for me after my scope the surgeon told me my acl was ruptured and even though just after surgery he informed me that I would be fine living without an acl, I feel my knee has been more painfull and unstable since so I now know I need the reconstruction, I really wish that I could have had it done at the time of my scan cos I needed time off work for the scope and now will need even more time off for the reconstuction.
When I was having a moan to my husband about why the o.s didn't just fix everything while he was doing the scope!! his answere to me was if a mechanic goes into fix your car engine he will fix the most obviouse problem and hope that will do the trick, same thing with knees, but you need to have a surgeon who will listen when you say something is not right and do something about it.
I really hope your pain improves and you find someone to help you  Take care Tez   
L K injured 25th June 2008
scope Jan 5th 10
diagnosis ACL rupture
fiberous band excised from acl
ACLr July 19th 2010  scope on 24th Sept 2011
ACL has failed incorrect tunnel placement
23rd July 2012 1st stage of a 2 stage ACL revision
10th May 2013 2nd stage ACL revision

Offline xhui

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Re: mri misses, meniscus, arthroscopy, pain.
« Reply #27 on: May 14, 2010, 04:56:22 AM »
Thanks tez for your reply.. It sure gave me some food for thought there.

I'm just wondering if I really should give my doc another chance to review my problems (after 1mth surgery now).

Is it 'normal' to have swellings & redness, stiffness and pain for a 4weeks+ post op? I do not want to be be sounding the alarm too early.. I'm just baffled that my knee hurts more then before :( I've even asked myself if it should get worse before it gets better!? Or should it be something I've to live with?!

I'm still contemplating calling my clinic to move my appointment forward to see the doc. Just not sure if my doc will actually be able to offer anything else (esp she might not see too much swellings as it usually comes up after a day out at work. Though pain is consistent throughout the day)..

Anyone has any recovery period to share so I can guage where I should be also?
Nov 09 - injury: twisted left knee
Jan 10  - first appointment with Ortho doc
Feb 10  - MRI showed normal, nothing conclusive
Mar 10  - started PT for a month
15 Apr 10 - Arthroscopy, medial meniscus trim (frayings)

Offline Vickster

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Re: mri misses, meniscus, arthroscopy, pain.
« Reply #28 on: May 14, 2010, 08:21:06 AM »
I had a scope 13 weeks ago (8 Feb) and still have pain and stiffness, some swelling around the portals but no redness (other than the incisions).  I too had a partial mensicectomy, shaving of patella cartilage (grade III defect) and washout.  My initial injury (~9 months ago) was the meniscus tear and an osteochondral lesion which had healed over with fibrocartilage plus extensive bone bruising. 

I am back on the bike and in the gym (cycling, stepping, XT, rower) - have been for a while now - the exercise being generally pain free but knee does get stiff afterwards (I am not very good at icing it  :-[ ).  It also gets stiff if I am sat for any length of time.  I get pain on walking, twisting, I cannot kneel an put any weight through the scoped side, nor can I sit back on that heel, and I get pain at each end of the ROM.  I saw the PT a couple of weeks ago to get his view and he did think that this level of discomfort is unusual after 3 months, but it wasn't a straightforward problem with the bone bruise (which can take a year to heal).  He suggested having a chat with the OS again if still troublesome in a few weeks (I am considering seeing him next week).

I would say most of the time my knee is sore and twingy rather than painful so not taking drugs for it (that said I didn't much after the injury either, nor once a few days had passed after the op).  I can put up with it but it is frustrating and demoralising.

4 weeks post scope, I was still using the crutches occasionally, so I don't think it is unusual to have some discomfort, especially around the incisions.  I would say continue to ice, don't overdo it - walking or gym etc and continue with PT exercises like leg raises and heel slides, plus anything else like wallslides if you can.  The OS said to me that it is key to get the leg muscles strong to support the knee.  Everyone's knees are different, but if you are concerned and struggling, do talk to the doctor or physio :)
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline xhui

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Re: mri misses, meniscus, arthroscopy, pain.
« Reply #29 on: May 18, 2010, 06:47:54 PM »
Thanks Vickster for sharing your recovery so I could estimate mine. Though it's just 5 weeks post op, I seemed to have developed some new "pain" recently.. It was quite disturbing actually, not sure where to proceed now also.

My level of activities had actually decreased as I'm currently on leave and away from work. But of late (these few days), I've started getting really bad burning and shooting pain on my numb patch on the left side of my Left knee. It was so bad yesterday night that I couldn't do any of my stretches nor leg raise exercises. My knee was so hyper sensitive, immense sharp burning pain with every movement i do, in the end, i had to lie in bed and attempt to sleep without doing any of my exercises!

Today, I've had my equal portion of knee pain while moving around too. It was quite bad with alot of knots behind my knee, especially on the left side (numb) area. I was sitting on a recliner when I suddenly felt real burning, sharp pain running down from the back of my knee down to my ankle! Was quite scary to see myself struggling to lift my ankle! My calf muscles area hurts too.. I was holding onto my leg waiting for the pain to subside.. I've a "knot" which I can feel behind the knee whenever I bend my it past 90degree or when i sit down (usually when weight bearing).

Now my question is, should i continue with my exercises and stretches? The pain is really bad especially after all those stressful positions on the knee. Anyway have anything to share in regards to nerve related issues? Though mine doesn't seem as bad as quite a few i've read here, i really appreciate all the sharing and encouragement from you kind folks here!

I've goton another appointment with a 2nd OS, but the appointment date is near the one with my current OS, so goto wait till end of June. I've read up a bit too on nerve entrapment and related issues, i'm not sure, but self-diagnosising really sounds wrong.. But now i'm more open to being referred to the pain management centre.. maybe they can help me better there also?

I can't imagine going back to work again..  :-\
Nov 09 - injury: twisted left knee
Jan 10  - first appointment with Ortho doc
Feb 10  - MRI showed normal, nothing conclusive
Mar 10  - started PT for a month
15 Apr 10 - Arthroscopy, medial meniscus trim (frayings)

Offline tez27

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Re: mri misses, meniscus, arthroscopy, pain.
« Reply #30 on: May 18, 2010, 07:46:12 PM »
Hi xhui
That dosen't sound like your having a good time at all, it also dosen't sound like normal post op pain saying that I am no expert, but is it possible to get in to see your either original or new o.s sooner than the end of June  or even your gp who might be abel to give you an idea of what is going on.
As for the excersises again I am not an expert but if it was me I would stop if something was causing me the kind of pain that you describe.
Sorry I cant be more help and I really hope thing improve for you soon.
Take care tez
L K injured 25th June 2008
scope Jan 5th 10
diagnosis ACL rupture
fiberous band excised from acl
ACLr July 19th 2010  scope on 24th Sept 2011
ACL has failed incorrect tunnel placement
23rd July 2012 1st stage of a 2 stage ACL revision
10th May 2013 2nd stage ACL revision

Offline Vickster

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Re: mri misses, meniscus, arthroscopy, pain.
« Reply #31 on: May 19, 2010, 10:05:24 PM »
I agree, increasing and acute pain does not sound right.  To have some is probably usual, but it should be improving. 

I don't have more pain, I just have the same degree of discomfort especially if I twist the knee wrongly (even with the initial injury, I didn't have so much pain that I needed to take anything apart from a few times).  After much procrastination, I am actually seeing my OS tomorrow as I am frustrated by the lack of improvement.  I have tried to use a treadmill this week and just ended up with pain and swelling - even a very slow jog (8kmh) for a minute was an utter no no and 5-10 minutes walking at <6kmh, flat and minor incline led to lateral and medial pain and a tight feeling.  I kind of feel my knee should be able to take that degree of WB 9 months post injury and over 3 months post scope (I have also lost 11kg in weight this year which should be helping too) !

I'll let you know how I get on - I fear it may be 'more time', bone bruising can take a year to heal  ::)
« Last Edit: May 19, 2010, 10:08:33 PM by Vickster »
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline xhui

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Re: mri misses, meniscus, arthroscopy, pain.
« Reply #32 on: July 08, 2010, 04:07:02 AM »
I was so wishing I could report back that i'm ALRIGHT and up on my feet as normal again!..

Sadly that doesn't seem to be my case nowadays..

Seen another doctor on the 29 Jun, was sorely disappointed he didn't even bother to do much "checking" or "asking".. such is with subsidised healthcare route. He played down all my "pain" issues, buckling, swellings, nerve-like pain etc. Brushed them aside by saying "every individual respond different, hence recovery period also differs".. Of which he then booked me for another appointment for review in 3months time!! Gosh. I had to insist on my conditions of which i've waited 2months to see him and all he had was to wait another 3months?

In the end, was only prescribed diclofenac and some vitamins (assuming to improve cartilage growth or sorts).

He insisted x-rays and even another MRI won't show anything much since my "first doctor" had went in to take a look.

Very frustrated.. I was thinking all these should be post-op complications now. No longer the meniscus issue.

Wonder if i should just live with this condition.. and just hope it goes away..  :'(
Nov 09 - injury: twisted left knee
Jan 10  - first appointment with Ortho doc
Feb 10  - MRI showed normal, nothing conclusive
Mar 10  - started PT for a month
15 Apr 10 - Arthroscopy, medial meniscus trim (frayings)