Advertisement - Hide this advert





Author Topic: Painfull knee after MUA - any thoughts?  (Read 393 times)

0 Members and 1 Guest are viewing this topic.

Offline MrUlv

  • MICROgeek (<20 posts)
  • *
  • Posts: 12
  • Liked: 0
Painfull knee after MUA - any thoughts?
« on: January 15, 2018, 01:45:09 PM »
Hi!
I come from Norway and have to apologize my English. Fortunately, I found this amazing forum. Hope some of you can help me.

On January 1, 2017 I was kicked 3 times lateral on my left knee. Noticed nothing this day, but the day afterwards the knee was very painful and stiff.

I went to work as usual, but my knee is still very painfull/stiff. It is painful to stretch / bend my knee and I have to gradually extend my knee for full extension. The knee becomes better after moving, but gets stiff when I sit down.

Gradually, the stiffness becomes worse day by day. The doctor thought there could be meniscus injury. MRI shows no signs of injury. But the knee is really not good. Finally, it is practically impossible to extend my knee. I was sick from work for 7 months. I could hardly walk and had to use crutches for a long time.

Orthopedist believed that this was an injury to the joint capsule that made the knee stiff. He recommended physical therapy. Tried this without any improvement.

Orthopedist did MUA of the knee. The orthopedist said that he had to spend a lot of power to extend my knee in anesthesia. MUA was done on September 19, 2017.

The knee was very painful after MUA, but finally I got full extension. But I'm back to where I started. The knee can quickly stiffen and it is very (!) painful to bend. Can not bend it completely.

Do you have any thoughts about what this may be and what I should do? I have taken several MRIs and they show no signs of harm. The orthopedic team is pleased with the outcome and will actually finish the treatment. Personally, I still think the knee is not the way it should be.

Could this be a adhesive capsulities of the knee? Could there be arthrofibrosis in the knee? Will I ever get well? The extension and stiffness feels better when im using the foot. Can this indicate something?   Thank you for helping!

Offline Brandon123

  • Forum Faithful
  • ****
  • Posts: 404
  • Liked: 42
Re: Painfull knee after MUA - any thoughts?
« Reply #1 on: January 17, 2018, 09:07:45 AM »
Hi there MrUlv,

Have you clearly told your doctors that your are still not OK in the knee, and asked about possible adhesive capsulitis of the knee or arthrofibrosis? Sounds weird that they are pleased with the outcome and will finish treatment when you obviously still have major problems! 
RK sharp pain while running, diagnosis chondromalacia patellae 6/09
RK arthroscopic chondroplasty 9/09
RK rehab, recovery, 90% normal, started running again -> back to square one 5/15
RK diagnosis patellofemoral arthritis + LK diagnosis chondromalacia patellae 8/15 -> conservative treatment

Offline MrUlv

  • MICROgeek (<20 posts)
  • *
  • Posts: 12
  • Liked: 0
Re: Painfull knee after MUA - any thoughts?
« Reply #2 on: January 18, 2018, 12:48:11 AM »
Thanks for answering.

Yes, i clearly told my doctor that my knee is far from good. The orthopedist writes in the report that "the patient is not happy with the progress, but the situation today is much better than when I first saw the patient bedridden with a chronically locked knee (I think that is pretty obvious, because my knee couldnt  become any worse...). I do not think that anything surgical can improve the situation."

The orthopedic and the manual therapist thinks this can be adhesive capsulitites in the knee. They find no studies / research on this condition in the knee (common to the shoulder). But they think I have signs similar to frozen shoulder in the knee (adhesive capsulities). But this is hard to look at MRI they say. Have now taken 3 MRI, all of which are quite normal.

I asked the doctor about scar tissue, and he thinks there is a possibility that I have scar tissue. But he thinks that all I can do to improve this is to keep the knee moving (for example cycling). He can not see scar tissue on the MRI.

Frozen shoulder usually starts very gradually, but my injury occurred acute the day after a kick to the knee.
The knee and stiffness feel better when I take a squat / go for a walk, which may indicate that it is soft tissue that is the cause. When the knee is warmed up through exercise, it really feels just fine. Extension is then good and painless, but can no longer hyperextend like the right foot. But I can never bend my foot completely, it's pretty (!) painful.

So the main problem is that the knee may stiff when not beeing used (I cant keep my knee warmed up through exercise all day) and bending the knee (maybe 120 degrees) is not possible at all.

Offline Brandon123

  • Forum Faithful
  • ****
  • Posts: 404
  • Liked: 42
Re: Painfull knee after MUA - any thoughts?
« Reply #3 on: January 18, 2018, 08:20:22 AM »
Well, I would say it is still a good sign that your knee feels fine after a warm-up.

Adhesive capsulitis of the knee seems to be quite unusual and literature is rare, but have you (and your docs) seen this paper:

https://www.researchgate.net/publication/235717429_Adhesive_capsulitis_of_the_knee

What about nerves and muscle control and such? Can anything like that play a role in your stiffness? What if those kicks you got damaged some nerve or something? I don't know, just thinking loudly.
RK sharp pain while running, diagnosis chondromalacia patellae 6/09
RK arthroscopic chondroplasty 9/09
RK rehab, recovery, 90% normal, started running again -> back to square one 5/15
RK diagnosis patellofemoral arthritis + LK diagnosis chondromalacia patellae 8/15 -> conservative treatment

Offline MrUlv

  • MICROgeek (<20 posts)
  • *
  • Posts: 12
  • Liked: 0
Re: Painfull knee after MUA - any thoughts?
« Reply #4 on: January 18, 2018, 02:38:42 PM »
I have read that paper you sent before. Dont think my doctor has...

Muscle control is quite good. I can activate quadriceps and im gradually building my quads pretty strong.

The problem seems that the doctor(s) dont know whats wrong, but just believes (or hopes) that my knee is a case of adhesive capsulitites. Thats why they decided to do MUA to the knee, like many frozen shoulders. Capsular release was discussed, but my ortopedic meant MUA was best/better in my case.

Thank you so much for your help Brandon123!

Offline Brandon123

  • Forum Faithful
  • ****
  • Posts: 404
  • Liked: 42
Re: Painfull knee after MUA - any thoughts?
« Reply #5 on: January 18, 2018, 03:50:02 PM »
Do you see any progress at all? A trend of less stiffness when still and/or stiffness goes away faster when you start moving?

I believe you can forget about the scar tissue theory, you have never (I assume?) had any surgery or anything. And your problems started after somebody had kicked your knee. Of course, I'm not a doctor, but I still think it is the least plausible theory.

Have you gotten a second opinion? Or is it the same doctor that have treated you all the time?
RK sharp pain while running, diagnosis chondromalacia patellae 6/09
RK arthroscopic chondroplasty 9/09
RK rehab, recovery, 90% normal, started running again -> back to square one 5/15
RK diagnosis patellofemoral arthritis + LK diagnosis chondromalacia patellae 8/15 -> conservative treatment

Offline MrUlv

  • MICROgeek (<20 posts)
  • *
  • Posts: 12
  • Liked: 0
Re: Painfull knee after MUA - any thoughts?
« Reply #6 on: January 18, 2018, 05:41:26 PM »
I have to admit that I notice some improvement after MUA. The stiffness when extending seems to be better. But if I sleep a night with my knee bent, I'm extra stiff in the morning. However, the stiffness /pain when BENDING the knee has not improved at all. Movement/warming up do not help the knee bending.

I have not had any surgery on my knee. Only mobilization. However, the doctor believes that with so long inactivity and locking in the knee (about 7 months) it MAY have formed scar tissue.

Have not received a second opinion. The orthopedic is very skilled, humble and credible. But it's possible I should try to get a second opinion? Is it normal to pay for this privately? Or get a referral to new orthopedic?
Again, thank you for caring!

Offline Brandon123

  • Forum Faithful
  • ****
  • Posts: 404
  • Liked: 42
Re: Painfull knee after MUA - any thoughts?
« Reply #7 on: January 19, 2018, 09:34:18 AM »
I still think it sounds good that you see some progress, maybe you should give it a bit more time and work with some skilled PT to reduce the stiffness with bending? But don't overdo PT!

If you can find an ortho at a private clinic and go there and just pay for a consultation, I think that would be a better alternative than trying to get a new referral to a new ortho within the (Norwegian) public system.   
RK sharp pain while running, diagnosis chondromalacia patellae 6/09
RK arthroscopic chondroplasty 9/09
RK rehab, recovery, 90% normal, started running again -> back to square one 5/15
RK diagnosis patellofemoral arthritis + LK diagnosis chondromalacia patellae 8/15 -> conservative treatment















support