Thread: looking for input

I saw my primary physician today and I have a referral to see the orthopeidic doctor. If my primary is able to (Insurance) I will have an MRI ordered prior to seeing my orthopedic doctor. I understand that it will take a trained orthopedic doctor looking at my knee MRI to have a sense of what is going on. All that said, I was wondering what thoughts people might have on here as I am anxious and this could be well over a month to get to the end diagnosis. And you know ski season is coming up.

Me: 48, Knee in question was scoped about 14 years ago for a meniscus tear. At that time arthritis and a partial ACL tear were noted. Last summer I had some knee pain and resulting leg stiffness. When doing a frog kick swimming, the knee felt very loose and as if power could not be generated from that leg. Took it easy and the symptoms seemed to go away. This summer pain and stiffness would appear and disappear with rest. Two weeks ago down hiking the knee became very painful and stiff. Certain movements created extreme pain and I was worried the knee was going to give out. My job requires me to stand for hours at a time and the leg stiffens up and becomes quite painful at the knee joint. My primary said there was swelling at the knee joint and he was unable to fully assess it because of the limited mobility in the knee. When I asked what might be going on. He said it could be a further meniscus tear or possibly that I am down to bone on bone, which would necessitate a total knee.

Any similar experiences, thoughts? Things to ask the Orthopedic Doctor?

I dont have any advice for you, but want to wish you luck and hope for good news. My husband had his knee scoped about 12 years ago, and started having trouble with it last year. He was told by his primary care physician to get an MRI done also. When he tried to schedule the appointment they said he had to pay his $250 deductible before they would even schedule the appointment. He was not happy and said "forget it". Insurance can really get in the way of medical care and it is very unfortunate.

Anyway, best of luck on getting your knee ready for ski season!!

Thanks for your kind thoughts. The question on the MRI is whether my insurance will allow the primary to request it or if I need to wait for the first appointment with the Ortho. I expect it is going to be a while before I know anything definite and wanted to know other peoples experiences. Mostly just kind of bummed this is happening now.

If you haven't had them yet, you definitely need xrays before an MRI. Go see the orthopod first so they get the right films. I can't tell you how many times I've seen people who's PCP ordered an MRI before xrays just to show severe arthritis. Total waste of time and resources. Your scope 14 years ago showed arthritic changes and that has most likely progressed further. Hopefully not too bad. The xrays should provide useful information. Even if you are down to bone on bone, there are conservative options short of knee replacement. If the xrays look OK, then an MRI may be warranted.

From what I know from dating a physical therapy (DPD student) and hanging out with a bunch of skier PTs, I think it is highly unlikely that you need a total knee replacement. The total knee replacement patients they see seem to be old, really out of shape. Have a long history of knee problems ie multiple sugeries, or one major major accident. One of my friends who is a really good PT has had bone on bone for years and is an avid snow boarder. He manages it with excersise. The stronger you make your legs the less it matters that you have bone on bone. He swears that If it does get to the poin of needing a total knee he wants the leg amputated at the knee, as apparently amputees are able to do more than recipients of total knee transplants. Also if you are over weight it is time to shed that extra weight. But then I'm no expert in this stuff, just find it very interesting.

Will see if I can get my friend to look at this post, he will be able to give you much more insight, but not sure if he would be violating some professional standards or somthing by commenting without seeing you. Where abouts do you live? If nothing else I am sure that he could give you some recommendations on PT clinics if it comes to that. From their perspective Dr's usually don't know if a PT clinic is good or not, so don't just automatically go to the one your Dr usually uses.

Thank you all for your thoughtful replies. I feel better now. Just was anxious waiting and skiing really is what makes the winter worthwhile for me.