Question: Dr. Aslam. Here is my question that you addressed again in relation to the MRI report.

Greetings. Further to my previous submissions with report about my wife's knee, she is in a situation where apparently because of the effects of a rupture of the baker's cyst, bone on bone, and lateral meniscus tear she did not benefit from physiotherapy and has alot of discomfort she is ready to tell the orthopedist that she needs surgery and not rely on Tramadol. She will see him in a few days. Since he had recommended conservative treatment does she want to mention a full knee replacement or a partial? He had said that lateral meniscus surgery by itself might not be beneficial. What would be your assessment in this situation? Thank you.

Thank you. As I described, my wife is in a situation where pain bothers her in bed, and she has discomfort in walking. She doesn't know if its the torn lateral meniscus or the cyst, but it has gotten worse since January when she had a cortisone or steroid injection. She feels that her knee is worse after doing the physiotherapy and cannot see life having to take tramadol and tylenol. It is unclear yet whether this calls for a full or partial replacement based on the report and her subjective pain, or repair of the lateral meniscus, which sooner or later would lead to a replacement. And of course when she has discomfort around her ankle with an Achilles tear and around the fascia it doesn't help her situation.

Hello, Dr. Aslam. My wife returned from the second visit today with the orthopedic surgeon. He reexamined the case and told her that her condition does not warrant an actual knee replacement at this time, but that he could provide a surgical procedure to clean the torn lateral meniscus. But that there is no guarantee it would help, and would probably make arthritis worse. The best choice he felt was what he calls a "nerve block" procedure provided by a pain management specialist because of the stiffness and great pain she feels, including moving in bed. He said that eventually her knee might worsen enough over time for a replacement, but that this is not yet.
I would appreciate what you feel about this scenario, and how much the nerve block procedure would help her and for how long. Thank you.

Many thanks Dr. Gurabardhi. Would a nerve block procedure be permanent so that it would always disguise physical problems that ordinarily cause pain and need attention? Or can it be done temporarily? My wife asks whether a permanent block could "hide" some other severe problem.....

And would the nerve block reduce her knee swelling as well?