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Patellofemoral arthritis anyone?

Discussion in 'Health and wellbeing' started by piglet171, Oct 26, 2011.

  1. piglet171

    piglet171 New commenter

    I read upside down today that I have grade II of the above, though I haven't actually been told this. I was so busy trying to memorise the term, and also quite stressed, so didn't ask. Waiting for physio but would be grateful for any experiences. Have looked on t'internet and it does not seem like good news.
     
  2. I've got arthritis on the back of my kneecap but yours I think is the one where it grates along the femoral cleft thing, wearing both surfaces out. Treatment's the same for both - they can do a resurfacing with plastic (or is it silicone?) when it gets more painful than you are prepared to put up with, and beyond that it's a knee replacement. I don't know how advanced Grade II is. Mine makes a hideous crunching noise when I get up from sitting, kneeling or squatting and hurts from time to time. It was discovered when I had an arthroscopy for a torn cartilage and is the excuse apparently for why my knee still hurts after a successful op!
    Why not ring your GP and ask him/her to explain it to you? It's a sod when you think of twenty things you wanted to ask the consultant, once you're out of the building!
     
  3. piglet171

    piglet171 New commenter

    Thank you for your reply Lily. That sounds about right. Had medial meniscus trim and not getting any better. Obviously this is what he found during the arthroscopy, however nobody saw fit to mention it. I had to read it upside down from the notes. I have instead been told that a knee can take up to 18 months to "settle down" after an arthroscopy, despite the fact that I was chucked out post-op with garbled physio exercises, no follow-up appointment, and told that of course I would be fine to go back to school in 3 weeks. He referred me for physio and marked my physio letter urgent, but when I took it to the Health Centre the secretary said they would send me a written appointment after they had assessed if it was urgent or not. When I pointed out the URGENT at the top, she said, "What the registrar says is urgent is rarely what the physio sees as urgent."
    I am so fed up - I just want to be told what is wrong and how I can go about improving things. I have found a picture of grade 2 - It says "partial thickness (less than 50%) defect or minor tears in the surface of the cartilage." Another diagram gives 2 years between Grade 2 and 3.
     
  4. If it's any consolation, I had the arthroscopy two years ago and it certainly hasn't got any worse - if anything somewhat better, though that might be partly down to the arthroscopy trim and clear-out.
     
  5. Anonymous

    Anonymous New commenter

    My sympathies, piglet. I am hobbling round on an arthritic knee that is due to be replaced on Dec 1st. It is a bloody nuisance and I feel for you!
     
  6. ljr

    ljr New commenter

    I had my long awaited arthroscopy 3 weeks ago. For the 1st week it was fine (I was told I could return to work 5 days later but I do only teach 2 days a weeks) but then the pain started again. I was given physio appointments the week after the op and am having my 4th this afternoon. My knee is really painful when I put weight on it and climbing stairs is something to be avoided if possible. The consultant told me that he had repaired a torn cartilage (which hadn't showed up on the MRI) but basically I need a new knee as the cartilage is so worn, but I was far too young. My point is that I would much prefer the knee now so that I can continue my active life style - I can sit in a chair when I'm 80. I am seeing the consultant for my follow up appointment next week but I suppose I'll be told to wait to see how it goes. All I know is that its now much more painful than it was before the operation.
     
  7. ljr

    ljr New commenter

    Hi piglet, my birth certificate tells me that I'm 58, but I'm sure its wrong - apart from my knee - the rest of me is still 20 maybe 30 something ( lol )!!! I enjoy long walks and cycling, neither of which are possible at the moment. The armchair aerobics sounds good - I need something to stop my weight from slowly creeping up whilst I'm not exercising. I can still do pilates, but it doesn't burn calories. I don't know whether it was the posterior or anterior, maybe I'll be brave enough to ask when I go back on Monday. The physio I saw yesterday is quite convinced that the pain will go as long as I do the exercises properly. She has strapped the knee up, so that the muscles have to work in a certain way. I feel a lot more hopeful after seeing her. Hopefully once you get going with some physio it will start to improve.
     
  8. My back was a lot better whilst I was conscientiously doing the physio. Then it felt better so I stopped and now it's hurting again. There's a lesson in there somewhere......
     
  9. piglet171

    piglet171 New commenter

    jjcool, you seem to have seen a few people. Did you manage this on NHS or did you have to go privately? I ask, because I have yet to see, let alone speak to, any consultant, apart from a 2 second glimpse as I went under the anaesthetic. Also, the registrar who has just referred me for physio did not mention the arthritis, either to me, or on the physio referral slip. Nor did he take any notice of the pain in my unoperated knee. Therefore the physio will not have full information, eg. squats are recommended for quad strengthening, but not if arthritis is present.
    In desperation I have booked to see a consultant ( yyyaaayyy) privately. All I really want is some reliable and full information and advice - apparently not available on NHS, at least where I live! Wish I'd done it 6 months ago.....
    PS From my research grade 2 is some cartilage on one surface.
     
  10. Piglet, my history goes waaaaay back. (I was 57 last week) I played netball every day at primary school (we had 1.5 hrs for lunch time in those days) so catching the ball in the air and landing on one leg on hard surfaces, wearing pumps took its toll (no such things as trainers in those days).
    I had my first problems with a swollen left knee age about 12-and had my first X ray then. I was ok throughout the growing up years-was pretty sporty and my knees were fine as long as I didn't overdo it. Continued to play sport through adulthood (tennis, squash, keep fit, step-aerobics plus hill walking, back packing and camping etc).
    However, so much sport does catch up on you; had my first arthroscopy age 35 in left knee and right knee 3 years later. I was meant to have physio referral but often with day cases the physios may have gone home by the time I came round from the anaesthetic. Have had a total of 5 arthroscopies (3 left and 2 right ), all NHS except for last one and my recent replacement surgery was private as husband has BUPA cover with job. After getting over each op, there was always some improvement in pain levels (though not noises the joints make) and I went back to playing some sport and walking about 2 miles a day to and from my kids school-which also helped keep my weight down -which also helps the knees.
    One thing I can vouch for is the professionalism of (most) physios-my daughter is one, (sadly she lives nowhere near me so I only get phone consultations) so I am well aware how hard it was for her firstly to get a place at university (harder to get into than medicine in terms of places available) and then how hard she worked for her qualification and how much CPD she does as part of her job. Each physio has a specialism, so try and ask for one who is a knee specialist with interest in sports rehabilitation, and then trust them to do a proper assessment of you and decide on the best course of action for you. Then most importantly do the exercises they give you (take pain killers beforehand and ice any sore areas for at least 20 minutes afterwards) to make it more do-able.
    As for mentioning arthritis, I wouldn't worry about this-, the physios know their jobs and you really need to work more on how your knee feels rather than what grade of damage-I walked around on a knee with grade 3 and 4 damage for 5 years before replacement surgery; however I would have been better and had a faster recovery time now, if I had had the replacement surgery 2 years ago.
    Feel free to PM me if you need any more advice-I can also send you copies of some of the exercises that are easier to do etc
    Take care
    JJ

     


  11. Hi Piglet, I never skied except for some cross country stuff in Norway in another life, but as my original degree was in Geography I was quite an outdoorsy person, I did a lot of hill walking, outward bound and worked for years taking students on D of E expeditions. I also played loads of sport (including running school football teams) until I was told to give away my squash and tennis rackets a couple of years ago. So I know from experience that there are things you can do to keep active in your chosen sports.

    Firstly supplements; do you take anything like Glucosamine-well worth it but you need to take about 2000mg a day (most recommended doses are lower) to have any effect. Can take about 3 months to kick in. Try a website like healthspan for guidance as well as good quality supplements.

    Next advice for skiing is wear heavy duty knee braces (the sort with hinges as sold by someone like Physio-med http://www.physio-med.com/-b2c9a2Orthopaedics-Supports/ ). So many to choose from-may be worth getting the catalogue and seeking out physio advice. My surgeon still skis and I know he has to wear a brace on one knee.

    For hill walking I assume you use trekking poles-these are a must for walking downhill to take some of the pressure off your knees-also try and carry as little as possible as the effect of any extra weight you carry (including body weight ) really takes its toll on down hill stretches.

    Did you know about surgery that's in the early stages where cartilage is taken from your knee, regrown in a lab and then reinserted into your knee. I was too old and my knees were too far gone to be eligible for this (but is on NHS)

    As a matter of interest do you know how you managed to tear the cartilage ? Was it intense exercise where you felt something give? The effect of any such problem will show up if your knees become swollen and warm after exercise; this usually indicates bits of stray cartilage floating around your knees joint, being treated by the body as a foreign invader and causing the inflammation. I didn't have any swelling in my knee prior to recent surgery as there was no cartilage left to come loose and cause inflammation !

    How old are you, as that often my indicate your best route for future treatment. Also what area do you live in as I or my daughter (the physio) may be able to recommend someone.

    As I say most of my surgery is due to a very active life-nothing I could really change although I made sure that my daughters had really good trainers (most cushioned and supportive rather than the latest trendy brand),nomatter how little money I had.

    The offer to reply to a PM if you have any other queries still stands

    Take care
     
  12. piglet171

    piglet171 New commenter

    How are things now, ljr? Better I hope.Your experience sounds very like mine,but I wasn't given any physio appointments, probably because I only had a trim. Hope they are helping.
    As for being far too young, again I fully sympathise. I am 54, and getting fed of being told that "at this stage in your life, you have to expect to make changes"....(registrar and optician this week - God bless the dentist, who didn't mention age, just the "extensive restoration work" on my teeth!!).
    At this stage, like you no doubt, I want to do the things I enjoy now I am no longer running around after kids, not sit on my bum and wait until I'm 70 and eligible. As a very impatiemt person, all this is driving me nuts....
     
  13. piglet171

    piglet171 New commenter

    I am also now attending physio for "general knee health". My kneecap is also being pulled and has now been taped, and my quads and hamstrings are also not equal. Are your exercises making any difference?
    Despite my knees "catching" all the time as they bend, they do not want to do anything beyond physio, although I suspect if I went private they would advise another arthroscopy to trim the catching cartilage. However I can't afford this and am not keen on further ops after the last one, so will soldier on....
     
  14. ljr

    ljr New commenter

    Hi Piglet - your knees sound so similar to mine. I hate to sound miserable but my physio & exercise seem to have go me nowhere. The taping was good - but as soon as it all came off I was back to square one. I was discharged from physio last week (and this was private sessions, I decided to pay for some extra to see if it would improve things), and was told that the only thing that would help would be a total knee replacement. I can't see me getting that on the NHS, not that I want it just yet, I can't be out of action at the moment. My cartilage (whats left of it) is catching all the time, I have to get my knee in the right position before I can attempt stairs & even then it is very painful. One good thing is that my memory is improving - I cant keep going up & down forgetting things! If I know it is going to be a hectic day I take anti inflammatories and just keep going. I wish you all the best & hope that you can soldier on for as long as you need to.
     

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