Good evening and welcome to the Arthroscopic Edition of WYFP?
If graphic medical/surgical details makes you squeamish, you might want to skip directly to comments.
Not that it's particularly graphic, but still…
WYFP is our community's Saturday evening gathering to talk about our problems, empathize with one another, and share advice, pootie pictures, favorite adult beverages, and anything else that we think might help. Everyone and all sorts of troubles are welcome. May we find peace and healing here. Won't you please share the joy of WYFP by recommending?
A few weeks ago I flew out to Seattle to meet my wife, there on business, for her birthday. We had a fantastic trip, part of which I chronicled over at Kitchen Table Kibitzing earlier in the month. From the great food, incredible waterfront hotel room, and generally decent weather we experienced, the whole long weekend was a real winner. Especially so because my best friend lives out there, and we hadn't seen one another in person for almost five years.
He's a forester and both of us are enthusiastic hikers, and while we were cutting trees out on Kitsap (see the diary link for pix), we also took a run along a forest trail he knows well. As I was descending a fairly steep path, I heard/felt a pop in my left knee. I am used to that knee sounding like Rice Krispies when I walk down stairs or work out at the gym. I have had a number of injuries and it hasn't really been right for about 7 years. This pop was different, though, and within four hours I was walking with an increasingly stiff limp and experiencing increasingly intense pain. By the next morning, I was in full out agony.
By the time I made it to a doctor here in Austin 5 days had passed and while the initial acute phase of the swelling had receded somewhat, the pain and stiffness had not. After a short physical exam where he employed some standard physical tests for torn ligaments, the ones that showed positive response were for meniscal tears. They did an MRI immediately in the office, which I thought was kind of odd. My appointment was the last of the day, by the time it was over myself and the imaging tech were the only ones in the practice. I found out later it was done because he knew from my presentation and the exam that it was bad news. He wanted the MRI done immediately.
I had never appreciated how bad my knee was until going over the report with the doctor when results were in. "How you have walked, run, lifted weights, and stood all day in your classroom with this knee without awful pain is beyond me." he told me at the follow up. "Your medial meniscus looks like someone put it through a grinder then pulled it half way out. It's a wonder your knee isn't locked."
With that he took me through the report and pointed out the relevant imaging on his monitor. "See this here? That's what is causing the pain on the medial side. It's all going to have to come out, I suspect." Meaning the entire medial will likely be a total meniscectomy, nothing to save. That is the most crucial part of the entire physiology of the meniscus, bearing the most weight.
For those of you that are interested in technical medical data, here is the relevant part of the report for your Saturday evening enjoyment.
Findings:
The anterior and posterior cruciate ligaments, the medial and lateral collateral ligaments, the popliteus tendon, the quadriceps and patellar tendons, the iliotibial band, and the patellar retinacula are normal.
There is complex tearing of the anterior horn of the lateral meniscus with a prominent radial tear component. Degenerative signal is seen in the posterior horn.
There is complex tearing of the body and posterior horn of the medial meniscus with vertical and horizontal tear components.
There is some degree of chrondromalacia, probably high grade, of the medial femoral condyle, and there is high grade chrondromalacia of the trochlear groove, and some degree of chrondromalacia of the medial trochlear surface. There is high grade chrondromalacia of the apex and medial facet of the patella. There are very mild osteophytes of the medial tibifemoral and patellofemoral joints.
Impression:
1.Complex tearing of the body and posterior horn of the medial meniscus.
2.Complex tearing of the anterior horn of the lateral meniscus and degenerative signal in the posterior horn.
3.High grade chrondromalacia of the patellofemoral joint and some degree of chrondromalacia of the medial femoral condyle.
4.Very mild patellofemoral and medial tibiofemoral joint osteoarthritis.
I'm not entirely thrilled about this, but it has to be done. I am hoping to avoid having to endure a partial knee replacement, at least right away, but I have the beginnings of arthritis happening that isn't looking good. I won't really know more until they go in.
Anyway, what is your fucking problem?