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Monday, September 16, 2013

Knee Problems

In my last post, I mentioned the sudden onset of a problem with my right knee for no reason at all.  So I had X-rays and an MRI done, and last week I got the results.  The good news was that all the ligaments are intact.  The bad news was that almost everything else sucks.
Knee X-ray showing severe arthritis

The findings were that I have maceration and tears in the medial (inner) miniscus that go from back to front, a possible tear in the lateral (outer) miniscus, joint effusion (aka water on the knee), Baker's cyst and a loose cartilage body behind the knee, and severe osteoarthritis in all 3 joints, with the most serious being chondromalacia (similar to runner's knee).  This latter condition is apparent in the attached X-ray picture, which shows that I have almost no cartilage between my knee cap and femur.  Normally, there should be about a centimeter of spacing there.  Now the bones are practically rubbing together.  Creak!

Looking at these findings, I was wondering how I could walk at all!  Shouldn't I be in a wheel chair?  Surprisingly, however, I've been pretty mobile.  I have some pain, mostly going up and down stairs, but especially after walking for a round of golf (I refuse to rent a cart!).  However, the pain has been tolerable, and I haven't bothered to take any pain relievers for it.

I was kind of disappointed that this happened, because I had been harboring secret thoughts about trying to get in shape to run in a 5K event some time next year in a cancer fund raiser for Multiple Myeloma or Dana Farber.  I had started combining walking with jogging on the treadmill at the gym early in the summer, but I kind of dropped out of the gym over the last couple of months.  I was planning to try to get back in shape again once fall rolled around, but ironically, this happened out of the blue, without my putting any stress at all on the knee.  Go figure.

Today I met with my osteopathic surgeon, Dr. Mattheos.  He was great at treating me after I fell off the ladder last year, although it hurt like hell when he yanked my dislocated finger back into place.  Grrrr!  But I have forgiven him for that.  He seemed a little surprised that I wasn't in more pain than I was.  My knee actually feels pretty good, with most of the pain on the inner side where the main meniscus tear is.  He explained that he could do arthroscopic surgery to repair the tear, but that could actually make things worse, which was his way of telling me that my knee is pretty fucked up.  The main problem is my arthritis, and cartilage repair surgery might actually exacerbate that.

The upshot is that he recommended a cortisone shot to reduce the swelling and let the cartilage try to heal naturally.  So that's what I got.  Who knows if that will work, but it feels pretty good right now.  I also got a prescription for some PT, which I may or may not use.  I have a follow-up visit in 4 weeks to see how it's progressing.  He thinks it is possible that I could get back to normal activity.  Who knows?  There might be a 5K run in my future yet.  But I don't think I will try running anytime soon.


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