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Surgery Done For Meniscus Tear. Having Pain And Stiffness In Knee. No Abnormality Seen On X-ray

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Posted on Tue, 2 Apr 2013
Question: I had a very large posterior horn tear of my medial meniscus which required resection. and had surgery on the 16th Nov 2012. The recovery period was complicated by a minor wound healing problem at one of the arthroscopy portals.
this settled but through lack of physiotherapy my knee became stiff. However physiotherapy was resumed and everything settled and i had very good mobility. During mid January the knee blew up hugely inflamed and acutely painful along the medial side of the femoral condyle and in the medial compartment of the knee. Also at the time I had a bad reaction the anti inflaminatory tablet Naprisan which caused me severe upper GI pain.
At the moment I am almost crippled by the knee pain along the medial side of the Femoral condyle and have slight effusion. An xray has shown normal appearances and no evidence of any abnormality in the region of the pain and no evidence of infection. Three weeks ago the knee was aspirated, and an injection of Suplasyn and Marcaine 0.5%.
I am currently almost imobile and in severe pain.
doctor
Answered by Dr. Mamun Kabir (2 hours later)
Hello,
Thank you for your query.
I am sorry to know that you are suffering from chronic knee joint problem.

It is about 2 months since the operation has been done.
Then the knee joint became swollen & painful.
It may be due to the same pathology, a newly developing infection, or a separate entity of arthritis.
Inflammatory marker like ESR & CRP should be done.

It will give some clue.

Culture of the aspirated fluid is a very beneficial investigation for you.

It will exclude the suspected infection.

Normal x-ray of the affected joint & clear aspirated fluid is not sufficient to exclude the infection.
You can consult your doctor again.

I hope I have some help of your query.
Please write if you have another query.
Take care.

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Mamun Kabir (19 hours later)
AS I AM ATTENDING THE CONSULTANT THAT ACTUALLY PERFORMED THE PROCEDURE, HE IS NOT RESPONDING TO MY ISSUE IN A MANNER OF CONCERN. ALSO MY OWN DOCTOR IS TAKING HIS TIME IN LIASING WITH THE CONSULTANT TO PLAN THE NEXT PLAN OF ACTION TO REMEDY THIS SITUATION
doctor
Answered by Dr. Mamun Kabir (15 minutes later)
Thank you for your follow up question.

I hope your doctors have cultured the sample of the knee aspirate. You can discuss with them about the possibility of infection.

Without an opportunity to clinically examine your knee, my comments are limited. As both of the doctors have examined your knee, they would know your condition better. So try to keep your patience and rely on them.

Keep me informed...

Take care.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Mamun Kabir (3 days later)
HELLO DR XXXXXXX
I THANK YOU FOR YOUR VALUABLE ADVICE AND I HAVE DISCUSSED YOUR SUGGESTION WITH OWN DOCTOR YESTERDAY. HE HAS NOW TAKEN BLOODS THE INFLAMMATORY MARKER ESR CPR. ALSO HE IS GOING TO DISCUSS WITH MY CONSULTANT THE ISSUE OF CULTERING THE ASPIRATED FLUID WHICH HAD NOT BEEN DONE PREVIOUSLY. THE CONSULTANT WAS DISMISSING THE POSSIBILITY OF A SECONDARY INFECTION BASED ON AN X XXXXXXX PLUS THE CLARITY OF THE ASPIRATED FLUID. BOTH MY DOCTOR AND CONSULTANT HAD NO INTENTION OF CARRYING OUT THE ABOVE MENTION PROCEDURES UNTIL I POINTED OUT YOUR OBSERVATIONS AND SUGGESTIONS. I INSISTED WITH MY DOCTOR TO THIS COURSE OF ACTION.
WITHOUT YOU I WOULD HAVE BEEN LEFT IN LIMBO AND SUFFERING.
THANK YOU FOR PUTTING ME ON THE RIGHT ROAD, AND NOT LETTING THE MEDICAL PROFESSION HERE IN XXXXXXX WALK ALL OVER ME, I AM SO GLAD I HAD SUFFICENT
DETAIL TO CHALLENGE THEM.
MANY THANKS & KIND REGARDS
XXXXXXX
doctor
Answered by Dr. Mamun Kabir (2 hours later)
Thank you for your valuable comments.

Your comment will help me a lot to become a better physician.

All the best.
Take care.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Mohammed Kappan
doctor
Answered by
Dr.
Dr. Mamun Kabir

General & Family Physician

Practicing since :2005

Answered : 364 Questions

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Surgery Done For Meniscus Tear. Having Pain And Stiffness In Knee. No Abnormality Seen On X-ray

Hello,
Thank you for your query.
I am sorry to know that you are suffering from chronic knee joint problem.

It is about 2 months since the operation has been done.
Then the knee joint became swollen & painful.
It may be due to the same pathology, a newly developing infection, or a separate entity of arthritis.
Inflammatory marker like ESR & CRP should be done.

It will give some clue.

Culture of the aspirated fluid is a very beneficial investigation for you.

It will exclude the suspected infection.

Normal x-ray of the affected joint & clear aspirated fluid is not sufficient to exclude the infection.
You can consult your doctor again.

I hope I have some help of your query.
Please write if you have another query.
Take care.