Advice for wrecked knee

[GAPeach]

What a wonderful site I have stumbled on... I could really use some advice from all the "knee veterans" on here..

I am a 34 y/o female with a history of knee problems, including arthroscopic surgery 20 years ago for torn meniscus and MCL on my left knee. I will be honest and say I have not taken the best care of myself in the last 15 years and allowed my weight to creep up to an unsatisfactory level (I am 5'4" and was 230lbs at my heaviest). For years I have battled what I thought was arthritis in both knees, but particularly the left knee (due to previous injury and surgery) and I know my weight was also wreaking havoc on my joints. I have lost 57lbs in the last 2 years through diet and mild exercise and my knees have felt alot better. I have been doing yoga and walking upwards of 3 miles a day, 3-5 days a week along with calisthenics for my core - another words all non or very low impact type activities. I am a mother of 2 and have a desk job..

Recently I had been experiencing stiffness and pain in my left knee after sitting for 30+ min at a time, but the pain was mild and the stiffness diminished after a few minutes of movement. A little over a month ago, I awoke in the middle of the night to the most excruciating knee pain I have had in years. My left knee was locked at about a 45 degree angle and I could not put any weight on it. In an attempt to get out of bed and into the bathroom I mis-stepped and put full weight on my left leg and heard a very loud pop, followed by even more pain. I spent the next 4-5 days in tremendous pain with significant swelling from my knee down into my toes (it was Christmas and I could not get into my doctor's office). Pain was localized to the MCL region and it was visibly swollen, with a slight bruising under the skin, as well as pain & "crunching" within the knee joint. Finally saw the doctor a week after the initial "injury". She stated it was probably a torn meniscus or similar injury. An MRI was ordered as well as physical therapy. I began PT and the therapist agreed based on her exam that something was torn. It took a month to get an MRI appointment and the therapist took a conservative approach to therapy so as to not make matters worse. PT causes a significant increase in swelling and pain despite the "gentle" exercises. Additionally after starting PT, I developed LCL swelling, pain and tenderness that had not been present before starting PT.)

After 3 weeks of therapy I have now gotten my MRI and the results indicate a past partial ACL tear, small Baker's Cyst, a small ganglion cyst on the ACL as well as chondromalacia patella/patellofemoral syndrome (which makes alot of sense as my left knee cap is very obviously misaligned - it tracks laterally when in motion, with a lateral placement shift while sitting) but there are no indications of menisci tears. I can bear some weight on the knee, though it often buckles or hyper-extends when walking or standing; the knee feels very unstable and pain/swelling continues to be significant. I realize the MRI suggests these are issues that have been present for sometime, but thus far the PT has not improved my pain at all although it has improved my ROM with the affected knee.

While I am not an athlete of any sorts, I do maintain an "active" lifestyle and would like to continue to do so. The last month has been miserable and I find the last of exercise is affecting my weight, mood and sleep. Not only am I in physical pain, but being sedentary is starting to make me a little crazy. I am currently waiting on an orthopedist referral (love insurance procedures). I have been researching ACL tears/injuries and find a mix of reviews as to when surgery is indicated. Can anyone share their opinion as to whether they regret having surgery/not having surgery? Granted I have not seen the ortho yet, so I do not know what his opinion will be, but should I, as a "non-athlete", push for surgery?? Believe me when I say I am in no hurry to miss work and go under the knife, but I have a limited time frame of support at home for me and my kids (husband is military and will be leaving soon) and if surgery is the best option I would like it to happen pronto while he is still here to help with the kids, me and the house.

Sorry for the length of the post. Any and all info/comments are greatly appreciated!!

Thanks,
K

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[marj]

If you are improving slowly, then be patient and keep plugging away. There was probably a cartilage fragment torn off your femur or patella, which may be gone now. This sort of injury can take a very long time to heal regardless of surgery, but typically if you are improving without surgery, do not have surgery. There is always a risk that surgery can make you worse. Maybe you could do some water walking, swimming, easy cycling etc while you are healing. Good luck. Marj

[bellasimon]

It is good to hear that you are recovering without any surgery. My advice to you is that you should undergo a full physio rehabilitation program that can help you in your recovery.Barclay Physical Therapy helps you to diagnose the problem and give you the professional treatment plan.