A Year of Knee Pain 💥

LIFETIME HIP & KNEE

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#134: A Year of Knee Pain

Part I

A great story coming up..

Last week we heard about Alf, 57, and before that Steve, 46. A superfast runner 🏃 a sportif cyclist 🚴‍♂️

If that’s not you, then read on..

How about someone, mid 70s..?

Someone with a bit of inside knowledge..

Meet Abbie

(name changed)

75 years of age..

Keen golfer, active, fit and well.. 🏌️‍♀️

Retired Head of Physio in a large UK hospital

Abbie's a family friend, so we’ve naturally shared a bit more information..

And the detail revealed in our back + forth is brilliant.

Thank you for consenting to share this story of..

Right knee pain
Mechanical block
Sudden onset

January last year: Abbie went to sit down.

Not the most dramatic of movements

And a long way off an ‘injury’.

Cue a sudden, “explosive” pain in the knee.

mainly at the back of the knee..
wouldn’t straighten, and..
could only walk on tiptoe

Next day Abbie went to A&E.

She was refused an x-ray . Told “no trauma”

Which I don’t necessarily agree with.. 🤔

And over the next few weeks, things didn’t settle. The knee stayed swollen, painful, and Abbie couldn’t fully straighten it.

Mid-Feb: she saw local doctor.

An X-ray film was taken..

=> Told “something odd” → referred to a knee surgeon.

Good. I don't think there's anything particularly odd.. indeed looks a lot like Steve + Alf's knee x-ray film, right?

There's reasonable joint space.. and that should cue a similar plan to the runner and the cyclist.

March: not getting any answers so 'went private'

Still not straight
Still painful.

An injection helped—for about a week.

Do NOT inject!

Abbie wrote ‘until I overdid it week later’ which isn’t right.

The key message.. DON'T inject!

She was back to square one..

MRI arranged. Physio involved. More questions than answers..

June: the predictable MRI result:

• Early arthritic change
• A medial meniscus 'tear'
• Generally preserved joint surfaces

My view => we treat people not scans

Abbie's symptoms hadn’t changed much:

Here walking was limited to ~100 yards
A LOT less than 5 miles of golf!
Still couldn’t fully straighten
Pain at the back.

At this point I hadn’t seen or examined Abbie’s knee

BUT I did have this excellent description..

(I’ve skipped some of the administrative back and forth.. lost and delayed MRI booking, missing referral details, long waiting lists).

My reply

V useful, and frustrating for you..

If joint space on XR, consider:

Arthroscopy
Scale up exercise bike slowly.

Listen to knee tho’ and work on extension as much as you can (I’m sure you are).

Consider medial unicompartmental knee replacement if no joint space on plain XR or later. Checking in to St Mawes, call in a mo’..

(a group of us were walking the SW Coast path)

Coming up..

Should Abbie persevere or not?

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Duchy Hospital
Truro
TR1 3UP
United Kingdom