Left Knee Injury

by Andrew D'Angelo
(St. Louis, Missouri)

I injured my left knee on 08/31/08. It popped and had severe pain/swelling (hasn't gone down yet). Its a Workers comp situation, unfortunately.

Had MRI: Alot of complicated medical language. I had prior left knee surgery (tendon/ligament/cartillage removal) in 1977, which showed up on MRI. Also had alot of "chondromalacia". And alot of "ostephytes" and "lesions". No meniscal tear seen, or damage to any ligaments or tendons. Mostly Grade 4 osteoarthritis (no cartillage seen...bone on bone, etc.).

My orthopedic surgeon told me I would need a TKR probably. But, he want's to try arthroscopic first, event though he highly doubts it will cure/solve my Grade 4 osteoarthritis ("my knee is pretty well shot). He said, "I doubt if it will help solve your osteoarthritis problem, but it "might" help your pain and swelling.

I guess my question is...is this good standard of practice to do a surgery that probably won't help my situation at all, and will more than likely still result in a TKR in the near future? Why go through 2 surgeries when the 1 big one could fix the problem for me right now?

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Oct 02, 2008
TKR or scope
by: Bart - SII

Most surgeons try to put off a TKR as long as they can - the biggest reason is that the parts they use in the knee wear out, and a second knee replacement is usuallly not as good of a result as the first...so if they can do a scope now, decrease your pain and discomfort and prolong an inevitable TKR for a few years, that is what they recommend.

In all likelihood, a scope to clean up the knee joint probably would help with your pain...for how long is hard to tell.

I would discuss all of these things with your doctor and see what their rationale is for not doing the TKR now.


Oct 04, 2008
Poss. Knee Replacement
by: Anonymous

Thanks, Bart as I appreciate your candor and your advice. Right now their rationale is because my current injury was WComp related, and I don't think they want to do the expensive surgery and face all the high future medical bills regardless if I need it to live and work. I guess I'm having problems with wondering when the "other knee/foot" will drop and I will need the TKR. I'd rather get it done while I'm still young and take my chances at 10-15 years (when I'll retire) of pretty much pain-free knee. I'm still young and I can rehabilitate quicker. I understand the TKR isn't a lifetime guarantee, but I'd rather get it done while I'm still young then have to go through another 2-3 years of gradual pain and discomfort again.

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