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i have swelling in my knee every ten to eleven days. i have ...

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i have swelling in my knee every ten to eleven days. i have had orthoscopic surgery twice, the first time it worked for three years. this time, i still have the swelling but not as severe since the surgery. the orthopedics have said they'd never heard of anything like that and there is no reason for it. any answers of theories?

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Age: 57

Submitted: 10 years ago.
Category: Health
Expert:  SUSIE . replied 10 years ago.

Hi, it would be helpful to have more information and once provided, I will try to help you with a response.

What were the reasons for the initial orthopaedic surgeries? What symptoms did you have at that time and what was done surgically? Do you have any other illnesses? Have you had any recent x-rays, MRI's or CT scans and if so, what was the outcome involving your knee. Have you tried any medications (i.e antinflammatory medications, had any cortisone injections to the knee and if so was this helpful and how many times did you have cortisone injections?) You mention one knee, is only one knee involved? Do you have other joints that swell? Thanks. Susan

Customer: replied 10 years ago.
the reason for the initial surgery was the swelling also every ten days. i have damage to the miniscus in both knees. the left one was not so bad as the right. when the arthroscopic surgery was done, my knee swelled for three more cycles. then, nothing for three years. my most recent mri showed that i had torn what was left of the miniscus. so, this time they trimmed it and hoped that enough scar tissue would form to cushion my knee. it is decidely better than before, but the cyclic swelling is disturbing to me. initially, it begins in the back of my knee, an achy sort of pain (day 1) then comes stiffness and swelling above my knee in the front (day 2) slowly on the third day it goes away. anti-inflamitories do not seem to help, nor does ice or heat. it just seems to have to run its course. i thought it might be some kind of nerve problem but the docs say no way. what do you think?
Expert:  SUSIE . replied 10 years ago.

Honestly, I do not know what your problem. However, what I am thinking here is that perhaps you have developed a chronic synovitis. Your knee has a joint lining of synovial membrane and when this membrane continues to get irritated, it swells and causes stiffness and swelling in the area above the knee, more commonly known as suprapatellar swelling is one of the characteristics of synovitis, but often the whole knee area will swell. A synovectomy to remove the synovial membrane is sometimes done to help remove the inflammed membrane. Pain, inflammation, stiffness, swelling are all cardinal symptoms of synovitis.

I am aware that about 15 yrs ago one treatment for this as a clinical trial treatment at the time was using radiation. I do not know the outcome of the clinical trial and radiation is a drastic measure and not without some potentially significant, life long complications. Synovectomies, when suggested, often do help the symptoms of synovitis however, the synovial membrane has the ability to regenerate after a number of months and then the symptoms return..A synovectomy is not a minor procedure and requires 4-6 weeks on average before "recovery." If synovitis is the diagnosis and if a synovectomy were suggested as a possible option, you would need to know that the symptoms could reoccur since the synovial membrane does regenerate. You might have relief of symptoms but they may not be long term and not worth the time and risks of surgery for a short term benefit potential.

There is no way to know if you would regenerate the same amt. of synovial membrane..Some people do benefit enough that it is worth the surgery, other people do not.

I am wondering if an MRI being done now would be able to show a more conclusive diagnosis of your problem. Has this been suggested? Have steroid injections recently been given in your knee? WHile the latter might help on a short term basis, they must be used sparingly because in time, too many steroid injections into the knee will deteriorate the integrity of the bone/joint and you would not want to risk that. However, I think it might be appropriate to ask your ortho. if he/she thinks injecting the joint once with steroids might help make a difference. If this is done, it sometimes takes several days before the effect is apparent.

I am also wondering if you have developed an "overgrowth" with too much scar tissue having developed. Has anyone mentioned this? An MRI would show this. Also, has anyone mentioned undergoing an arthrogram for your knee?

Re some sort of a nerve problem with the knee, I would definitely think that an ortho would be able to tell if this was a culprit or not. I cannot help but wonder if your problem is not a chronic synovitis myself, this can surely make for a painful knee and make it swell, make it stiff, make it feel achy and often times oral antiinflammatories don't do much to help but a cortisone injection might help, maybe talk to your ortho about this.

I hope this helps If so, please click the accept button. Best of luck. All the best, Susan

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