experence with synovitis

[lor]

Hi,

I have had knee pain for 1 1/2 years. They did a MRI a year ago and it said I had a torn meniscus. They drained it and injected it and it was great for 6 months. Then it started coming back. They told me I had to get the meniscus fixed. So I finially had the surgery done 10 days ago. They said there was no tear and I had synovitis. They cleaned it out. Causes RA. I am being treated for Lyme disease with ABX for years. I guess I am wondering if anyone else had had there joint cleaned out and did it work? I sure would not have had surgery had I known I had no tear. They said they were sending the stuff they cleaned out to pathology. And mentioned a Rheunotoligist. No way, been there done that. I just feel kinda sick inside. Will this nightmare ever end.

lori

[Maz]

@lor wrote:

They said there was no tear and I had synovitis. They cleaned it out. Causes RA. I am being treated for Lyme disease with ABX for years. I guess I am wondering if anyone else had had there joint cleaned out and did it work? I sure would not have had surgery had I known I had no tear. They said they were sending the stuff they cleaned out to pathology. And mentioned a Rheunotoligist. No way, been there done that. I just feel kinda sick inside. Will this nightmare ever end.

Hi Lori,

So sorry to hear about your knee…so common with Lyme. I have one dicky knee still, too.

Could they not see the tear from MRI?

I’m sorry I don’t have any experience of this problem to share, but synovitis is basically the problem of any RAer or anyone with gout, lupus with joint involvement, etc. It’s basically swelling of the synovium and resulting build-up of fluid in the joint capsule.

One interesting thing will be the results that come back from pathology. Dr. J., a well-known LLMD in Wash DC, talks about Lyme knees on his website and a “cheesy, fibrous exudate” that often needs cleaning out when joint surgeries are performed.

http://www.jemsekspecialty.com/lyme_detail.php?sid=8

“In a few cases, actual arthritis is evident, although only rarely does this persist. When it does persist and comes to joint replacement surgery, we have anecdotal reports in which orthopedic surgeons, upon opening the joint in question, discover a cheesy, fibrous exudate which is uncharacteristic for the usual bacterial infection and which proves to be negative or sterile on routine smears and cultures. This is the prototypical “Lyme joint” which almost no one in the operating arena ever recognizes. In fact, some surgeons stop there and refuse to go on, believing that their patient has an unusual and previously unrecognized infection that makes their job impossible. However, if the arthroplasty continues after these initial concerns are addressed, we have noted a high rate of success in joint replacement (personal experience).”

I hope that now they’ve cleaned out your joint, you might have better results with your abx therapy getting better penetration into your knee. Are you taking a tetracycline?

[Eileen]

Hi Lori,

It’s really crummy when you lose, or start to lose a knee. I went through something very similar to you. Three years ago I had an MRI done on my knee. Results: displaced meniscus and bone on bone, unilaterally. Had MRI done this past May which revealed a ‘torn meniscus, bone on bone and some free-floating junk.’ Walking was impossible. Off to scope surgery in July. You asked if the surgery helped? Yes. Some. They trimmed the meniscus, chondroplasty of the femur, and cleaned the
free-loating debris, and after fluid was drained and sent for analysis, showed inflammatory cells. Bingo! It will patch me up until I am in a position to have a knee replacement. As far as synovitis, I have synovitis of my left SI joint and depending on which RD (I’ve gone through four and can’t be bothered to look for a fifth — totally understand what you’re saying) they keep changing the diagnosis. So long to them. I’m not going down that road either. Had the first RD actually done something about my Lyme/Psa, and not waited to figure out what to do with me three years into it, I might still have this knee. I have a long history of LD and co-infs.. I’m now in the hands of an inf. dis. dr. I was 47 when I was told by an ortho. that I needed a replacement.

Now…comes the preaching…ice that knee, A LOT!!! You just had surgery and might feel some better but don’t do too much too soon. Elevate it. Your knee might feel a bit better, but it is unstable and the slightest twist that you don’t anticipate can send you to the floor. It happened to me two weeks after my surgery and I could not get up and I was alone. Be careful in what you do. I was told it would take up to three to four months for optimal healing. Saw another ortho. dr after this in Boston. I have a brace, but cant stand it. It’s more trouble than what it’s worth. Inflammation is down some.

So don’t go trying to run a marathon, but I know, you wish you could and you will someday.

We’re all going to be walking down the road back. Stay with it!!

ICE, ICE, ICE and REST!!!!

Eileen

[mary77]

Lori,
My history is 10 years sick with Lyme before a diagnosis and treatment. About 4 months before I was finally diagnosed, my left knee became very swollen and sore. Migratory arthritis was (and still is) one of my main symptoms. My ortho MD was sure I had a torn ligament, so I went ahead with surgery. Once in the joint, he found “stuff” he’d never seen before, but no problems with anything else. He did a synovectomy and sent the “stuff” to a lab. The lab reported back that the “stuff” was normal…they could not culture anything from it. My surgeon insisted there was nothing “normal” about it!

4 months later I began IV antibiotics for the Lyme…to this day (19 years later), my left knee has been great. The synovectomy saved my knee…

I am still treating the illness but doing quite well these days.

I hope you recover quickly and your knee improves like mine did…ice and elevation would be helpful during this time!

Good luck!
Mary

[lor]

Hi all,

Thank you for all your responces. I don’t feel so alone any longer. I will take your advice and do more iceing and I printed out the liturature and am going to give it to the ortro, Doc. I was going to skip the next follow up appointment, that would tell me what pathology said, I just don’t want the usual RA lecture. But I will go and have my information from here handy.

The MRI said I had a small tear. Is the only reason I had surgery. Bad MRI????

I am going to rehab, which is good, hoping it will help rebuild mucsle in that leg. Right now the knee hurts a little worse than it did before surgery, but is improving, not getting worse. Surgery was on 2-24-11.

Again thanks.
lori

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