Knee Arthroscopy

[Sue New]

Hello Everyone,

My admission date came through today for my third knee arthroscopy (2nd on right side). I only saw the orthopod surgeon last week and I have been scheduled for January 24th - only 3 months away. I was really shocked as I thought there would be a really long waiting list. I think I must have been put on the surgeon's "soon" list.

I think the surgeon wants to take a look at my knee for himself before deciding the next plan of action. My right knee (and right side in general) has always been a lot worse than my left and I knew a follow up was on the cards. I had the 1st surgery on my right knee 5 years ago. At that stage the op was cut short (I was due to have a lateral release) due to complications. I have now developed an abnormal "Q Angle" and associated problems with my hip and ankle. There was talk last time of them removing the kneecap so this may be what is decided after the next op - who knows .

I guess I will just have to wait and see..... I think I felt more comfortable when I thought there was a long waiting list as I thought I waould have the chance to discuss the op with Dr Hakim at my review appointment in March, but that does not now seem to be the case .

Dr H did say that my ostoarthritis issues with my knee were due to a seperate degenarative process to the EDS - even though people with EDS are prone to early onset OA . So I guess if there is a chance that the surgery will give me a few more years grace before needing a knee replacement - something that was predicted that I will need when I was in my teens - then I should go along with it.

Sorry for my ramblings, I have not got a question as such, I just needed to get my thoughts down in writing.

Take care all

Sue.

P.S. This will be my 12th operation in 10 years

[Sue New]

Hi Guys,

I had a very "eventful" pre-op appointment today (what's new I hear you all groan ).

My hubby dropped me off at the hospital at 8.30am for my 9.15am appointment (on his way to work) so I killed some time having a coffee and a danish (naughty but nice ) . I went up to the ortho ward at about 9am only to be told my name had been on the list but it had been taken off as my date had been changed .

Basically, it transpired that the weird letter I got some time back saying that my "suppossed" op with the hand surgeon had been changed, was actually telling me that my knee op date had been changed and was no longer being done by the specialist knee man but by the locum hand surgeon "who sometimes does knees"

I actually spoke to the hand surgeon at the time and even he thought this letter was regarding the carpal tunnel release - how confusing . I also showed the letter to both the hand and knee surgeons (at this stage I had 1 op booked for 17th Jan and another a week later which just was not feasible) and it was agreed that the Carpal Tunnel Release would be postponed/cancelled and they would go ahead with the knee op as this was more important.

Eventually I got to see someone in the booking dept and explained that I did not feel very comfortable having the knee op performed by a hand surgeon who did not know all my history - particularly as I have EDS. It all got sorted eventually but the soonest the proper knee surgeon can do the op now is Jan 26th (only 2 days later so that's not too bad).

Anyway, as is normal by BP was really high - the 1st reading was 150/90 and then when they took it a bit later it was 162/108. I explained it goes from really high to really low and they have made notes about this on my file to show the anaesthetist. I explained all my health problems to the Junior Dr and gave a copy of my health history on CD Rom as well as a copy of the EDS "All Types" CD Rom produced by the EDNF to the Senior Nurse. She commented that whenever they have EDS patients they always come in with lots of info, but she had not seen the CD Rom before so was pleased with that. I asked if they saw many EDS patients and it seems that one of the knee specialists there (funnily enough the Dr who did my previous 2 arthroscopies, before I was diagnosed with EDS) had a spate of EDS patients a while back as they kept being referred to him. I won't mention his name as it will probably be edited out, but he is quite a well known "knee man".

Anyway, I did eventully get to see the main knee consultant and he said he remembered me from my 1st appointment last August (it is always nice to be remembered isn't it?). He said my knee problems are "significant" and although he thinks having the arthroscopy will help tidy up some damage for a while, it will not be a long term solution and I will require a replacement further down the line . He is pretty sure I will notice some improvement though otherwise he said he would not recommend doing it.

It is 5 years since my last arthroscopy and at that time I was due to have a lateral release, but the op was cut short due to BP problems. He told me to be prepared that he may perform the lat release this time so I may have to stay in over night if that is the case, and this will also mean a longer recovery period .

He said I have "J angle" mal-tracking of the knee (whatever that means)and he even went so far as to say "he felt sorry for me" - he wasn't being patronising - he sounded quite geniune. I really like this consultant actually. He seems very thorough and caring He also commented on the fact that he will be sure to take special precautions during the op due to my EDS.

He asked me if I experienced any numbness and I said I get a lot in my legs and arms and showed him where and when I get it. A lot of my problems seem to be stemming from my lower back and he asked if I was seeing anyone about my back in particular. I explained Dr Hakim is about to refer me to have a Back and Neck MRI. I later heard him talking into his dictaphone saying after my op I need to have the Lumbar and Cervical MRI's asap due to suspected Spinal Canal Stenosis

Anyway, that's the short version of today's events - I was there for 5 hrs all in all .

Le's just hope that the anaesthetist is happy to go ahead with my surgery this time - watch this space .........

Take care all,

Sue.

[Mari]

Hello Sue,

What a day! Thank goodness it was sorted out in the end, with only an extra 2 days to wait. Why can't life ever be simple, eh?

My (neck and) lower back MRIs are to look for stenosis, too. I wonder if he thinks there's anything you can do if it is spinal canal stenosis? (Here's hoping, eh, Sue? )

Take care,
Mari

[Sue New]

Hi Guys,

I posted breifly on the Doctors & Diagnosis section about the medical secretary translating my consultants clincal notes incorrectly. Well, here is the full version of the clinic note. I guess it explains why I have so much trouble with my right knee as it seems it is permanently displaced (dislocated?) in two directions:

This lady's for right EUA artroscopy and possible lateral release. She has a bone loss syndrome (ahem - should read Ehlers Danlos Syndrome ). She will need very careful EUA at time of surgery. I note that her arthroscopy in 2001 noted her to have significant chondral lesions to the patella with lateral meniscal tears and associated cysts which were debrided.

Most of her problems seem to be related to the patello-femoral joint and she is clearly J tracking with patella tilt and patelo-femoral joint irratibility. She has good movements of the patella with a two quandrant displacement both medially and laterally.

Following surgery she will need an MRI scan of her cervical and lumbar spine to try to work out wheter her arm pain, parathesia and numbness on the right side is cervical and also whether the right side buttock to knee pain which she is getting is due to central lateral canal stenosis.

Intersting huh? I don't usually ask to be copied into clinical notes, but any evidnence I can gather for my upcoming appeal on February 3rd will be useful at the moment. I don't know how soon I am likely to be booked in for the MRI scans, but at least finally a consultant has taken the initiative to order the tests. I was told back in November 2004 by an ostepath that the numbness in my arms and legs was probably due to my neck and spine, and depsite me keep mentioning this to various GPs/Consultants, I kept banging my head against a brick wall (other than Dr H at UCLH of course, who came to the same conclusion when I saw him on Jan 5th and has also written to my GP to order the tests).

Anyway, I have rambled on a bit again, sorry about that . I thought it might be interesting for people to see the type of things that are written up in clinical notes though.

Take care

Sue.

[Sue New]

Hi Guys,

I went to my 2 week post op appointment yesterday (re my right knee arthroscopy, medial and lateral menisicectomy, patella debridement and lateral release). My knee is still swollen and very painful and I have a very tender area on my thigh about two inces above the knee where the consultant thinks that fluid has leaked into the surrounding tissue as a result of the surgical tear made in the retinculum during the lateral release (sorry for the poor explanation, I am not sure of the correct medical terms). The consultant said that due to the amount of work that was done during my surgery it could take upto 6 weeks to start feeling better so he has signed me off for another 4 weeks .

I also went to physio after the consultant appt and apparently I have sprained a muscle in my calf as a result of the way I am walking at the moment and I have a lot of myofascial pain in multiple areas. She has shown me how to massage these spots but they are soooo tender and painful, I am still having to take the extra strong painkillers they gave me post op and ice the knee 3/4 times a day..

I showed the consultant the rash that has appeared on the back of my leg (curiously enough in the same area where the intense pain is) and he said he didn't know much about rashes (he was actually the consultant's registrar) but he did not think it looked like a rash caused by internal infection

I spoke to the doctor about the MRI's of my cervical and lumbar spine that the consultant wanted to order after surgery and he is at least getting in touch with the MRI unit to try to hurry these along (the consultant is thinking my numbness and tingling in my arms and legs maybe due to spinal canal stenosis).

Anyway guys, that's my latest news. Other than sleeping loads and loads I am not able to do much more at the moment so I think the additional month on sick leave is going to pass by very slowly. I think I need to get my hubby to stock up on some puzzle books for me to help me pass the time

Take care all (Sorry I ahve not been around much lately to answer people's posts but it hurts to be sitting at the computer for any length of time ).

Sue.

[Retro]

Hi Sue. I'm not surprised it's going to take a while to recover, it did turn out to be a huge operation. I was signed of for 4 weeks straight away when my foot was operated on and that was a teeny weeny operation! I had expected to be back on my feet more or less straight away.

I hope you can find plenty to occupy you. Rest is a good healer too don't forget Make the most of it! What about cross stitch? Knitting? Macrame(sp)? Origami?

[Mari]

Hi Sue,
I'm glad the doc has signed you off for another 4 weeks. As I mentioned in another post, I was concerned about you going back too soon. Try to make a list of things that need doing, that you are able to do from where you sit!

Mind you, I planned to get our drawer full of photos sorted while I was recuperating...I'm back a week Tuesday, and I still haven't started!

Take care,
Mari

[Sue New]

Thanks Retro & Mari for your replies.

I got a Sequin Art picture at Xmas which I planned to do as a project whilst signed off but I am finding it too fiddly to do with my hands at the moment - hurts too much without my wrist and thumb splint but wearing the splint I do not have enough movement in my fingers to pick up the pins and sequins. Oh well, I guess I will have to stick to TV, Puzzle Books and sleeping!!

I had a visit from a work colleague who lives in our village yesterday and a woman from my hubby's bowls club is coming around tomorrow afternoon. I still have to ice my knee 4/5 times a day (20 mins a go) and do all my physio exercises so that is time consuming as well. My parents are also coming over on Saturday to keep me company and take me to my hospital appointment on Monday morning, so that is something to look forward to .

I am afraid that where I have been having this pain above my knee I was doing trigger point massage as the physio suggested but it was so painful I lightly dug my fingernail into the skin (a bit like doing a Maltese cross on an annoyingly itchy bite) but the skin has broken and now I have a fingernail shaped wound that looks a bit yellowy/green (i.e maybe infected?). I don't want to bother my GP again and my physio is away next week so my next scheduled appointment is not until Feb 27th. I am due to see the Pain Management Clinic on Monday so if it is still looking bad (the area is all red around the actual open area), I will show it to the nurse then.

Don't you just hate having EDS skin When I went in for my op I had an open sore on my big toe that had taken weeks and weeks to heal - I don't even know how it happened, I just looked down one day as it felt itchy and it was all bleeding and the registrar and consultant were in two minds whether to go ahead with the surgery or not. They told me if it was a Total Knee Replacement they were doing, they would have sent me home as they did not want to increase the risk I already had due to the EDS.

Aaaarrrrggghhhhhh (gosh, I feel better for that )

Anyway, enough of my whinging, take care all - I will be off to watch "Deal or No Deal" soon - me and my Mum are both hooked on that - it's great when the contestents win a lot of money.

Bye for now,

Sue.

[Retro]

Hi Sue, shame you can't do what you'd planned but try to make the most of the rest, although you seem to be quite busy really.

Where you've dug you're nail in and it's starting to look a bit infected, give it a good clean a couple of times a day and stick some savlon followed by a plaster on it! Savlon's a great antiseptic and a plaster will stop you a) rubbing the savlon off and b) keep any nasty infection causing bugs out!

Hope it all gets better soon.

Hugs. Lindsey

[nonyanomemory]

Hi Sue, just a quick note to wish you well. If the wound is oozing yellow green then it may be best to show a pharmacist who I have always found helpful, especially at the weekend! for further advice but Lindsays advice sounds sound if you know what I mean. If the area sort of under and around the tear is like that then it could be bruising? Hope the weekend goes well and good luck at the appointment on Monday.

nonya

[Sue New]

Hi Guys,

Well, it's time for me to open up this old thread. I went to see my knee surgeon today as my left knee has been causing me a lot of problems lately. It keeps getting stuck and locked up, and is crunching and grinding when I use the stairs. A couple of weeks ago I had a really bad dislocation and it was soooo painful. It was out if joint for ages and the pain just got worse and worse. It took all mine and my hubby's force to get the leg straight again.

Anyway, the knee surgeon told me last year he wanted to do an arthroscopy and possible lateral release on it, but at the the time I was going through a particularly low patch and couldn't make a decision. He left it for me to get back to him when I couldn't take the pain anymore. I contacted his sec a couple of weeks ago and hence the appt today.

The upshot of it is that I am on his 3 month waiting list for the arthroscopy and possible lateral release. I am also going to have another MRI at my pre-assessment appointment to get an up to date view of what is going on inside the knee - particularly as I have had some nasty dislocations lately.

Anyway, that's my latest news. I just have to let work know now

Sue.

[Eloise]

Let me know how you get on, as I really want an MRI and arthscopy and wash out on my left knee. Not been right and keeps swelling right up since i fell full weight on it over 2 years ago. The chiropractor said my tibia was out of line and moved it - but it is still no better. Going to try and convince my GP to refer me when I see her on the 2nd Dec.

Take care

[Sue New]

Hi Eloise,

I will definately keep you posted. I am sadly no stranger to this type of surgery as I have had 2 ops on my right knee and 1 on my left already . I can tell it is time for the next tidy up scope though, as I have severe osteoarthritis in both knees and i can feel/hear all the lose cartilage floating around. My last surgery on my left knee was in 2001, so I have waited a while before needing to have it done again (saying that, I should have had it done last year really, but I wasn't well enough for other reasons).

Good luck on Dec 2nd. I hope you are able to convince your GP to refer you to a knee surgeon, and you are able to get the MRI .

Best wishes,

Sue.

[Sue New]

Hi Guys,

I have spoken to my manager now about my upcoming operation, and she was ok about it. Not much she can really say, as I have put the operation off for a couple of years. Work wise, I used to do a job that only I was trained to do, but knowing about my ongoing health problems, my new manager has got me to train someone up to cover most of my work now, so things should go ok, and I won't be coming back to piles and piles of back log.

I hope I get my date through soon. The nurse asked me if I was on the pill and I said no. I nearly went on to say this was because I had had a hysterectomy and that I take HRT, but I didn't bother in the end. When I read the paperwork about the Atrhroscopy when I got home, it said that because this operation makes you bleed quite profusely, you need to stop the Pill or HRT for a month before the surgery (that will be fun, a whole month without HRT - I tried going without it for just a couploe of days a while back and I felt awful). I just hope I am given enough notice so I can stop the HRT in time. Do you think I should contact the hospital to let them know, so they can organise their schedule?

Any advice greatly appreciated.

Sue.

[hannah]

Hi Sue,
Yes, it is worth telling them that you are on HRT - you don't want to be only given 2 weeks notice and then have to say no because you don't have time to stop the meds And I hope you cope OK without them for that time.

I'm glad you employer seems to be being OK with you having the necessary time off - and knowing someone will be able to cover for you should make it a lot easier on you too.

all the best
H