Knee Injuries

[Jack Moroney (RIP)]

So there I was, talking Bill Harsey's advice and attempting to do a little more logging. I was dragging a half cut tree out of the brush by walking backwards when I had a hell of a shock, my knee gave out and I found myself on my back unable to move or even lift my left leg. Using my ax I cut a small tree and used it as a crutch to pull myself up and found that as long as I locked my left knee I could shuffle along by stepping with my right leg and sort of swinging out my left to bring it along side. Damn thing swelled quickly, I iced it and got my sorry butt to the local hospital. An xray showed not much with the exception of what the doc on duty called something that sounded like an acclusion, inclusion or some other thing that resulted in my confusion. As he explained it ,it sounded like a small chip had come off the patella. As long as I lock the knee I can walk, if I bend it even slightly it will not support my weight. There is no bending it while I am sitting because there is no strength to raise it. Laying down on my back I can bend it several degrees and after continuous trying it will move almost to 90 degrees. Right now my left leg is trussed up in a splint with more velcro on it than some of the high speed vests that have been displayed on this site. So I am sitting here trussed up like a frigging one legged turkey and was told to make an appointment for next Thursday-good thing I don't have a sucking chest wound.

My question is this. Looking at the top of my knee and compressing the area along the top right quadrant and along the inside of my leg I see some discoloration and their is some discomfort under pressure but not what I would call real pain. There is still some obvious swelling. I have put myself on motrin. Now this doc was not an orthopedist and from his demeanor I am not sure of what his qualifications might be but in a call to the hospital's only orthopod, whose cell phone kept on cutting out, he came to the conclusion that he needed to imobilize it. Now I have gotten better diagnosis from African Zoes, but their treatment for leg injuries are usually to take a chicken, break its leg and when the chicken's leg heals so will yours. I am thinking about getting myself down to the VA for a check before Thursday, but would like to know if any of you folks-who I know can do a better diagnosis sight unseen that what I just got-might have any ideas.

Jack Moroney

[Bill Harsey]

Very sorry about the injury Sir. You know there is no "md" anywhere my name and wait until those more qualified answer. Here is information that I'm sure will hold up to the Docs here, x-rays don't show soft tissue damage very well. Icing will help reduce swelling. Get information from others before doing anything I say again.

[ccrn]

I dont have much experience in knees, most of it limited to the ortho floor helping with knee replacemets.

My fear is you might have torn a ligament such as the ACL (Anterior Cruciate Ligament) or other major ligament that supports the knee especially if a film was inconclusive.

Perhaps the patellar "chip" might have been a piece of cartilage? Was the word the MD used "effusion"?

In any case I certainly would not wait until thursday or tomorrow but would go somewhere with a reasonably decent ortho ability and be seen right now. Until then RICE (rest-ice-compression-elevation).

[Eagle5US]

Sir,

high probablilty you have torn your ACL, less probable (but in the ballpark) your PCL.
Some clues from your story...
Immediate swelling: this indicates blood in the joint space. Blood usually appears with significant ligamentous damage. Cartiledge has a general poor blod supply for a good portion of the structure...so though it may be affected also-usually it is not the cause for the immedate swelling.
Inability to do a leg lift: This has a couple of connotations-a partial quad tendon rupture or tibial tendon rupture / but the remainder of your story doesn't fit these very well...this feeling of inability is also present with ACL ruptures.
The "Bone Chip"- may be a small avulsion fracture (piece of bone pulled off if the ligament was ruptured near the insertion point instead of in the middle.
Treatment: Immobilization for about 10 days to let some of the swelling go down. Then do some vigorous testing and manipulation (Anterior Drawers test for one) checking for ligamental laxity. This can be done sooner if they draw the blood out of your knee, inject some local anesthetics to prevent you from gaurding during the testing, then do the manipulation.
An MRI is the gold standard and should be accomplished once the swelling goes down.

Don't push this-it will not have a positive outcome.
Good luck-use Ice, the velcro thingy, and stay on your motrin consistantly for a full 2 weeks-it will help with the inflammatory response .

Eagle

[The Reaper]

Sir:

Not a Doc, but I had a similar injury, turned out to be a torn medial meniscus, they told me that I would eventually have the lock-up when a piece broke off and jammed up the works.

I suspect that if X-Rays show nothing (and they may not), that you get an Orthopod to refer you for an MRI, which is how they finally identified my injury.

And get well soon, Jefe!

TR

[Jack Moroney (RIP)]

I appreciate all the input. This is going to tougher on the wife than me, now she has all her chores and mine and I am sure payback will be an extended shopping tour on QVC or the HSN or that AFFES catalogue that arrived today. After 40 years of marriage sympathy around here usually is a word that falls between shit and tea in the dictionary. Not really, but she is reminding me that 62 means 62 and she is not using any excuse such as dyslexia where I can claim 26 for my age.

Jack Moroney

[Sacamuelas]

So there I was, taking Bill Harsey's advice

LOL Thank God it is ONLY a knee. This could have been fatal.

Originally Posted by Eagle5US

Sir,

high probablilty you have torn your ACL, less probable (but in the ballpark) your PCL.

An MRI is the gold standard and should be accomplished once the swelling goes down.

Don't push this-it will not have a positive outcome.
Good luck-use Ice, the velcro thingy, and stay on your motrin consistantly for a full 2 weeks-it will help with the inflammatory response .

Eagle

Agree 100%. Sir, I would get a referral to an orthopod for eval.