Last week my left knee popped and locked, for two days I was unable to fully straighten it. I went to doctor (GP) who examined it and scheduled me for orthopedist (surgeon) for today.
The surgeon poked and prodded, asked a couple of questions and deemed that I need surgery soonest. He assumes that it most probably a torn medial meniscus (been there, done that with the right knee) however he expressed concern that something else may have broken off and is loose in there since my knee locked for so long (cartilage?).
I’m to expect a phone call tomorrow to set up the surgery in the next two weeks. Talking about it doctor appears to want me to get this done ASAP. I am puzzled, there was an x-ray taken but no MRI or CAT scan. My understanding is that x-ray does not show soft tissues well enough to diagnose issues like this. When my other meniscus tore, folded over and formed a cyst, the surgeon who did that waited nearly 2 months, took two MRI and seemed reluctant to operate.
When I had my right knee done I was on crutches for 2 weeks, complete bed rest for 3 days. This doctor says that I will be walking out of the clinic without crutches, further I will be up and about in 3 days no bed rest needed. Has the surgery changed in some way to reduce the bed time and crutch time?
Now according to this doctor he can operate on both at the same time and I will be ambulatory within days after the surgery. As I recall when part of my right meniscus was removed, shaved down, I couldn’t put any pressure (weight) on it for nearly a week without it buckling.
He wants to operate on my right knee since it has been giving me issues for over a year now. The MRI taken on that shows a possible new tear in what remains of the meniscus (medial), the other surgeon who looked at it said she did not want to operate on it. Also old Arthur Itis has made a stand in that joint. For a year I have been told that nothing can be done and that I just have to bear with it until I’m in my late 50’s early 60s since my only option would be a total knee replacement which no surgeon (so I was informed) wants to do that on a young person because the joint will wear out and replacement of that replacement joint is a harder surgery to do.
Both doctors work at the same office (Partners?) yet both have radical views on how to deal with my right knee – one does not want to touch it, the other is nearly eager to throw me on a table and poke around in the joint. Though when my Left knee locked I was pretty certain that it was a torn meniscus (once you tear one when the other goes you know the symptoms enough to know what is coming next) so I assumed an operation a month down the road or so. I was kind of amazed at the suddenness and the urgency to have this done so soon.
I opted for having one then the other done later when the first heals. Was this a good idea?
Maybe because I have better insurance things are going faster? Or should I be a bit more concerned that things are going this fast?
Lastly the surgeon said there may be a need to biopsy what ever they take out of the left knee. I do not recall a biopsy on the stuff taken out of the right knee – Is this now standard procedure to biopsy removed tissues?
Posts: 4070 | Location: Neither here nor there | Registered: 06-03-02
I know that new surgical techniques do allow for faster recovery of knee repairs.
I do think that not having them done at the same time is a good idea. If you are NOT mobile and recovering quickly, at least you are not totally laid out because at least you can stand and hobble to the bathroom etc with the other leg.
As for biopsy, maybe the doctor saw an unusual mass or spot on the x-ray that he wants to check out. Biopsy is not a frequent part of this surgery that I recall. Of course, I may be wrong, but I don't THINK that I am.
CAT scan has quite a few side effects with multiple uses (more radiation than X-rays), so many physicians opt to use it sparingly.
Due to the use of the strong magnet, MRI cannot be performed on patients with implanted pacemakers, intracranial aneurysm clips, cochlear implants, certain prosthetic devices, implanted drug infusion pumps, neurostimulators, bone-growth stimulators, certain intrauterine contraceptive devices, or any other type of iron-based metal implants. MRI is also contraindicated in the presence of internal metallic objects such as bullets or shrapnel, as well as surgical clips, pins, plates, screws, metal sutures, or wire mesh.
If not, I don't know why he didn't choose to do further scanning with the MRI. Perhaps you should ask for a more complete analysis with an MRI. It is a discussion that you should take up with your doctor if you have any doubts.
If you are truely worried, why not see a totally different orthopaedic surgeon for a third opinion since these two seem to not concur with each other.
Posts: 9153 | Location: PA, USA | Registered: 06-05-02
Hey David - - I've had both done for exactly the same thing. I had the full surgery on both and the arthroscopic later on one knee. While I can't comment on the timing and such - - just a word of advice. Do not, I repeat, DO NOT let them do this under local anesthesia! I've had it done under local once and it was horrible!!! I did have arthroscopic surgery a second time on the same knee (yep, a total of 4 surgeries on my knees!) and had it done under general - - MUCH better! Good luck with everything!
Originally posted by Sherasi: Are you going to try to get another opinion.. or are you going to have the surgery as scheduled?
In order for me to get a second opinion (according to my GP) at the Stone Clinic I would have to wait a month for that to clear through my insurer since the Stone Clinic is a specialized clinic that deals only with knee and sports injuries. It appears that though they are usually accepted by my insurance carrier, my insurance carrier does not always opt to pay for that. My right knee (which has been a long term illness) can wait for the stone clinic and my insurance to go through a couple three times to be approved. Most likely I am still young enough for a meniscus replacement from a donor, but too old for a meniscus repair in the right knee.
My GP said that waiting another month would lead to more injury which would lead to more surgery and that since there is an obvious "cyst" in the left knee to have that removed immediately is going to be the diagnosis from any doctor. (I assume they saw this cyst in the x-ray but failed to mention it?)
Of course a "cyst" was not mentioned until my last visit (this morning).
Frankly I am a bit miffed by the bed side manner thus far and the apparent inability to inform me of everything going on.
Yes I am going through with the surgery as scheduled – as it stands my knee is all achy and “weak” it has failed me a couple of times already this week. Since I have no jobs lined up (big jobs) for a month now is as good as any other time to have this attended too.
Posts: 4070 | Location: Neither here nor there | Registered: 06-03-02
Originally posted by Lydia: Hey David - - I've had both done for exactly the same thing. I had the full surgery on both and the arthroscopic later on one knee. While I can't comment on the timing and such - - just a word of advice. Do not, I repeat, DO NOT let them do this under local anesthesia! I've had it done under local once and it was horrible!!! I did have arthroscopic surgery a second time on the same knee (yep, a total of 4 surgeries on my knees!) and had it done under general - - MUCH better! Good luck with everything!
I'm opting for the needle in the back - I forget the name, they give it women who are giving birth.
When my right knee was operated on I was awake, though dead from the waist down. The idea of being asleep is not appealing to me.
Posts: 4070 | Location: Neither here nor there | Registered: 06-03-02
I think it's called an epi-somethingoranother! That'll work too - when they did mine the first time, all they did was give a novacane kinda thing to the knee area - - that was NOT a good thing!
I got to see the Aneste-stes-sthess – I can’t spell it or say it- The doctor who administers the drugs during the procedure.
I told him I wanted to be awake (To tell the doctor just how the procedure should be done) and he said the needle is fine, though most patients prefer to be put to sleep, er, um, under general anesthesia.
I found out that I am not really a smoker - My oxygen sensor was at 98-99-98-99 % (it kept going back and forth) The nurse who did my vitals was duly impressed and checked no for smoking based on the reading. Once corrected and telling her I have been smoking since 13 (over 20 years) she was surprised. I’m clear to go tomorrow morning. I shudder a little, I’m a little nervous.
I’ll have Danny put in the out come here tomorrow afternoon BTW.
Posts: 4070 | Location: Neither here nor there | Registered: 06-03-02
The operation was a success - I am home, have only used the crutches to get up the steps.
They decided a general at the last minute for a swifter recovery in the recovery room. I woke up before even reaching Recovery.
I'm still a tad bit woosy, and the cyst and half of my meniscus is now gone. According to doctor it appears that there have been repeated injuries (scar tissue).
Still going to biopsy the cyst however the doctor is optimistic that it appears benign and is most likly a meniscus cyst - however to be safe they will biospy the cells to cover all bases.
Cheers
David
Posts: 4070 | Location: Neither here nor there | Registered: 06-03-02
DvdGStwrt, I'm happy to hear everything went OK with your surgery. Get well soon.
quote:
The doctor who administers the drugs during the procedure.
Anesthesiologist in U.S., anaesthetist in Canada and U.K. The U.S. also uses nurse anesthetists.
quote:
My oxygen sensor was at 98-99-98-99 % (it kept going back and forth) The nurse who did my vitals was duly impressed and checked no for smoking based on the reading. Once corrected and telling her I have been smoking since 13 (over 20 years) she was surprised.
Usually you'd have to have significant lung disease to have a lower than expected reading on the pulse oximeter, so don't infer too much from it. A normal oxygen saturation level unfortunately does not rule out smoking-related lung injury (excess mucus, bronchospasm, reduced capacity, etc.) that may have developed or be developing.
Once you recover from surgery, get a chest x-ray, see a doctor, etc. -- and of course keep trying to quit smoking. Good luck!
Posts: 2100 | Location: U.S. | Registered: 06-03-02
I'm glad to hear that you are home and apparently well on your way to recovery, David. I am also glad to hear that the operation is much better than it used to be, since I am probably facing it in the not-to-distant future. My oxygen level was at 97%, and I was also surprised, since I have smoked for almost 40 years. X-rays showed no problems, and I am trying to quit while I am "ahead." My father smoked for almost 70 years, and was worried that he would get emphysema if he didn't quit. He died from kidney failure, and his lungs were still clear. I don't think I will try to best him in this.
Posts: 17630 | Location: Lincoln Place, Granite City, IL, USA | Registered: 06-03-02
Here I am day two and able to limp through the house unassisted (no cane or crutches).
The knee aches but really not much worse than before the surgery - the worst part is the muscle pain where the instruments cut through some muscle. Now the itching where the wounds are healing. Well I did over do it, walked too far and got the knee to throbbing this morning. There is an occasional tweak of pain if I move too fast or twist or turn the knee too far.
I've been icing for 20 minutes every hour - only had 3 vicodine today - been exercising and moving it, resting it up on a pillow mostly, took a few short walks outside with cane - I find the knee starts getting wobbly after a short walk - I am utterly amazed at how easy this is.
Under the bandage there is tape holding the two small holes closed. One is still seeping a bit of blood, but the swelling isn’t too terrible and the bruising is not that bad either (I usually bruise rather easily). I changed the gauze and rewrapped after my bath (vision sitting in about 2 inches of water, leg up over the side to keep the knee dry).
Last time was extremely painful I was on crutches for nearly 2 weeks and in agony enough to go to ER twice. I was doubtful that I would really be able to get about without crutches and really doubtful about there being just a little pain do to my last experience.
I’m still sleepy and still groggy – It might be that I have become sensitive to vicodine?
Posts: 4070 | Location: Neither here nor there | Registered: 06-03-02
