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Fibro synovial thickening

Discussion in 'Knee Replacement Recovery Area' started by Roy Gardiner, Oct 8, 2012.

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  1. Roy Gardiner

    Roy Gardiner Forum Advisor

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    Thought I'd start a new one on this as it might be of wider interest.

    My left knee works as smooth as silk. My right now has this fibro synovial thickening, aka gristle on the back of the kneecap (Mr Ireland says). So, on crouching, taking stairs 2 at a time, or other stressful activity at 90 degrees flexion plus, I get a quite loud 'crunch' from the knee. Not that awful bone-on-bone thing, but just like if you bite into a really gristly bit of meat.

    It is sometimes a little painful, always gross and uncomfortable. It doesn't seem to be either getting better or worsening, after its appearance a few weeks ago - prior, both knees were dead smooth.

    Q. Will it get worse? Is it likely to go away? Ireland says microsurgery can work - anyone know anything about that? ( Josephine Orthodoc if you please)
  2. bassplayer

    bassplayer Senior

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    I have that on my left knee - it has that crunchy sound when I stand up, but not always. My OS said not to worry about it unless it causes pain, which it doesn't, meanwhile. But it's very unpleasant to hear it.
  3. bottomshollow

    bottomshollow Moderator

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    "Crunchy" knees---gosh guys hope you have no problems due to this. Doesn't sound like a lot of fun.
  4. maryo52

    maryo52 Sr Bonesmartie

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    Roy, good topic. I have this big time and while it doesn't hurt, I don't agree that no pain = no problem. I've never known any working part anywhere, whether human or mechanical, to make crunching noises without something bad happening. Even if there's something miniscule happening, it adds up over time. My knee just doesn't operate smoothly. I can feel the resistance during bent-knee type of activity e.g. stairs, getting up, etc.

    I'm going to be getting an experimental injection for this. More later. But tell us more about the "microsurgery" that's being proposed.
  5. Orthodoc

    Orthodoc Forum Advisor

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    Will it get worse or is it likely to go away... Unfortunately. there is no way of knowing this. I am a little surprised that this showed up this late (10 months post-op), but anything is possible.

    I would assume by microsurgery you mean arthroscopic surgery. Arthroscopic removal of adhesions (with the small "microscopic lens" and shavers) can be an effective treatment in some circumstances. It works better if there is a specific adhesion that needs to be removed (such as in a patella clunk syndrome with a PS device) rather than trying to removal global adhesions to achieve more motion.

    Orthodoc
  6. Dulcimer Diva

    Dulcimer Diva Sr Bonesmartie

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    My left knee has crunched for several years, but only became audible when I was first getting out of bed after my RTKR this past June. FWIW, after all the physical therapy I had to do to get me travel-worthy for my recent river cruise with walking tours, the crepitus is once again tactile but not audible. Maybe strengthening the quad was the key.
  7. Jamie

    Jamie Administrator

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    That is a very important aspect of it, D.Diva.....you're right on target!
  8. Roy Gardiner

    Roy Gardiner Forum Advisor

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    I used the term John Ireland used. He said the problem is gristle on the back of the kneecap, not tendons or ligaments being stuck (which is what I understand 'adhesions' to mean).

    So, wait and see it is.
  9. maryo52

    maryo52 Sr Bonesmartie

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    Roy, adhesions is scar tissue that adheres thus tethering tissues and restricting movement.

    I find whatever is in there that souldn't be causes sensation and noise I try to avoid. Which means I'm favoring it and that's not good.
  10. Josephine

    Josephine Forum Admin and Mother Hen Administrator

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    I've had some crunchy sensations in my knee but to be honest, I've never really paid any attention to it. After all, the knee's had majorly intrusive surgery and is never going to be the same as the one God gave me (depending upon how you think of your surgeon! :heehee:). I kind of disregard it as being a acceptable consequence of the surgery. :shrug:
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  11. Dulcimer Diva

    Dulcimer Diva Sr Bonesmartie

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    My crunchy left knee is definitely bone spurs grinding away. My right knee was actually audibly crunchy in the last few weeks before surgery. Quad strengthening helps the ligaments support the joint, increase the space between tibial and femoral compartments, and lessen the painful and noisy contact of bone-on-bone.
  12. maryo52

    maryo52 Sr Bonesmartie

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    I can't speak for some of the others, but my knee goes beyond crunchy. I do my best to ignore it. I ignored knee pain for years. But it's more than I can ignore.
  13. skigirl

    skigirl Moderator

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    MaryO is the noise crunchy or like velcro ripping? I had a small velcro sound at about 10 months or so. It only happened with a deep bend, like a squat--and only sometimes. Then, it began to appear more often. Finally, I could not ride my bike because my knee cap was scarred down with adhesions. I made quite the racket by the time of surgery---3 years after the tkr.

    Now, with the new spacer I have no motion in the knee and so far, no noise either.
  14. maryo52

    maryo52 Sr Bonesmartie

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    Kelly, based on what orthos have said to me (my own, plus the two 2nd opinion docs), and comments here, I think there's simply a lot about this that doctors, or most doctors, don't know about. Why else explains why I'm two years out and have never had a doctor, for instance, palpate my knee and at least try to figure out why it's so much bigger and investigate my symptoms further?

    Anyhow I have noises and sensations both. If I'm sitting and go to get up and use the TKR leg equally with the other leg, the pressure over my knee cap is enough to make me depend on the other leg, and there's a crepitus noise to go with it. I have the same experience going up and down stairs.

    Sometimes flying out to see your doctor has its appeal.
  15. maryo52

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  16. skigirl

    skigirl Moderator

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    Mary, that was a very interesting article. I have a PS stabilized device myself---do you? My doc talked about the problem of the synovioum getting caught in the joint. He knew that I did not have that. Yes, I would be interested in a doctor who specialized in adhesions. There is a doc at the Steadman clinic who does specialize in that---Dr. Frank Noyes. He has written a six part article on adhesions. It is very technical, but quite interesting. Kelly
  17. maryo52

    maryo52 Sr Bonesmartie

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    Yeah I've read lots and lots about all this stuff. And yes I have a PCL substituting prostheses.
  18. maryo52

    maryo52 Sr Bonesmartie

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    This was the perfect thread to help me get in the right frame of mind to propose to my OS another arthroscopy. I've noticed the kneecap symptoms have worsened and I do have pain but avoid motions that cause pain. My OS said he has found significant tissue growth on the underside of patellas while doing revisions, in people with no history of adhesions, many months after TKR. So I'm excited to have some hope of resolving my knee issues because, in truth, I never did reach a point where I felt I had "crossed the finish line," so to speak.
  19. Josephine

    Josephine Forum Admin and Mother Hen Administrator

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    Good, that's really good. I wish you luck.
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