Online Health Advice > Knees and hip question >

Ask Your Health Question. Health Experts Answer You ASAP.

(Not a Health Question?)

On 4-4-04 I had bi-lateral knee replacements. Eight months after surgery I sliped on ice 2-23-05. I experienced spinal stenosis, four herniated disks in my neck , c4c5c6c7.
I injured both my knees and had a revision performed on my right knee. The prosthesis was loose on Sept. '05 I had my plastic meniscus replaced, a couple centemeters thicker. My left knee was totally hyperflxed but prosthesis was fine. Ever since my fall and after my Sept.'05 surgery I have had a lot of crunching on the outer side of my right knee and my leg is unstable. It is now afecting my right hip, I thought I had a severe groin pull. My PT specialist evaluated my right hip and determined, along with zrays that my hip movement was pinching muscles in my groin area among other injury pain in my hip
My doctor states that my only alternative is to fuse my right phiibia (spelling?). My PT told me to ask my Doctor about Prolotherapy. Another suggestion was to have an MRI and forward to Stedman-Hawkins Clinic in Vail, Co. Dr. Marc J Philipon performs ostearthritis surgery, a treatment not available in Alaska. I am in constant pain in my hip and my right knee. My left knee is starting to have the familar early symptoms I experienced in my right knee. Any suggestions? I know this is a lot of information but I wanted to paint as much of a picture as I could. Thank you in advance, Bill

Optional Information:
Male , Age: 56

Already Tried:
I have been going to PT for the most part since I slppped on ice for my neck and my back. My knee has been problamatic also since my fall but not treated. I have had 7 PT treatments so far with no real improvements with my hip. I have been doing home exercises provided by my PT.

Customer (name blocked for privacy)

Status: Closed Value: $15

Bill - I'm so sorry to hear about this turn of bad luck. I know you've been through a great deal, and you must be pretty tough from all of this.

You don't mention where you are in Alaska, but even in Anchorage (which, if memory serves me, is a city of 200,000+) your options for an orthopedist who is a real pro treating knee replacement revision, and your developing hip pain (which I think is most likely related to the knee, I agree with you there) will be limited.

You may indeed need to at least consult with someone out of the state. Although I'm not an orthopedist myself, I was planning on going into ortho, so I know a little about it. There are a number of "centers of excellence" in orthopedics, and depending on what exactly you are seeking, these will vary a bit. Vail might indeed be one of these locations, but in my experience, some of the best orthopedists are located in the larger cities in the US (NY, Pittsburgh, Iowa, and CA all have many fine practitioners). Nevertheless, depending on your exact situation, one provider might be better than another for you.

I assume that your orthopedist has suggested fusion of the fibula? This might, indeed, be a great option - but again, depending on where you go and who you talk to, opinions will vary. Some physicians are renowned as the "best in the business", and in my opinion, if I was in your position, I would want to get the best opinion available if I could.

If you haven't had an MRI already, then it can't hurt (so long as with your prostheses this is o.k.). It could help show what the problem is, and if you are able to get a good list of your symptoms, and a description of your physical exam, in conjunction with this MRI (and the other studies that have been done) you might get someone out of town to take a look at your case and give you an opinion. Often, if a physician thinks that someone else might be better-suited to perform a surgery, then they will refer you to them. So, Philipon (if he is a good choice, I'm not familar with him) could even refer you to someone else, as well, if that is the best option.

As far as prolotherapy is concerned, I don't know too much about it. But, if I was you, I would definitely want to run the idea by my orthopedist first to get their o.k. before I tried it. Prolotherapy involves injections in the tendons/ligaments, and could, if performed incorrectly or in the wrong place potentially be dangerous. Then again, there may be substantial evidence that it could help you. Your orthopedist would be the best one to discuss this with, as they'll know your entire case.

It sounds like you're doing all of the right things - the PT, the home exercises, etc. But this may be progressing anyhow. So I think, like you suspect, it is time to get moving on a solution for this.

I suffered from a few slipped cervical discs last year and had to have a fusion. So I know what a pain in the neck that can be. I hope it's at least tolerable.

So - speak with your orthopedist and tell him/her you want a second or third opinion. Ask for the names of the "best in the business", even in the lower 48, to help with this, and get in touch with them. Place a call, and see how they would consider your case, and what they would need. Hopefully, they'll be able to oblige. And, again, run the prolotherapy by your doc first, before you start, just to make sure. We can't afford for anything else to go wrong with your knees and hips.

I hope this helps. Please let me know if you have any further questions - I'm more than happy to try and help.

Take care and hope you feel better - Dr. Fay

If I have helped, then please click the ACCEPT button and leave positive feedback - Thank you, and take care

Reply to Jonathan Fay, M.D.'s Post: The doctor's response to my question was some what obvious. He has no experience in these areas and was agreeing to my suggestions simply. For example, he agreed I should consult my doctor and ask questions about prolotherapy and ask for his referrals whom he thinks are the best in this field. The doctor agreed that that an MRI may be a good idea to provide to any experts I may seek out. In otherwords his response was inadequate.

O.K. Bill. I do, however, have experience in orthopedics - I'm not an orthopedist, but there is no orthopedist on this site. I disagree that my answers were somewhat obvious, but that notwithstanding, what would you consider an adequate answer, exactly?

Do you want to know if you should have fusion surgery, prolotherapy, or an MRI? In my opinion, that is an impossible question to answer without all of your records present, and your specific, total health history. Or do you have another question?

Let us know, and if you don't want me to field the question, then someone else can.

Dr. Fay

If I have helped, then please click the ACCEPT button and leave positive feedback - Thank you, and take care

Think you can answer this question?
Login or Become an Expert

DISCLAIMER: You acknowledge that any information you may obtain from individuals you contact through use of the Just Answer service comes from those individuals, not from Just Answer!, and that Just Answer is not in any way responsible for any of the information these third parties may supply. The site and services are provided "as is" with no warranty and no representations are made regarding the qualification of an Expert. Responses and comments on Just Answer! are for general information and are not intended to substitute for informed professional advice (such as medical, legal, investment or accounting) and do not establish a professional-client relationship. Just Answer! is not intended or designed to address EMERGENCY QUESTIONS which should be directed immediately by telephone or in-person to qualified professionals. Please carefully read the Terms of Service.

Just Answer! > Online Health Advice

Related Answers