not healed 6 months after knee arthroscopy

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Date Joined Jul 2017
Total Posts : 1
   Posted 7/11/2017 1:37 PM (GMT -6)   
In January, I had a knee arthroscopy to address a suspected tear in my medial meniscus due to pain, mostly dull but occasionally sharp, in my right knee while running. The Department of Veteran's Affairs performed the surgery. Upon going in, the surgeon apparently discovered an intact meniscus, and determined that instead, the medial plica was causing the problem. He trimmed the plica and ended the surgery uneventfully.

Prior to surgery, I was running long distance for exercise. I've always been a runner. The week before the surgery I put in at least 20 miles. I have not been able to run more than 10 steps in a row since the surgery without intense pain in my right knee. Even cycling hurts on the downward stroke of the right pedal, though not enough to prevent me from cycling. The knee aches constantly in various places; sometimes the proximal medial, toward the quad muscles, sometimes the distal medial, closer to the patellar tendon, sometimes it feels like it's just the kneecap itself hurting.

My care was transferred to a civilian orthopedic clinic, and the doctor there discovered an IT band issue, which was sorting out by some Voltaren gel and my physical therapy. After I continued to have knee pain, that doctor gave me me two cortisone injections, 40ml each, into both the medial and lateral sides of my knee, near the surgical portals. Then I was referred to the clinic's surgeon, who examined my post-op MRI, compared it to my pre-op MRI, and called it "confusing." He ordered a month of increased physical therapy visits with iontophoresis (which we've already been doing). He does not feel it's a tracking issue, as his basic examination indicated fairly normal tracking and an acceptable Q angle.

These are other things we've tried in meantime:
- 800mg ibuprofen 2x/day (total of 1600) for 3 weeks
- ice 2-3 times/day (in conjunction with ibuprofen)
- heat 2-3 times/day (in conjunction with ibuprofen)
- Voltaren gel in various painful spots
- physical therapy since February doing mobility and strengthening exercises, ultrasound therapy, and iontophoresis
- physical therapy exercises at home as directed

The two cortisone injections were recent, and I feel they helped to localize my pain symptoms, though I still cannot run. Yesterday I indicated to my physical therapist that one portal was particularly tender to touch, so she massaged the area with tools and applied an iontophoresis patch directly over the most painful area. Symptoms did abate some, but are back today just like normal.

I follow up with the new surgeon at the end of July, at which time he wants to try a trigger point injection into the medial retinacular band. If this doesn't work, he mentioned the possibility of exploratory surgery. The last surgery has knocked me off my game for 6 months, the last thing I want is more.

I have a new job pending which will eventually require a physical fitness test, including a distance run and a sprint. This needs to be resolved ASAP. Does anyone have any advice?

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Date Joined Feb 2003
Total Posts : 16416
   Posted 7/12/2017 11:31 AM (GMT -6)   
Hi MM, sorry to read about what you are dealing with. I have had many issues with my knees over the years from meniscus tears to partial tear of the ACL, for a total of 5 scopes. My first scope was done by an orthopedic who could not find the problem & he referred me to a dr that did knees only. I was floored when he said your knee needs to be re-scoped. He found the problem & he did all my other scopes. I suggest that you either get in with a dr that does knees only or a highly skilled sports medicine dr.. There is a big difference here.

To be honest for your sake I do hope the trigger point injection works. If it doesn't get your knee looked at again. Your problem was basically misdiagnosed all along & this is why your recovery has not been the best. No, this is not a normal recovery at all. You have had a lot done since the scope & I can assure you the recovery does not take this long at all. Something that has helped me more than anything is getting in a pool & doing exercises. You are weightless & cannot injure it in the water. I have had more than my fair share of PT & this by far has helped more than anything.

I do hope you will let us know how things go. Take care.
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