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Author Topic: Patellofemoral arthritis  (Read 2201 times)

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Offline kmb66

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Patellofemoral arthritis
« on: August 05, 2013, 10:07:28 AM »
Hi everyone.
I would be most appreciative of any advice/ experiences with kneecap arthritis. I have been diagnosed with grade 3 in both knees and am having an arthroscopy on my right knee in October for polishing. Then later cortisone injections. I cycle a lot for fitness and to work to save money. This really causes a lot of pain. My surgeon is losing patience with my questions- how bad will it get, how can I limit progression, can I have a unicompartment replacement etc. His answers are generally  - it's only a bit of pain, some people have cancer so just get on with it. This isn't particularly helpful. Yes I'm anxious. It seems to have developed quickly. He recommends cycling but I wonder whether that's caused it and may worsen it. My wife has MS and needs some help so the prospect of increasing mobility problems due to my knees is especially depressing. It's bad enough anyway. So I wonder if anyone has any experience with this and can provide advice? I have read about patellar resurfacing. My surgeon is dismissive of this. I would love to hear from you. Keith.

Offline JaneDown

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Re: Patellofemoral arthritis
« Reply #1 on: August 05, 2013, 11:03:14 AM »
Hi Keith, I don't have the same issue as you but would advise you firstly to take a look at the patellofemoral board which if you go to the main page and scroll down to the Specialilist' Office is the first one on the list. Loads of people on there will have first-hand experience of what you are going through and you will be able to read up about recovery times from and experiences of the surgery you are due to have in October.
What I would say though is that it sounds like your surgeon is a bit unhelpful to say the least. Having surgery (no matter how the surgeon may try to make you feel like it isn't a big deal) IS a big deal and it really helps if you feel you have a surgeon you can communicate with. Telling you that your pain isn't that bad and that you should just deal with it or that there are people dying of cancer so you should just suck up a bit pf knee pain is totally unhelpful and rather insulting. If he is like this before surgery and is not happy to take the time to answer perfectly reasonable questions then imagine how you will feel after surgery if you have any problems or concerns etc. Are you in the UK? The NHS allows you to have choice, it may mean waiting a bit longer but you can research other surgeons and request that your GP refers you to one if you do not feel comfortable with the one you are currently under. Presumably if you're not in the UK and are in a country with a different health system then you might have more choice anyway. The other option in the UK is that many NHS surgeons also practise privately and you could pay to have a thorough private consultation with one (probably about £170-£250 mind you!) but then if you feel more comfortable with them you can opt back into the NHS and join their NHS waiting list. Take a look at the patellofemoral board though and see what others who have experience of this have to say. Good luck.
Knee pain since 2002
2006 MRI shows lateral meniscal tears
Oct 2008 Bilateral partial lateral meniscectomies (long recovery!!)
Jan 2009 MRI shows surgery caused damage to medial meniscus!!!
June 2013 knee injury, agony!!!
August 2013 - left knee medial partial meniscectomy

Online vickster

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Re: Patellofemoral arthritis
« Reply #2 on: August 05, 2013, 11:45:12 AM »
It sounds like a consult with another surgeon would be helpful. Not sure what country you are in and thus how this might work?

Cortisone isn't generally useful for bone issues, it helps inflammation in soft tissues, such as tendonitis. Hyaluronic acid jabs are indicated for knee arthritis, helps lubricate the joint, and also inflammation. I have had these twice, work well for me. I would ask the surgeon to give one of these in advance of the arthroscopy. Do you know the cause of the damage - trauma, bone malalignment, wear and tear? If the bones are poorly aligned this needs to be addressed ideally or the knee will likely continue to deteriorate and any sort of repair / replacement will be less effective over time. Muscle imbalance can also cause poor tracking, so targeted, specialised sports physio can help.

Also, if cycling, have you had a bike fit - to make sure reach is correct, saddle height and position are right, cleats are correctly positioned etc. A poor fit can exacerbate knee issues, as well as back, hips, neck, shoulders etc

Good luck  :)
« Last Edit: August 05, 2013, 12:45:19 PM by Vickster »
Came off bike onto concrete 9/9/09 (lat meniscus, lat condyle defect)
LK scopes 8/2/10 & 16/12/10
RK scope 5/2/15 (menisectomy, Hoffa’s fat pad trim)
LK scope 10.1.19 medial meniscectomy, trochlea MFX
LK scope 19.4.21 MFX to both condyles & trochlea, patella cartilage shaved, viscoseal, depo-medrone

Offline kmb66

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Re: Patellofemoral arthritis
« Reply #3 on: August 06, 2013, 09:01:48 PM »
Hi Jane and Vickster, thanks for your replies. I have considered seeking the opinion of a different consultant. Until next April I have private medical insurance in the uk so I'm trying to get the surgery over by then. This means I probably don't have time to go elsewhere. I'm sure he'll do the best he can but I do think his response to my questions was a bit unprofessional. I don't know the cause. I have read that bilateral patellofemoral arthritis is unusual at 46. He us dismissive if trying to pin down a cause, concluding that it is probably just wear and tear. Well obviously, but I really want to stop it getting worse. It already hurts significantly at times. I'll repost this on the patellofemoral board. Thanks again for your replies. Keith. And good luck with your knee issues.

Online vickster

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Re: Patellofemoral arthritis
« Reply #4 on: August 06, 2013, 09:48:20 PM »
If you have private insurance in the UK until April why are you unable to see anyone else?   Normally, you can get a private consultation within a couple of weeks.  I saw my first OS privately the day after my GP said I needed to be referred, unusual, lucky he had a slot, but not impossible.  Then when it was decided surgery was necessary, it was done within a couple of weeks - depends on surgeon availability, what is convenient for you, but again speed and being able to be seen when convenient for you is the key benefit of private healthcare here in my experience. 

When I needed to see someone else for insurance reasons, I saw him within a month (he is very busy) again, once the insurance company agreed to the second surgery, the scope was within a month again if I recall.

Are you not in the UK full time hence only having a limited window for treatment?  Have you been seeing a physio for targeted muscle building? 

I am no expert, but bilateral kneecap damage / wear and tear is normally due to poor alignment and tracking which needs to be dealt with (the surgeries are pretty full on, but people make good recoveries with patience and good rehab).  There are a few PF specialist surgeons in the UK as well as those who specialise in cartilage damage, especially in younger patients.  Depends where you are in the UK?  I would readily recommend my OS who although not a kneecap specialist does have an interest in cartilage issues and is extremely approachable, honest, good at explaining things etc. 

Good luck



Came off bike onto concrete 9/9/09 (lat meniscus, lat condyle defect)
LK scopes 8/2/10 & 16/12/10
RK scope 5/2/15 (menisectomy, Hoffa’s fat pad trim)
LK scope 10.1.19 medial meniscectomy, trochlea MFX
LK scope 19.4.21 MFX to both condyles & trochlea, patella cartilage shaved, viscoseal, depo-medrone















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