Knee Issues - Had surgery, didn't help. Suggestions?

[roadrat]

OK, so I'm at the brink of going insane. Hoping someone here that has had similar issues can give me (and my surgeons) suggestions. Sorry it's so long but I'm hoping that by going into detail I'll get some good help. Here's my story:

I'm 29 years old and have been playing soccer since I was 4. Never once had a single injury or issue. Last July, I got tackled from behind and landed really hard on my knee. It was hurting a little but I had a big tournament the next week so I pushed through it. Following the tourny, I decided to give it a few months off to recover (I never felt any pop, break, etc so I figured it was just a deep bruise). Well, September came and it was still hurting so I went to go see a surgeon.

As far as the pain, there were two issues:
1) I couldn't actually straighten my leg/knee. It seemed locked like it wouldn't go past a certain point no matter what any of us did.
2) When I did try to straighten it, there was a sharp piercing pain under the front of my kneecap.

So, went in for MRI and Xray. Both came back 100% clean. First surgeon told me to just get a cortisone shot, I said no way and went to see a 2nd. The 2nd said the scans were clean so he didn't know what to do. Being a salesman, I sold him on the fact that my pain isn't going away, so he agreed to do arthroscopic surgery to try and find the cause.

Had surgery 3 1/2 months ago. When in there, he found and told me he fixed the following problems (none of which came up on the scans):
1) Found a blood vessel was attached to my acl and filled with blood. None of the surgeons had ever seen that before. It was causing my acl to pinch off when I tried to straighten my leg.
2) Found small meniscus tears. He said he smoothed it out.
3) He also said he removed some fat pad that was in there.

So, after the surgery, I was immediately able to fully straighten my leg, but the pinching in the front of the knee was still there. They told me it would go away after doing significant PT to strengthen the muscles again. So, went to 3 months of PT, 3 times a week. My knee was swollen the whole time. Towards the end of the PT rounds, we started to push it harder because it had been 3 months since surgery but my knee kept swelling up like I just got out of the operating room. The pinching was still there and it was starting to hurt more and more as the days went by and we kept working out. Eventually the pain was so severe I couldn't continue PT. My straight leg raises are 100% straight but the pain occurs when trying to straighten my leg from a 90 degree angle to fully straight and extended. Running hurts as there is a pinching/piercing pain under the front of my knee.

Went back to the surgeon and he wanted to give me a cortisone shot to see if we could get the swelling down which then hopefully would get the piercing pain to stop. Got the shot, it lowered the swelling for a day or so and then went right back to inflamed. It's gotten to the point that I feel the pain when I go on stairs, walk, everything. My leg also seems to be slipping or giving way a few times a day. I'll just be walking and it almost seems like the bones aren't lined up because all of a sudden the leg gives, the bones feel like they are grinding, etc. If I sit on the edge of a bed with my legs hanging off and try to straighten it, I can, but there's a lot of pain for the last few degrees of straightening behind the knee cap. Last week, they made me get an arthrogram mri (man did that suck), and of course they found nothing. Now the surgeon has no idea what to do.

I've been dealing with this for half a year now, have already missed a season and a half of soccer, and have my wedding coming up and I really don't want to be in pain for it all. I'm thinking that something is going on that is causing the meniscus to tear, as everything I've read seems like it's a meniscus tear... and he fixed the tear he saw, but maybe not what caused the tear. I don't know... any thoughts? I'm going out of my mind here. If I'm going to have to get surgery again, I just want to get it over with. I have a consult with a 3rd surgeon this Wednesday.

[Heidi]

Hiya
Have read your post and here are my thoughts:
1) I think going straight for surgery may not have been the best thing to do and trying PT before surgery is usually advisable.
2) I don't think surgery should be your immediate answer again.
3) Your PT shouldn't have been pushing you into pain, discomfort is usually ok, but pain is a no - it basically indicates that something is being damaged.
4) Your symptoms sound to me like a problem with the patella and its movement, probably too much movement. Pain on stairs and feels of it giving way are classic symptoms. Have a look on site for patellofemoral pain syndrome to find out more.
5) In the meantime, just rest it, ice it, anti-inflammatories if suitable and a compression bandage to help reduce the swelling