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Author Topic: MRI results in! What to expect next!  (Read 4847 times)

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Offline treach515

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MRI results in! What to expect next!
« on: May 21, 2010, 04:56:10 PM »
Hi hope this in the right section. Just want to share this with others and hopefully get some much needed advice!

MRI Results show: Large joint effusion with early tricompartmental degenerative changes, in addition there is a shallow impaction fracture and moderate oedema in the weight-bearing surface of the lateral femoral condyle and posterioly in the lateral tibial plateau.

Small radial tear in the body of the lateral meniscus. Complex tear of the posterior horn and body of the medial meniscus.

Rupture of the ACL. PCL and collateral ligaments are intact. Normal extensor mechanism.


Sorry it's a long post. I'm really down right now, my GP has suggested I'll never kick a ball again (or shouldn't).  Any input from others who have had this type of injury would be greatly appreciated and what do I expect next? I've been referred to an Ortho Consultant.

Cheers
Treach515

Offline kneetmare

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Re: MRI results in! What to expect next!
« Reply #1 on: May 21, 2010, 05:28:24 PM »
Hi treach

Has the doctor explained what procedures they are going preform on you? I know some of the problems in your MRI can be 'fixed'. There is some of it I don't know if it can defintely be fixed or if it will heal on its own although.

Offline Kaputt_Knee

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Re: MRI results in! What to expect next!
« Reply #2 on: May 21, 2010, 05:40:53 PM »
You've ruptured your ACL and that will need fixing if you want to return to football. Good news is that the other ligaments are OK and you can bend and extend your knee normally (when it doesn't hurt!) because the mechanism is not damaged.

You have some early signs of arthritis on the outside of your femur where it joins the knee and the same towards the rear of your tibia head where it meets the knee. And a lot of swelling in the joint (effusion)

You have a bone bruise (they hurt like he!! and take ages to heal) on a weight-bearing part of both bones

There is an impact fracture on the head of the femur in the knee

The lateral (outside) meniscus appears to be torn and the rear (posterior) horn of the medial (inside) meniscus is torn.

If you read about these structures in the Information Hub it will help you understand the anatomy of your knee a bit better.

As for your GP - tell him to get a wee bit more up to date and ask him to refer you to a specialist knee orthopaedic surgeon.

I had a similar diagnosis in 1989 when my right knee was wrecked in a ski accident and again in 2006 after slipping on some black ice and damaging the left one. All doom and gloom, never walk again without a stick and limp, that sort of thing. Not what a PE specialist wants to hear when they are busy with their teaching career. I'm still skiing and have done just over 40 days this season and the advantage of having such a cold spring means my season is still not finished.

Don't give up, fight for a specialist and you will be able to return if you get the treatment you need and rehab according to the protocol you are given.

Good luck - Michael Owen made it back after his horrendous 2006 injury.

Sue  ;)
1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline treach515

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Re: MRI results in! What to expect next!
« Reply #3 on: May 21, 2010, 05:55:35 PM »
Thanks for your posts folks!

Sue - the Grimsby Hospital I've been referred to has two Ortho Surgeons who specialise in Knee surgery, one in particular Sports Injuries. Are these the type of surgeons you mean?

Hope on the distant horizon then......phew! Wanted to play for a few more years yet and promised my eldest lad I'd help him improve his own game (which will mean kicking a ball no doubt!)

One other question is there anything I can do in the meantime to get myself ready for surgery and fighting fit for Rehab?

Thanks again..............I'll put the Scotch bottle back now then!  ;)

Treach515

Offline Kaputt_Knee

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Re: MRI results in! What to expect next!
« Reply #4 on: May 21, 2010, 06:13:28 PM »
Yep - that's the type I mean, especially the sports injury specialist.

Yes there is a lot you can do to prepare for meeting the Sports Injury specialist as long as you can use the leg normally. If the bone bruise is causing you too much pain try to do fitness training in a pool - the warmer the better! I use aqua jogging when my knee is too painful to take normal training.

Try to maintain your quads and hamstring strength and if you can try to improve it. Work with the pain NOT against. Any pain is useful in telling you that you are over doing it, BUT do not allow it to take over control. Just work on ways of getting round the pain rather than through it. Neither should it deter you from doing anything.

Most importantly see this as a challenge not a defeat! Read up on this site and ask questions when you don't understand things. There are enough of us here who know because we have been through this, sometimes more than once (OK I'm a champion Klutz but I'm still skiing  ;D )

The other thing to do is to make a note of how you did the injury in plain simple non-technical language (also not a subjective report with lots of blame - try to be objective as if you were a policeman reporting on an accident!). Then keep a note of what particular movements cause more pain, if the knee is unstable and when. How it impacts on your day to day life - work, home life, that sort of thing. Record the levels of pain and make a note of when it is worse.

When it swells, elevate it as much as you can by raising and supporting the ankle and heel. Do not give in to the temptation of putting a pillow or cushion under the knee - although this is the most comfortable, it is absolutely lethal to your range of movement (ROM). And you want to keep or achieve the best range you can (compare with your good knee).

All this information will help the specialist diagnose the best possible treatment and anything that you can tell them is a bonus and shortens their options and therefore moves the decision making process along at a faster pace.

BTW Don't let them use age as a reason for doing nothing until you need a new knee! Sport is the best preventative measure in maintaining a long productive, happy and healthy life.

Sue  ;)

1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline treach515

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Re: MRI results in! What to expect next!
« Reply #5 on: June 21, 2010, 12:26:11 PM »
Ok seen the specialist today and had check x-rays done on my knee. Apparently there is Radiology evidence (as well as MRI) of the onset of arthritis around most of the knee and as the meniscus tears are severe repairing them needs doing first and a general tidy up of the knee.

As the knee has already started to deterioate he doubts that an ACL would be of benefit, advised that I 'hang up my boots' and cycle or swim for exercise. If I decide to have the ACL done at a later date, he recommends a specialist in another Trust who does many of these Ops but is not sure he will because of the degenerative damage already sustained on my knee.

Any thoughts folks? Could I Referee instead or is that as bad as playing!!!!

Gutted
Treach515  :'(
« Last Edit: June 21, 2010, 04:41:44 PM by treach515 »

Offline sleepylawyer

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Re: MRI results in! What to expect next!
« Reply #6 on: June 21, 2010, 10:41:02 PM »
I know nothing about ACL as I am discoid meniscus sufferer  - bad meniscuses on the outside of the knee which tear easily.  But i also have arthritic changes like you.  As to the OS advice that there is no point in having ACL done i just do not buy this at all   I am sure if you look on the ACL forum on here you will see lots of people who have had ACL ops and who have other dodgy bits including arthritis.

 Also how much arthritic change are we talking about  there are scientific grades of arthritic damage from 0 none to 4 full thickness damage to the cartilage and down to the bone.  You must be entitled to a proper scientific assessment and not just vague words.  MRI can show the damage to some extent and an arthroscopy  - key hole surgery can put a camera down and have a look and get a video recording and a proper operation note of all the knee structures including the ACL the menisci and the state of the articular cartilage including the grades of arthritic changes. This is day surgery.

 You do not say how old you are but you must be entitled to surgery that allows you to walk and work reasonably painfree.  The football may have to go but I think it really is too early to say.  Look at all the forums on here and see what other people have and go back to the OS or your GP and ask again for a proper assessment.


Meanwhile do read all the info stuff on here as well as another poster said there are diagrams and articles which will give you a good idea of what is out there.



07/09 diagnosed with lateral discoid meniscus with large tear RK menisectomy
03/10 diagnosed with new meniscus tear RK.
05/10 partial menisectomy, lavage and debridement 2x2 cm square Grade 4 hole in medial femoral condyle articular cartilage RK
07/11 LK medial meniscal tear
08/11 APOS shoes fitted

Offline tony1233

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Re: MRI results in! What to expect next!
« Reply #7 on: August 01, 2010, 09:01:22 PM »
Hi
Ok seen the specialist today and had check x-rays done on my knee. Apparently there is Radiology evidence (as well as MRI) of the onset of arthritis around most of the knee and as the meniscus tears are severe repairing them needs doing first and a general tidy up of the knee.

As the knee has already started to deterioate he doubts that an ACL would be of benefit, advised that I 'hang up my boots' and cycle or swim for exercise. If I decide to have the ACL done at a later date, he recommends a specialist in another Trust who does many of these Ops but is not sure he will because of the degenerative damage already sustained on my knee.

Any thoughts folks? Could I Referee instead or is that as bad as playing!!!!

Gutted
Treach515  :'(

Hi Trech,

not too sure what cam of this b
09/30/07 Diagnosed with partial ACL tear (left knee)
02/03/10 American Football injury, Diagnosed with ACL & MCL complete tear (right knee)
(R)lateral meniscotomy 08/11/10
(L) Lateral meniscotomy 10/28/11
(L) MCL & Medial Meniscus tear 07/12
(L) injury 01/23/12

Offline treach515

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Re: MRI results in! What to expect next!
« Reply #8 on: September 02, 2010, 04:24:53 PM »
Well I've not not replied since until I have had something done! Surgery today - Partial meniscectomy to Lateral & Medial, so that should help the grating sensation, occasional locking/stiffness and pain!!!!

One thing I was curious about (OPA in 2/52 when I'll find out for sure) was that the diagram showed to me by my Recovery Nurse and the Arthroscopic Images were of a ACL Tear Remnant...............the remnant/tear is all too evident but part (a good part IMHO) of the ACL looks reasonably intact! Maybe I'm clutching at (hopeful) straws but is it possible the MRI didn't show the exact damage to my ACL and its partially intact?  ???

The reason I ask is I've had very little instabilty associated with a complete rupture and if that's the case hope to return to Football (Soccer) using a knee brace if my knee is functional/stable enough to cope!!!!

Cheers
Treach515  ;D ??? :'( :)
« Last Edit: September 02, 2010, 04:27:32 PM by treach515 »

Offline Kaputt_Knee

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Re: MRI results in! What to expect next!
« Reply #9 on: September 02, 2010, 05:20:08 PM »
Hi Treach

good news on the operation - was it done by one of the sports orthos in Grimsby then?

Try not to build up your hopes until you have seen your surgeon again and then ask. Unfortunately all to often partial tears turn into full tears at some stage or another. One of the reasons that you have not experienced the instability problems could be that you have very good muscle strength in and around the knee. The key is keeping that as time goes on. Unfortunately the degeneration has already started in your joint and any loss of muscle strength will result in that increasing in severity and degree. On the other hand, there's no reason to give up hope all together is there!  ;)

Concentrate on getting the swelling down from this operation and returning as quickly as possible to full extension. The flex will actually come by itself once you are walking properly again and the swelling has reduced. Follow the post op protocol you have been given to the letter and do not be tempted to push it just because someone here says you should or you read a different rehab protocol on here. Only the people who are treating you in the real world know exactly what has been done and what their expectations are.

Good luck and keep posting!

Sue  ;)
« Last Edit: September 03, 2010, 12:56:02 PM by Kaputt_Knee »
1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline treach515

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Re: MRI results in! What to expect next!
« Reply #10 on: September 05, 2010, 12:39:56 PM »
Thx for that Sue, yeah the Op was done by the Orthos is Grimsby.

I'm really quite pleased with the progress so far, I have full extention and flexion is coming on nicely.............I do get horrific Hamstring cramps which tell me I'm overdoing it occasionally but considering its Day 3 post Op I'm pretty chuffed!

Has anyone any advice on knee braces, I've looked at several which are very much beefed up versions of what I've previously used but not sure on the practicalities or benefits!!!!

Not sure if I'm allowed to post the link so apologies if not but this is the sort of thing I've been looking at!

http://www.return2fitness.co.uk/Supports_And_Braces/Knee_Supports/muellerhingedknee

Many Thanks
Treach

Offline Kaputt_Knee

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Re: MRI results in! What to expect next!
« Reply #11 on: September 05, 2010, 06:51:08 PM »
Braces are a "hot" topic, both with patients and with the medical staff. Some doctors always use them post-operatively, some use them part of the time, others never use them!

I have a Townsend Rebel CI for my left knee which is primarily protecting the reconstructed Lateral Collateral ligament which was reconstructed in my last operation. I only have to wear this for the coming season when I'm skiing, then I don't have to wear it any more (this is my second full season post-op). It is light and comfortable and my surgeon as well as my physios were very impressed by it. I had asked here about braces then read up on what I learnt. The Townsend braces are relatively unknown in Europe and my people had never seen one.

The problem is that there is a bit of a chicken and egg situation with wearing a brace so finding a happy medium is often difficult. The jury is still out as to whether they prevent re-injury, but they do protect weakened knees. If you wear one all the time, it does inhibit muscle development. We all know that the best protection for the knee is the strength of the muscles all around it. Wearing a brace 24/7 tends to inhibit that process.

Then there is the psychological dependency aspect, which is a hard nut to crack. I know this from personal experience because I still wear a brace on my right knee  and I know it's function is purely that of a psychological crutch  ::) But I still wear it for skiing. It has become as much a part of my ski equipment as my boots or my skis! Dumb or what!!!!!! ::)

To be honest I would discuss this with your surgeons and your physios. The Over-the-Counter type braces are not really any more than a comfort blanket with a nod in the direction towards support. They keep the muscles around your knee warm and the two metal strips each side make you think you have some "support", but functionally they do not really achieve much. A proper functional brace gives much more lateral support beginning both higher up the thigh and lower down the calf. Properly measured and fitted they do an excellent job of supporting the knee.

Just concentrate on getting your extension and flex sorted out and reducing the swelling around the knee itself. Follow the rehab protocol you've been given to the letter. And when not exercising, elevate the leg, preferably above the level of the heart (couch king now  ;) ) and pump the ankle by pointing the toe back and forth. This "pumps" the lymphatic fluid around the trauma site back towards the lymph nodes in your groin where it is then re-absorbed.

Support your leg by placing cushions under the heel and ankle, NOT under the knee. This encourages passive extension by letting gravity work on the knee. If that is too uncomfortable for long periods then let the whole leg lie flat on the sofa. Icing the knee for no more than it takes for the skin go red then pale also helps to reduce the swelling and inflammation. I used to have a large bag or two of frozen peas (the cheapest you can buy from Iceland cos they are inedible any way  ;D), which I would wrap in a towel or tea cloth and then mould around my knee and graft harvest site.

The cramping of the hamstrings is often a result of you over stretching the hammies, which, if you had a hamstring graft, they definitely do not like! Keep on top of your pain meds and maybe also up the ante by taking magnesium supplements to help dissipate the cramps.

Ask a way if you are unsure of anything - there are plenty of us here who have been in your situation  ::) 8)

I hope the weekend went well and that you are seeing lots of improvement day by day

Sue  ;)



1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee