Arthroscopy - Should I?

[Pulse]

Hoping some others may have experienced similar...

I tore a ligament in my knee a year or so ago (sorry, can never remember which one, but it wasn't bad apparently). Since then, my knee has been grinding, but more importantly when I try to run (or even squat too much), my knee fills with fluid and the knee is painful.

I've since had an MRI scan, which 'reported as showing no evidence of a cartilage/meniscal problem' and 'there is nothing on the scan that would obviously benefit from arthroscopic (keyhole) surgery'.

He has said however that since I went to physiotherapy, which was 5 minutes long and they said I was fine, he suggests I may want to consider an arthroscopic assessment anyway, since MRI and arthroscopy are 'not mutually exclusive investigations'.

Not sure what I should do. I'm not keen on any type of surgery if it's not needed - I should note that nothing like that scares me in the slightest, but in the interest of preserving my body in the best condition, would rather not be operated on unnecessarily.

He has suggested I speak to my GP about it if I want to. Should I speak to my GP about potentially going onto a proper physiotherapy programme, or will that likely not do anything for me? As I say, the knee is grinding (which he thought was more from the kneecap itself, but it has only happened since the tear), and fills with fluid as soon as I've tried running. An example would be the other day, I tried running and ran about half a mile maybe, and the pain was so much I had to stop. I then walked the rest of my trip, but later that day my knee got even more painful.

Also should note I guess (just in case it's worth mentioning) that I'm able to cycle fine, and cycled 32 miles the other week with no issues at all. Walking doesn't bring it on either, and have walked up to 10 miles in one go in recent weeks, too.

Any ideas?

[Roger645]

I had an issue with fluid re-occurring on my knee when I used to do a bit of jet-skiing years ago. Nothing showed up on scan but I had an arthroscopy & wash out of the joint. Knee has been fine since then. Mine was done keyhole and was out the same day.

[Mojooo]

Just have it.

The MRI doesnt show up every issue.

If there is somehtignwrong they might be able to fix it on the same day anyway.

Grinding isn't good - so I dont see how not having it would be any better in the long run.

[Toilet Duck]

Please, please research the background of who ever will be doing the arthroscopy, this is more important than the actual procedure itself.

I am due to have arthroscopy for the third time on one of my knees (also had more invasive procedures) due to an ongoing problem/nightmare. In hindsight, the first time I had it done the surgeon was not particularly good. Some surgeons will do general knee arthroscopy (wash outs etc) but not ligament repairs and more complex stuff. I would personally avoid "general" surgeons. In my case MRI's etc showed "nothing" but after the key hole I was told my knee was basically fked and needed X Y and Z doing, but the surgeon telling me this was unable to carry out the necessary work and said I needed a "specialist." Hence why I recommend you ensure you see the organ grinder and not a monkey.

After my first key hole I did a lot of research and found out who are the most respected specialist knee surgeons and got my GP to refer me to one of them. What a difference! I now feel comfortable in whatever is recommended to me. Don't take any chances, the knee is the most complicated joint in the body. Get a decent knee specialist to do the operation (my surgeon only does knees and has operated on loads of premiership footballers, cricketers etc) and you'll have less to worry about.

Good luck

[Pulse]

Thanks everyone. I'll go for it then! The question now is, where do I find a good surgeon? I'd rather get it right first time, rather than messing around.

[Toilet Duck]

Pulse said:

The question now is, where do I find a good surgeon?

Whereabouts in the country are you?

This is a good place to start: http://www.kneeguru.co.uk/KNEEtalk/

Assuming you are going NHS, find out which hospitals your Primary Care Trust covers. Out of those hospitals, find out which one is the best for dealing with knees. Then ask your GP to refer you to that one, and the specific knee surgeon that you have researched. You are supposed to have a "patient choice" under NHS guidelines, but they don't make it easy. However, you can specify any hospital under the control of your particular Primary Care Trust as they come under the same budget. I'm under a specialist knee consultant at a hospital out of my area and not overed by my PCT. However, my PCT originally agreed to fund one appointment for a second opinion after I made my GP submit a referal for this particular surgeon. The surgeon I saw recommended surgery and I've been under him ever since. Once they take you on as a patient you should be OK, its just a matter of sticking to your guns and insisting on seeing who you want, not whoever your GP wants to refer you to as that is a lottery.

Of course, if you are going private then you don't have to jump through hoops and cut through red tape.

[Pulse]

I'm in Swindon, and I'll be going NHS. I actually work for a PCT, so fairly up on the rules. In fact, you have the choice to go anywhere you want (any NHS hospital in the country) and see any surgeon, but finding one is the issue.

I'll take a look at that link, thanks.

[Toilet Duck]

Pulse said:

I actually work for a PCT, so fairly up on the rules. In fact, you have the choice to go anywhere you want (any NHS hospital in the country) and see any surgeon, but finding one is the issue.

Thats interesting. How come I had to get "permission" from my PCT to get a second opinion from someone outside my area? At the time my GP wrote to them, I remember him saying it was unlikely that they would agree to pay for it.

Also, for an unrelated issue, I got referred to another specialist part of the NHS which happened to be outside my PTC, and my PTC refused to fund it. Instead, they made me go to a local place (no where near as good and not specialising in the field that I require). Even though I complained to the PTC, they still refused to allow me to go to the original place that my treating consultant wanted me to go. They denied it had anything to do with money (bullst).

So in my experience, all this "patient right to go anywhere they want" is utter toss.

[Wacky Racer]

I had an arthroscopy on my right knee five years ago, it had been giving me pain for about three years before this...simple 30 minute operation on the NHS.

I was told I would need crutches and be off work around a week.....I walked unaided out of the hospital four hours later and was back at work the very next day.

I accept I was probably lucky, and was told I MAY have problems with arthritis in later life, (I'm 58) but so far everything's fine.

Go for it.

[x type]

Had mine done last Friday

I've had problems with my right knee for 2 yrs after picking up a washing machine with someone else the correct way , back straight bend knees etc.

Had the job done and surgeon removed some cartlidge which was bit iffy

before the op I could bend the knee but it gave a bit of pain

So far after the op ...........

I walked out of hospital no problem ,no crutches 4 hrs after op

Last Saturday it hurt like and had to use crutches and pain killers

Sunday ,hurt like and had to use crutches and pain killers

Monday to today getting easier ,pain killerrs down to 2 a day using 1 crutch now but still very stiff even though I'm bending the knee a little more each day

hope to god it gets easier or it will be never again !!!!!!

Good luck with yours

[Wacky Racer]

x type said:

Had mine done last Friday

I've had problems with my right knee for 2 yrs after picking up a washing machine with someone else the correct way , back straight bend knees etc.

Had the job done and surgeon removed some cartlidge which was bit iffy

before the op I could bend the knee but it gave a bit of pain

So far after the op ...........

I walked out of hospital no problem ,no crutches 4 hrs after op

Last Saturday it hurt like and had to use crutches and pain killers

Sunday ,hurt like and had to use crutches and pain killers

Monday to today getting easier ,pain killerrs down to 2 a day using 1 crutch now but still very stiff even though I'm bending the knee a little more each day

hope to god it gets easier or it will be never again !!!!!!

Good luck with yours

Be patient, keep up the physio (very important) and painkillers..

You'll be OK hopefully in a week or so.

Good luck...

[The_Doc]

Mojooo said:

Just have it.

The MRI doesnt show up every issue.

If there is somehtignwrong they might be able to fix it on the same day anyway.

Grinding isn't good - so I dont see how not having it would be any better in the long run.

This I like

Toilet Duck said:

Please, please research the background of who ever will be doing the arthroscopy, this is more important than the actual procedure itself.

I am due to have arthroscopy for the third time on one of my knees (also had more invasive procedures) due to an ongoing problem/nightmare. In hindsight, the first time I had it done the surgeon was not particularly good. Some surgeons will do general knee arthroscopy (wash outs etc) but not ligament repairs and more complex stuff. I would personally avoid "general" surgeons. In my case MRI's etc showed "nothing" but after the key hole I was told my knee was basically fked and needed X Y and Z doing, but the surgeon telling me this was unable to carry out the necessary work and said I needed a "specialist." Hence why I recommend you ensure you see the organ grinder and not a monkey.

After my first key hole I did a lot of research and found out who are the most respected specialist knee surgeons and got my GP to refer me to one of them. What a difference! I now feel comfortable in whatever is recommended to me. Don't take any chances, the knee is the most complicated joint in the body. Get a decent knee specialist to do the operation (my surgeon only does knees and has operated on loads of premiership footballers, cricketers etc) and you'll have less to worry about.

Good luck

This is like alot.

OP: Go and chat to a local specialist knee surgeon.

William
Specialist Knee Surgeon, Leeds.

[TuxMan]

I had my knee surgery last December and to be honest the knee is still crap , fills up with fluid as soon as I do any running and is painful to bend fully , anybody got any ideas ??