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Author Topic: Frustration with Knee Dr.  (Read 1054 times)

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Offline zcapehart

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Frustration with Knee Dr.
« on: December 21, 2012, 06:15:54 PM »
Hello,
In March of last year, I was hit by a car while running.  The car was rolling through a stop and I hit my left knee car pretty hard on the front.  Since the injury I have seen 2 Drs, for minor pain, and MAJOR grinding that now occurs in that knee.  The first Dr. said everything was just fine and to keep running on it etc.   The 2nd Dr. did do an MRI which he said came back clean.  I went to see him again recently because the grinding has not improved at all and it has now been 9mo.  The grinding seems to have increased, I have pain in running and other activities.  He recommended some more physical therapy, but again wasn’t actually able to tell me what he thought the problem was.   Regarding the grinding he stated, “Knees grind more as you get older”.  I’m 31, I have 2 knees and it is very clear that my left knee grinds many orders of magnitude more that the right due to the accident. 

What I hate about this, is no one seems to be able to say with any certainty what the problem really is?  and what will really fix it? 

Part of my frustration is that these Drs.  Give you about 5 min before sending you out of the office with no reassurance that you’ll actually get better. 

If anyone has any recommendations, insight around this type of injury I’d really appreciate it.  Does anyone know if continuing physical therapy is really the best for this?  It has been 9 mo.

My best guess is that is either, “Chondromalacia patellae” or “dislocated patella”.  This site seems to indicate this.  http://www.genufix.com/patella_problems1.htm

Thanks for the help!
Zach

Offline MTLover

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Re: Frustration with Knee Dr.
« Reply #1 on: December 21, 2012, 08:00:38 PM »
Have you had x-rays on your knee?  Specifically weight bearing x-rays?  If so, was there any abnormalities found?  I assume that you were(or are) going to PT?  If so, did the PT say anything about your knee?  Unfortunately, if you aren't satisfied by the two doctors you have been to, you need to keep searching for someone who specializes in knees.  They may recommend getting your knee scoped, which has it's pros and cons.  (I had my knee scoped and that seemed to be the thing that sent me in a downward spiral of knee pain more than anything else).

I agree in that doctors should give you more than 5 minutes.  What really bothers me is that they already have their decision in their mind before they even walk in the room to talk to you based on what info is on your chart and if the nurse asked you any questions prior to seeing the doctor.  Plus it's all about insurance and money/profit.  The more people they can see in a day, the more money they make.  Then they can get you to keep coming back for "check ups" to see how you're doing.....

Offline silverghost

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Re: Frustration with Knee Dr.
« Reply #2 on: December 21, 2012, 08:26:35 PM »
Hi Zach

I agree with the previous comment and you could do with an MRI rather than just an x-ray.  Grinding can be caused by a number of things within the knee joint but this would normally occur following a trauma to the joint whether in your case an accident or old age and a reduction in joint fluid which helps the joint move effectively. 

Unfortunately, in most surgeons eyes your pain in caused when you run or do activities... the answer in there heads would be too stop.  If you had constant pain in day to day activities then you would find they would be more interested.  I found similar and once I was over the 30 barrier I noticed a distinct lack of interest..

Following your accident it could be that you have developed a small cyst or pocket of fluid within the knee that is causing catching and grindiing and a simple arthroscopy could resolve the issue.  I would say if the grinding is getting worse then PT is not necessarily the best therapy.

Good luck in finding someone but you can just get your GP to get you an MRI in the meantime..

SG
'96 ACL reconstruction
'09 Arthroscopy/cartilage repair
Diagnosed with Grade 4 OA no medial cartilage and significant varus alignment
'11 fitted with off loading knee brace
'12 HTO, meniscus transplant, acl reconstruction & microfracture all in 1 go!

Offline captainruss

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Re: Frustration with Knee Dr.
« Reply #3 on: December 23, 2012, 08:54:23 PM »
Zach,

I am not always agreed with here, but if you have "ANY" doubts about your doctor, go see two more.  Specifically, I have had three (3) surgeons who stated my knee was infected and took the joint in and/or out multiple times each.  At no time was my knee infected.  I find that I have scar tissue (AF) as my knee is trying to protect itself from the trauma.  My last doctor operated several times telling me it is infected and not agreeing that scar tissue was a problem.  Only when he split for TN in the middle of the night due to a nasty divorce did I obtain my surgical records from the hospital.  I find out that he has been cutting out scar (AF) tissue during each surgery which causes it to grow back at a greater rate.

If you don't find a specialist, you are going to have problems.  I was working full time as a ship's captain prior to my first TKR.  I am not disabled and do not work.  Please understand, I am in the 1 percent of failed TKR's and my outcome is not normal (disclaimer) but it has happened to others on this site. 

The same surgeon who operated on my knee the last three times, my back the last three times, and my shoulder almost did a Lateral Release on my 15 year old daughter who has knee issues.  This would have caused her lifetime problems (in my opinion) and not cured her problem.  Only thru my pain and suffering did I come to Knee Guru and learn enough to make the right choices.  I have found, thru the the outstanding people on this site, 2-4 surgeons I would let operate on my daughter.  Now we have had nearly a dozen (12) opinions and multiple tests, X-rays, MRI's, and thousands of miles traveled, but we are nearing the decision to have her surgery.  I hope it is the one and only surgery she will have to suffer with, but I so easily could have ended her future if I had listened to my old doctor.

Honestly, I trusted the guy with my life.  I cannot fathom the logic in his recommendations, but thank God and the folks here are KG for helping me to find the information necessary to make an informed and correct decision.

There are thousands of surgeons, but only like I said 2-4 that I would allow to operate on my daughter.  This is your future!  Take your time and get good medical advice.

Merry Christmas!!!

Russ
80 Shattered patella 5 surg
09  TKR 
09  MUA
09  MUA
09  Knee infected??
10  TKR  Scar Tissue
10  2nd OS  Diagnosis Infection
10  TKR with antibiotic spacer, no joint
4/11  TKR
11  TKR PT
11  TKR
11  TKR  AF diagosis
12/11  HO diagnosed
2012  Intractable Pain
2012  OS split
amputation possible?

Offline RLE

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Re: Frustration with Knee Dr.
« Reply #4 on: December 24, 2012, 02:28:19 AM »
I usually agree with you Russ especially this post. Something is absolutely wrong with the OP's knee and he needs to find a good surgeon. Easy to say, hard to do. I had a couple of surgeons tell me there was nothing wrong (read my signature all the damage that was done) and a couple who at least admitted they didn't know what to do and a couple more who offered a lateral release (not sure what that would have done except allow my knee to slide around) and one who was going to clean it out which was nice but my kneecap was stuck somewhere north of my knee.
Anyway, yeah, finding a good surgeon is 3/4 of the battle and I wish you luck, OP. Check the list of surgeons on here.
Accident 2011: permanent dislocation, hole under the patella, bone fragments/debris embedded, scar tissue, 3 torn ligaments, fracture, cartilage sheared off, contracture,
2011 MUA
PT on-going
2012 MPFL reconstruction,TTT
        TTT
        Lateral lengthenin
        Arthroscopy/clean out
Thx Dr. T

Offline MTLover

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Re: Frustration with Knee Dr.
« Reply #5 on: December 24, 2012, 03:49:53 PM »
Unfortunately, in most surgeons eyes your pain in caused when you run or do activities... the answer in there heads would be too stop.  If you had constant pain in day to day activities then you would find they would be more interested.  I found similar and once I was over the 30 barrier I noticed a distinct lack of interest.

Sad but true.  And once you are over 40 it gets even worse.  I consider myself a pretty active person and always tried to go to orthos who say they "specialize" in sports medicine as I thought they would want to help and keep their patients active.    Most could have cared less about me and my activities.   It was always rest, ice, ibuprofen and cortisone shots.  And now talking knee replacement.

I have had issues with my knee after my HTO that I never had before.  I was more active before my surgery, and now I can hardly walk around the block let alone run.

As RLE said, finding the right OS is 3/4 of the battle and even then I'd still get another opinion.

Offline captainruss

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Re: Frustration with Knee Dr.
« Reply #6 on: December 26, 2012, 03:38:45 AM »
Absolutely!  I am actually not wasting time on any surgeon who is not recommended by a KG who has had actual surgical results with the OS.  I have flown my 15 year old daughter all over the U.S. to see three (3) different surgeons, all in what I would call the KG Top Ten and will pick from one of four (4)!

You may believe that to be extreme, but I took what I thought was from three (3) of what I might call Florida's Top Ten and all three agreed that I was infected, and their three attending infectious disease specialists stated I was infected, despite the fact that not one of what would easily be a total of fifty (50) different cultures/tests between the six doctors came back positive.  I can't tell you how many times they jammed that 18 guage needle into my knee from the sides, top, and bottom taking fluid and tissue samples.  If they did not get fluid, they aspirated the knee and then tried to take samples all the while I am screaming like a banshee! 

I am a good sport......but when they put me thru all of that and the cultures come back negative....they still tell me I am infected!  If they are not going to rely on the results, why put me thru it.  Also, the doctors here are famous for interpreting SED Rate and C-Reactive Protein levels as an indicator for infection when the rates are elevated.......not the case.....they are simply an indicator of inflammation....at least in my case...not infection. 

All the surgery....all the PT (50 sessions after each surgery) ...the MUA's....and I am less mobile and in more pain than before we started.  The REALLY frustrating part is they left me on a pic line way too long with vancomycin going directly into my heart as it was too strong to be injected into my veins and have ruined my immune system.  I am told I am on oral antibiotics for life.......and each time I try to stop taking them I have ended up in the I.C.U. for severe pneumonia.  I would rate the damage to my immune system as worse than the damage to my knee.....back and hip.

Sooooo....don't give up....get lots of opinions if possible...and find a surgeon if possible who has actually operated on a KG alumnus!!!

Russ
80 Shattered patella 5 surg
09  TKR 
09  MUA
09  MUA
09  Knee infected??
10  TKR  Scar Tissue
10  2nd OS  Diagnosis Infection
10  TKR with antibiotic spacer, no joint
4/11  TKR
11  TKR PT
11  TKR
11  TKR  AF diagosis
12/11  HO diagnosed
2012  Intractable Pain
2012  OS split
amputation possible?