Saturday, December 12, 2009

Knee Injury Update

Click here to see the first post.

We went to the 2nd opinion Dr. last night for my follow-up visit. After doing a little research on the internet and seeing the two different Doctors, I've learned a lot about knee injuries and the many different areas where a knee can be damaged. Again, he said the ligaments are good (collaterals and cruciate). The swelling is down and there is less pain (probably due to the anti-inflamatory and pain killer he put me on???lol). He did not rule out the meniscus (which was the first Dr.'s diagnosis), but said I should rest some more before doing anything else to let the Medial Collateral Ligament heal completely (the first Dr. did not mention anything about that ligament, but the 2nd Dr. did a more thorough exam and found that it was damaged a little--as if I had stretched an elastic band too much). Apparently, this is nothing serious, it just needs about four weeks to heal itself.

What I conclude is:
1. Medial Collateral Ligament: The 2nd Dr. is right about it needing to heal itself. I give this a 100% chance of being right.
2. Medial Meniscus Tear: The 1st Dr. is probably right about this and the need for repair with arthroscopic surgery. I think what I've researched supports what he says even though his diagnosis was not as thorough as the 2nd Doctor's, I give this about a 99% chance of being right. Especially for this statement and others that I found in the link above: "Weight bearing and rotation at the time of injury tend to cause meniscal injuries." Remember that I landed on my leg fully extended and it rotated.
3. Anterior Cruciate Ligament: Niether Doctor said this was what was wrong. However, that's what they said 20 years ago about my right knee and once they looked at it through arthroscopic surgery 9 months after my injury, they immediately found that it was torn. I found this in my research..."The most common mechanism for ligamentous knee injuries is an inward, medial force usually accompanied by some external rotation and flexion (as when being tackled in football). In such cases, the medial collateral ligament is usually injured first, followed by the anterior cruciate ligament, then the medial meniscus." This is similar to what happened to me. I would give this a 5% chance just because of my past experience with the missed diagnosis of my right knee.
4. Posterior Cruciate Ligament: The 2nd Dr. rose concern about this because of 1--pain in the back of the knee when I extend it and 2--the way I fell on it, hyperextending and twisting. He gave me a pass to have an MRI done to see if this is a possibility. However, it is a very uncommon injury and usually occurs with blunt force like a car accident or Football. I researched this here. I would say there's a 1% chance of it being this.

The Plan...
  • I give more weight to the first doctor's diagnosis because his specialty is the knee. The 2nd doctor's specialty is the back, but does work on knees; it worked well to have him as a second opinion and would explain a little bit of his doubt as to what could be wrong.
  • I will not have the MRI done because of it's cost and the two doctors contradicted themselves on the quality of what can be seen in them. The first doctor said you can see ligaments, but many times the parts of the meniscus is hidden.
  • Monday morning I'll go to town to get my blood tested in preparation for surgery.
  • That afternoon, I'll call the first Doctor and let him know the results. As well as asking him some more questions. An important question I have is if he'll not just work on the meniscus, but look around and see if there is anything else that is damaged (ie: ACL, PCL, etc.).
  • If he says he needs to see me one more time, I'll go. If not, we'll set a date for surgery...hopefully this next week!
Thank you for your prayers, I'll post again about this after Monday.

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