Do I need MRI or CT b4 getting Arthroscopy? How long is recovery?

Dub47

Hi,

I am a 34 year old female, healthy and quite active. I cycle to work and home each day (15 mins each way), go to Curves 4 times a week and I do fast power walks a few times a week.

I have had knee pain for a few months now and have been going to a physio for 2.5 months trying to relieve it. He diagnosed the problem as tendinitis and id some work to loosen up all the built up scar tissue in the knee, i iced my knees to reduce swelling and i did exercises to bulk up my quad muscles, etc. he also told me not to do any running, jogging or any real impact aerobics or hard impact cardio at Curves. This worked well initially and my knees improved about 80% but when the pyhsio had me start to add back in some bounding (jumping) exercises my knees went straight back to the pain and they have not improved since.

The physio was at a loss as to why this was and seeing as i had lost 1 stone, 7 pounds during the treatment time you'd think my knee pain would have disappeared. The pain is mainly there when walking down stairs and when i am sitting on the couch with my legs in the same position for a while. my knees are also very stiff when i wake up in the morning and i have to limp a bit going down stairs. in general when i walk they do not hurt but if i tried to run they would feel like they would not hold up through all that impact.

i also stopped the fast walks for 2 weeks to see if that helped but it did not so the physio referred me to a knee specialist. the specialist examined me and moved my knee and kneecap around a bit, pressed all around my knee, etc. i feel a good bit of pain in many areas when he pressed in - on the side of the kneecap and on the side lower down and in quite a few places on and around the kneecap. my left knee is definitely the knee that is the most painful.

anyway he said that he does not need to do an MRI as he does not think i've torn anything. he thinks we need to do an arthroscopy and once he sees everything he will do whatever is necessary to fix the problem. he said the issue is under my kneecap.

anyway, after thinking about everything now i am just a little hesitant that no x-rays or scans were done. is this not necessary or advised before proceeding with a serious surgery requiring general anesthetic? i have Vhi and this will cover the procedure but a 2 week recovery period off work after the operation and then 4-6 weeks before i can really exercise properly again scares me so i want to be sure i need this operation!

also during the recovery period how much can i really do? my physio and the consultant say that i have great quad bulk and strength so this should help speed up recovery but i am worried about not being able to do the level of exercise i am used to. i am getting married in a few months and now was supposed to be my final push to lose weight and get as fit as possible. instead i am looking at being incapacitated and/or unable to do much. please help me - what will i be able to do for exercise and how soon will i be able to get back to my old routine???

i'd really appreciate any advice...

thank you!

bwardrop

Simple - follow the advice the consultant gave you. They will know best.

DM-BM

Simple!!! not in my eyes. He' s human and can fcuk up just like anyone else.

If i was in your position OP, i would need a second or third opinion and even at that nobody would be operating on me without first showing me what was wrong or at very least trying to.

siochain

DM-BM wrote: »

Simple!!! not in my eyes. He' s human and can fcuk up just like anyone else.

If i was in your position OP, i would need a second or third opinion and even at that nobody would be operating on me without first showing me what was wrong or at very least trying to.

exactly

ronbyrne2005

DM-BM wrote: »

Simple!!! not in my eyes. He' s human and can fcuk up just like anyone else.

If i was in your position OP, i would need a second or third opinion and even at that nobody would be operating on me without first showing me what was wrong or at very least trying to.

If the guy was a knee specialist I'm sure he knows what he is doing and whether MRIs are necessary. Exploratory surgery like this is common where diagnosis is unclear. but ring the consultants secretary and say you would like an MRI done and ask for a letter from the specialist to get one done , you don't have to ask the consultant himself. If he wont reffer for an MRI then consider going to another Ortho consultant if you don't trust him.
As for exercising when recovering from operation. You could swim using your arms only or do upper body weight training in the gym on a bench/machine so you are not standing on the bad leg.

Hanley

ronbyrne2005 wrote: »

If the guy was a knee specialist I'm sure he knows what he is doing and whether MRIs are necessary. Exploratory surgery like this is common where diagnosis is unclear. .

+1

There's alot of stuff that isnt gonna show up on scans and sometimes you just need to go in and take a look. To dismiss this approach as a rule is a great sign someone doesn't know what they're talking about.

If you're having doubts ask your specialist why he isn't doing a scan.

DM-BM

Don't get me wrong, i'm not dissmissing exploratory surgery, but if i was in the OP's situation, and to me she doesn't seem overly confident with the treatment she is recieving, then i would want another specialist to have a look.

Casshern88

Could it be beyond the realms of possibility that the exercises they give you at curves are contributing to the problems, correct me if im wrong but its curves usually a circuit resistance machines? Maybe it just so happens that doing endless leg extensions and ham curls are the problem , I also hear people say that curves instructors have no real fitness qualification , maybe you’ve been thought the exercises with wrong technique or just been give controversial exercises.

Ive also heard of other curve goers experiencing knee trouble related to machines not suiting them.And improper screening by instructors there.


Could be completely wrong on all the above so apologies if so.

mattym

I have just last week been told that i have a tear in my medial meniscus cartilage which will require surgery to fix. I had been going to physio for close on 3 months doing every exercise and stretch in creation but was not improving. It wasnt so bad while not training but as soon as i started running again the pain came back. I went for an MRI for my own peace of mind because i really needed to know what the problem was. It was €420 but was worth it to find out the problem. My opinion would be do as much as you can to diagnose the problem before surgery is considered.
Best of luck..

Dub47

Casshern88 wrote: »

Could it be beyond the realms of possibility that the exercises they give you at curves are contributing to the problems, correct me if im wrong but its curves usually a circuit resistance machines? Maybe it just so happens that doing endless leg extensions and ham curls are the problem , I also hear people say that curves instructors have no real fitness qualification , maybe you’ve been thought the exercises with wrong technique or just been give controversial exercises.

Ive also heard of other curve goers experiencing knee trouble related to machines not suiting them.And improper screening by instructors there.


Could be completely wrong on all the above so apologies if so.

I can see where you are coming from and I'm sure some of the instructors are not the best qualified in Curves but I know what I'm doing. I've been going to gyms for 16 years now and have had a lot of instruction and personal training sessions in the past. The machines in Curves are quite simple and none are machines that I would not have already been using in other gyms for years. Also when the knee problems started I stopped doing the leg machines in Curves that could possibly make it worse but this has not helped.

Thanks for all the advice from everyone. I think I will query whether an MRI could at least show something and I am due to talk to my physio on Monday to tell him what the knee specialist said so I'll also ask his opinion.

Thanks...

Zzippy

I had an operation on my right knee a few years ago - the consultant knew from the initial examination that it was torn cartilage (meniscus), he ordered an x-ray anyway just to be sure, but it didn't tell him much that he didn't know already. It wasn't a serious tear but he was still able to suss it straight away.
2 years ago I had a very small tear in the cartilage on the left knee - it hasn't required surgery as I was no longer playing competitive hurling. Got an MRI scan that time and the tear was so small it needed an MRI to ID it - didn't show up on x-ray and a different consultant (I'd moved location) wasn't sure from examining it if there was a tear.
Basically - its likely from reading your post that you have something wrong in your knee, possibly cartilage-related. An MRI might be required, but if your consultant doesn't think its necessary he's probably right. In any case, he'll know exactly what it is once he operates.

As regards recovery, arthroscopy is very non-invasive these days. You should be off crutches the day after the op, it will be very stiff for the first week or so then start to loosen up. I had the stitches out one week post-op, and was able to start jogging in straight lines (on sand) 2 weeks after the op. After about 4 weeks I was able to start turning on it, side-to-side, increasing pace, etc, and I played a full match 6 weeks to the day after the op.
Since you've already got good quad strength and bulk, you won't lose out too much. I'm sure you can work on upper body for the couple of weeks you'll be out of action, or get in the pool once you've had the stitches out. Best of luck, its like having a new knee!

Dragan

No medical discussions please folks.

Dub47

Zzippy wrote: »

I had an operation on my right knee a few years ago - the consultant knew from the initial examination that it was torn cartilage (meniscus), he ordered an x-ray anyway just to be sure, but it didn't tell him much that he didn't know already. It wasn't a serious tear but he was still able to suss it straight away.
2 years ago I had a very small tear in the cartilage on the left knee - it hasn't required surgery as I was no longer playing competitive hurling. Got an MRI scan that time and the tear was so small it needed an MRI to ID it - didn't show up on x-ray and a different consultant (I'd moved location) wasn't sure from examining it if there was a tear.
Basically - its likely from reading your post that you have something wrong in your knee, possibly cartilage-related. An MRI might be required, but if your consultant doesn't think its necessary he's probably right. In any case, he'll know exactly what it is once he operates.

As regards recovery, arthroscopy is very non-invasive these days. You should be off crutches the day after the op, it will be very stiff for the first week or so then start to loosen up. I had the stitches out one week post-op, and was able to start jogging in straight lines (on sand) 2 weeks after the op. After about 4 weeks I was able to start turning on it, side-to-side, increasing pace, etc, and I played a full match 6 weeks to the day after the op.
Since you've already got good quad strength and bulk, you won't lose out too much. I'm sure you can work on upper body for the couple of weeks you'll be out of action, or get in the pool once you've had the stitches out. Best of luck, its like having a new knee!

Thanks for that - it helps to hear someone else's experience. Appreciate all the advice!