Knee arthroscopy for moderate to severe arthritis

Tests and investigations
1

Hi Last year I was booked for arthroscopy on right knee during the wait for surgery pain improved so much that the surgeon advised against surgery saying that it might start it up again and also they were not sure when they suggested it that it would work.  I am now waiting for referral to hospital again as the left leg is now giving pain and stiffness.  Can anyone tell me if they had had this procedure with arthritis whether or not it worked.  Also amount of pain afterwards painkillers etc (can't take many because of IBS).

I want to go to the apppoinment with all the facts especially as I was not told until the cancellation that it might not work.  Thank you

2

Hi there I had a right knee arthroscopy last october and didn't really feel that it had made such difference then early this year my left knee became really painfull then I went back to the consultant who sent me for a MMR scan it appeared that the left was much worse than the right where it had been taking all the strain so I went back in two weeks ago to have the same operation on that knee. On the morning of the surgery I asked why they couldn't consider me for knee replacement as it seems pointless having this surgery if it does not make much difference and he said they don't do these operations until I'm in my 70s so they don't have do them again, I think the recovery time is about six months and now would have been a better time for me as I'm 62 and I think I would have a better chance of recovery than when I'm 70 but hey what do I know I'm really hoping that these two ops will make a big difference as I could only walk for a little while at a time, in each op the recovery was very good only took painkillers at night  and after a few days I didn't take any, my leg is very stiff so walking is still a bit difficult so I'm trying to rest and exercise in equal amounts, the one thing I'm sure about is that just because your pain subsided before if you don't have the op now you will be back at the doctors in another short time, my right knee was painfull for three years before having the op maybe if I had been offered it before my left knee would not have to have taken the strain and might not have needed the second op. Hope that helps good luck

3

Hi Sue, Thanks for your reply.  I am 66 and I wonder if the age they do knee replacements varies from area to area.  So many had said they have had it done in their 60's  I live in Greater London and I will ask about age limit when I finally get my appointment through.  I also asked a year ago about steroid injection and was told no we don't do them anymore, although I read on this forum about some patients

having them.  I am over weight so I suppose they quite rightly would

need me to lose some before surgery.  Can you tell me for either knee

did/do you get pain behind the knee and thigh going down outside of

leg into foot as well as knee pain.  This leg and foot pain is worse

then the knee itself and prevents me from going out at the moment.

It is enough just to walk round the house.  Stairs are hard have to come up and down on one leg only.  I still think there is something else going on as well as knee OA.  I have OA in neck and spine and varicose veins to add to the mix.  I have seen a vasular doctor who

said the pain is not from the veins.  I am on a lot of medication for

IBS,thyroid,blood pressure.  I have had 2 cataract ops in the last 2 years and also suffer with dry eyes and blepharitis.  I have had enough of all these things and wonder what next.  Feel better to have a moan.  Hope your knees continue to improve.  I think like you the left knee has taken the strain for the right one.  I just hope I can get some help.  I am going to try and diet.  I lost 2 stone a few years ago so I know I can do it except I can't exercise.  Just have to wait for appointment to come through and try and do my exercises and increase walking.  All the best

Carol

 

4

Hi carol you may be right about the areas I asked about the injections and was told they wouldn't make any difference I live in Essex and I didn't have to wait for this last operation it came through in two weeks but it's just luck I suppose I'm a bit overweight  well about two stone but they didn't mention that would make any difference the pain in the was on the front with it clicking when I bend it I couldn't go up stairs without going up on my hands and knees and couldn't bend down to get stuff off the supermarket shelves if they were low down I was so fed up with limping everywhere and had trouble taking my dog out. I definitely didn't have any pain  down the back of my leg or foot so not sure what's going on there it's does us good to have a little moan from time to time you take care and I will let you know how my stitches come out tomorrow, last year they put disposable ones in this year they didn't .

kind regards sue

5

Your surgeon advised against an operation then ?  Sounds to me like a bit of NHS cost cutting.

I read an article in one the national newspapers a few months ago about the NHS cutting back on these operations saying that they class them as "non-essential". It was written by a leading orthopaedic surgeon who disagrees with this policy and says that patients that have conditions like osteoarthritis of the knee would regard an arthroscopy as an "essential" operation because it makes them so more mobile afterwards and reduces the pain and discomfort. This surgeon went on to say that if the NHS thinks it's saving money by reducing these sort of operations, then they should think again. Sustained lack of mobility causes a whole host of other conditions like weight gain, heart disease, diabetes etc.. which is going to cost the NHS a lot more money in the long run. But that's typical of the NHS and this government  - short term gains and no thought for the long term future.    

My surgeon was very keen to do my arthroscopy  - when I saw him for the first time I got the impression he was the "roll sleeves up and get stuck in" type of guy. Just what I'd hoped as I didn't want to go down the steroid injection route.  That doesn't cure the problem - just masks the symptoms.

 I had my left knee arthroscopy last November. I'd been suffering pain for some months and was finding walking very difficult - especially going up and down stairs. I had an MRI scan which revealed osteoarthritis and two meniscus cartilage tears as well. I was told this was probably a result of an Achilles Tendon rupture that I suffered back in 2011. (three months in plaster and hopping around on crutches -  not recommended !!) 

My surgeon warned me that there was a small chance that I might not see any improvement. Also the nurses gave me chapter and verse on pain relief after the operation. However, I couldn't have asked for a better outcome. No pain after the operation - not even an ache or twinge. Knee joint was very stiff and  initially I was using two crutches to help walk around. That reduced to one crutch after about 3 or 4 days and exactly a week after the operation I walked up to my local pub and back, (albeit slowly),  with no crutches - a distance of about half a mile. I still had to use crutches to get up and down stairs for a few weeks.  A month after the operation  I was out on my bicycle and did a 9 mile ride with no problems at all - in fact my knee felt better for it.   

The secret is physiotherapy - lots of it. I was given loads of exercises to do. OK they are boring and monotonous, but stick with them, do more if you can, and you feel the benefit. The more exercises you do, the less stiff your knee becomes, and the less stiff it is, the more you can exercise.. and so on...

It's now about 8 months since I had my op and I can honestly say that it feels like I never had any knee problems at all. Just very occasionally I get a tiny twinge if I twist my knee into certain positions - but it's nothing really.  I've been told not to do any activities like jogging or racquet sports which put pressure on the knee joint. The cartilage is still worn and you have take care not to make it worse. Cycling is an excellent exercise - it puts virtually no "impact pressure" on the cartilage and knee joint, but strengthens the upper leg muscles. The stronger these are, the less pressure you place on your knee.

I'll admit not everyone that has this operation will be as lucky as I was - there will be some that will only get partial relief and may require pain relief after the operation. But I would strongly recommend it. The worse that can happen is that you are no better off, but there is every chance you will see some improvement.

6

Thank you for your reply.  You may well be right about NHS cuts, especially as I am in Greater London.  I have suspected this in other areas of health.  However I had actually arrived at the hospital for the surgery and been booked in etc.  It was only when the consultant came round before the op that the decision was made not to go ahead.  They don't do injections they told me, now I think that definitely is a cut.  I have had OA in both knees for over 20 years.

It has only been bad this last couple of years.  Twice during the 20 years I had flare ups in both knees at separate times. Which got better quickly with rest medication and course of physio.  Then the pain was just on the inside of the knee and did not stop me walking.  I have had physio again last year but it caused so much pain that I had to stop.

I personally think I need TKR's but am worried about surgery as I cannot take most pain relievers and have arthritis in spine and neck as well.  I would need to lose weight and be a lot more healthier.

That said will see what consultant says when I eventually get the appointment through.  Thanks and all the best to you.

 

7

Hi carol well had the stitches out didn't  feel a thing and apart from the bruising around my knee you can't even see I have had any surgery at all, I'm glad I had it done and have decided to give it a year and if it's no different I will be back to see the consultant as I don't want to wait until 70 I'm not prepared o be limping around another 8 years have you heard anything from the hospital yet, I hope you hear soon good luck

kind regards sue

8

Glad everything went well,hope you find your knee pain has improved.  

You are right deciding to give it a year and then back to consultant if not difference.  I have still not heard from the hospital.  If I remember from last time it took about a month for the appointment to come through.  Does not seem long but if you are in pain it is.  Yesterday and today I am in more pain, both legs now.  The knee pain is bad enough but can't stand the pain down outside and back of legs into foot and lower back pain.  My IBS is playing up as well.  Have not slept

very much last two nights and have not been out for a week as too

painful to walk other than around the house.  Will let you know how it goes at the hospital expect it will be weeks before I get there.  Going to try and make it to my CBT appointment on Wednesday if I possibly can.  All the best Carol

 

9

Hi Carol this pain going down your leg to the ankle sounds like sciatica as I have had this before when I had back problems a few years ago so that could be another a problem on its own you sound as if you have had a painful weekend one way and another hope the appointment comes through quick and then you can get some answers good luck

kind regards sue

10

Hi Sue, Yes I wondered that as well.  I get so frustrated not knowing what's causing what.  I had arthritis in the spine diagnosed earlier this year following an xray for odd aches and pains in the back.  To try and cut a long story short my left knee starting playing up a bit earlier this year (not the one last year).  I then very foolishly helped my husband assemble bunk beds for grandchildren.  My husband also has arthritis iIn the hip so could not let him do it on his own. Well I paid for it afterwards.  Then would you believe one morning I bent very slightly over to do something and felt pain in my lower back and couldn't straighten up. It was hard walking for a few days.  To crown it all just after my grandchildren had left after their visit (which had tired me out anyway) I twisted my knee getting back into the car. Pain was awful but has improved a bit since. So now I am left with both knees stiff and painful worse is the lower pain pain most of the time and pain in legs and feet especially outsides of leg below knees.  The referral was made for knee before all this happened so wonder if I should revisit gp and and ask if I need separate referral for back etc.

Did I mention I have severe varicose veins (had them stripped over

20 years ago but they have come back).  The vascualar doc said pain is not from veins, but I am not sure at least I think it might be part of the problem.  I want to get to what is causing this pain and keeping me almost housebound.  I don't want to have unecessary treatment and find no improvement.  Sorry to go on but my husband is fed up with me moaning, so need to talk about it.  Hope you continue to feel better with your knee.

Carol

11

Hi carol don't worry about having a moan we all need to sometimes and it's always better if you can find someone to identify with I definitely now think it's sciatica that's causing the pain down your leg and to the foot that's a classic symptom from your back problem it doesn't get easier does it as we get older lots of little niggly things create a lot of pain and then it's hard to tell where the actual pain is as it seems everywhere I would be the same I'm always doing stuff that I think whoops shouldn't be doing that but get away with it at the time, I have to realise that I'm not as flexible as I used to be I have run marathons and done lots of voluntary stuff but realised that some things are beyond me now, my mum is 85 and sufferes with COPD has said this weekend I didn't think I would get old this quick up to last year she was mobile and going to bingo (her passion) every week now she can't get out without her shopping trolly and sometimes not even with that, anyway best thing to make an appointment with your doc and see what they think of the sciatica maybe you will need to see a different consultant for that bets get everything sorted out at the same time

good luck

kind regards sue

12

Thanks Sue Will let you know how I get on.

Carol

13

Hello Sue,  Hope you are well and your knees are not giving any or too much pain.  Just to bring you upto date Knee pain has really improved I think the main problem was when I twisted it.  I used ibuprofen gel for 3 weeks and could not go out as could not walk.  I started to get side effects so changed over to Pernaton gel which does help a bit.  Now down from paracetamol 4 times a day to twice a day.  The pain has much improved and am now starting to go out although I have to sit and rest if the pain starts.  Using a stick. I have an appoinment to see consultant on 25th of this month.  I will tell them about leg and back pain as well (that too is much better).  Will let you know what they say.  Off to hairdressers now so that will make me feel better.  

Best wishes 

Carol

14

Hi carol glad the pain is subsiding a little and that you are getting out and about a bit more now glad the appointment has come through perhaps now you will get some answers for the pain. I'm a bit sad to say my knee op has not made much difference I'm still limping about, maybe it takes a little time but I'm so impatient still waiting for a follow up appointment to see what the consultant says I did hope that it would make a bit of difference and I would be able to walk without limping but the pain is still there maybe I will try some paracetamol, I have been taking the meds the hospital gave me cocodamol to get get some sleep at night but not not taken them through the day. Oh I'm so impatient carol I just want to be able to walk without pain.

you take care

suexx

 

15

Hi Sue, Sorry you are still in pain as you say maybe you just have to be patient, not easy.  The jury seems to be out as to whether these arthroscopies work for OA.  Last year when mine was cancelled the surgeon actually told me that when I was offered it they did not really know whether it would work or not, and as the pain had improved they

did not want to cause more pain as long term it might or might not work.  When I go on the 25th I am sort of expecting them to offer it again for this leg

(left on now right one last year).  I don't suppose they will think I am bad enough for TRK and if arthroscopies don't always work you are just left with physio and painkillers and in my case lose weight.  Oh well not long to wait now see what they say.  I must admit I don't relish the idea of TKR I have heard a few bad tales of the amount of pain you are in for several weeks afterwards and as you know I can't take the painkillers they would prescribe.  I have also heard of knees being numb and stiff even after recovery.  I am a worrier so perhaps I am being over dramatic.  I think you need to be as fit as you can prior to surgery and I am not.  Take care I hope it does improve for you.

Carolx

16

Hi carol any luck with your appointment or are you still waiting I can honestly say there has been no improvement at all with my operation and am now thinking of knee replacement I don't think I can hobble around until I'm 70 goodness knows what I will be like then so I am going to try to see the consultant again and see what he says.

hope everything's okay with you

kind regards

sue

 

17

Hi Sue Good to hear from you.  I am sorry that your surgery has not made any difference.  Yes you should see your consultant again.  Surely TKR is the next step.  I don't understand the NHS surely as you say you will have better recovery now than when you are 70.  All about money really.  

Now the saga of my appoinment.  My long awaited appointment on 25th September was cancelled by the hospital the day before.  The reason I had been booked under the wrong consultants clinic.  I did notice that when the letter arrived that it was a different consultant but assumed because the clinics were now at a different hospital my consultants clinics were full or he was not working there.  It was orthopaedics so as I had waited so long I just accepted it.  They gave me another appoinment for this month but I had to cancel it because my husband was at another long awaited hospital app on the same day. Anyway I now have one for Nov 6th.  Now my pain is much better  just like last year with the other leg so I am thinking that they won't 

do anything just painkillers exercise etc.  Now all this is overshadowed by another problem I have now silent reflux.  It has sent my anxiety soaring.  It seems to be one thing after another.  Going back to the knees I use a stick for walking and yes I do get some pain but nothing like before.  My back still hurts but I still believe it is all connected. I will ask about my back when I go but I think I am right in saying I would have to see another orthopaedic doctor who specialises in the spine.

This all takes for ever. 

I hope you can get an appointment with your consultant soon you will have to let me know what they say.

Carol