PKR/TKR when NOT bone-on-bone

[cabland]

This is the conclusion of my MRI findings. The more detailed reporting did talk about some "deep chondral fissures " on the medial and patellofemoral compartments but overall it is reported as moderate arthritis.
Wonder if your Grade 4 in those compartments suggests a lateral PKR might not be enough? I would be asking my surgeon about that and whether the level of arthritis in all three compartments meant a TKR.

Complex tear affecting the anterior horn and body of the lateral meniscus with severe lateral tibiofemoral chondrosis.

Moderate medial tibiofemoral chondrosis affecting the weightbearing medial femoral condyle.

Severe pes anserine bursitis. Semimembranosus bursitis demonstrated in addition and there is a Baker's cyst as described.

Moderate patellofemoral chondrosis.

Large knee joint effusion with synovitis.

Agree with your comment about the TKR vs PKR given what I've read. Really appreciate you sharing all of your details here.

 

[JusticeRider]

Hi @cabland , I agree with @EalingGran . I had a patellofemoral PKR, but I absolutely would have opted for a TKR instead of a PKR if multiple compartments of my knee had had significant damage, as yours do. It sounds like your patellofemoral compartment is in bad shape as well as your lateral AND medial.

 

[Grammy57]

I have some of the same questions. I have made an appointment with a knee surgeon for next week, 8/31/23. My knee has been getting progressively worse. I have trouble with stairs and cannot walk as far as I used to. But today is the worst so far. I went to turn around and my knee "popped" so severely I wasn't sure if I heard it or just felt it. I could not put weight on it and barely got to the couch. It hurt all the way through, front to back. The back of my knee has never hurt. The pain is usually on the interior side and then radiates around the kneecap and sometimes under it. Sometimes it swells slightly. Sometimes the pain goes down my shin and/or up into my thigh. Today I can't even lie on my stomach because it causes too much pain in my knee. In 2017 I had the same pain (not today's pain) and a 'scope showed I had plica so bad/long that it had worn a groove in the kneecap. Clipping the plica helped for a couple of years. I'm not sure what to think but sure hope the Dr provides answers to help me heal.

 

[Grammy57]

If you are in severe, persistent pain and your ability to function is decreased, you really are candidate for a PKR or TKR. If it was me, I'd find another surgeon!

I saw the surgeon yesterday. He said my x-rays showed only minimal degeneration and my pain wasn't from arthritis. He said it was pes anserine tendonitis. I mentioned having plica removed on that knee in 2017 so he added I also had plica on my PT 'script. On the visit summary, he also added internal knee derangement. He gave me the PT 'script, an injection, and a prescription for Meloxicam then told me if I wasn't better we'd re-evaluate. I'd like to see another surgeon but he's in the same group and I'm afraid he wouldn't do anything.

 

[Mutti3]

@Grammy57
Some dr don’t allow you to see another OS in same practice. Have you thought about going to OS that has no association with current OS?

 

[cabland]

I have my own next appointment on the 14th. As a bonus, my "other" knee (that is bone-on-bone) is now giving me grief. Hoping to plead my case!

 

[kneeper]

Tendonitis and bursitis can be very painful. I think it makes sense to have your doc give you a good explanation of what's what.

 

[Grammy57]

I saw PT today. I start twice a week next Tue for 4 weeks and re-evaluate from there. Now my other knee is occasionally hurting. Ugh.