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Author Topic: Poor ROM (Extension) and implications.  (Read 542 times)

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Offline bobby boy

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Poor ROM (Extension) and implications.
« on: December 29, 2014, 11:50:36 AM »
 

Hello I am posting on this thread as a wild stab in the dark.

I have had the following procedures carried out on my right knee.


Arthroscopy in 1999 discovered meniscus damage and torn ACL

ACL reconstruction in 2000 patella tendon graft.

Arthroscopy 2011 following found and done.

Right knee
Stable knee but ext def of 10 degree - ROM 10 - 140.
PF-joint - OA grade II - IV. Small areas with bare bone. Delaminated cartilage resected.
Medial plication resected
Medial - OA grade II - IV. Central on the femoral chondyle an area of 3 cm2 with almost bare bone - delaminated cartilage resected - microfacturing.
Stable meniscus.
Central - osteofytes resected. Reconstruction stable but at 11 o'clock and posterior on tibial side. PCL stable.
Lateral - OA grade ii - ii + stable meniscus.

After this procedure I asked the consultant what the prognosis was and was told that there was little more that could be done,and the next procedure would be a new knee.


I have really poor ROM on extension which affects my gait and I walk with a limp.  If I accelerate from a walking or standing still position I feel immediate discomfort in my knee.  To make an analogy, it feels like my knees mechanics are a bunch of cogs which join and work correctly.  However the startle impact of explosive acceleration feels like the cogs have all jumbled up and jammed. I hope that makes sense.

When I stand for any period of time my knee locks.  If I sit for any length of time my knee locks and goes really stiff.  If Gets particularly stiff in the cold.

Couple of questions I wish to pose

Is anyone aware of any medical literature in respect of research on the impact of poor ROM
Is there a technical term for the affect described in my analogy
In 2011 when I had my last arthroscopy the surgeon gave diagnosis and treatment which is written above.  What in lay persons terms do the aforementioned medical terms mean
What are commentators views on the prognosis and getting a knee replacement at 48 also what alternatives are there.

I thank you all in advance for the attention this receives and any feedback given.

Offline Vickster

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Re: Poor ROM (Extension) and implications.
« Reply #1 on: December 29, 2014, 01:59:44 PM »
Which bits of the report don't you understand?

It sounds like your symptoms are fairly typical of arthritis - stiffness, worse in the cold.  The shiny surfaces of the bones in all three knee compartments are damaged, this will stop them moving together smoothly as you describe.  The locking could be caused by loose bits moving around and trapping the joint

There are some younger TKR patients on here if you look in the knee replacement section :)

Have a read of the arthritis primer in the information hub

http://www.kneeguru.co.uk/KNEEnotes/primers/joint-cartilage-and-arthritis-primer

You might find hyaluronic acid injections help with inflammation and lubrication in the joint, or steroid if you've not tried these (not a long term solution though)

Best to go back to your consultant, perhaps for an Xray / MRI and to discuss the options.  The other cartilage repair techniques are generally only available for younger patients (under 40) and not necessarily funded either by the NHS or private health insurers (you are in the UK, I assume?)

There are surgeons who will do TKRs in younger patients, although again you may need to fund as the NHS tends to only cover for older (60+) patients due to the probable need for a revision when done younger

Good luck :)
« Last Edit: December 29, 2014, 02:04:30 PM by Vickster »
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















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