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Author Topic: Banged my knee not sure if I've injurred it  (Read 45817 times)

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Offline kscope09

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Banged my knee not sure if I've injurred it
« on: January 16, 2011, 02:14:55 PM »
I can't believe what a stupid thing I've just done today.

I was at church and I moved to one saide to let someone past and banged my right knee (the one I had scoped) very hard on the side of a pew.  Almost right away I had a red line at the top of my kneecap and towards the outside where I hit it and I just couldn't believe the pain.  I can see I'm going to have an impressive bruise there soon.  I  can still walk OK so I'm hoping I havn't done anything too bad but I'm very worried that it might have knocked some cartliage off, damaged a ligament or encouraged the plica to grow back (my plica was in that region).

So I'm icing it like mad and if things get any worse I'm going to A & E.  I'm more worried about tomorrow than I am today because it will stiffen up and swell over night.

If I had a fracture on either the patella or the lfc, even just a small one woul di have been unable to walk?
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline vickster

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Re: Banged my knee not sure if I've injurred it
« Reply #1 on: January 16, 2011, 02:29:27 PM »
I would be very surprised if you have fractured anything banging it . Bruised soft tissue most likely. Ice it, slap on some arnica cream and take some paracetamol. Bones are pretty hard. It took me coming off a bike at 15mph onto concrete to damage the cartilage.  Rest up and trying not to think the worst. :)
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 kscope09

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Re: Banged my knee not sure if I've injurred it
« Reply #2 on: January 16, 2011, 02:55:20 PM »
Thanks Vick.

When you've got knee problems already it makes you more snesitive when things like this happen.

I'm lots of ie and taking diclofenac and maybe I'll put a little voltarol on the bruised area.

One thing that is worrying is that my last mri on that knee backing december 0- said that my patella and lfc had some bone loss so if it gets any worse I'll have it checked out.  Plus the pew I hit was very heavy and fixed in place if it had been something light I don't think I'd be anywhere near as worried.  But I can still walk OK so hopefully I havn't broken or fractured anything.

Thanks again.
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline vickster

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Re: Banged my knee not sure if I've injurred it
« Reply #3 on: January 16, 2011, 03:19:19 PM »
Indeed, we do become much more aware of bangs and knocks - but just think how many times as a kid you fell, banged things etc and didn't break anything.  Bones are pretty strong really! I bet you had permanently bruised and scraped knees and didn't think anything of it :)

I wellied the side of my bad knee about 2 days after this scope when I slipped getting in the bath to have a shower...I managed to do it twice in quick succession  ::)  Hurt of course, but I just ended up with another new bruise for my troubles!

Be careful if taking diclofenac,, as Voltaren gel contains the same active ingredient (check the packet for contraindications), but Arnica really is the best thing for preventing (or at least relieving) bruising...I get through plenty of the stuff  ::)  At least it's natural stuff  :)  Should be able to get in local Boots or big supermarket

Is the knee very swollen now a couple of hours have passed - usually a sign of something more than a bruise (although not necessarily).  If it does swell a lot, see the doc, but bruises do unfortunately hurt too, but go away with patience - just think of all the pretty colours it will go through while it heals, your very own rainbow  ;D
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 kscope09

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Re: Banged my knee not sure if I've injurred it
« Reply #4 on: January 16, 2011, 03:28:21 PM »
When I was a kid of could drop straight down onto my knees on a wood floor and jump straigth back up or skin them on gravel or break a branch accross them.  Now it's like having a glass knee.

The swelling is in a funny palce thoug.  When I stand it is on the kneecap put when I sit down and bend the knee it is actually on the area wjust above which is normally coered by the kneecap when the knee is straight.  So it could be the trouchlea, it dfinatly isn't weight bearing.  i;ve had the ice on 3 times and it seems a bit stiff but it hasn't gone squidgy yet.
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline vickster

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Re: Banged my knee not sure if I've injurred it
« Reply #5 on: January 16, 2011, 03:37:17 PM »
You really do not have a glass knee now, you just think you do - because you have been told that you have some minor damage that everyone your age probably has.  The difference being you are aware of it from the MRI ;) 

You are still young and fit...not an old dear with osteoporosis :)

Just chill out, watch some TV and stop thinking about it and looking for issues.  Hey go cycling as I just did, yeah it's cold, wet and windy but fresh air is great and so was my skinny latte!  ;D  Or have a bath maybe

I suspect my right knee has wear and tear like the left but I don't think about it as I haven't been told about it or seen any pictures of it.  I get aches and pains in that one too, but no swelling, just put it down to whatever I have been doing. Dealing with any chronic condition takes mind over matter IMO   :)
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 kscope09

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Re: Banged my knee not sure if I've injurred it
« Reply #6 on: January 16, 2011, 04:00:49 PM »
Is it worth alternating hot and cold at this stage or should I just use cold.

I'm in too much pain for cycling, I'd rather things settle down first

Could I have damaged my trouchlear or would that be too deep to damage by banging.

Bones are hard but iron and oak are a bit harder so I'll ty and give it some tlc and see how things go.
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline vickster

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Re: Banged my knee not sure if I've injurred it
« Reply #7 on: January 16, 2011, 04:14:00 PM »
I always find a bath good for aches and pains.  Don't ice too much, 15 minutes, every couple of hours. Elevate too above heart. Take paracetamol for the pain if it is that bad, as well as the NSAIDs :)
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 kscope09

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Re: Banged my knee not sure if I've injurred it
« Reply #8 on: January 16, 2011, 04:29:39 PM »
I've been very lucky with ice, not to get ice burns as more than once I've fallen asleep ith the icepack on.

I'm going to put some more on now and tkae my next diclofenac.  I find it works best but you ahve to get the full 3 tablets in a day for a minummum of 3 days for it to do anything.

On the plus side I'm looking forward to the pretty colours.

I jsut had a chat with my auntie who fractured her patella a few years ago and she said that right away she couldn't walk and even bending it was excruciating.  4 hours after the injury and the injurred knee was thicker than both legs put together and too sore to touch.  So no I don't think there's a fracture and I don't think it would have damaged my already crumbling acl i just hope it didn't mess up my chrondoplasty which copuld have failed anyway.
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline vickster

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Re: Banged my knee not sure if I've injurred it
« Reply #9 on: January 16, 2011, 04:33:41 PM »
Cool.  I broke my big toe and it swelled like crazy.  Even then the hospital nurse was surprised it was fractured.  I am sure all is intact, just bruised and sore from the impact

Make sure you eat with the diclofenac and I assume you have your ice pack wrapped in a cloth :)
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 kscope09

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Re: Banged my knee not sure if I've injurred it
« Reply #10 on: January 16, 2011, 04:41:59 PM »
Oh no I never put it straight on the skin.

Come to think of it I once fractured my middle finger blocking a kick in Karate training and it swelling up like mad once I stopped moving it and went black and the skin aroudn the joint felt like it would burst because it was so inflated.  I used a splint and took lots of paracetamol and NSAIDs (not at the same time) and it was good as new in a couple of momths.
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline Lottiefox

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Re: Banged my knee not sure if I've injurred it
« Reply #11 on: January 16, 2011, 05:33:12 PM »
Your trochlear groove sits under the kneecap so I doubt you've damaged that! Cartilage also doesn't just fall off unless you've had an ACUTE trauma, and it doesn't sound like one, despite it hurting like hell.

Relax. Even when we have slightly bummed out parts our joints don't degenerate through banging them on an object. If so, no one would be walking around, we'd all be in hospital! Ice it at the moment, you shouldn't heat a new injury as the inflammation is at an acute stage.

I smacked my kneecap on holiday - a lovely bruide came up but no further problems and I have loads of wear and tear.

I'd stop going to church. Dangerous to your health  :P

Get well soon

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 Snowy

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Re: Banged my knee not sure if I've injurred it
« Reply #12 on: January 16, 2011, 05:39:50 PM »
Sounds like it's settling down, but just an FYI for you - Vicks is right about the Voltaran. I was told not to use it while I was taking Diclofenac because they have the same active ingredient, and it's very important not to take too much of it.

If it's any reassurance, I once came off a motorbike onto directly concrete on my right knee - no padding (I was young and foolish and hadn't invested in armoured pants) - and all I did was cause some really nasty bone bruising. The bruising and swelling made it hard to walk for a couple of days, and the whole joint was very sore, but there wasn't that really sharp, excruciating pain that comes with a broken bone. As you say, I think you'd be well aware by now if something was broken. The ACL is at risk during twisting falls or severe impacts where the foot remains planted and the leg twists, so it shouldn't have suffered any harm from a nasty bash on a pew.

Keep up the icing and NSAIDs, and hopefully it will settle down in a day or two. It's funny how bad knees seem to become lightning rods for every knock, slip and jolt...
Mar 11: R Biceps femoris tear (skiing)
Jul 10: ACLr (hamstring autograft)
Mar 10: L ACL rupture (skiing)
Feb 06: L partial ACL tear (kickboxing)
Dec 03: R bone edema (motorbike)
Jan 01: R patellar chip (motorbike)
May 93: R ACL sprain (hockey)
Ongoing: bilateral PFS and OA

Offline kscope09

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Re: Banged my knee not sure if I've injurred it
« Reply #13 on: January 16, 2011, 07:43:42 PM »
People ahve been wearing out their knees at church for centuries, didn't you know church is notoriously bad for your knees.  Maybe I should tka emy chance with the Dojo if the physio didn't tell me I was at risk of dislocation.  Before I knew what was wrong with my knees I managed 15 years of Karte, training everyday some weeks and never had so much as a twinge in the knees.

Did you know St James is the patron saint of Arthritis and St Roche is the patron of knees.

By the way the bruise is coming nicely; its a very strong red at the moment
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline vickster

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Re: Banged my knee not sure if I've injurred it
« Reply #14 on: January 16, 2011, 07:46:55 PM »
Why are you at risk of dislocation when you managed ok before - I know nothing about martial arts by the way!?

Missed that Arnica boat, oh dear  :P
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 kscope09

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Re: Banged my knee not sure if I've injurred it
« Reply #15 on: January 16, 2011, 08:18:22 PM »
Well, I'm not sure.  I've got the shallow trouchlear and the pronation in my feet but I've always had them even when I could do anything and pronation neer made my knees suffer even when my feet used to hurt a little.

My acl was slightly torn and he basically said that I couldn't aprticipate properly at my old level without a full acl and that I couldn' have a new one because it was unethical to remove the old one.  he had a word with my OS on my behalf and he said he that I'd have to be falling about the plae before I'd be a candidate for acl surgery.

Then he added the bit about dislocations and I'm not sure if a torn acl can in any way make you more likely to have dislocations.  I thought about it and wondered if maybe it was because the acl damae was supressing my vmo and my vmo wouldn't be able to pull properly if the lateral forces tried to take the kneecap to the outside.  Does this sound about right.  Anotehr pt ldid a lachman and said it was within normal limits and couldn't see a problem.

I havn't gone back because of various setbacks but I do intend to.
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline Snowy

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Re: Banged my knee not sure if I've injurred it
« Reply #16 on: January 16, 2011, 08:33:37 PM »
Quote
I couldn' have a new one because it was unethical to remove the old one

Whoever the "he" is that said this, I think you need to talk to someone else - this is at odds with everything I've ever heard first-hand from doctors and read in the research. If the ACL is damaged to the point where it cannot provide proper support for the knee, of course it can be replaced; in fact most surgeons would recommend it if you want to return to sports at your previous level. Of course there are factors that influence the decision to reconstruct or not (do you mind reducing your activities? Has a comprehensive PT program strengthened the knee to the point where you can participate in sports regardless of the tear? Are you willing to participate in sports accepting the risk of future damage with a compromised ACL?) but it's absolutely not true that it's unethical to remove a partially torn ACL. If my partial tear had been correctly diagnosed 5 years ago, both my OS and PT said they would have strongly recommended a reconstruction given that I wanted to continue high level sports.

Quote
he said he that I'd have to be falling about the plae before I'd be a candidate for acl surgery

Again, this doesn't sound right. The recommendation here in Canada is that if the ACL is damaged and you want to continue participating in sports, you need a reconstruction. I know from my own experience that it's possible to have a very stable leg even without an ACL at all; my leg wasn't the slightest bit unstable after my full tear, probably because my muscles were in really good condition. However I would always have been at risk of damaging other structures in the knee if I fell or injured the leg again, because it lacked the lateral support under duress that an ACL provides.

Then again, if your ACL is so slightly damaged that it tested within normal limits, there's no reason you can't be participating in sports without needing any kind of invasive treatment.

I have to be honest - the advice you've been given sounds conflicting and possibly detrimental to your ability to determine the best course of action for your knee and ensure that you can participate in the sports you enjoy. I would talk to a knee specialist (you mentioned that you have an OS - has he given you an opinion on the ACL?) and see what they say about how damaged the ACL is and whether or not you should be restricting your activities.
Mar 11: R Biceps femoris tear (skiing)
Jul 10: ACLr (hamstring autograft)
Mar 10: L ACL rupture (skiing)
Feb 06: L partial ACL tear (kickboxing)
Dec 03: R bone edema (motorbike)
Jan 01: R patellar chip (motorbike)
May 93: R ACL sprain (hockey)
Ongoing: bilateral PFS and OA

Offline kscope09

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Re: Banged my knee not sure if I've injurred it
« Reply #17 on: January 16, 2011, 09:51:22 PM »
I havn't seen him in oer a year but I could go and see him and ask him about my acl.  he said it didn't need recopnstructing, so I categorically asked him if I could go back to karate and he said yes.  But I never had the proper recovery that I should have.  I got the knee feeling fairly good but it took 8 months, not 8 weeks.  Physio made it as stable as any knee and just as able to turn corners without moving like a robot and I can walk in a figure 8 OK, I'm just not too keen on twisting on it quickley.  The tear I'm told is small, so small that it didn't show up on mri but the leg is a bit awkward at times when making little steps.

Anyway, I've had this discussion before on the board and the fact is that doctors in the UK are just not as gun-ho for reconstruction and as they are in many other countries because they don't see sports are necessary.  If I was a professional instruction I would be offered it or a member of the national squad, but I'm just an amataur who lieks to train and start a non-profit club and that being unnessential for my physical well being is not reason enough to reconstruct my acl.

Back to my other question and I would really value your opinion on this one Snowy, Does having a slight acl tear put you at any greater risk of dislocations if you were to spin or twist on it, or drop to the floor very quickly.  Would it make it difficult to jump in the air and landin a crouch.
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline Snowy

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Re: Banged my knee not sure if I've injurred it
« Reply #18 on: January 17, 2011, 01:07:24 AM »
I have to be honest, I'm not exactly sure of the answer to that question. I've done a bit of digging around online and the two key pieces of information I've found indicate that:

a) ACL rupture is typically referred to in the literature as a consequence of knee dislocation
b) ACL deficiency leads to greater knee laxity, leaving other structures in the knee - especially the meniscus and cartilage - at greater risk of a shearing injury if excessive lateral force is placed on the knee

Here's what I'd take from that, keeping in mind that I'm not a medical expert and I'm relying heavily on information that I've been able to find in a relatively brief search.

The ligaments essentially act as stabilizers within the knee. If you're missing one of the stabilizers, your knee joint will inevitably not be quite as secure overall. However, the forces required to cause a full dislocation (defined as complete displacement of the tibia in relation to the femur, with disruption to three or more ligaments) in an otherwise healthy knee are pretty extreme. Those of us who frequent this board probably think of knee dislocations as a lot more common than they actually are, given that the demographic here is heavily skewed toward people with knees that have injuries or abnormalities. The Mayo Clinic, for example, cites 14 knee dislocations in more than 2 million admissions (1); eMedicine states that "the knee is a very stable joint generally requiring high-energy trauma to produce dislocation," (2) and WebMD says "knee dislocations are rare. They usually happen only after major trauma, including falls, car crashes, and other high-speed injuries." (3)

In other words, although I haven't been able to dig up an article that talks specifically about a correlation between ACL deficiency and knee dislocation (I'm not sure if such a study has been done or not - I may have another look at work tomorrow, where I have access to a wider selection of licensed databases) it seems likely that ACL deficiency would slightly increase the risk of a dislocation, given that dislocation occurs when at least three ligaments fail and a ruptured ACL would already have taken one ligament out of the picture. However, the degree of force required to dislocate even a completely ACL-deficient knee would be quite significant; it doesn't seem very likely that the activities you describe (spinning, twisting, dropping down quickly) could cause such a traumatic injury. The real risk of ACL deficiency is meniscus or cartilage damage resulting from excessive lateral movement of the leg.

Having said all of this, if the test that showed your knee to be within normal parameters is accurate, your ACL deficiency is so minimal that you're probably at no more risk than someone with two intact ACLs. Martial arts isn't an especially safe activity for the knees (I got my partial tear after an awkward fall kickboxing) but then again, Tez tore her ACL coming down stairs in high heels - there's no guarantee that you're 100% safe from injury doing anything. Given the rather confusing advice you've been given, I'd say that the first thing to do is establish whether the very small tear that you have in your ACL is the source of any deficiency, and if so how much. Once you know that, you can figure out what to do next. If the damage is going to keep you from the things you enjoy then you have every right to push for a reconstruction, regardless of what the doctors say about professional vs. amateur athletes. Just think of all those NI contributions that you've made to the NHS over the years - you deserve the right treatment for the needs of your knee. :)

http://emedicine.medscape.com/article/1250829-overview (1)
http://emedicine.medscape.com/article/823589-overview (2)
http://www.webmd.com/pain-management/knee-pain/knee-dislocation (3)
http://www.sportsci.org/encyc/aclinj/aclinj.html
« Last Edit: January 17, 2011, 01:58:51 AM by Snowy »
Mar 11: R Biceps femoris tear (skiing)
Jul 10: ACLr (hamstring autograft)
Mar 10: L ACL rupture (skiing)
Feb 06: L partial ACL tear (kickboxing)
Dec 03: R bone edema (motorbike)
Jan 01: R patellar chip (motorbike)
May 93: R ACL sprain (hockey)
Ongoing: bilateral PFS and OA

Offline Snowy

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Re: Banged my knee not sure if I've injurred it
« Reply #19 on: January 17, 2011, 02:08:44 AM »
This is what happens when you ask a librarian a question they don't know the answer to. ;)
Mar 11: R Biceps femoris tear (skiing)
Jul 10: ACLr (hamstring autograft)
Mar 10: L ACL rupture (skiing)
Feb 06: L partial ACL tear (kickboxing)
Dec 03: R bone edema (motorbike)
Jan 01: R patellar chip (motorbike)
May 93: R ACL sprain (hockey)
Ongoing: bilateral PFS and OA

Offline kscope09

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Re: Banged my knee not sure if I've injurred it
« Reply #20 on: January 17, 2011, 12:39:26 PM »
Well, good news is it wasn't the size of a watermelon this morning, it isn't even spongy, just the bruise which is starting to go through the colours.  So it seems OK for now, just a bit sore.
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline vickster

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Re: Banged my knee not sure if I've injurred it
« Reply #21 on: January 17, 2011, 12:43:40 PM »
All good then :)
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