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Author Topic: So frustrated... Hoping for some advice please  (Read 1232 times)

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Offline Jbriss

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So frustrated... Hoping for some advice please
« on: January 31, 2012, 03:05:03 PM »
My injury occurred in July 2011. After 2 months of pain and stopping running, my OS found a partial ACL tear. I did PT for 2 months and continued the exercises at home. I had stopped running all together. Pain still present so I went for 2nd opinion. 2nd doc did 2nd MRI, found ACL tear was healing, but couldn't see cause of pain. Told me to go another month doing PT at home and see if pain subsided. It didnt so I went back to doc. He gave me a cortisone shot in knee to see if that helped. I decided this was my opportunity to get back into light running to see if cortisone helped.  It is causing more pain than before. And I can run with little pain which is the strange thing.  It's after the run, when I am not active that it hurts the most. Especially with my knee bent or standing straight putting all my weight on that knee. I get the pain inside my knee and at the bend in the front of my knee. I go back to doc Friday. He told me at the last visit arthroscopy was next step. Do I do the surgery? My
Concern is he won't see anything else and the pain will not go away or get worse. Any suggestions? I really wanted to do my 5ks in the spring.

Offline knee2no

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Re: So frustrated... Hoping for some advice please
« Reply #1 on: January 31, 2012, 04:36:23 PM »
Heres my advice from somebody who has been there/done that:    Dont do it.  So you cant run..right now.  Give it time.  Knees take a long time to heal.  Surgery might work...or like many on this board it wont and you might be worse (why else the need for this very busy message board?)  Notice on the presurgical consent form it warns "you may end up with worse condition". Theres a reason they tell you that.
I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.

I will not be ashamed to say "I know not", nor will I fail to call in my colleagues when the skills of another are needed.

Offline Lottiefox

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Re: So frustrated... Hoping for some advice please
« Reply #2 on: January 31, 2012, 05:15:16 PM »
Yes, surgery is of course a risk. I had foot surgery and had one of the rarest and most frustrating complications you can get (RSD/CRPS) - yet I had to have it done if I wanted to return to being active. I don't regret the surgery which has been 100% successful. No one knew what complications might happen to me, its a risk you take. But you take a risk every time you cross the road.

You need to weigh up the risks versus the benefits. MRI scans are NOT infallible. There are many on here who have things like an ACL tear missed on imaging only to find there is an issue when they undergo a scope. Similarly MRIs may miss things like meniscus damage, the overall health of the cartilage on the bones...many things. It is impossible for us to tell you why you're getting the pain but clearly something isn't right. Yes, knees take an AGE to heal, but you say it is worsening. Do you have any feelings of instability or buckling? has the doctor done the standard tests for ACL laxity since the imaging?

If you go for the surgery be very clear on what the surgeon has consent to do if he finds an issue. Read around on here about possible things they can during a scope such as chondroplasty, microfracture, lateral release, debridement, meniscus repairs or removal......you want to be very sure what you are giving consent for. Many people go to sleep for an exploratory scope and wake up with a surprise. Again, don't rule anything out (although I'd not be letting a doctor into my knee who talks about performing a lateral release "to see if it helps"), but be very clear on what and why the surgeon is doing as he is. What country are you in? Is your doc a knee specialist not a general bone cruncher?!

Good luck. Surgery is not what any one of us would choose. But remember you have a skewed population on here. All the people who have no problems never come looking on KG!! They are too busy living their life with a happy knee!

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 Jbriss

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Re: So frustrated... Hoping for some advice please
« Reply #3 on: January 31, 2012, 08:11:42 PM »
I am in the US. He is a general ortho surgeon. He is a referral from my 2nd opinion doc. I really am afraid if I continue pushing through the pain I will be causing more issues. And I really want to get the the root of the problem.

Offline marco4432

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Re: So frustrated... Hoping for some advice please
« Reply #4 on: January 31, 2012, 10:35:22 PM »
Just my experience had artoscopic surgery in june 2010 since then pain increased 20 fold,  I had 3 further surgeries pain just gets worse and worse
R Knee Arthospic  06/01/2010, partial lateral menisectomy synvisc injections
Start of dibilitating pain after operation
Ri knee Arthosopic Meniscus tear 03/13/11
partial lateral menisectomy synvisc
 Nerve Surgery09/15/2011Right knee
12/23/11 CT scan nerve block
02/29/12 2nd failed nerve surgery

Offline 4thtime47

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Re: So frustrated... Hoping for some advice please
« Reply #5 on: February 01, 2012, 07:00:02 PM »
Some truly great comments here, but I believe time will tell all.

Of course age, occupation and aspirations should play a huge factor in your decision making.  Only speaking from personal experience.  This past October I fell from a ladder.  By mid-December I knew something was wrong to the point that time could not address.  I have desk job for the most part but the activites I embrace leisurely could not be pursued at my preferred pace so I wanted the problem fixed via surgery.

Immediately after the Oct incident Dr. wanted to scope, but I canceled surgery because I knew that things would heal on their own....

To this point glad I had the surgery, but as is with REHAB, there are small victories as well as set-backs.

As was shared previously, having a good understanding with your Dr., I would reccommend the scope so at least he can see inside what may be wrong with the knee vs. what the MRI is not revealing. 

It had been 26 years since my last surgery and I had been very happy with the knee since then.  Work Hard; Pay Hard.....no your limits

Best Wishes in your decision making.

4thtime47

Offline Jbriss

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Re: So frustrated... Hoping for some advice please
« Reply #6 on: February 01, 2012, 07:13:27 PM »
Thanks for advice. The whole push through the pain thing isn't working out so well. Ran 2.25 miles last night, trying to get ready for spring races, and about a mile in I felt this sharp stabbing pain that ran from inside my knee and down my shin. I walked it off and ran after it subsided. Today my knee is so much worse. I have this awful ache behind my knee, and frequent stabbing pains as I am sitting at my desk with bent knees. Hopefully ortho will give some good insight on Friday. This is no fun at all.

Offline Lottiefox

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Re: So frustrated... Hoping for some advice please
« Reply #7 on: February 01, 2012, 10:33:31 PM »
Sharp stabbing pains when running and continued pain the next day needs to be checked out. I am guessing that you've had things like your running gait and biomechanics looked at? Is it just on the one knee or do you get similar pains on the other one? Do you stretch regularly after runs?

Sometimes we have to just bite the bullet and go for the surgery. You'll know if you feel ready for it. As said, be clear in what you consent to. Be prepared that even after surgery you might take a while to get back into running; people on here have had relatively "minor" scopes with things like plica removal and clean ups and they've taken months to get back to a running stage. You need to be kind to your knee if you have it looked at. Doctors are really good at saying how minimally invasive a scope is - yes, it is compared to an open surgery but its a still a joint op on a very complex joint so don't beat yourself up if you don't get back to running straight away. But, it sounds like you need to try and find some answers. Good luck and keep us posted. It is really useful for others to follow what happens and what is found on stories like this.

Hope you get back to the running 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 ElSquinto

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Re: So frustrated... Hoping for some advice please
« Reply #8 on: February 01, 2012, 11:22:47 PM »
Well, the best advice I can give you is to continue to try to rest your knee.  Don't resume running until the situation is well and truly resolved.  And, unfortunately, there are no guarantees.  Some of us have to give up doing certain things in order to avoid making a difficult situation worse.  I have entire days where I'm pain free but prior experience tells me that if I indulge in any of the activities that led to the onset of my pain - even the least little bit - I'll be worse off than ever.

If the surgeon continues to advocate arthroscopic surgery then just ask him the following question...

"Doctor, what in your own experience makes you believe that this procedure will solve my particular problem?"

and...

"Doctor, among your patients with this exact same condition - what has been the success rate of the surgery and what sort of complications have arisen?"

Any surgeon should be willing to answer these questions as a starting point.  If he/she isn't - take that as an indication you are talking to the wrong surgeon.

The very first ortho surgeon I talked to was talking up the idea of scoping my knee if as little as 4 weeks of RICE treatment didn't resolve the problem.  I asked him that question and his explanation was along the lines of "well...we've had great success in alleviating pain in many of our patients with this procedure and you're young enough that this should do some good".  But he didn't cite anything in any clinical or radiological test he administered to me that established that I was a good candidate for the procedure with a very-high likelihood of success and very-low likelihood of failure or complications.

And we haven't spoken since.
« Last Edit: February 01, 2012, 11:27:37 PM by ElSquinto »

Offline Jbriss

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Re: So frustrated... Hoping for some advice please
« Reply #9 on: February 02, 2012, 02:31:22 AM »
Thanks everyone. I know on my 1st MRI, a partial ACL tear showed up. It was pointed out that my symptoms of pain sounded like meniscus, and that sometimes tears don't show up on MRI. This surgeon is in agreement that MRI'S can miss things, and doesn't think this pain is consistent with an ACL tear. Especially 6 months later. Just hoping he can figure out the source of the pain.

Offline Jbriss

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Re: So frustrated... Hoping for some advice please
« Reply #10 on: February 03, 2012, 07:06:50 PM »
Update.... Going in for scope in 2 weeks. Doc was pretty mellow about the whole thing. Thinks he'll find something in there to fix, and I'll be up and around right away. We'll see. He's putting me under though which I was hoping he wouldn't. Want to know what he does when he's in there. I'll keep you posted.