Banner - Hide this banner





Author Topic: Second referral to an orthopaedic consultant  (Read 7250 times)

0 Members and 1 Guest are viewing this topic.

Offline Roberts

  • Regular Poster
  • ***
  • Posts: 64
  • Liked: 0
Re: Second referral to an orthopaedic consultant
« Reply #15 on: April 15, 2010, 03:42:40 PM »
:D Yep I am in fact a lady!

I actually think my bin of icey water had an even better effect than the cryo cuff, but its not very practical especially if my toes are going to fall off  ;D

The auto chill system means it continually cycles the icey water through the cuff so the cuff never warms up from being against your warm body. It sounds good but I didnt fancy paying the extra money as it costs enough as it is! Though in the future it could be a good idea especially if I have arthroscopy.

Are there any particular questions I should be asking the orthopadic man? I can only think of - Can you make my knee better? and if yes, when can you do it?!!!!
9/05 Tore calf muscle, wouldn't heal, led to bad limping, led to painful opposite hip, weakened hip, led to weakened quads
7/07 Quad tendonitis, knee pain and swelling after 1 legged squats
6/10 Arthroscopy! Smooved cartilage, now have LOTS of strengthening to do

Offline Lottiefox

  • SuperKNEEgeek
  • *****
  • *
  • *
  • *
  • *
  • Posts: 2393
  • Liked: 16
Re: Second referral to an orthopaedic consultant
« Reply #16 on: April 15, 2010, 03:52:08 PM »
Hellloooooo another laydeee! Sorry for calling you Robert!!  :P :-[

Loving the bin of cold water idea!  ;D

I shall jot down some of the questions that I have asked in the past later on - just off to the gym to do some non-kneedemanding work whilst I can before D-Day and monitor the state of the UK air space as we're meant to be flying to the Canaries on Saturday for a week of sun before a few weeks of chilled water and crutches! Come on volcanic ash - dissipate!!!!  :o ::)

Lottie  :)
Bilateral patella OA since 2009, no surgeries.
Euflexxa working well x3 to current
Right forefoot CRPS post fusion surgery 2011
Refusing to let the ailing parts stop me....

Offline anniehine

  • Forum Faithful
  • ****
  • *
  • Posts: 261
  • Liked: 0
Re: Second referral to an orthopaedic consultant
« Reply #17 on: April 15, 2010, 04:24:46 PM »
Ha ha, I couldn't believe it when I heard they'd grounded all the flights because of a volcano..thought it was a joke!   :o

I live close to Heathrow and am used to hearing the planes pass overhead all day so it's eerily quiet here today! Will keep my fingers crossed that the cloud shifts for you Lottie  ;D

Great questions Anna!  I would be most interested in how many arthroscopies he has done to date, what the risks are, what the recovery rate is, what kind of rehab you would need, exactly what the operation would entail (even if you don't understand half of the jargon it looks like you're keeping tabs-and you can do more research in to it), what if any pre-hab you can do.  Umm, can't think of any more.  When I went to see my surgeon I asked him if his daughter was in my position would he want her to go ahead given all the risks and he said yes..so you might want to try that one if he looks old enough to have a daughter your age..don't want to offend him !

Annie.
Left knee started dislocating at 7 years old
Hypermobile
Arthroscopic scope April 2009
Trochleoplasty at 28 years old (10.2.10)
Did 1st SLR 1.4.10 WHOOP!!
Walked through house without crutches (12.4.10) very pleased with myself!!

Offline Lottiefox

  • SuperKNEEgeek
  • *****
  • *
  • *
  • *
  • *
  • Posts: 2393
  • Liked: 16
Re: Second referral to an orthopaedic consultant
« Reply #18 on: April 15, 2010, 05:03:42 PM »
Clearly travel today is doomed as there is a fire at the M40 junction I need (thank you radio 2 traffic!) so I have turned around and come home - whoops no gym work for me today!

Good questions I think Annie - definitely ask about what he thinks is wrong, what are the causes/what are symptoms e.g. I have cartilage defects but they are the symptoms - the cause is my tilted patella. No point mending symptoms if the cause remains. Both need addressing! What is the recovery time, will you be non weight bearing, what level of PT might you need, when can you return to normal daily activity, more intensive sports etc, driving. Whats the success rate for what he proposes and if it fails - how does it fail? I asked my chosen surgeon what he would do if it were his knee - and I am pretty sure the answer he gave me was the honest one. (which is the option I am going for!). He didn't wail and sit in the corner at the thought of being stuck with my troublesome knees...in fact one of the reasons I chose him was the fact he always gives me time for questions and always sees my knees as perfectly treatable. One other OS basically said they were shot to **** and I may as well book in my bionic parts after attempting a shaving and a microfracture (neither of which would have addresed the root cause....because he never bothered to get CT scans....)

Right everyone, get blowing air into the skies above London!! Annie - we're meant to be going from Gatwick - come on cloud - go away!!

Good luck Robert-Anna x ;D
Bilateral patella OA since 2009, no surgeries.
Euflexxa working well x3 to current
Right forefoot CRPS post fusion surgery 2011
Refusing to let the ailing parts stop me....

Offline Clarkey

  • SuperKNEEgeek
  • *****
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • Posts: 4190
  • Liked: 77
  • Neil TheElephant knee packed up carrying his trunk
Re: Second referral to an orthopaedic consultant
« Reply #19 on: April 17, 2010, 01:08:15 PM »
Sorry Lottie, you cannot fly out this weekend and bet you was looking forward to your holiday and think all airports will remain closed until at least 1am Sunday Morning and could be even longer. Your surgery is not too long away next month and hope you benefit from the surgery. I was unlucky and my knee is worse off now then it was before my scope but it just one of those things as many people seem to have ongoing knee problems.

Anna do not be put of by what I mentioned about my scope 5 months ago as most peoples recovery goes ok. I was just unlucky and have some scar tissue causing me the problems. The GA is not as bad as people make it out to be and just before going under it is a pleasant feeling and the after affects are not too bad, I had slight headache and sore throat. You have had knee problems for sometime and as the other pointed out surgery is the best way for the OS to look inside your knee as MRI's are not always accurate.

My MRI came up normal but had a inflammed fat pad and my medial plica was enlarged and had to be removed as it was rubbing against the bone. Do not be put off what said at the pre op clinic as they will tell you the risks involved such as DVT and scar tissue along with other risks.

The risks are low and rare and knee surgery is done worldwide everyday and most people recover ok from their surgery. If you look at how many members are on KG compared to how many people worldwide have had knee surgery a year the percentage is very low. Members that join KG mostly have had knee problems for years and surgery has not fixed their knee problems.

There would be a lot more members on KG if knee surgery was unsuccessful, most people have surgery which fixes their knee problems.

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 Redwing

  • Forum Faithful
  • ****
  • Posts: 346
  • Liked: 2
Re: Second referral to an orthopaedic consultant
« Reply #20 on: April 25, 2010, 09:15:20 AM »
Hi Anna

Re The Horder Centre:  I've recently been a patient there twice and they are fantastic.  I had bilateral arthoscopies last summer and a total knee replacement  there in January.  Everything they do there is to do with joint surgery, hips, knees, wrists, shoulders etc.  Nothing else.  They are real pros and do about 100 TKRs per month, I felt I was in good hands going there.  Most patients are NHS these days but it used to be a private hospital.  The staff are wonderful, the nurses and assistants are totally clued up in how to deal with knee patients and my feeling was that I was being very well looked after.  It's quite a big place, they have three theatres and operate 6 days per week, lots of surgeons.  I can only speak for the one I had but he is good but you will probably have a different one. 

PM me if you want any more specific info.  Good luck.
« Last Edit: April 25, 2010, 09:20:34 AM by Redwing »
2001: first referral to OS for osteoarthritis in knees after about 5 years of OA pain.  Told I was too young for knee replacement.
July 2009 Bilateral arthroscopy
Jan 2010 TKR-right knee

Offline Roberts

  • Regular Poster
  • ***
  • Posts: 64
  • Liked: 0
Re: Second referral to an orthopaedic consultant
« Reply #21 on: May 04, 2010, 10:07:34 PM »
I had my appointment today! The consultant was a lot nicer than the last one I saw - he actually talked to me! He did some knee tests, ie wiggling it around and pressing it in different places, he then asked if I was having a 'good knee day' as what he did didnt really cause pain apart from a bit in the medial joint line when he pressed it. I explained how I hardly do anything and just rest it most of the time but it does confuse me why their tests dont hurt my knee, which is why I kept avoiding arthroscopy in the 1st place.
I explained that my knee flares up if I put weight through the medial side of my knee & I walk on the outside of my foot to avoid the pain, but he said this could be the symptom of over 750 things?!
He has agreed to do an arthroscopy and says he reckons theres a 60% chance it could be a meniscal tear, if its not, I'll just have to learn to live with a painful knee.

I'm now confused that maybe I shouldnt be having an arthroscopy because there might not be a problem, but there must be, but the professionals make it sound like I shouldn't have any pain or problems with walking, I'm soo confused why my knee can't just be painful for a reason & be mended.  ???


Redwing, its good to hear you found the Horder centre good, it did seem a really nice place & everyone organised and understanding whats going on, not like the usual nhs hospital set up. I was particularly happy when I arrived and the front sign said 'specialists in joints' :)

Thank you for the questions to ask although I got flustered by the consultant trying to run through the appointment fast so that I forgot to ask most stuff. The main decision was whether to have an arthroscopy and he said my only option was to have it or carry on with physiotherapy (which I've been trying for nearly 3 years & made progress once but then hurt my knee again) so I guess I didn't really have an option.
He also said he has seen thousands of knees and can't tell me whats wrong with mine?

Anyway, I'm yet again confused, and hoping Ive made the right decision.
9/05 Tore calf muscle, wouldn't heal, led to bad limping, led to painful opposite hip, weakened hip, led to weakened quads
7/07 Quad tendonitis, knee pain and swelling after 1 legged squats
6/10 Arthroscopy! Smooved cartilage, now have LOTS of strengthening to do

Offline anniehine

  • Forum Faithful
  • ****
  • *
  • Posts: 261
  • Liked: 0
Re: Second referral to an orthopaedic consultant
« Reply #22 on: May 04, 2010, 11:56:02 PM »
Hi Anna lady (!)

Hooray that you had your appointment but boo that he was so vague.  If he didn't know what was wrong was he unwilling to refer you to someone else? You can't just 'live with a sore knee', that's just silly! 

You really mustn't be worried about the arthroscopy, it needs to be done to find out what's wrong, and with the amount of pain you have daily there's obviously something wrong. I had a scope last year and I was on crutches for a few weeks and it was a bit sore but really nothing serious so please don't worry about it!

The bottom line is, YOU know that you're in a lot of pain, the 'professionals' need to catch up with what you know already and help you.  There IS a reason that you are experiencing pain, it's just a matter of finding out what it is and the arthroscopy will do that.

Annie  :)
Left knee started dislocating at 7 years old
Hypermobile
Arthroscopic scope April 2009
Trochleoplasty at 28 years old (10.2.10)
Did 1st SLR 1.4.10 WHOOP!!
Walked through house without crutches (12.4.10) very pleased with myself!!

Offline xhui

  • MINIgeek (20-50 posts)
  • **
  • Posts: 26
  • Liked: 0
Re: Second referral to an orthopaedic consultant
« Reply #23 on: May 05, 2010, 04:55:37 AM »
Hi Anna!

Thought I'll share my experience here. It seems like you have quite similiar symptoms as mine (and also went through the same dilemma!).

I saw my doctor for knee pain (after about 2 months of pain) and I was able to recall vaguely a twisted knee injury cause though I was not able to confirm if it was then that my knee was injured.

She did some twisting, wriggling around, pressed on my L knee medial joint line and i had some pain. It was tender along that line and pain was mainly across the front of the knee (when weight is placed but not much when i'm lying down).

Went through the MRI way but results came back normal. Was pretty frustrated as I knew the pain isn't getting any better and the knee is getting pretty knotted up and painful with more clickings as i walk. I didn't have much swellings but probably slight.

Doctor suggested physio to see if the pain would go away. I tried it for a month while I was considering arthroscopy as per suggested by her the best way to see what's happening inside the knee. I kept going back and forth about doing the scope and ending up with nothing found or to go ahead. I gave up and went ahead with the scope and she found a torn meniscus. She trimmed the frayings and sides and smoothen out the edges too.

It was a day surgery and I was able to limp off the bed with some pain meds and i'm off pain meds the next day. I would say if you follow your physio stretches and exercises, you should recover quite fast. Of course it really depends what they do and find inside your knee and each individual respond differently to the procedure. I went under General Anesthesia and my experience was a pleasant one.

Hope this helps and please 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 Roberts

  • Regular Poster
  • ***
  • Posts: 64
  • Liked: 0
Re: Second referral to an orthopaedic consultant
« Reply #24 on: May 05, 2010, 01:03:45 PM »
Hi Annie & xhui :)
I think I am pretty definite that I need an arthroscopy to find out what is wrong with my knee & that I can't get it better with just physio exercises but when I see a professional person every time they seem confused as to why I can't walk & make out that what Im saying can't be true so then the doubts start again.
Its funny because the consultant started saying that the other option is physio & strengthening the muscles surrounding the knee & I started to say maybe I should carry on trying, but luckily I had brought my husband with me who quickly jumped in saying I had been trying for 3 years & its ridiculous that old ladies can walk further than me! Which led to the consultant saying he's happy to do an arthroscopy. So they almost talked me out of it again!

The consultant was asking me if I could remember a twisting incident but I couldn't, all i know is I've limped for ages from possible piriformis syndrome which has stressed my knee joint for ages. I never get any clicking just a sharp pain when I've pushed my knee too hard eg, I tried going out on my mountain bike the other month, pushed a little too hard on a hill & felt an immediate sharp pain in the medial side below my knee cap & I knew I wouldn't be able to walk hardly at all for the next week or so. It then went a bit stiff where the pain had been which I think is signs of inflammation, so all this says to me there is a problem in that section of the knee which starts to heal & then I re-injure it again. And from what I've read this could be a meniscal tear, but I'm not sure what else would cause the same symptoms, especially not 750 other things - thats what confused me again as it seemed a lot more clear cut to me.
Oh also I didn't have any swellling in my knee which confused the consultant too. I did when it first happened though.

I think my biggest fear is that I'll wake up from the arthroscopy and they'll tell me they found nothing wrong, & I'll sink into the biggest depression ever!!!
9/05 Tore calf muscle, wouldn't heal, led to bad limping, led to painful opposite hip, weakened hip, led to weakened quads
7/07 Quad tendonitis, knee pain and swelling after 1 legged squats
6/10 Arthroscopy! Smooved cartilage, now have LOTS of strengthening to do

Offline tez27

  • SuperKNEEgeek
  • *****
  • *
  • *
  • Posts: 2010
  • Liked: 8
Re: Second referral to an orthopaedic consultant
« Reply #25 on: May 05, 2010, 03:43:07 PM »
Roberts I have every sympathy with you, after my o.s agreed to do the scope I started doubting myself, just like you, even though I knew I needed to find out what was going on with my knee, I was worryed that like you ,I would wake up from the anasthetic to be told there aint nothing wrong, I was going to say by luck!!!!!! they found a acl rupture mcl tear and a load of scar tissue but I dont think luck would be the best way to describe it lol.
Anyway its the only way to find out what your probem is,you really NEED the scope so there will be no more silly talk of wimping out and stuff. WHATS THE WORST THAT COULD HAPPEN.
I know I know loads of stuff but you get what I mean I'm just trying to keep you motavated.
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 anniehine

  • Forum Faithful
  • ****
  • *
  • Posts: 261
  • Liked: 0
Re: Second referral to an orthopaedic consultant
« Reply #26 on: May 05, 2010, 03:50:52 PM »
Hi Anna,

O.K. you need to stop worrying!  You are not making anything up and I'm sure no-one thinks that so stop worrying about what the professionals think.  

Think positively, nothing ventured nothing gained, I think it's great that you've got yourself to a consultant after worrying and being in pain for so long so pat on the back to you  ;D  

Also, P.T. is the first stop shop for all consultants it would seem.  Keeps NHS costs down and is safer to offer that as a first conservative measure.  Even I was sent to P.T. before surgery was discussed and my kneecap used to roam about of it's own free will  and it was obvious a bit of strengthening alone wasn't going to help it! Don't let his suggestion of P.T. make you feel as though he shouldn't be operating-it was him just following protocol I'd imagine!

Take your husband with you to every appointment you ever have!!!!-I think you need someone to push for you because you almost seem apologetic about the whole thing.  You have to be strong with the consultant..at this stage you and your husband know more than him about it  than he does!

Did he mention how long the wait would be?
Left knee started dislocating at 7 years old
Hypermobile
Arthroscopic scope April 2009
Trochleoplasty at 28 years old (10.2.10)
Did 1st SLR 1.4.10 WHOOP!!
Walked through house without crutches (12.4.10) very pleased with myself!!

Offline Roberts

  • Regular Poster
  • ***
  • Posts: 64
  • Liked: 0
Re: Second referral to an orthopaedic consultant
« Reply #27 on: May 06, 2010, 01:28:26 PM »
You guys are soooo helpful  :) Thank you

Ok positive thinking from now on! I spoke to an nhs physio today as well and she said even if they dont find a tear they may still find bits floating around that need to be removed so I am prepared for the arthroscopy result!!

Annie you saying I almost seem apologetic about my knee is just what I complain at my mum for being like!! How scary I'm like her without realising lol.

The physio has given me some gentle strengthening exercises and stretches to do for my left glute as it keep cramping up really badly when I sit for too long. But she understands that I can't do too much as it irritates my knee so I have to wait till after the arthroscopy before I can start strengthening that too.
She did explain that my glutes are probably cramping because I walk on the outside of my foot now so its irritating my hip.

And I forgot to say on my last post I have a date already! 22nd of June as long as my pre op phone call goes ok a week saturday. So its not too long to wait. :)
9/05 Tore calf muscle, wouldn't heal, led to bad limping, led to painful opposite hip, weakened hip, led to weakened quads
7/07 Quad tendonitis, knee pain and swelling after 1 legged squats
6/10 Arthroscopy! Smooved cartilage, now have LOTS of strengthening to do

Offline Roberts

  • Regular Poster
  • ***
  • Posts: 64
  • Liked: 0
Re: Second referral to an orthopaedic consultant
« Reply #28 on: May 08, 2010, 02:16:15 PM »
I've just had a letter come through the post from the OS to my local GP giving me more information about my knee.
As well as saying I have 'tenderness along my medial joint line suggestive of a medial meniscal tear' it also says 'she is also tender over her medial femoral condyle and I wonder whether she has a chondral flap of the medial femoral condyle'.
Now I understand the 1st bit about meniscal tears, but chondral flaps? Does anyone know what this means? Or should I not be worrying about it?!
9/05 Tore calf muscle, wouldn't heal, led to bad limping, led to painful opposite hip, weakened hip, led to weakened quads
7/07 Quad tendonitis, knee pain and swelling after 1 legged squats
6/10 Arthroscopy! Smooved cartilage, now have LOTS of strengthening to do

Offline Lottiefox

  • SuperKNEEgeek
  • *****
  • *
  • *
  • *
  • *
  • Posts: 2393
  • Liked: 16
Re: Second referral to an orthopaedic consultant
« Reply #29 on: May 08, 2010, 03:50:30 PM »
A chondral flap means they suspect you have some damage to the articular cartilage that sits on the bottom of your femur and the same sits on the top of the tibia. They are suggesting some damage/flap of loose cartilage on the medial side of the femur. I have one in the same place (mine is great - right down to the bone). You don't need to worry as such about it (it might not be there!!) but if that is suspected you need to be clear on what the surgeon might DO if he finds such a thing. Depending on the depth of damage they can smooth it, shave it, (all relatively simple and no need for non weight bearing) or they might decide on a microfracture (they pick holes in the bone and allow a clot to form to create a form of "scar" cartilage"). If they do this, you'll be non weight bearing for around 6 weeks if the defect is in a weight bearing area. Then weaning off crutches for 6 weeks. Be very clear on whether you want the OS to do such a thing if he finds it. Be prepared, be well read, take charge of what they will or won't do in your knee.  :)

I wouldn't stress too much - it is basically just the OS making hypotheses and this is a good thing. But do your homework. In my view (Queen of the Procrastinators....and into my NEXT round of PT!!!) you owe that to your knee.  ;D

Good luck!!

Lottie  :D
Bilateral patella OA since 2009, no surgeries.
Euflexxa working well x3 to current
Right forefoot CRPS post fusion surgery 2011
Refusing to let the ailing parts stop me....