Fix My Knee

Now that my doctor knew the location, size and shape of the tear, he suggested that I may be able to recover with physical therapy, and not have to have surgery. Tears at the outer edge of the meniscus have a better chance of healing than tears in the inner part, and the type and shape of the tear also makes a difference.

I agreed that I’d prefer to avoid surgery if possible, and I was glad to learn that my doctor didn’t head straight for the operating room until trying other less-invasive treatments first. We started a course of PT, but after a few weeks it became apparent that it wasn’t helping. We ended up scheduling knee surgery.

My doctor brought in another surgeon to assist with the actual surgery, one who did have some experience with arthroscopic surgery, which was then in its infancy. They attempted — but failed — to repair or remove the meniscus using an arthroscope. Remember, this was almost 30 years ago; arthroscopic surgery wasn’t nearly as commonplace or as advanced as it is today. They ended up doing a conventional surgery, making a 4-inch incision in the outer (lateral) part of my knee. For many years, I thought they had simply cut away the torn part, but years later I was told that I had no meniscus there, so they must have removed it altogether, or enough of it that my later doctor considered it to be non-existent.

I’m a little hazy on the exact details; remember, I was only 17, and it was a long time ago. But I know for sure an arthroscopic surgery was attempted, because I had 3 tiny little “scope hole” scars on my knee, in addition to the scar from the large incision. My knee is such a Frankenstein’s monster today, I can’t distinguish those scope scars from the later scope scars, but for years they were readily apparent on my knee, if you knew where to look.

Here I’m going to take the time to write a little rant about a 17-year-old’s first surgery.

After the surgery, I was back on crutches for several weeks, and had physical therapy exercises to do. Over the coming months and years, my knee recovered to the point where I paid it no attention at all. I could do everything I wanted to do. About the only thing I could not do was run or jog, but I hated running and jogging, so the knee was a handy excuse for not doing that. But I could water ski and snow ski, and ride my bicycle, and do pretty much everything I liked to do and wanted to do. I considered it to be a closed book, a done deal.

Until 20 years later, one day in the fall of 1999, when my knee locked up on me again.

Tags: General Knee Surgery by sonjay
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My knee surgery saga started back in 1979, when I was 17. At the time I didn’t have any idea it would lead to the epic catalog of surgeries that eventually resulted. I was at a park one afternoon near my home, kicking around a soccer ball with some friends. We weren’t even playing soccer; I wasn’t a soccer player, nor were my friends. We were just hanging out, killing time before going to see a movie.

I kicked the ball, and my right knee locked up on me, just as it had done many times before. Except this time, when I tried to straighten my leg, the knee didn’t “pop” back into place. It stayed locked. I couldn’t bend it or straighten it. And it hurt. The other times it locked up, there wasn’t really any pain.

My friends took me home, and my parents took me to the hospital. (I could have saved myself some traveling — the park was right next door to the hospital.) At the hospital, they poked and prodded and X-rayed. Somehow they got my leg straight again, and sent me home with a prescription for painkillers and a referral to an orthopaedic surgeon.

Back in those days, when dinosaurs ruled the earth, arthroscopic surgery was only just appearing on the scene. Most surgeons didn’t do arthroscopy; arthroscopic surgery was mostly reserved for pro athletes. It was also more primitive than it is today, and it certainly wasn’t used for diagnostic purposes as it is today.

So my orthopaedic doc didn’t do an arthroscopy to find out what was wrong with my knee. X-rays don’t show cartilage. I don’t think MRIs even existed. What they used to do back then was a procedure right of of some Creature Feature torture chamber: the dreaded arthrogram. My orthopaedic doc sent me to an imaging lab for the arthrogram. At that point, my knee was doing pretty well; I walked into the imaging lab, but afterward, I could barely hobble back out on crutches.

The arthrogram consisted of the guy — doctor? radiologist? technician? I dunno; I was 17 — anyway, the guy in the lab injected some kind of dye, maybe iodine, into my knee. The dye clings to the surfaces of the cartilage and shows up on X-rays. After he injected the dye, he then used a giant syringe filled with air to blow up my knee like a balloon until it was the size of watermelon. Then he twisted my knee into several dozen different contortionist positions, making me hold each position while he X-rayed it.

I don’t know if they still do arthrograms today. But if anyone ever again tells me they want to do an arthrogram on me, I’ll tell them no thanks, I’d rather have bamboo shards stuck under my fingernails.

After the arthrogram, I was back on crutches for more than a week. My orthopaedic surgeon informed us that the arthrogram showed a torn lateral meniscus cartilage.

Tags: General Knee Surgery by sonjay
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I’ll start with a general overview of what happened, when, and how. It all started back when I was a senior in high school. I was young, fit and healthy. I had complained of my right knee occasionally “locking up” on me, but I didn’t complain too loudly. It didn’t seem serious — I would just force the leg straight, and the knee would sort of “pop” back to normal. But at one point it locked up and wouldn’t “unlock.” I ended up having conventional surgery for a torn lateral meniscus cartilage. I was on crutches for a few weeks, then back to normal, and I thought no more about it

Fast forward about 20 years, to 1999. The same knee locked up again, and again wouldn’t “unlock” no matter what. I had an arthroscopic surgery, in which the doc removed a “loose chondral body” (I think that means a piece of cartilage). I was thrilled. Immediately after the surgery, I was able to stand up, walk around, bend the leg, straighten the leg.

Then the doc told me the bad news: I had no meniscus cartilage in there, and had lesions (holes) developing in the articular cartilage. I needed two major, complex and expensive surgeries in order to avoid a knee replacement. I needed them both — either one alone would leave me vulnerable. And I needed them fairly soon, or the lesions would result in full-blown osteoarthritis and it would be too late.

Later on I’ll go into my long battle with the insurance bureaucracy to get this covered. I did eventually get it covered. I had a major open-knee surgery that lasted 4 hours and left me on crutches for about 2 months. Then I had an arthroscopic surgery. Then another open-knee surgery. Then another arthroscopy. Then finally another open-knee surgery. (I think that about covers the surgeries; it’s possible I’ve forgotten one or two.) The first of these and the last of these were planned and expected; the others came about unexpectedly.

That series of surgeries took place in 2000-2001. Today I can climb stairs, ride a bike, rollerblade, water ski, snow ski, pedal my Adventure Island kayak, and do nearly everything else I want to do. I don’t have full 100% contraction, so I cannot squat, nor do I have full 100% flexion. I probably have about 95-96% both ways. The knee is still sensitive, and if I have to kneel, I have to have a pad or cushion of some sort under the knee. Also, I can’t kneel for long periods of time. But in general, there’s little to no interference with activities of daily living, or recreational activities that I enjoy.

It was a long, painful, and costly journey. But I’d do it all again if I had the same choice to make.

Tags: General Knee Surgery by sonjay
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This blog will be a chronicle of my knee injuries, surgeries, therapies, and recuperation. What started out as a simple meniscus tear back in the 1970s turned into a journey of surgery after surgery, long periods on crutches, lots of physical therapy, and ultimately, nearly full recovery.

Some of the procedures I had done on my knee were quite advanced and not commonly performed in the U.S. at the time. I was fortunate in that one of the few orthopaedic surgeons outside of Boston with any real experience in those procedures was just across the bay. Far enough away to be a PITA when I had an appointment with him, but close enough that it was plenty reasonable to make the drive in order to benefit from his experience and skills.

Tags: General Knee Surgery by sonjay
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