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Q&A with Australian Health Practitioners
77 with arthritic left hip cysts left femoral head etc + left knee. What should be attended to first?
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Saw public surgeon on 4th Dec 15 for left hip knee severe pain. Surgeon said lists well over 1 year to wait so if could, best go private. Told him already had Sept 15 when told waiting lists for surgery. But he didn't mention knee. Now limited walk + left leg is shrinking makes it harder on knees. Should I get knee seen to prior to hip as it is so painful and getting worse, regularly bone on bone sends pain a 10+ involuntary shrieks, which upsets others. Hip excluded 12 mths 6 to go to Sept 16. Had both X-rays at the same time but knee ignored along with pain being in muscle in left leg. I find it harder to stand up now, need pulling out of chair which is worse than 4.12.15 when saw surgeon. What is the cause of shrinking leg? What worries me the most is a mobility loss. Hip causing shrinkage of muscle? Always had pain more muscular than hip bone that is just a bit sore at times. On Norspan and 8 Panadeine Forte plus have 100 x30mg codeine Other meds too many side effects. Just going to doc knocks me out rest day. -
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Dr Razvan Stoita
Orthopaedic Surgeon
Dr Razvan Stoita is an experienced specialist orthopaedic hip knee surgeon with expertise in hip and knee replacement surgery, knee ligament reconstruction and trauma of … View Profile
To start first with the knee pain. This can be caused by a problem in the knee (e.g. arthritis) but if you have already been diagnosed with hip arthritis it is likely that the pain in the knee is a referred pain from the hip. Often patients with hip problems experience just knee pain due to the proximity of the hip and knee centers for pain in the brain. So your knee pain may come from the hip but you can have both hip and knee arthritis. Only a clinical assessment can ascertain the exact source of the pain. Moving onto the "shrinkage of the leg", if you mean by this leg shortening, then this happens because of wear and collapse of the femoral head (ball of your thigh bone) and the leg ends up shorter. If by "shrinkage" you refer to a decrease in the circumferential size of the leg, this is related to muscle wasting as a result of muscle disuse due to pain. Finally, loss of mobility happens in the majority of patients with arthritis. The worse the arthritis is the worse the mobility. As the joint cartilage wears out and the joint responds to this by forming osteophytes (abnormal bone) around the joint edges, the movement becomes more and more restricted. This happens in any joint affected by arthritis.
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ValerieHealthShare Member
Thank you doctor-X Ray on left knee, shows tech told me, that patella - back of knee gone. Last few days very stiff cant sleep in bed have to sleep in lift chair as knee too painful even with opoids and pillow to lie now. Ok in chair sitting position. I am grateful re leg shortage as thought muscle had shrunk and do try light exercise - so bone it will be for sure. I will be able to wait til Sept- I was having nightmares that I would finally get to see a surgeon and he would say to me- "oh dear, if only you had comne sooner, too late now to do anything". Silly maybe but at 3am these thoughts are terrifiying. So thank you again for caring enough to give your time to helping out others in your own time.
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Mr Ilan Freedman
Orthopaedic Surgeon
Mr Ilan Freedman is a Dual-Fellowship trained Melbourne Orthopaedic Surgeon with specialist experience in Direct Anterior Minimally Invasive Hip Replacement, Bikini Anterior Hip Replacement, Conformis … View Profile
The general principle when a patient has both KNEE and HIP Arthritis is do fix the HIP first, for two reasons:
1. Knee pain is often referred from the hip, therefore even if you do have knee arhritis, the knee may become sufficiently better after sorting out the hip problem.
2. Knee Replacement is sensitive to adjustments in the mechanics of the leg, so if given the choice I'd do the hip replacement FIRST, so that the KNEE can be done later and not be affected by a later hip replacement ....
Ilan Freedman - Orthopaedic Surgeon
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ValerieHealthShare Member
Thank You Mr Freedman - Since posting the knee has got a lot worse clacking around - has been noisy climbing stairs etc since around 1983 when gave me problems bending to pick up at work - running supermarket at time, picking sweeties for kiddies got me so read re the Maori never having arthritis etc and green lipped mussels staple diet so went on these - called Sea Tone and have taken them since. I think would have had this escalating problem earlier without. When bone meets bone feels like its back of the left knee wow! Imagine electric shock similar. Also had burning pain in left heel for couole of years not diebetes. Think has to be nerve pain and then big toe left foot also - now its coming earlier around 11.45pm ast night and use Ice Gel to cool it but last around 1 hour then awoken by pain - means exhausted and fallling asleep if I sit and stop doing something like computer cant even read at times. Codeine doesnt help but hasnt bothered me before as fast metabolizer - like anesthetic doesnt knock me out unless steady dripped - soon as get up (or used too) and walk away - drive home.
Also noticed that left side of genital area has, when looking with a mirror - twsted towards the left leg so when I urinate, it goes down the left leg. Can lift it so avoid this to some extent, just again hope that this goes back into place once hip is operated on etc.
Thanks for helping others in your spare time.
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