Knee surgeon - anyone got any questions?

Knee surgeon - anyone got any questions?

Author
Discussion

xjay1337

15,966 posts

117 months

Thursday 23rd November 2017
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Is being a surgeon like it appears om Greys Anatomy?

pidsy

7,960 posts

156 months

Thursday 23rd November 2017
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You don't know a friendly orthopaedic surgeon who specialises in sciatica and degenerative disc disease do you? smile

They're not easy to find.

pushthebutton

1,096 posts

181 months

Thursday 23rd November 2017
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Very kind. Thank you.

Are there any new options for meniscus replacement or regrowth? I occasionally read about new procedures for cartilage, but they don’t appear to apply to the meniscus.

Thanks again.

Phil Dicky

7,162 posts

262 months

Thursday 23rd November 2017
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Don't think the mods will appreciate the advertising.

mattwade24

66 posts

80 months

Friday 24th November 2017
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Had ACL reconstruction last year (Oct '16) in my left knee following a football injury. Been passed/fobbed off by the physiotherapy team.

Over a year later the knee is still noticeably swollen over the right knee, although it's all soft and fluid like. I cannot fully extend or bend the knee. It doesn't cause me any real pain day to day, but I know it's there and it can occasionally become stiff. I can run on it fairly comfortably for 2km +.

Is there any way I can get my full extension and bend back? Can the knee be drained of fluid?

FWIW - I'm a active, otherwise healthy 24 y/o.

Thanks for any help!

sjc

13,884 posts

269 months

Friday 24th November 2017
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Are you Mark Davies from the London Foot and ankle centre by any chance ?

ColdoRS

1,796 posts

126 months

Friday 24th November 2017
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I’m 6ft5” and around 115kg, I do a lot of sport - running, martial arts and weight lifting and have done for about 7 years now, bit of rugby before that.

Over the last 3 years(approx) I’ve seen the odd ‘clicky’ knee develop into pretty audible crunching every single time I go up a set of stairs. Worse in the left knee than the right but apparent in both. So loud if my missus is in bed and I come up afterwards, she can hear my knees creaking over the sound of my footsteps.

I have 0 pain in either knee and feel strong and powerful in both. Occasionally I’ll feel an ache in my left knee but that’s generally only after a long run or a particularly intense few days of activity, I consider that pain as my body telling me to rest a bit and generally have a day off from anything strenuous.

Should I be concerned at the crunching?

FBP1

499 posts

148 months

Friday 24th November 2017
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Hi Mark,
Thanks for doing this - much appreciated and makes sense after " I'm a car salesman - ask me anything" type threads !
I've been helping various orthos build their pension pots after 18 ops so far on the left knee; all preceding from a late teenage diagnosis of OCD in the left MFC and rugby/ skiing etc. 2 arthrotomies and loads of arthroscopies. Everywhere from NHS through Harley st and RNOH.
Cutting a long story short, now at 55 I have no PCL and one giant lesion on the left MFC where it's bone on bone. Last arthroscopy 12 mths ago and the surgeon said you may have a year or two before a TKR. I can't run any more, but I do still ski ( or least cruise the slopes in an elderly gentleman stylee ).
Two questions: how long do TKrs last for these days - I was told at 19 to try to hang on to my knee as TKRs then didn't last very long and only one revision was generally possible?
Secondly, my good knee, having done most of the work for the last 35 years is getting painful - clicky, and sore when squatting where the tendon goes over the patella plus various other random pains that move around below the knee / at the back and so on. I had an MRI on the "good" knee, but it was inconclusive. Any suggestions as to what I might look for?
Thanks again
John

skilly1

2,700 posts

194 months

Friday 24th November 2017
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Knees ok normally but since running a year ago (now stopped) when I kneel on one knee I get a bad pain. Seems to be below the kneecap, should I be worried !

Hoofy

76,253 posts

281 months

Friday 24th November 2017
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Markframe said:
Happy to take my site address off. Not my intention.
Put it in your profile. smile

What exercises would you recommend for maintaining healthy knees?

When doing squats, lunges etc, people say you shouldn't let your knee go past your toes and the knees should be in line with the toes. How true is this?

pushthebutton

1,096 posts

181 months

Friday 24th November 2017
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pushthebutton said:
Very kind. Thank you.

Are there any new options for meniscus replacement or regrowth? I occasionally read about new procedures for cartilage, but they don’t appear to apply to the meniscus.

Thanks again.
Do you have any advice for me? I’m pinning my hopes on advances in procedures as there doesn’t appear to be anything concrete to deal with the Meniscus. I have very little in one of my knees and I’m relatively young.


skilly1

2,700 posts

194 months

Friday 24th November 2017
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Markframe said:
Any new pain if persistent should be directed to your GP. better to be safe than sorry. lots of things it could be. most likely from between the knee cap and the groove it runs in. but impossible for me to really comment on as you can understand.
Yes - thanks, should prob visit GP but does not impact my life too much so have ignored it for 12 months!

FBP1

499 posts

148 months

Friday 24th November 2017
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Thanks Mark,
20 years is better than it used to be albeit it still leaves me facing a revision should I unexpectedly get to 75 wink.
Yeah shame re the PCl as a partial KR might have been an interim option.
Various options were considered over the year for articular resurfacing, and I had a carbon fibre mesh and abrasion/ hyaline cartilage that lasted for circa 12 years that was a good stopgap, but the hole is just too large now. I did have cartilage harvesting at the RNOH under Prof Bentley, but in the end the insurance company wouldnt pay for the re implantation as it was too early then - only two had been done in the Uk up to that point.
Re skiing, I'll carry on skiing gently until I can't go on and hope to do the same post TKR. I understand your stance re skiing post op, but I do know several types that have successfully kept on and would hope to do the same (in a cautious and gentle manner).
Re the other knee - the surgeon did give me an inconclusive report afterwards but, as you say, probably time to go back and have it looked at again as it's almost more painful than the other these days.
Thanks again

pushthebutton

1,096 posts

181 months

Friday 24th November 2017
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Markframe said:
...The guy that is the world expert is Tim Spalding in Warwick. worth a google if you want an opinion.
Thanks.

I hadn’t seen that name before.

I will.

BoRED S2upid

19,644 posts

239 months

Friday 24th November 2017
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Some exciting new procedures for knees that involve removing cells growing them in a lab then shoving them back in your dodgy knee (as you can tell I’m no scientist) but heard the trials for this are about to get NHS backing?

Markframe

Original Poster:

16 posts

76 months

Friday 24th November 2017
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BoRED S2upid said:
Some exciting new procedures for knees that involve removing cells growing them in a lab then shoving them back in your dodgy knee (as you can tell I’m no scientist) but heard the trials for this are about to get NHS backing?
It was approved for certain sites before and Southampton was one of them. It then was pulled. There is talk of this being trialed again, but it is not for everyone. Not for growing cartilage when you have arthritis. more for cartilage damage from trauma.

PDP76

2,569 posts

149 months

Friday 24th November 2017
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I’m 4 weeks into pain down the right side of my left knee. I’ve had to have this week off work, I couldn’t put weight on it, pain and letting go on me. I’ve iced it up all week and used a support.
Is there anything else I can do ?

( it is better, I can walk on it now but carefully)

The_Doc

4,856 posts

219 months

Friday 24th November 2017
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Hi Mark, be careful with advice over t'intenet. Advice You can build an ace reputation without it.

smile

The_Doc

4,856 posts

219 months

Friday 24th November 2017
quotequote all
Markframe said:
pushthebutton said:
pushthebutton said:
Very kind. Thank you.

Are there any new options for meniscus replacement or regrowth? I occasionally read about new procedures for cartilage, but they don’t appear to apply to the meniscus.

Thanks again.
Do you have any advice for me? I’m pinning my hopes on advances in procedures as there doesn’t appear to be anything concrete to deal with the Meniscus. I have very little in one of my knees and I’m relatively young.
Meniscal replacement does exist, but again not out of the realms of experimental. also not a great idea for those that are young as the unknown outcomes longer term. The guy that is the world expert is Tim Spalding in Warwick. worth a google if you want an opinion.
and I'm taking exception to this.

I've spent the last three days with Tim Spalding in Staffordshire, and he and Alan Getgood and plenty of others including Romain Seil et al would dispute this. It's precisely for the young, we just don't know quite when. If you're interested, see if you can ask for an invite to MATFest next time around.


The_Doc

4,856 posts

219 months

Friday 24th November 2017
quotequote all
Markframe said:
It was approved for certain sites before and Southampton was one of them. It then was pulled. There is talk of this being trialed again, but it is not for everyone. Not for growing cartilage when you have arthritis. more for cartilage damage from trauma.
and newsflash from the coalface, ACI is back on again. 04/10/2017

https://www.nice.org.uk/guidance/ta477

NICE now says a limited yes, mostly thanks to Leela Biant's work with the ICRS