PKR My Drama Queen Patellofemoral Knee

So sorry to hear of your troubles and particularly your recent fall.
I understand the problems of trying to disentangle multiple joint issues and feeling that doctors don't always believe/ trust your feelings that it is the knee causing the problem. I guess just keep pushing for a knee MRI to see what is happening.
I still have some medial twinges ( admittedly only 14 weeks post op lateral pkr) and some tightness at the front of the knee- which my surgeon feels are soft tissue issues (stressed medial collateral ligament and patella fat pad) and will settle. Who knows? I agree with your concern about further surgery though . I just wish I had a definite prognosis but I guess that is impossible. But it is that uncertainty that doesn't help the anxiety.
Jockette, I hope you get some answers soon. I went to an orthopaedic urgent care after I couldn't walk up my driveway. They did an xray first and said my knee looked ok but ordered a MRI just to make sure. The MRI showed the real damage. Then I made an appointment with ortho. Few years back it took weeks before they would order a MRI of my knee after a fall playing soccer with my grandson. That time I had seen the orthopedic doctor first. Why it makes a difference is a mystery and I know frustrating!
Jockette, good for you for pushing for further opinions and real answers after all you’ve been through with your knee. Don’t give up! Get a 4th opinion, and a 5th (6th!) if necessary. Somebody needs to figure out that knee, :censored:

It took me 2 years of pushing and 5 orthos to finally get a diagnosis of my knee. My x-rays looked fine, plenty of joint space. Finally got somebody to do an mri and it looked fine too. Every doctor I saw kept telling me nothing was wrong with my knee. I could barely walk! I was starting to think it was all in my head and I was losing my mind.

Finally, a wonderful surgeon decided to do an arthroscopy and look inside there. And it turned out I had 4 out of 4 damage to my cartilage in two places and was bone on bone with tons of edema. The mri everyone had been working off of was faulty, though no one could explain why. As for the x-ray, the cartilage surrounding the damage was full thickness so it appeared as if I had plenty of joint space. Everyone had been saying my knee was fine, but I knew it was NOT fine and had to fight to get answers and get it fixed.

All that to say, (I’m so sorry, I cannot write a short post to save my life) keep fighting for that knee and your quality of life! You deserve some answers and somewhere, there is the surgeon who will find them for you. I am behind you all the way Jockette
Your situation is so incredibly frustrating. Many issues do not show up on an MRI or x-ray, including popliteal tendinopathy. Issues with the popliteus typically cause pain on the lateral back side of the knee. Doctors have discovered a new physical exam for the problem—lie on your side with the bad leg on top. Raise the top leg and then flex the knee to 90 degrees. If you feel pain, that is probably the popliteus. (See the link to the article below)

I hope that you can find someone who will do arthroscopy to see what is going on. I’m going to a surgeon in Altoona for my surgery next week. She is a sports medicine doctor who does not do replacements but does arthroscopic procedures after TKR. She is in the same practice as my TKR doctor and is consulting with him about this.

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Jockette, Have you checked out Dr. Joseph Alhadeff? He is at OSS Health in York Pa. They also have an ortho urgent care. My daughter used to work for OSS and he is a highly respected doctor.
I‘ve had some concern for my hips for a while now, so he did X-rays of them, and they are fine, so that’s good. They don’t seem to be affecting my knee issues.

On the hip X-ray he saw the lower part of my spine, so I have a lumbar MRI scheduled for the end of February. He thinks maybe my spine is the cause of some of my knee issues.
My doctor, himself, called today. I was away from my phone but he left a voicemail, which is better, I can replay it if I need clarity on anything he said.

He was very nice. He said my MRI looked good. Some arthritis, but nothing to be concerned with. He didn’t see anything that would suggest nerve impingement, which would cause some of the issues in my knee. He sees no need for any surgery. He said if things worsen in the future, he’d be happy to look at the situation again. No mention of any further tests actually on my knee, and he basically dismissed me.

Same old, same old, as my other second opinions. I really believe that whatever my issue is, it’s so elusive that they don’t really know what to look for. Not that any of the 3 second opinions have done any specific tests actually on my knee. I would think that with the level of experience with revisions that these men have, that they would look for something, if they thought there was something to look for. When all 3 agree, I have to trust they they know what they are doing.

I’m relieved that I‘m not facing a revision, and all that entails, at this time, considering all the PTSD issues I have from this whole PKR experience. But also means I am stuck in this situation, but I could be a lot worse. Whenever I go through these second opinions and they say no surgery, I come out feeling free as a bird!

Maybe some time in the future something will happen that will cause a fixable issue. Apparently that time is not now.

I can’t keep going through all the PTSD stress of preparing for these second opinions so I’ll just wait and see what happens in the future. I won’t be making a fourth second opinion appointment unless it’s necessary. I don’t view this a “giving up“ but rather as accepting the current situation.

My knee has healed well from the fall. I’ve been using some CBD cream that I bought at my chiropractor’s office, and I think it may be helping the sensitivity to settle a little. When this jar is done I might look into some essential oils, my sister had a good result with that recently, for an issue she had.

On to my upcoming cataract surgery! :dubious:

(I’m so sorry, I cannot write a short post to save my life)
As you can see, I can’t write a short post, either! :heehee: Have you read my first one?
Now that I’m feeling much better from the fall, I’m ok with this outcome. As always, things could be much worse. And, knowing that revision surgery is not looming in front of me, I feel free as a bird!

On to my upcoming cataract surgery! :dubious:
Good luck for the cataract surgery.
Glad you have recovered from the fall and no revision surgery is necessary.
Sorry you still have issues but pleased the sensitivity is better.
I'm glad the CBD cream is helping you. I haven't tried that but found an older tube of Diclofenac cream that was prescribed a few years ago that I'm using on my aches and pains and it's helping. You have to have a prescription for it, so if the CBD cream isn't working as well as you hoped, you can ask the doctor about the Diclofenac cream. It's much better for the tummy than the pills!
You can get 1% Diclofenac gel on Amazon without a prescription.

It is still an NSAID so if you use the maximum dose you cannot take any other NSAIDs such as aspirin, ibuprofen, or naproxen (Aleve). You can still take acetaminophen (Tylenol) though since that is not an NSAID.
I’m happy you’re relieved that a revision isn’t happening any time soon.
Thanks. It’s such a conundrum. I don’t understand why they won’t do an MRI, or CT scan, or something, of my knee, but when 3 highly skilled revision surgeons, from 3 different locations, all come to the same non conclusion, and don’t offer further tests, I have to think that maybe they are right, at least at this time.

My recent surgeon did say in his voice mail that if in the future anything comes up that gives him a better idea of what to look for, he’d be happy to reevaluate. So, he has dismissed me, but we are parting on good terms, leaving the door open for the future.

My knee really does feel a bit better very recently. Maybe the fall jolted some sense into it :heehee:, or maybe the CBD cream I’ve been using for about a month is doing something.

Either way, while not great, it’s definitely something I can live with. When I read so many other posts here, I’m grateful my poor outcome isn’t any worse.

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