/ Knee Arthroscopy

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Gav Parker - on 10 Oct 2017
I've been advised by a consultant to have a knee arthroscopy.
MRI scan showed Osteochondral injury in the medial femoral condyle.
I'm 54 and 90% of the time not in pain, generally it doesn't stop me doing anything. It's worse when I've climbed stairs, gripes now and again when out in the hills and climbing.
My concern is could the procedure make it worse or is it the right thing to do at my age? Also feel my pain is more muscular at not the said injury.
Thanks.
Dave80 - on 10 Oct 2017
In reply to Gav Parker:

I can't comment on the injury but the arthroscopy itself is unlikely to cause you any issues. Last one I had for a look around inside my knee to try and see why I kept dislocating it was done as a day case and I was in the pub that night and spent most of the evening standing at the bar...... I think it took me around 2-3 weeks to fully recover from although I was in my early 20's at that point and it was just a look around rather than repairing any damage.
If you think your pain is muscular then it might be worth paying to see a private physio to get their opinion before committing to the operation.
Gav Parker - on 10 Oct 2017
In reply to Dave80:

Thanks Dave
Toccata on 10 Oct 2017
In reply to Gav Parker:

Can't comment specifically on your case but most surgeons enjoy arthroscopy regardless of the evidence. Be cautious.

http://www.bmj.com/content/350/bmj.h2747
Gav Parker - on 10 Oct 2017
In reply to Toccata:

Interesting... thanks
Climbing Pieman on 10 Oct 2017
In reply to Gav Parker:
Had a knee arthroscopy but not for the same reason as you. Would I have it again - no, or not at least unless there were no other non surgical treatments possible. I'll not go into detail but it left me with more problems than I had before.

My GP advised caution at the time and suggested some surgeons operated too quickly. Since discovered that at least some knee arthroscopy ops have very limited or short term benefit and the risks of an op have to be put into that context.

Maybe I was the 1 in a .... whatever to be in a worse position, but you have suggested that it maybe muscular. If you are in any doubt about the consultant's advice, get a second opinion first, and also explore all other treatments.
Gav Parker - on 10 Oct 2017
In reply to Climbing Pieman:

Thankyou yes thats what Im worried about!

Physio thinks it could be the Adductor Muscle where it joins the knee??
ian caton on 10 Oct 2017
In reply to Gav Parker:

Try everything else first. I agreed to an arthroscopy and a bit of flush out. Woke being told I had had an almost total meniscectomy. I had never heard of it!
Climbing Pieman on 10 Oct 2017
In reply to Gav Parker:
Having had lots of physio since op, I now know that part of my original problem was due to muscle imbalance.

Lots of powerful muscles above, below, in and around the knee and they all have to be appropriately trained and kept in shape - c/w say climbing elbow injuries and need for eccentric training.

If your physio is not a sports one, find yourself a recommended sports physio for a second opinion, even if you have to pay for it. Do the physio first would be my thought.
SouthernSteve on 10 Oct 2017
In reply to Toccata:

Similarly, BUPA looked at the evidence for flush and look–see as a technique and saw no benefit as it was being done, because it could be in some cases! A good case of evidence based medicine. However, they did not comment on more invasive techniques on the radio interview I heard.

In your 50's small cartilage or meniscal damage seems to be left alone in the majority of cases and I would definitely see a sports specific physio before any surgery. I like the idea of the viscous injectable joint lubricants to give everything a chance to settle without making a moderately big hole in the joint capsule, but the evidence is not at all conclusive.

Although less likely to be applicable to people on this site, losing some weight may have a good effect
nniff - on 10 Oct 2017
In reply to Gav Parker:

I've had it done twice, on the same knee, about 15 years apart. Can't say that I regret it because my knee wasn't working beforehand and was afterwards. I've stopped running now - that's just asking for more trouble, and I breakfast on Ibuprofen when long days in the hills are ahead, and use walking poles. Rock-overs on my left knee are viewed with suspicion. I cycle lots without any problems.
Gav Parker - on 10 Oct 2017
In reply to nniff:

Thanks for all the replies and advice.....will have to make the choice!!
DerwentDiluted - on 10 Oct 2017
In reply to Gav Parker:

Mrs Diluted is currently halfway through a long period of absolute rest after having an operation for a grade IV fracture of the end of her femur caused by Osteochondritus Dissecans. This (I now know) is a pretty rare condition causing poor blood flow to the ends of the long bones and subsequent tissue death and bits dropping off. We face an uncertain and possibly long road back to activity.

My point here is that this was not diagnosed until the very last minute and only after her surgeon went on holiday and the senior surgeon saw her MRI images. He rushed her in for surgery as the detached bone will die after 6 weeks, massively complicating recovery. When she initially presented at A&E with severe knee pain and for several weeks this was not diagnosed and she was advised to move it and bear weight on it, leading to a sudden and dramatic deterioration. So I would advise anyone with knee issues to bear in mind and be aware of this rare, but pretty unpleasant, condition.
Gav Parker - on 11 Oct 2017
In reply to Gav Parker:

Anymore advice or first hand experiences?

Thanks again
Chris the Tall - on 11 Oct 2017
In reply to Gav Parker:

Had one done about 10 years ago and it worked for me. I though I had damaged my left knee with a skiing fall. In fact there was underlying problem- plika (sp?) - which was cleaned up. Took a couple of months to recover, but not had knee problems since
steveriley - on 11 Oct 2017
In reply to Gav Parker:

The wisest thing anyone said to me after my op was 'surgeons like to operate and physios like to physio.' You'll be doing the physio afterwards anyway to recover, so might it help in advance?

Mine was 20+ years ago, so things might have changed and my problem was different to your problem
Gav Parker - on 11 Oct 2017
In reply to steveriley:

Thanks Steve

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