KNEES UP (AND DOWN).

KNEES UP MOTHER BROWN

I don't know who Mother Brown was but that was a bit of a laugh.

******************

I went for a MRI scan last week and had a follow up consultation with an orthopaedic surgeon to check out the left knee I damaged at the end of last year.

Knee Mri
medial meniscus tear

MRI LEFT KNEE
Indication:
 Ligamentous or meniscal injury
Technique:
Sag T2FS, T1; Cor PD, PDFS; Ax PDFS
Findings:
The anterior and posterior cruciate ligaments are normal.
There is a complex morphology tear of the medial meniscus. This has a predominant oblique tear, which disrupts the undersurface of the body and posterior horn, however there complex irregular tear components in the posterior horn with some maceration of the free margin.
Mild generalised thinning and partial thickness fissuring of weight-bearing medial tibiofemoral compartment cartilage with a superimposed 6 mm area of essentially full-thickness fissuring medial femoral condyle. The medial collateral ligament is intact.
The lateral meniscus and lateral tibiofemoral articular cartilage is intact. Lateral ligamentous supporting structures are intact.


5/14/2018 High-grade articular cartilage loss and fissuring involving the patellar apex, extending into medial and lateral facet. Small 5 mm partial-thickness chondral flap just lateral to the apex. Small area of partial thickness chondral irregularity at the inferior aspect medial facet femoral trochlea but the majority of trochlear cartilage is preserved. The distal quadriceps and patellar tendons are normal.
Moderate knee joint effusion. No loose intra-articular body.
Interpretation:


1. Extensive complex tear posterior horn and body medial meniscus.
2. Moderate chondral damage medial tibiofemoral articular cartilage.

          3. Moderate patellofemoral chondral damage, particularly involving the patellar apex.


OK. Got that?

My knee is a bit stuffed but I can still walk on it.

I discussed options with the surgeon and he basically said that I could have the standard investigative operation for which he would make lots of money from the health service and ACC or that I could 'suck it up'. He said that when people have the op which involves inserting a camera thingy behind the kneecap and having a bit of a fossick around, which is quite invasive, often the after op result is worse than before and that people can have mobility problems which necessitates an earlier than normal requirement for a joint replacement..

I asked him about non surgery options and he said that cortisone or PRP (platelet rich plasma) injections can be done but the jury is still out on the effectiveness of this. Also, it costs $3000 a jab!

I said that I'd 'suck it up'.

I can't afford to have an op that would result in walking difficulties. Post op care requires 6 weeks of having your leg up (not over) and basically that's no good for me. Sure I'm retired and have the time but I live in a remote place and have to drive to stores to get provisions (my car is a manual drive). Also, The Old Girl works in Auckland during the week.

We bantered a bit about how other people have coped. He said that some patients complain about not being able to do things that they used to and that he tells them to just adjust their activity to suit. I told him that old doctor's joke which he seemed not to know :

Doctor: "So what's the problem?"
Patient: (raising his arm up above his head) It hurts when I do this"
Doctor: "Then stop doing that."

The doc (actually a 'mister') advised against too much hill climbing as the descent can cause problems but that coastal walks are OK as is golf and tennis if I'm sensible (no fossicking for golf balls in the creeks I fear). He said that cycling is best as it involves low impact repetitive movement. I'm going to get an exercycle.