Torn knee cartilage : Am due to have an arthroscopy... - PMRGCAuk

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Torn knee cartilage

bakingD profile image
35 Replies

Am due to have an arthroscopy and repair as my knee MRI shows 3 separate areas of torn cartilage and a knee effusion- am in so much pain plus stiffness and swelling making walking v uncomfortable and gave to ge careful with every step

My brother read me the riot act saying don’t go for surgery you could end up worse

Feel v upset am worried that steroids have caused this as my other knee us starting to feel a bit sore too- guess it could never be proven

Am not sure what to do don’t feel can keep going like I am

Am on 3.5 mg Pred currently

Anyone else had surgery for torn cartilage?

Thanks everyone

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bakingD
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35 Replies
SheffieldJane profile image
SheffieldJane

I would be guided by my surgeon. Preserve us from well meaning relatives! The other knee is most probably reacting to the extra work. Best wishes for relief from your awful pain.

bakingD profile image
bakingD in reply to SheffieldJane

thanks v much for your advice!

piglette profile image
piglette

Knee replacement surgery has an extremely high success rate. By following the exercises recommended after surgery can make you as good as new. What is the comment on knee surgery by your brother based on?

bakingD profile image
bakingD in reply to piglette

My brother knows of a couple of people who went to top knee surgeons and ended up worse but not sure what their problem was

piglette profile image
piglette in reply to bakingD

I suppose if we know someone who has had a bad time we assume everything is always bad. I know several people who have had very successful knee ops and so would have no problem going for one. I assume the surgeons you mention did not become top knee surgeons because all their ops made people worse!

bakingD profile image
bakingD in reply to piglette

that’s a very good thought thanks 🙏

PMRpro profile image
PMRproAmbassador in reply to bakingD

Top surgeons are just that - surgeons! And surgeons are very keen on surgery - obviously! There are situations where surgery ISN'T the best option - I macerated my knee skiing some years ago. I saw a paediatric orthopod when I got to the ED - and he recommended no surgery for the totally snapped collateral ligament. I got a brace and it healed well and 18 months afterwards it was fine. An op would have been quicker at the time perhaps but studies have found the results at 18 months are similar. He told me of a colleague's wife, identical injury (and cause) to mine but her husband arranged surgery with a top surgeon. Unfortunately, she developed an infection and in the end had 3 ops - with a similar result after 2 years to me. People don't like the conservative approach because it takes longer. But when the conservative approach fails - you try surgery. And that is where you are at.

bakingD profile image
bakingD in reply to PMRpro

thanks that is such useful info you’re all so helpful and knowledgeable makes me much more relaxed

PMRpro profile image
PMRproAmbassador

And on exactly WHAT grounds is he saying that? To be fair to him - studies have shown that conservative therapies can achieve as good results in certain cases but it depends what. It isn't worth it for osteoarthritis or other degenerative conditions - but it does have a role in meniscus tears. What approaches have been tried so far?

This is quite a good discussion I think - because he does present both sides of the argument and tells you what you should be asking.

medstarhealth.org/blog/arth...

bakingD profile image
bakingD in reply to PMRpro

Thanks for your help it helps calm me down

Have tried steroid inj and taking off the fluid but the relief only lasted a couple of weeks!

PMRpro profile image
PMRproAmbassador in reply to bakingD

And it is so bad you CAN'T take the exercise approach. I suppose it is a stage to be negotiated before you reach the TKR approach. I suspect in the UK at present they wouldn't be offering surgery if they didn't think it was required. A torn cartilage isn't going to spontaneously heal and the longer you are immobile, the worse it will be in the end. You were so active too weren't you?

bakingD profile image
bakingD in reply to PMRpro

Hi thanks yes have managed to be pretty active despite my PMR ado now finding it so hard

Thanks to everyone that’s so helpful

PMRpro profile image
PMRproAmbassador in reply to bakingD

Good luck - let us know how it goes. Have you a date?

bakingD profile image
bakingD in reply to PMRpro

Yes Thanks so much 3 rd March

DorsetLady profile image
DorsetLadyPMRGCAuk volunteer

Is your brother feeling your pain? Or is he a knee surgeon?.

If neither, then by guided by your pain and your surgeon….

I had a very successful knee replacement (not quite the same as yours, and probably more straightforward ) in 2018 and my DIL’s father had one about 9 months before me…mine is absolutely brilliant, and so’s his…

bakingD profile image
bakingD in reply to DorsetLady

thanks very much exactly!am glad yours went well!!

SnazzyD profile image
SnazzyD

I’ve seen plenty of people helped by repair. To be blunt, what do you have to lose? What will you lose by increasing pain and disability? I agree that with dwindling resources they wouldn’t offer it unless there would be expected value added. Also, you don’t know if it would have happened with or without Pred. If it was that easy for Pred to cause it, you’d see so many more here. I’d love to know the basis for your brother’s assertions.

bakingD profile image
bakingD in reply to SnazzyD

thanks v much

Think my brother is ott about having any intervention but as it’s not his knee or his disability!!!!

Mary63 profile image
Mary63

I have had two arthroscopies since I have been on prednisolone. Both times because cartilage was torn, broken off and floating around. Both v successful for a year or so. I was like you…limping, in a lot of pain so not able to do much. Eventually needed a total knee replacement. Successful. Important thing is steroid injection and PRP? Injection helped not at all. Could do little in the way of exercise. So arthroscopy was the only option for me at that time. It is true that some people get good results with physio and exercise for knee pain but if you have torn cartilage it needs sorting out!

bakingD profile image
bakingD in reply to Mary63

hi glad you got sorted

Bee2222 profile image
Bee2222

I have just had the operation 3weeks ago and am on the mend. It is quite painful for a short time If you can get hold of a walking frame. Instead of the crutches it's much easier. Also found a seat lift on toilet a great help. Best wishes hope it works for you

bakingD profile image
bakingD in reply to Bee2222

thanks v much and good luck best wishes for a speedy recovery

Bee2222 profile image
Bee2222 in reply to bakingD

Thanks hope you get on ok.

Hi baking D

Knee surgery or total knee replacement is a very interesting yet complex subject. I have researched and read journals/ articles about TKA.

I have severe osteoarthritis in both my knees due to sporting injuries about 42yrs ago.

1) traditional method is whereby the orthopaedic surgeon uses his knowledge and experience to perform the surgery.

2) newer technique ROSA knee surgery :

What is the ROSA® Knee System?ROSA® Knee System is a robotic surgical assistant developed by Zimmer Biomet ( American company)that enables surgeons to carry out knee replacement procedures with greater precision and a higher standard of care during knee replacement surgery.The ROSA robotic system utilizes real-time information and assists surgeons with precise placement of the knee implants based on a person’s unique knee anatomy.

Factors to consider:

is whether the knee components ( femur/ tibia) are off the shelf,

is the fixation cemented or cementless.

To advance further, customise knee implants are the latest.

Symbios( Swiss company), after modeling your femur in 3D from a scanner, designs and manufactures a custom-made prosthesis specifically for your knee. The custom-made implants are then manufactured on a just-in-time basis for delivery a few weeks later to the hospital for your operation.

Next month, I will be having bilateral TKA using the customised components. I have completed my 3D scan of the knees with the dimensions agreed by the orthopaedic surgeon and the data sent to Symbios(Switzerland )to manufacture the components. Hopefully it will enable me to walk further and return to normal activities with less pain.

I ended my tapering regime of prednisolone in July 2022.

Best wishes for your health .

PMRpro profile image
PMRproAmbassador in reply to

But they aren't looking at TKR - it is arthroscopy at the moment.

marionofnorwich profile image
marionofnorwich

No, but I have the same issue. I have been on pred for 2.5 years - down to 4mg in March but then had to increase back up in April and currently on 6mg. In April I had Covid and a flare which coincided with incredible pain in my right knee (I am no wimp) which felt like toothache following being whacked with a hammer, and inflammation all around my knee front and back. An Xray in September showed damage to bone and cartilage but I am waiting for an appointment to find out how much damage and what course of action is recommended. In the meantime, much relief has been gained by wearing insoles to support my arches and simple exercises as recommended by Bob and Brad (see YouTube) and my knee sometimes feels almost normal. Massage has helped too and exercises such as the Tailgate Swing - sitting on a table and swinging my legs to increase circulation. Although personally, I will weigh up guidance from doctors (when I get any) but will try non-surgical first as I think it is too easy sometimes to resort to operations which are a privilege (that we can have them) but also a huge assault on the body which we should avoid of possible - so I think a middle road with self-help first a good idea

bakingD profile image
bakingD in reply to marionofnorwich

good luck-with your knee troubles too- I think yes you do have to weigh it up and have had such helpful replies

Depends how much your life is being restricted am happy now to go for it

marionofnorwich profile image
marionofnorwich in reply to bakingD

That's good. It will help if you have a settled mind. A friend of mine just had a knee replacement (privately paid for) and it has gone well. Another couple of friends have had hip replacements also gone well. I think knees are more complicated and I am sure that you must be careful to follow the rehabilitation exercises to make sure that the surgery has the best chance. You are lucky, in many ways, to have had an op offered I think. I have been waiting months just for an assessment to see what is needed

bakingD profile image
bakingD in reply to marionofnorwich

Thanks v much am lucky to get private care via hubby work

Gosh that’s a long time to wait hopefully you’ll get sorted once you’re seen

1951grumpa profile image
1951grumpa

Hello bakingD, I’ve had PMR since 2011. In 2016 I had a TKR which was definitely needed. And in 2018 a torn meniscus on my other knee. Cartilage doesn’t tear it wears off. Meniscus, the “cushion “, is what tears. Both times I was on 5-7 mg and all was good.

bakingD profile image
bakingD in reply to 1951grumpa

Ah thanks am so pleased it worked well for you

A2525 profile image
A2525 in reply to 1951grumpa

did you take longer to recover from meniscus arthroscopy being on pred

Because I’m worried with pmr nothing will mend as our bodies attack the soft tissue so will swelling ever go away

Last time I had one I was good in 3 weeks

Nit sure this time but have no life with pmr and this extra burden stopping me walk without swelling and pain bending knee

1951grumpa profile image
1951grumpa in reply to A2525

I didn’t think so. It was outpatient surgery and I walked (Crutches) to the car for the ride home. I don’t recall any abnormal swelling. I think I was at 5mg prednisone then. I was also on 10mg methotrexate injections at the time. Later on that year I had a surgery for a blocked sphenoid sinus. Both while on 5p/10mtx. The end of 17 I hurt my back and in January of 2018 I had a microdisectomy(sp). At that time I was at 2.5mg and no mtx. That caused a flare! I settled at 5 mg. And seem to be stuck at 4 now. Hope things work well for you. Geo.

A2525 profile image
A2525 in reply to 1951grumpa

thanks that’s good to know you can recover on the meds

A2525 profile image
A2525

I’m in your position now

Diagnosed pmr in November mint just before that in so much pain in shoulders I took a bath and could not get out so used my left knee. Week later meniscus tear ( I know be used had it 20 years ago and arthroscopy cured it.

I’m on 12.5 pred and 10 methatrexate

We are supposed to walk to keep away osteoporosis, I did play golf also

I’m in agony with swelling every time I do a 7 km walk or try to play golf and pred hides it until tablet wears off so nights ain’t good.

Do I

A/ try a cortisone ultrasound guided injection which may work or go for arthroscopy.

It’s bad enough with pmr but I have now zero enjoyment ( no golf or walking)

I could live with the shoulder and groin stiffness with pred but feel so unlucky for this to happen on top

I share your pain !! I wear a knee strap but still swells

Think I will see surgeon soon snd have to have it but will we recover from the inflammation given our bodies are attacking soft tissue ?

That’s my concern because of the drugs and pmr

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