Knee Arthroscopy Pre Arthroplasty

[janeym]

I’m 48 with grade 4 OA.
I’m not overweight and am otherwise healthy.


I had an arthroscopy 2 weeks ago. During the minor keyhole op they did a total meniscectomy and also debridement blah blah blah.

I am surprised that I’m struggling with pain following this minor (keyhole) op. It feels worse than before the op tbh!

I really expected to bounce back with no delay - after all it’s a minor op! (Ps over the years I’ve had various knee ops including an osteotomy in my mid 30s so figured this would be a breeze!

If (??) the arthroscopy has hastened the OA wld it do it so soon??! It’s 2 weeks today since the keyhole op.

Am I simply being impatient?

I am walking etc and went back to work 2 days later (sedentary tasks) but every single step I take is painful.

Worse than before the op.

Is this normal?

I’ve been to one physio session where they massaged my stiff calf and thigh but the pain isn’t stiff type pain- it’s really sharp at every weight bearing step.

Ps - when the surgeon visited me when I woke he told me I’d be needing a full knee replacement - likely within a year to 18 months - so I guess I’m asking if I’m likely to get worse before this time ?

My OA is caused by knee traumas (many dislocations ) my R leg also has OA

[janeym]

Btw to summarise for the esteemed sqad:

F 48y
Stage IV OA -
arthroscopic debridement, total
Meniscectomy 2/52 ago.
Sx: sharp
Pain on even mild weight bearing.
Hx of recurrent patellar Dislocation
PSHx lateral release+medial plication x 4, osteotomy x 1.


Yes i admit to 2 things (a) I know sqad is the resident medical guru because I used to be on this group years ago but subsequently forgot all my log in details so created a new one
(B) I’m trying desperately to show that I still recall some medical abbreviations from my years as a medical sec lol

[Sqad]

Two weeks is a little early for a painfree knee following those arthroscopic procedures that you have described, so yes, I think that obe could say that you are a little impatient........but understandably so.

It is intersting that you mention that the procedure could have stirred up you OA, might thoughts exactly.

The other factor could be that there is a loose body knocking around in your knee stopping yhe healing process.

My advice is to give it another 2 weeks on pain killers and if there is no improvement then get back to your Orthopaedic surgeon.

Many thanks for a full and helpful history.

[Barsel]

I didn't realise that OA is classed in stages. How do they determine what stage you have?

[Sqad]

Barsel

Based on the X-Ray appearance of the joint, the severity of OA is given a grade from 0 to 4, with grade 0 signifying no presence of OA and grade 4 signifying severe OA.

[Barsel]

I'm currently on the waiting list for both knees to have total replacement and yet nobody has ever told me what grade they are. Where could I get that information, GP or Ortho consultant?

[Sqad]

Barsel, there is little doubt your O.A is grade 4, but if you really want to know, then phone the secretary of your Orthopaedic surgeon.

[LadyCG]

Is your pain sharp and stabbing in nature or a dull ache?

[bednobs]

sorry, im not the OP but
"it’s really sharp at every weight bearing step."

[Barsel]

LadyCG, I wish it was just a dull ache.:-) For a few months now, both knees just keep giving way when I walk and I cannot get about without the Zimmer frame which is on loan from the hospital. I haven't been able to drive for 3 months either, so I'm more or less house bound at the moment. I was offered the op a year ago but I turned it down as I wanted to try other things like acupuncture which didn't work. Wish I'd had it done now.

[Barsel]

Sorry, I thought ladyCG was asking me. I must apologise for ambushing this thread.

[bednobs]

lol perhaps she was barsel - and i misunderstood :)
incidentally, nice to see you posting again

[Sqad]

I am certain (almost certain;) that the grading of O.A is purely on the basis of X-Ray appearances with little or no imput from symptoms or disability.

[Barsel]

Thanks bednobs. I stopped posting but was still 'looking in', just so I could keep an eye on you all. :-) x

[bednobs]

^^^ that went well! :)

[janeym]

Barsel
My understanding is:
1) Joint Replacements are not offered until it’s grade 4 (therefore you’re thAt stage unfortunately)
2) grade 4 is bone on bone (ie no cushioning between the joints)
And that the space between the joints on significantly narrowed

[janeym]

Ps my knee is feeling better daily - still the sharp pain but otherwise improving. I
Gonna GUESS the sharp pain is simply the OA… but I see the surgeon for follow up 29th so will ask him obv