PKR Raffs' Recovery Thread<'
- Thread starter Raffs
- Start date
New Zealand
OP
OP
Raffs
graduate
Appointment with OS this morning.
I told him about my on-going pain and problems. He examined me and could obviously tell very quickly that things aren't quite right.
I'm having an MRI scan on Friday. He wants to look at my patella tendon, fat pad and all the surrounding soft tissues.
Depending on the result of the scan, he said he might give me a 'platelet-rich plasma injection' which he said should relieve pain and speed up healing. Apparently, this is something to do with taking some of my blood, putting it in a centrifuge and then injecting it into my knee!
@Josephine and @Celle - any views/experience of this type of injection, please?
He isn't concerned about the implant - checked my ROM and general movement and said he thinks it is fine.
Bit annoyed that I can't get to see him for a follow-up after the MRI until March 12th but I am on the wait-list for a cancellation. I am supposed to be attending an important Conference over Easter so would ideally like any treatment carried out before then if at all possible.
@momweb - have tagged you as I know you'll be interested in all of this.
PT tonight - may update again tomorrow depending if he says or does anything of interest!
Thanks for reading.
I told him about my on-going pain and problems. He examined me and could obviously tell very quickly that things aren't quite right.
I'm having an MRI scan on Friday. He wants to look at my patella tendon, fat pad and all the surrounding soft tissues.
Depending on the result of the scan, he said he might give me a 'platelet-rich plasma injection' which he said should relieve pain and speed up healing. Apparently, this is something to do with taking some of my blood, putting it in a centrifuge and then injecting it into my knee!
@Josephine and @Celle - any views/experience of this type of injection, please?
He isn't concerned about the implant - checked my ROM and general movement and said he thinks it is fine.
Bit annoyed that I can't get to see him for a follow-up after the MRI until March 12th but I am on the wait-list for a cancellation. I am supposed to be attending an important Conference over Easter so would ideally like any treatment carried out before then if at all possible.
@momweb - have tagged you as I know you'll be interested in all of this.
PT tonight - may update again tomorrow depending if he says or does anything of interest!
Thanks for reading.
CATSMUM
post-grad
That's quite a long wait for you, hopefully, you'll get a cancellation and get into see him before then.
I'm due to see my OS in an hour or so about my troublesome knee, will update my thread when l get back.
Good luck for tonight with the PT.
I'm due to see my OS in an hour or so about my troublesome knee, will update my thread when l get back.
Good luck for tonight with the PT.
I'm sorry, but I don't know anything about those injections.
That's only about two and a half weeks, which doesn't seem too bad to me and you could still get a cancellation.
momweb
graduate
@Raffs I found this information online. I've heard about platelet rich plasma for healing before. Not too many doctors around here use it for some reason, it could be insurance, but I'm not sure. Since your issue seems to be a patellar issue, it may work really well. I'm anxious to hear how it all works out.
"Chronic Tendon Injuries
According to the research studies currently reported, PRP is most effective in the treatment of chronic tendon injuries, especially tennis elbow, a very common injury of the tendons on the outside of the elbow.
The use of PRP for other chronic tendon injuries — such as chronic Achilles tendonitis or inflammation of the patellar tendon at the knee (jumper's knee) is promising. However, it is difficult to say at this time that PRP therapy is any more effective than traditional treatment of these problems." https://orthoinfo.aaos.org/topic.cfm?topic=A00648
"Chronic Tendon Injuries
According to the research studies currently reported, PRP is most effective in the treatment of chronic tendon injuries, especially tennis elbow, a very common injury of the tendons on the outside of the elbow.
The use of PRP for other chronic tendon injuries — such as chronic Achilles tendonitis or inflammation of the patellar tendon at the knee (jumper's knee) is promising. However, it is difficult to say at this time that PRP therapy is any more effective than traditional treatment of these problems." https://orthoinfo.aaos.org/topic.cfm?topic=A00648
Rob 68
member
@Raffs @momweb I looked into PRP a while back (BKK - Before Knew Knee), and back then it was still considered experimental treatment, hence no insurance coverage. I had a friend who was bone-on-bone, and she took the treatment. She told me it was not very pleasant, but she felt it worked well enough to keep her moving and away from surgery. However, she had to give up running. Haven't checked back with her since leaving the D.C. area, so can't offer any long-term details. I never heard of the procedure being used post-knee replacement, but the doc must know what he's doing. Good luck.
OP
OP
Raffs
graduate
Thanks for your comments, much appreciated.
Got a copy of the letter my OS has sent to my GP. He says:
'....she is still suffering with pain over the soft tissues particularly around the patella tendon. Occasionally she feels there is a catching movement in the joint. Her symptoms are exacerbated by loading the knee in flexion ie walking up and down stairs. There is some residual swelling over the anterior aspect particularly about the patella tendon. She has excellent ROM with full extension and flex to 135. I think her symptoms are due to swelling in the patella tendon and possibly the fat pad. I have arranged an MRI scan to look at these areas in detail. Treatment may consist of a PRP injection to the areas of inflammation.'
I had the MRI scan on February 26th. I'm seeing the OS again on March 12th. So now we wait.....
BTW, I've just realised that in the 9 months or so I've been on this site I've never heard anyone say that they have a female OS!!!!
Got a copy of the letter my OS has sent to my GP. He says:
'....she is still suffering with pain over the soft tissues particularly around the patella tendon. Occasionally she feels there is a catching movement in the joint. Her symptoms are exacerbated by loading the knee in flexion ie walking up and down stairs. There is some residual swelling over the anterior aspect particularly about the patella tendon. She has excellent ROM with full extension and flex to 135. I think her symptoms are due to swelling in the patella tendon and possibly the fat pad. I have arranged an MRI scan to look at these areas in detail. Treatment may consist of a PRP injection to the areas of inflammation.'
I had the MRI scan on February 26th. I'm seeing the OS again on March 12th. So now we wait.....
BTW, I've just realised that in the 9 months or so I've been on this site I've never heard anyone say that they have a female OS!!!!
CATSMUM
post-grad
Neither have l!
Wish my ROM was a good as yours, I've gone from 110 to 95 according to my OS!
There are a few female OSs around, but not many (yet). Orthopaedic surgery is often hard and heavy work, requiring considerable strength. That's why it used to be almost exclusively a male profession.
charmed-life
graduate
At my clinic, there are 3 female orthopedic surgeons and 5 male. The women are mostly younger - 30 or 40 years ago there were fewer women in medical school and it was even more rare in things like orthopedics. But it seems to be evening out now. My daughter is a urologist, also few women in that field.
Sent from my iPad using BoneSmart Forum
Sent from my iPad using BoneSmart Forum
momweb
graduate
I just realized that you said you would see your OS on March 12th. That's a Saturday. Your OS is not only female, but sees patients on Saturdays? Wow! That's not something we see very often.
OP
OP
Raffs
graduate
@momweb Yes, he (not a she, I was just making a casual observation about the lack of female OS's, lol) sees patients on a Saturday. In the UK, consultants work for the NHS (National Health Service) during the daytime (generally) and do their private work early mornings, evenings and weekends (again generally but of course this varies hugely from consultant to consultant).
OK, bit of an update. Received a letter by email from the OS today:
'I have reviewed the MRI scan which shows inflammation of the patella tendon which is the area of soft tissue below the kneecap. This would account for your ongoing symptoms. I think it would be appropriate for you to undergo a platelet rich plasma (PRP) injection into the area of inflammation of the patella tendon to try and settle down this inflammation. There may be a requirement to have a follow up ultrasound and a further injection depending on the progress in the soft tissues.'
I have an appointment for the injection at 6pm on March 15th. That's the good news.
The bad news is that our health insurance won't cover it as they say it is an 'unproven' treatment. Consultant insists that it is proven and he has been using it for several years. Husband and I have both been on the phone this morning having words with the insurance company. At present, they are still saying no but will reconsider if we can send them a copy of the letter from the OS (done) and some documentation about PRP injections (requested from the OS).
So looks like we will be paying for this ourselves and it ain't cheap. But what else can I do? I need to try it as this appears to be my OS's recommended treatment for this condition. I have used our health insurance for everything to do with my knee so far and haven't been via the NHS. It won't be possible to use the NHS now as I've already bypassed them by having everything done privately. I probably could ask my GP to refer me to the NHS but I dread to think how long the wait would be, months and possibly even into a year or so.
Anyway, ending on a positive note - I have a diagnosis, I am not losing my mind and imagining things, I have been right for months about my patella tendon and I have treatment booked. Onwards and upwards....
Thanks for reading. Hope everybody is doing well.
OK, bit of an update. Received a letter by email from the OS today:
'I have reviewed the MRI scan which shows inflammation of the patella tendon which is the area of soft tissue below the kneecap. This would account for your ongoing symptoms. I think it would be appropriate for you to undergo a platelet rich plasma (PRP) injection into the area of inflammation of the patella tendon to try and settle down this inflammation. There may be a requirement to have a follow up ultrasound and a further injection depending on the progress in the soft tissues.'
I have an appointment for the injection at 6pm on March 15th. That's the good news.
The bad news is that our health insurance won't cover it as they say it is an 'unproven' treatment. Consultant insists that it is proven and he has been using it for several years. Husband and I have both been on the phone this morning having words with the insurance company. At present, they are still saying no but will reconsider if we can send them a copy of the letter from the OS (done) and some documentation about PRP injections (requested from the OS).
So looks like we will be paying for this ourselves and it ain't cheap. But what else can I do? I need to try it as this appears to be my OS's recommended treatment for this condition. I have used our health insurance for everything to do with my knee so far and haven't been via the NHS. It won't be possible to use the NHS now as I've already bypassed them by having everything done privately. I probably could ask my GP to refer me to the NHS but I dread to think how long the wait would be, months and possibly even into a year or so.
Anyway, ending on a positive note - I have a diagnosis, I am not losing my mind and imagining things, I have been right for months about my patella tendon and I have treatment booked. Onwards and upwards....
Thanks for reading. Hope everybody is doing well.
OMG! I hope that's a typo and you meant to say 1 year to 18 months. It has been hard enough being patient for that outer limit when it was 18 (vs 28). Ugh.
Great news on getting the MRI update in advance. I investigated PRP as a pre-surgery alternative. It was not covered by my insurance, was not administered by anyone in my old OS' rather large practice (Rothman), was quite expensive and did not have evidence that it would do anything for severe OA. With that said, it seemed a joint treatment that should gain in popularity as more cases are available. It makes good conceptual sense to me (take that with a grain of salt since I am not a healthcare professional).
momweb
graduate
@Raffs glad to hear you got your results sooner than you thought and that you are not losing your mind. 
(At least not with this issue, anyways). It's such a good feeling when you know you've been hurting, you know why you've been hurting and now you have proof. Such a nice validation!!! It's too bad that the cost of taking care of it falls on your shoulders. But I'm with you; after all we've been through, if I could afford it, I'd be paying for this treatment and praying it works as you are. How soon after you receive the injection will know if it worked?
(At least not with this issue, anyways). It's such a good feeling when you know you've been hurting, you know why you've been hurting and now you have proof. Such a nice validation!!! It's too bad that the cost of taking care of it falls on your shoulders. But I'm with you; after all we've been through, if I could afford it, I'd be paying for this treatment and praying it works as you are. How soon after you receive the injection will know if it worked?
OP
OP
Raffs
graduate
@hawk2go It seems that PRP is a recognised treatment for tendon problems but not for OA. We are arguing with the insurance company that I am not having the injection for OA but for tendonitis. My sister-in-law told me yesterday that her friend had a PRP injection for her tennis elbow and the result was 'immense'.
@momweb Two weeks. Possibly sooner. If I don't feel any difference after two weeks then I'll know it hasn't worked. I'm now seeing my OS on March 29th instead of March 12th (no point seeing him before the injection) to get a full report on the MRI scan and also to discuss the success (or otherwise) of the injection. With regards to paying for it, we will need to dip into our savings but as my husband said last night 'well, we can't take it with us when we go'. I don't mind sharing how much it is going to cost - £850 which is approx. $1200. A lot of money but if it works I'm guessing I'll feel it was worth every penny/cent. Somebody said this to me yesterday - work out how many days of your life you potentially have ahead of you and divide by £850 - the cost per day will (hopefully) be so small compared to getting your quality of life back. So very true.
@momweb Two weeks. Possibly sooner. If I don't feel any difference after two weeks then I'll know it hasn't worked. I'm now seeing my OS on March 29th instead of March 12th (no point seeing him before the injection) to get a full report on the MRI scan and also to discuss the success (or otherwise) of the injection. With regards to paying for it, we will need to dip into our savings but as my husband said last night 'well, we can't take it with us when we go'. I don't mind sharing how much it is going to cost - £850 which is approx. $1200. A lot of money but if it works I'm guessing I'll feel it was worth every penny/cent. Somebody said this to me yesterday - work out how many days of your life you potentially have ahead of you and divide by £850 - the cost per day will (hopefully) be so small compared to getting your quality of life back. So very true.
I hope this works for you. The description of the procedure reminds me a bit of how the doctor described a "blood patch" that can be given after a back injection. Crazy question, but wouldn't a cortisone shot also reduce the inflammation? What is the advantage to PRP over cortisone?
My PT suggested "shocking" the area where I am hurting. It looks like I have a pocket of swelling directly over the new joint, as well as a bit of pain at the tendon ends. To shock the area, he said to freeze water in a Styrofoam cup. Then peal away the bottom of the cup. Use that small circle of ice and rub it on the knee for 5 minutes (not longer). It will go to cold, painfully cold, and then numb.
My PT suggested "shocking" the area where I am hurting. It looks like I have a pocket of swelling directly over the new joint, as well as a bit of pain at the tendon ends. To shock the area, he said to freeze water in a Styrofoam cup. Then peal away the bottom of the cup. Use that small circle of ice and rub it on the knee for 5 minutes (not longer). It will go to cold, painfully cold, and then numb.
OP
OP
Raffs
graduate
@iamshrdlu Thank you. Cortisone masks pain and does not repair the injured tendon. PRP injections have healing properties that alleviate inflammation and pain as well as encouraging cell growth and tissue regeneration. As PRP injections use your own blood the risks and complications are less than with cortisone. This is what I've been told anyway! I've seen that 'shocking' technique mentioned somewhere else on here, I think. I may give it a go tonight - thanks!
momweb
graduate
@Raffs from what I've read about PRP, you are right, steroid injections help inflammation where PRP helps heal injuries such as elbow tendonitis and knee tendons. It hasn't been used enough to have it a proven medical procedure which is a shame. Every time a new procedure comes around it takes years (look at stem cells) or even mother's umbilical cord cells and how valuable they are to the healing process. But they are considered experimental and insurance won't take a chance on paying for something that won't work. But they'll continually pay for steroid injections that many times don't work. Go figure. I'd pay $1200 in a heartbeat, and I'm retired, if I even had a chance that the pain in my knee would go away for good. So, kudos to you, kid. I'm sending good thoughts across the ocean your way!!
tdawgs
junior member
I was offered PRP and a stem cell injection procedure prior to my surgery. Unfortunately Insurance doesn't cover either one of the procedures and they are both very costly. The PRP was a series of 3 injections (prior to surgery) and I believe the stem cell procedure was 2 injections. Both procedures have really good outcomes so far. I have a daughter in college and we're paying dearly to keep her in school, so we just didn't have anything extra to be able to afford either one of these procedures. I would have gladly tried both before having had surgery. I hope you get Insurance approval and have a successful outcome!
