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Help! I have excessive laxity and lateral knee pain

Question: Help! I have excessive laxity and lateral knee pain

I've had 4 knee surgeries in the past 4 years. First started with a medial meniscus tear. Felt great and though why didn't I do this sooner? 11 months later I found myself with a lateral tibial plateau stress fracture that kept getting worse NWB after 2 more months and another meniscus tear. Had a warning of it about 2 months previous during some cardio work at that time that I thought was the IT band and so I worked on my rehab exercised and stepped up my combo walking/jogging while I gave the cardio a break. Had a scope, stem cell therapy, and ORIF. Had ORIF removed due to stress on the peroneal nerve and EVERYTHING was healed. Doing ok until I had sprained my opposite ankle. Last MRI in July showed edema building in the same spot, with 3 small tears (one in a remnant of the medial meniscus) and the others lateral meninscus. Full thickness cartliage defect, so this time the menisci were debrided and had a microfracture in the lateral tibial plateau. There are no ligament issues present in MRI or at surgery--my doctor says every time he load the knee under anesthesia and and pass all of the ligament tests but when conscious I fail every one of them---guarding for whatever reason that I cannot break the guarding cycle.

Through all of this I've had lateral pain--to the point that it cannot be touched and many rehab exercises aggravate this pain make the foot hurt worse too. Lift off my toes when walking "normally" causes lateral pain because my knee glides backwards and a lot of anterior tibial plateau pain. My knee has excessive laxity. I've been through the gamut of PTs and the last decision was it is a core issue--ok; however anything that engages my knee or ankle (such as bridging, deadlifts, squats--just examples of a few)--my knee glides backwards--pain on the lateral side--not issues with IT band either. Also, to make matters worse is that with full WB my right leg spasms uncontrollably similar to a clonus effect I've been told (been through the MS evals too). Anyway, the spasm also causes shearing and just worsens the situation. Brace shuts in down to less noticeable but I've been in a brace for 10 months. So far, in other consults unfortunately I've been told there's nothing that can be done or the first words from the medical professionals are not professional as they are surprised even though I try to prepare them for it because they do not believe it. I've been evaluated at the hip, ankle, knee, and back and no issues with strength; just laxity and pain. My initial stress fracture occurred while walking/jogging--I was mile 3 into a plan of 4 miles for the day (and I had been working up to this and wasn't the first time to do it); the last edema appeared and I've only been walking or doing yoga (no other cardio). I gave up yoga for about 2 months per a PT because of laxity and all my back did was protest and had to go back to it. I have so much going on (there's shoulder history too but that's another story) that I cannot find the balance of body parts.

Haven't made any progress with the pain (it's exactly like it was before surgery a month ago and pretty much the same through the last few years)--yes WB after the microfracture. That's what they are doing in my area these days. And while I don't expect at a month out to be "cured" I tire of the pain and want to endure through it for PT. My current PT has been very creative but he's running out of ideas too.

No nerve issues detected with EMG either. While I can accept the fact that I will probably not run again (I am 40). I was always a mixed cardio type and haven't done any of that for over 2.5 years since the stress fracture, and yet I still ended up with another edema issue in the same location on the lateral tibial plateau (no accidents with just walking and daily life activities. Beyond frustration. Any ideas for treatment or the type of doctor for another medical opinion? I've seen probably 6 orthopedics including other "bests" in my area who are happy that I have an ortho as I've gotten comments like "he's doing fine go back to him", a number of rheumatologists for the laxity who just stare and are surprised by my issues and only try to give me meds (and no the nerve block or meds didn't work with the ORIF) and tried to convince me to go to a children's hospital for pediatric physical therapy since "adults outgrow this sort of thing". GPs, osteopaths, physical medicine MD, PT, acupuncture, pain management, prolotherapy, have been on my slate in the last year. I might be leaving out a couple, but you get the idea.....

Any ideas on what to try next for evaluation and or rehab? My current goal is to get out of the knee brace for the majority of the day and have no lateral pain. My doctor hasn't offered it, but I've read about botox in the knee. Wondering if anyone has had this done and what that was like.

Answer:

CherylChris, I have very similar symptoms that have been ongoing for 14 months. There is laxity in my knee to the point that I cannot bear weight for more than a few minutes. MRI does not show anything but a 2mmX6mm cyst in popliteal area which doctors say should not cause any of my problems. Weight bearing results in additional strain of the supporting structures and is making recovery unachievable. Since your post was over a year ago, was wondering if you have had any alleviation of your symptoms? Have you healed? Did any subsequent procedures help?

Answer:

For any cyst forming within the knee, make sure you put a cold compress on it as much as possible.

I have attached some information you both may find helpful. It is about meniscus tears and other knee injuries.
http://www.kingbrand.com/Meniscus_Tear.php?REF=46PV11
http://www.kingbrand.com/Knee-Injury-Treatment.php?REF=46PV102