Banner - Hide this banner





Author Topic: Acute patellofemoral arthritis - please respond if you can help!  (Read 2169 times)

0 Members and 1 Guest are viewing this topic.

Offline Brambledog

  • SuperKNEEgeek
  • *****
  • Posts: 1079
  • Liked: 10
I joined this site a few days ago and started a post-op diary, and have posted a couple of messages on other threads. No replies yet, so thought I'd try this one!

I finally had my diagnosis yesterday, after an arthroscopy on my left knee early in august. My ortho said the good news is my biopsies are normal and there's no sign of RA, but the bad news is that I have quite advanced patellofemoral arthritis, and that given my right knee is getting worse every day, it's extremely likely that I have it in that one too, he'll do an MRI on it to rule out anything else, but won't do an arthroscopy on it as it won't do much good. My only option surgically is microfracture, which he said is not that successful on the patella and would involve full knee surgery, so doesn't want to do it yet.

As nothing showed up on either x-ray or MRI before the op, I was expecting to be told that they had found something, sorted it out and my recovery time would be ??  Instead I've been told that my knees will never now be 'good' and I have to try to strengthen my wasted leg muscles to help support them and basically find ways to cope. Pain management, physio, hydro and positive thinking. I've always been active and had assumed I'd go back to being so again. He said I CAN do most things, but the pain will prevent me doing quite a few of them.

Also, my job is retail, all standing and walking - he said I might find that difficult and it would probably be better to do something I will find less less painful. but I've been off work for 5 months with this... who will employ me now?  I have a 'fit note' with everything ticked, but no chance of my work being able to accommodate me at the moment, and only another few weeks before my SSP ends and I have to start applying for benefits.

I'm feeling very down and I wish I'd asked more questions. My head's in a whirl. If anyone out there has this or knows about it I'd love to hear your thoughts. I've read up about it, but it's not the same as a real person's experience...

Thanks.   :-\
2009 - diagnosed coeliac
Aug 2011 - L knee arthroscopy
Aug 2011 - diagnosed PF arthritis L knee
Nov 2011 - diagnosed CRPS L knee
Dec 2011 - MRI R knee, PFOA is worse than L!
June 2012 - no surgery 'til TKR's
Nov 2012 - CRPS spread to L foot/thigh, increasing pain
- Worsening pain/symptoms R knee
;-)

Offline Sam123

  • MINIgeek (20-50 posts)
  • **
  • Posts: 22
  • Liked: 0
Re: Acute patellofemoral arthritis - please respond if you can help!
« Reply #1 on: August 27, 2011, 04:47:54 PM »
Sorry I don't think I know the answer to your question. Arthritis, I am so sorry and hope you find a solution that works for you. Know that you are not alone. There are many more people who have knee problems. Maybe, we can help each other by keeping our spirits up. They say swimming is good for muscles and not hard on the joints. :)


You know what you were saying about the knees and muscle exercises being the only solution they could give you, i think that is the main suggestion the doctors have for most with any kind of knee problem....The knees are so precious only God can provide us with the fix, or the essentials we need to keep them in good shape. Doctors can't find ways to heal this, the best cases are in which the body has it own internal healing system. Bones will heal, muscles will heal, cartilage (a big part of the knee joint) is precious and won't regenerate :( unless the damage is not so bad and it is on the outer edge. All we can do now is just keep as much as we have left and try to find out how not to lose it. I would walk on the sidewalk all the time. From now on I'm staying away from man-made surfaces. Gonna do my best to stay away from stair climbing. I wish that I had known how precious cartilage was in my early twenties, and how easily it can be lost. However it seems that we don't really learn the value of something, or gravity of a situation until it seriously effects us.
It really shows us the magnificence of God and how he is our creator, because only he can regenerate our cartilage. Surgeons, doctors, they are often very confidant and self-assured, sometimes pompous b.c of the schooling they have gone through. They are so proud of themselves for being able to interpret the design...and possibly manipulate it through some practice. However, they need to be humble b.c they really don't know the human body and how to help it, like its creator does.

Forgive me if you have a different opinion. I don't mean to upset anyone. I value all opinions and feel that we should all be able to state our own and be fine with the others.
« Last Edit: August 27, 2011, 04:53:17 PM by Sam123 »

Offline Brambledog

  • SuperKNEEgeek
  • *****
  • Posts: 1079
  • Liked: 10
Re: Acute patellofemoral arthritis - please respond if you can help!
« Reply #2 on: August 27, 2011, 05:21:26 PM »
Sam123, it doesn't matter that our beliefs are different. I can still value your understanding and appreciate your kindness without sharing your belief.

Thanks for your response, I am going back to hydrotherapy next week - love the warm water!

It's a painful old game trying to build up quads on a poorly knee...  ;)
2009 - diagnosed coeliac
Aug 2011 - L knee arthroscopy
Aug 2011 - diagnosed PF arthritis L knee
Nov 2011 - diagnosed CRPS L knee
Dec 2011 - MRI R knee, PFOA is worse than L!
June 2012 - no surgery 'til TKR's
Nov 2012 - CRPS spread to L foot/thigh, increasing pain
- Worsening pain/symptoms R knee
;-)

Offline kneepaincure

  • Forum Faithful
  • ****
  • Posts: 360
  • Liked: 0
Re: Acute patellofemoral arthritis - please respond if you can help!
« Reply #3 on: August 28, 2011, 03:31:57 PM »
Are you old enough for a partial joint replacement? You can ask your doctor about it..
Have had tilted kneecaps for many years, and occasional patellar tendinitis.

Offline Brambledog

  • SuperKNEEgeek
  • *****
  • Posts: 1079
  • Liked: 10
Re: Acute patellofemoral arthritis - please respond if you can help!
« Reply #4 on: August 28, 2011, 03:54:18 PM »
I'm 40 and weigh about 10.5 stone (if that's relevant!). OS didn't mention PKR but there was an 'umbrella' hint of major surgery down the line... I'm going back in 6 months, by then I think I'll have many many questions.

Seems to be an awfully long road ahead of me.  Not used to this much thinking time.

Best foot forward though (hollow laugh!)
 ;)
2009 - diagnosed coeliac
Aug 2011 - L knee arthroscopy
Aug 2011 - diagnosed PF arthritis L knee
Nov 2011 - diagnosed CRPS L knee
Dec 2011 - MRI R knee, PFOA is worse than L!
June 2012 - no surgery 'til TKR's
Nov 2012 - CRPS spread to L foot/thigh, increasing pain
- Worsening pain/symptoms R knee
;-)

Offline Brambledog

  • SuperKNEEgeek
  • *****
  • Posts: 1079
  • Liked: 10
Re: Acute patellofemoral arthritis - please respond if you can help!
« Reply #5 on: August 31, 2011, 04:56:24 PM »
I'm applying to have copies of all my medical notes on this. Apparently there are some very pretty pictures taken during my arthroscopy which I'd quite like to see...

Still hoping for some ideas on physio exercises to build up my quads without putting too much force through my poor patella!

 :)
2009 - diagnosed coeliac
Aug 2011 - L knee arthroscopy
Aug 2011 - diagnosed PF arthritis L knee
Nov 2011 - diagnosed CRPS L knee
Dec 2011 - MRI R knee, PFOA is worse than L!
June 2012 - no surgery 'til TKR's
Nov 2012 - CRPS spread to L foot/thigh, increasing pain
- Worsening pain/symptoms R knee
;-)

Offline kneepaincure

  • Forum Faithful
  • ****
  • Posts: 360
  • Liked: 0
Re: Acute patellofemoral arthritis - please respond if you can help!
« Reply #6 on: August 31, 2011, 06:43:20 PM »
Hydrotherapy is the best option for that.. There is barely any weight on the knees and muscles get exercised as well.. Try walking about in a pool in chest deep water..
Have had tilted kneecaps for many years, and occasional patellar tendinitis.

Offline chandra

  • MINIgeek (20-50 posts)
  • **
  • Posts: 34
  • Liked: 0
Re: Acute patellofemoral arthritis - please respond if you can help!
« Reply #7 on: August 31, 2011, 07:40:46 PM »
Hi..if you are living in UK then there is a cartilage regenaration procudure called MACI availble for treating cartilgae lesions.


Offline Brambledog

  • SuperKNEEgeek
  • *****
  • Posts: 1079
  • Liked: 10
Re: Acute patellofemoral arthritis - please respond if you can help!
« Reply #8 on: August 31, 2011, 07:58:12 PM »
Thanks for your posts...

Kneepaincure - yes I agree, I've got my first hydro appt (since my op) tomorrow, and I can't wait. Really looking forward to the warm water, and as you say, so much easier to move the knee with only 25% of the weight on it!

Chandra - I hadn't heard of MACI before but read a thread about it earlier. It sounds interesting, and is apparently easier to recover from than micro-fracture. There seem to be so many options, but so many differing opinions on how successful they are! It's a minefield, so hoping to get a second opinion from a specialist before too much longer...

 ;)
2009 - diagnosed coeliac
Aug 2011 - L knee arthroscopy
Aug 2011 - diagnosed PF arthritis L knee
Nov 2011 - diagnosed CRPS L knee
Dec 2011 - MRI R knee, PFOA is worse than L!
June 2012 - no surgery 'til TKR's
Nov 2012 - CRPS spread to L foot/thigh, increasing pain
- Worsening pain/symptoms R knee
;-)

Offline Lottiefox

  • SuperKNEEgeek
  • *****
  • *
  • *
  • *
  • *
  • Posts: 2393
  • Liked: 16
Re: Acute patellofemoral arthritis - please respond if you can help!
« Reply #9 on: August 31, 2011, 10:20:10 PM »
MACI isn't much good for generalised OA. It needs decent cartilage around the lesion to anchor onto. Unfortunately OA behind the patella tends to generate several areas of differing wear and MACI isn't suitable. It is great for a traumatic lesion, or even more than one - but the type of damage that comes with wear and tear is hard to repair with grafts. I know there is research going on and the NHS has a trial called ACTIVE that is using MACI so you could always look at their criteria for inclusion. It isn't easier than microfracture though - it is two surgerie
s, one to harvest then the second open process to implant. Long long rehab.

Cartifill is a new repair technique - google Anan Shetty and Cartifill and have a look. He is based in Kent.

Euflexxa lubricates knees - I have it in both worn out kneecaps and I've gone from pain all the time to no pain unless I push too hard or walk down a steep hill. I spin 4 times a week, weight train, squat, kneel...I can't run as that HURTS but thats OK. I also had a course of Celebrex as a COX 2 NSAID which seemed to settle down the bad flare up I was having a year ago. Euflexxa or similar things doesn't always work. Many people get no respite but to me it was worth a go. I paid for it, 350 per knee. Ouch - but done by the actual OS, painfree administration and my second round has lasted since February.

There are so many options. It is mind blowing but hard to get through when your knees are so painful...

Good luck

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 Brambledog

  • SuperKNEEgeek
  • *****
  • Posts: 1079
  • Liked: 10
Re: Acute patellofemoral arthritis - please respond if you can help!
« Reply #10 on: August 31, 2011, 10:26:33 PM »
Heartfelt thanks, Lottie - loads of really useful info. I'll do some more reading...

 ;)
2009 - diagnosed coeliac
Aug 2011 - L knee arthroscopy
Aug 2011 - diagnosed PF arthritis L knee
Nov 2011 - diagnosed CRPS L knee
Dec 2011 - MRI R knee, PFOA is worse than L!
June 2012 - no surgery 'til TKR's
Nov 2012 - CRPS spread to L foot/thigh, increasing pain
- Worsening pain/symptoms R knee
;-)

Offline Lottiefox

  • SuperKNEEgeek
  • *****
  • *
  • *
  • *
  • *
  • Posts: 2393
  • Liked: 16
Re: Acute patellofemoral arthritis - please respond if you can help!
« Reply #11 on: August 31, 2011, 10:36:55 PM »
I guess the other thing that helped me, before all the pills and injections....was finding a Physio who understood. Yes, quads are vital. BUT I saw a different PT, a private one, and she told me I had extremely weak glutes and hip muscles. I went back to basics working hip flexors, glutes, some basic quad work but literally nothing open chain (so quad sets, straight leg raises, mini bend and straighten with my knee in a resistance band tied to the table leg so no stress on the joint but working the muscle...), loads of calf stretches, lots of hamstring stretching. I literally could not "push up" on steps before she started me on that. Last October I ran up the 140 big steps or so at Cliveden in Oxfordshire. I now do stairs "properly" (with noisy kneecaps!) although downwards is still not my fave and I am very careful...but can do them.

Aqua work is great as you've said but working the glutes and hips helps the kneecaps too!

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 Brambledog

  • SuperKNEEgeek
  • *****
  • Posts: 1079
  • Liked: 10
Re: Acute patellofemoral arthritis - please respond if you can help!
« Reply #12 on: September 05, 2011, 07:08:54 PM »
'noisy kneecaps' LOL - rings a few bells!

My main disappointment with the hydro was the walking. I was really looking forward to the big decrease in weight-bearing stress on the knee, coupled with the warmth, really making it easier to walk. Instead I found that just trying to push through the water with my leg was really difficult and I could hardly move it forwards at all! Made me realise how crap my quads really are - I think gravity has been helping my foot move forwards more than I thought!

 ;)
2009 - diagnosed coeliac
Aug 2011 - L knee arthroscopy
Aug 2011 - diagnosed PF arthritis L knee
Nov 2011 - diagnosed CRPS L knee
Dec 2011 - MRI R knee, PFOA is worse than L!
June 2012 - no surgery 'til TKR's
Nov 2012 - CRPS spread to L foot/thigh, increasing pain
- Worsening pain/symptoms R knee
;-)