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Medical Forum / General / General / October 2007

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knees are so bad. Advice?

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MZB - 24 Oct 2007 18:38 GMT
I'm frustrated and seeking some advice/support

About 8 years ago, my knees both started hurting quite badly after I overdid
some treadmill work and jogging. It has never been the same since.

Until recently, its been mostly the right knee acting up. Anyway, an MRI a
few years ago showed a torn meniscus and x-rays showed arthritis. After a
year with relatively minor problems things suddenly got bad in August. I
went to see the orthopedic surgeon a few weeks ago. The news was not good.
He says the x-rays and my type of symptoms point to some kind of
inflammatory arthritis as the main cause of my pain (and it's bad in both
knees). He said eventually we can do a scope when the bad days outnumber the
good days but he didn't think the scope would be all that great (but it
would probably help a bit). Apparently it won't really arrest the disease.
Down the road, we are looking at TKR. He'd like to wait as long as possible;
I am a 61 yr.old male.

Since then (really in the last week) both knees have gotten much worse.
Walking is very painful and even not walking still hurts (feels like razor
blades are in my knees). I'm going to give it another month (in the past
this problem has waxed and waned but each time the waxing hurts more and the
waning is not as good as the previous time). I'm a college prof. and if
things don't improve, I'll schedule the scope for mid-December. Right now it
really feels different and I suspect it might not get better. The pain is
just greater and more intense and the inability to walk is terrible. I'm
trying the tylenol stuff and if that doesn't work better it looks like
NSAIDS (OTC ibuprofin) but I fear the side effects from the NSAID..

I really don't know what to ask, but it is frustrating. Have any of you had
the scope clean out surgery and did it help? Any suggestions? (Perhaps the
medicos could add something!)

MZB
eml - 25 Oct 2007 12:00 GMT
> I'm frustrated and seeking some advice/support
>
> About 8 years ago, my knees both started hurting quite badly after I overdid
> some treadmill work and jogging. It has never been the same since.

> MZB

are you taking any medications?
Howard McCollister - 25 Oct 2007 13:50 GMT
> I'm frustrated and seeking some advice/support
>
[quoted text clipped - 30 lines]
>
> MZB

Might help. Unlikely to hurt anything.

You have degenerative arthritis - the cartilage of your knees has worn out
and is allowing a certain amount of bone to rub on bone. That degeration of
the menisci with resultant bone-on-bone is setting up your arthritis. An
arthroscopy can clean up the cartilage tear, remove loose bodies, smooth
down any bone spurs, and that *might* help if any of those abnormalities are
contributing to your arthritis, but you will still have bone-on-bone - once
the cartilage is gone...it's gone. It may improve your arthritis, and your
pain, but unfortunately the process of cartilage degeneration can't be
reversed. Short-term temporizing measures to forestall joint replacement
might include periodic injections of a steroid (usually Kenalog) into the
joint every three months or so (will likely decrease the inflammation)
and/or possibly injection of a cartilage precursor into the joint (HyVisc).
Results of these things are mixed - work better in some people than others.
Something to ask your orthopedist about.

HMc

If the degeneration is mostly on the medial compartment, one other thing
that might be considered, short of a total knee replacement is a joint
liner. Another thing to ask your orthopod about.
MZB - 25 Oct 2007 20:24 GMT
Howard:

The orthoped says it is not the normal degenerative arthritis (ie: OA). It
is some kind of inflammatory arthritis.

Does that change any part of your answer?

Mel

>> I'm frustrated and seeking some advice/support
>>
[quoted text clipped - 55 lines]
> that might be considered, short of a total knee replacement is a joint
> liner. Another thing to ask your orthopod about.
H McCollister - 25 Oct 2007 22:25 GMT
> Howard:
>
> The orthoped says it is not the normal degenerative arthritis (ie: OA). It
> is some kind of inflammatory arthritis.
>
> Does that change any part of your answer?

Arthritis by its very nature is inflammatory. There is no such thing as
non-inflammatory arthritis. The phrase "inflammatory arthritis" is
redundant.

Maybe what he means is that it's some kind of arthritis mediated by
something other than wear and tear...Lyme disease, for example. If that's
the case, then no, arthroscopy won't help a big. However, we're talking
about a 61 year old with an MRI that shows at the least a torn cartilage.
And he doesn't think it's degenerative? Hmmmm.....

In the meantime, have you had borelia titres drawn for Lyme disease?

HMc
PeterH5000@gmail.com - 26 Oct 2007 23:21 GMT
> I'm frustrated and seeking some advice/support
>
[quoted text clipped - 29 lines]
>
> MZB

I've heard of a new product called "Supple". It's all natural
ingredients, but they claim "pharmaceutical strength" effects. It
contains glucosamine, chondroitin, plus a mix of antioxidants,
vitamins and minerals that's supposed to give you relief starting in 7
days. Anyway, there's a review about it at http://trueblue-review.com/arthritis-pain-relief
Might be worth a look.
Jeff - 27 Oct 2007 15:51 GMT
<...>

> I've heard of a new product called "Supple". It's all natural
> ingredients, but they claim "pharmaceutical strength" effects. It
> contains glucosamine, chondroitin, plus a mix of antioxidants,
> vitamins and minerals that's supposed to give you relief starting in 7
> days. Anyway, there's a review about it at http://trueblue-review.com/arthritis-pain-relief
> Might be worth a look.

Have any of these ingredients been shown to work?

I mean for the patient, not the people taking in the money.

Jeff
Howard McCollister - 27 Oct 2007 16:59 GMT
> <...>
>
[quoted text clipped - 11 lines]
>
> Jeff

Generally speaking, they have been shown NOT to work in most studies of use
in patients with degenerative arthritis like the OP. OTOH, they are unlikely
to hurt anything. Might be worth a try. I will say that any manufacturer of
these homeopathic nostrums that advertises as "pharaceutical strength" is
blowing smoke. Price this stuff before buying. Plain old generic
glucosamine/chondoitin sulfate in the cheapest form you can find will be as
good as any of the other stuff in "pharmaceutical strength" and with
"special antioxidants, vitamins, and minerals".

HMc

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