arthroscopic knee proceedures

[lissa]

I'd like everyone out there who has had orthoscoptic proceedures on either/both knees to tell me the reasons you did that before having knee replaced. I know age is a factor, so rule that out. What did they do, what was the intended purpose and did it help...even for a year or so. If it didn't help, I'd like to know age of your knee... the condition that caused you to have the proceedure. Oh! Rule out injury/accident as well.

I have persistant bursitis,patella causing inflamation of Hoffa's Fat Pad...its been inflamed since June 2000(in the good knee!). That's a long time...have done nothing, some exercise stuff, more stuff, less stuff, stationary biking on land in water, leg press, bed leg lifts, you name it..., all within the guidelines of physical therapist, then more nothing...icing, aleve, vicodin it's been a round the merry-go-round thing. End result, the inflamation is not getting better..there is cartiledge apparently, so replacement is not on the table...other knee has been approved for replacemnt, but pain in bursitis knee keeps me from moving forward.

One surgeon said she could do the orthoscopy and see about smoothing down the back of the cartiledge...but there are NO bone spurs and no tears apparent on MRI. ! Don't tell me then, what's she looking for to help you...I'm at that point of needing to do something so I can walk, period! I could use your informed opinions! Thanks!

Lissa

 

[Nursepair]

Re: orthoscopic knee proceedures

Welcome to the "family" Lissa.

I don't know if this helps you. My arthroscopies for partial menisectomy's started off with trauma, but now it is wear and tear (weight and age never helps). The procedures definately helped for many years, but the more cartillage they take out the quicker you get to bone on bone. Cortisone also helps at first, for me they used to last 18 months at a time, now only 6months in my left knee, but only if you have any cartillage left for it to work on I think.

I don't know if cortisone will be effective for your case, Jo will be able to answer your question better.

I had my RTKR done January 2008 (I was 53 at the time)and I now have a near normal life back without pain in that knee. When the cortisone stops working in my left knee, I won't hesitate to get it replaced too.

Good luck. Sue

 

[Jamie]

Re: orthoscopic knee proceedures

Hi, Lissa and welcome to BoneSmart!

About 2 years ago I started having a lot of pain and swelling in my right knee and the MRI showed some torn meniscus. I had arthroscopic surgery to "clean up" the cartilage. My recovery from the scope did not go well - LOTS of serious swelling. My doctor didn't respond very well and the ultimate consequence was that within 3 months I developed avascular necrosis (dead bone) in a small area of the joint and major loss of what cartilage was there. It happened very fast and then I was limping and in lots of pain - significantly worse than before the "minor" procedure.

I tried Supartz injections for a couple of months and they helped a little. But in the end only a knee replacement a year ago relieved the pain.

Sorry to give you the bad side of having a scope, but it happens sometimes. Before my doctor did mine he warned that going into the knee could accelerate arthritis. I was one of the unlucky ones who had that happen.

But based on what others have written, my outcome is not the norm.

 

[JudyS]

Re: orthoscopic knee proceedures

WElocme Lissa
I am 51 and had a hip replacement in June. In Dec I had arthroscopic surgery on my right knee.
My doc did a synovectomy, removed a lot of scar tissue and did microfracture surgery on the trochlear groove. The trochlear groove is the part the patella glides on as it moves up and down. the only damage in my knee is in the patello-femoral section. I had the next 6 weeks with weightbearing only while in a brace keeping my knee straight. I could bend my knee with no weight bearing. I have just started walkiing on it about 2 weeks ago. I still have swelling and some discomfort with walking up and down stairs. I am not allowed to walk hills yet and am just to start physical therapy to strengthen the surrounding muscles.

My other knee will need the same.

Good Luck to you
Judy

 

[Josephine]

Sounds to me like you need the fat pad (Hoffa's pad) trimmed rather than the cartilage assuming she means the articular cartilage rather than the meniscal cartilage. If this be the case, then a word of caution - what she is proposing to do is debride the cartilage which produces roughly the same result as arthritis does. In other words, it could risk exacerbating a pre-arthritic condition. Sad fact is that the line between doing good and doing damage is very fine and it takes some considerable restraint on behalf of the surgeon to not cross that line.

In case you hadn't already looked it up, this is what a Hoffa's pad looks like

It's the lower fat pad under the patella and if it gets swollen, it obviously protudes into the joint more, thus getting pinched. After that it's a bit like when you bite your cheek. It gets swollen and protrudes so you bite it again!

Have you tried injections of cortisone? It might help the swelling to go down but ultimately a trimming of the fat pad would seem to be the obvious solution. I would certainly talk to your surgeon about this more, find out exactly what she is proposing to do and what her plans will be if this doesn't work. You could also suggest the cortisone shots.

These acute on chronic conditions are a real bugbear and it's not easy to stop the cycle of pinch and inflammation causing pinch, causing more inflammation, etc. You could also consider a second opinion. Some surgeons are more familiar with this relatively uncommon condition that others.

 

[beachcomber]

Lissa,
I had a LPKR 15 months ago and arthroscopy 9 months ago on my right knee. The surgery was for a large oblique medial meniscus tear. My doc said the OA in my right knee is grade 2 (they can "see" it much better during the surgery than only from Xrays and MRIs.
I recovered very well from the 'scope. I had a spinal anesthetic and came home the same day. I had the surgery on a Friday and only missed one day of work post-op before returning to work.
Today both my knees are doing very well. I have swelling behind my right knee--- my doc says it is a Baker's cyst---but both will swell and hurt if I over-do it.
We are hoping the 'scope will buy me several years before needing a PKR on that knee too.

Good luck.

 

[Nursepair]

Hey Beach!! So good to see you back. Missed you lots. Glad your knees are doing better. How is the back now? ((((HUGS))))) Sue

 

[beachcomber]

Hi Sue--
Just coming up for air. I have been so busy at work, then just come home and collapse. Nice to hear from you too! Take care good friend(s)!
Beach