Dr. Timothy K. Durnin - 11/30/2007

Question
A few years ago I suffered a posteromedial tibial plateau avulsion, my ACL remained intact (it's actually forked).  I had surgery to fix it and then hardware removal.  I still have pain in that knee sometimes and the most recent intense bout (about 2 1/2 months worth) sent me back to my orthopedic.  Since it had been so long since the last MRI, he sent me for another.  It showed scuffing on the meniscus.  He said there wasn't really anything he could do for that. But what is it and what does it mean for my future?  I've accepted that knee will never be the same and I've learned my limitations with the pain I get sometimes.  I guess the question is why does it continue to be painful?  My ortho can't answer that.  When it does get painful, it gets hot too, real hot.  All my ortho can do for me is drugs and a TENS unit.  Granted, I know this might be as good as it gets, but I guess I just don't understand why it can't be better.  Can you offer any insight into recovery from an injury of this type?

I know this may be a no brainer question too, but can I ski?  I would really like to try that sometime in my life and will have the opportunity this December.  Are there any special precautions that I should take?  Should I get a brace of some sort?  Or should I not even take the chance?  I don't want to stop living because of this knee, I've already made concessions because of it.  I'm only 29 and there is so much more to do!  I know these are questions I should discuss with my ortho, but it's really hard to get in to see him.  If you can offer any advice, I would greatly appreciate it!  Thank you so much for your expertise!  Cheers!

Answer
Hi Sara,

This issue has been covered extensively in past questions. If you were not told by your Ortho to take Glucosamine Sulfate and receive therapeutic ultrasound, then I would look for another doctor. NSAIDs prevent new cartilage growth, so while they temporarily reduce pain, they actually accelerate arthritis.

Skiing can devastate a healthy knee, I ski and have had multiple knee surgeries. I would get a lateral stabilization brace to be safe. If your doctor isn't accessible for questions, he is too busy with himself instead of his patients. It is usually a good sign to find another doc. Take 3 grams a day with MSM or don't take it at all. That is the proven dosage to regrow cartilage. The scuffing is erosion of the cartilaginous surface and will only worsen under the present care, get some ultrasound on that knee and take the supplement and go skiing!

Take Care

Dr. Timothy Durnin