Knee gives way after Op

[headache5678]

After several years of running, typically 3-7 miles once or twice a week and mainly on pavements/sidewalk I stopped running a few months ago. I was not aware of any particular injury but my right knee did make a few cracking noises if I climbed steep steps. My desire to eat food had taken its toll.

Recently I found that my right leg felt as though it wanted to give way, mainly after I sat down for periods in excess of 1 hour. This was more noticeable if my right leg was bent back, by which I mean if the interior knee angle between the tibia and fibula was less than 90 degrees. This happened if I am on my low-seated motorcycle of if I sit in an office chair with my feet “tucked under” the seat.

So a month ago I had an arthroscopy together with lavage and debargement (“a look see, rub, wash and suck”) and two parts of my right knee cartilage were trimmed. X-rays and MRI scan and several appointments with my consultant preceded the operation. Whilst I am pleased that my torn cartilage has been fixed, my fundamental problem of the knee giving way remains a problem. Upon discharge the registrar assisting the consultant explained that the problem I was describing was “instability” which apparently covers actual “giving way or “a sensation of giving way” but with no pain. However, as the doctors saw that the operation was healing well, they declined to fix up a re-visit to re-assess my problem from scratch.

There is still an occasional twinge in my leg / knee but it is not unpleasant and is very difficult to locate precisely. The right knee is always a little larger than the left but that may be due to some swelling (or could it be my right knee has larger muscles?).

Looking on the Internet is confusing with many possible causes of instability being mentioned e.g. ligament, ITB, Runner’s Knee, Chondromalacia/Patella Syndrome and I wonder if whether I need a second opinion from another consultant.

Basically, I would appreciate any steer on what is the most likely cause of “instability” / my knee giving way and where might I get some more detailed information, please? This will enable me to talk to my consultant more intelligently.

[mattw]

The word "instability" gives you the answer: muscles. Muscles move bones and without adequate muscle engagement and balance the knee joint cannot and will not function correctly. This would be worth reading: http://egoscueportland.wordpress.com/2010/01/26/cartilage-damage/

Also getting the book Pain Free by Pete Egoscue will explain why this problem has occurred and how to start fixing it.

Remember that running is not the problem as this helps explain: http://egoscueportland.wordpress.com/2009/12/03/activity-does-not-cause-knee-pain-faulty-posture-causes-knee-pain/

http://egoscueportland.wordpress.com/2009/10/29/the-human-body-is-built-for-distance/

http://egoscueportland.wordpress.com/2010/01/14/musculoskeletal-pain-is-not-caused-by-activity-age-or-genetics-what-causes-musculoskeletal-pain-is/

Best of luck and remember with commitment to fixing the underlying problem you will be back to running soon!

[Heidi]

Hi

You haven't mentioned any specific point of injury, so I am presuming that this came on gradually.
For this reason, it is unlikely that the instability you describe is coming from ligament or cartilage injury (especially given the 'clear out' operation you had).
ITB is also an unlikely cause of feelings of instability.

My personal feeling, given the description of creaking on stairs, is that patella pain syndrome is more likely.
You can read a bit more here:

http://www.sportsinjuryclinic.net/cybertherapist/front/knee/patellofemoral_pain_syndrome.php