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Author Topic: Put your thinking caps on folks  (Read 896 times)

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Offline CompetitiveCyclist

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Put your thinking caps on folks
« on: June 07, 2015, 09:31:44 PM »
Age 32, 5'11"-146 lbs
Bi-lateral knee pain for past 3 years from weight bearing, standing, cycling -- 0-5 pain scale
No visible swelling/inflammation
Pain builds based on activity level for consecutive days
Applying the brake & accelerator on a car is enough to cause pain

Neg X-Rays
Neg MRI
Neg bone scan
Neg blood tests for auto-immune
NSAIDS have no effect
Continued PT has helped a minor amount
Orthotic insoles have improved biomechanics & helped pain slightly

I have gone from cycling 10+ hours per week & working a physical job to no cycling, the occasional hike, and a non-strenuous job as a result of the pain.  I am to the point that I want to request exploratory arthroscopic surgery.

Thank you for your thoughts!



Offline dal_knee

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Re: Put your thinking caps on folks
« Reply #1 on: June 07, 2015, 10:59:35 PM »

Perhaps consider getting another MRI and opinion? Perhaps something was missed. Sounds like bone edema , it's only picked up definitively on T2 fat suppressed MRI sequencing.  However the bone scan would have been abnormal too, so it's not likely 2 tests would have missed that.  Sorry I don't have any other ideas.
2007 - partial medial meniscectomy
2010 - full thickness chondral defect & adjacent subchondral edema MFC.   Direct result of stupid partial mensicectomy from 2007.
2014 - Subchondroplasty, chondroplasty, unauthorized 2nd partial medial meniscectomy.
2015 - partial failure of subchondroplasty.

Offline vickster

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Re: Put your thinking caps on folks
« Reply #2 on: June 08, 2015, 07:28:44 AM »
Perhaps CT scan to check the alignment of your bones, if you say orthotics help, possibly your alignment is out

If nothing shows on x Ray or a repeat MRI, the tides for meniscus and ligament are negative, it's unlikely an arthroscopy will show up anything new. P

Get a second opinion and fresh pair of eyes :)
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 mmrocker13

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Re: Put your thinking caps on folks
« Reply #3 on: June 08, 2015, 04:45:06 PM »
Have you looked at origins elsewhere (so spinal, for example)?
89: Pat. dislocation, lat. meniscus tear, femoral OCD lesion
89: debridement, chondroplasty, lateral partial menisectomy
02: partial lat. menisc., debride
02: mfx
09: subtotal menisc., debride, c'plasty
10: scope/debride
10: varus DFO
13: HWR
15: total menisc., debride, c'plasty, notchplasty

Offline CompetitiveCyclist

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Re: Put your thinking caps on folks
« Reply #4 on: June 08, 2015, 08:49:32 PM »
Thank you for the suggestions!

--  I have faith in the bone scan.  It actually showed an unrelated ankle issue from a low-speed moto fall.

--  CT scan?  I will check that out.  Now that I think of it, I do walk duck-footed.

--  I visited a chiropractor who felt no spinal issues...

Offline vickster

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Re: Put your thinking caps on folks
« Reply #5 on: June 08, 2015, 09:04:02 PM »
If you do go back to cycling, make sure you get your cycling gait and technique looked at by an expert. You may well need orthotics for riding too if wonky legged, as well as the usual stuff like cleat positioning, saddle height and position, making sure reach is spot on 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