Upcoming Orthopedic Appointment - Advice

Hello everyone!
I have an orthopedic appointment approaching, 3 weeks from now, and I wanted some advice regarding the appointment. I already have knee x-rays from last month and pain history, but is there any advice on what I should talk about or ask? I don't want to jump to surgery unless it's major and necessary. BUT, I am very tired of the knee pain.

Thanks in advance.

I always ask if physical therapy would be appropriate. The answer is often yes.

And ask about visco-supplementation. That can often give you relief for months if the joint isn't too far "gone".

Thanks ladies! I am hoping for a physical therapy referral but there is a chance I might need minor surgery to move my knee caps back into place. I really hope not. I would rather try exercise first. Though, I am tired of all this before the knee pain. This ortho appointment next month and rheumy in September. I'll get something figured out.

On the plus side I have very little fatigue and brain fog, and little stiffness in the morning. That's always good to hear.

I'd be checking out the surgeon every second, trying to gauge what I thought of him. The first orthopaedic surgeon I saw about my bunion told me that he couldn't guarantee that I wouldn't be in pain every moment of my life after the type of surgery required. But then he had named his little area something like 'Dr Tonto's lump & bump clinic' and struck me as very pleased with himself. Didn't really inspire confidence but his warning put the fear of god into me. The second one I saw a few years later was a very thoughtful, measured person who laid out the risks / benefits very sensibly. And as it happened the result was excellent.

I'd want to know exactly what the surgery involved and what the success rate is.

Little fatigue and brain fog? Wowzer! Great to hear!

Hi everyone! How are ya?

So, UPDATE: I went to my orthopedic appointment today and it was a success. It was a long wait to see him but he turned out to be a very nice doctor. He was knowledgeable about PsA and created a plan that included my limitations to fix my knees. I start physical therapy next week and I am considering cortisone injections into the knee to help ease off the pain for a little while. NO SURGERY or PAIN PILLS. I am so happy. I was really scared he would jump at the chance to cut me open! I'm going shopping for knee braces... any recommendations?

Thanks everyone!! I should have done this YEARS ago!!

Excellent! And do you have a follow up plan, like six weeks of PT then see him?

Nothing formal, no appointment made. 2 to 3 months of PT (either on location or at home) and knee braces. Also to include some mild biking and elliptical workouts. I wanted to think about the injections, so I'll make an appointment if I decided to inject. I see rheumy next month and will discuss this ortho apportionment. The ortho's office doesn't have a long wait time for appointments.

Don't get carried away there are Hundreds of choices. Less is more with knees. Too much bracing can backfire with PsA. Even a slight loss of muscle toe can increase the enthesitis pretty quickly. I'm not saying you don't need a brace or not tuse one. My favorite was a simple patellar tendon strap specially if you are doing eliptical Its really comfortable through the day. .Another favorite is a simple Runners brace (or Patellar Stabelizing brace) They even come in collors. Your PT will surely have some recommendations, just don't buy it from her.... Your insurance company will likley require injections before surgery. That is the only time to consider it. Keep in mind a reputable doc (and it sounds like you have one) will offer the procedure but NOT push it. You can only have a few injections before the soft tissues get even softer..... Thats what leads to replacements. FWIW the numbers for a rotor-rooter knee job vs nothing in terms of success are about the same. Individual docs have better results because of better patient selection so don't over research. Relaligning the patella is a differen thing. You will know after a few months of bracing and/or PT if its really necessary............

MDUB Medical Patellar Tendon Strap MDUB Medical Patellar Stabilizing Brace

Thanks TNT! Doc did recommend a brace with a patellar stabilizing brace with no bracing or stabilizers on the sides. I like the one you have pictured. Something like that is all i want anyway. Right now I use knee socks but the don't have the patellar hole in them.

I agree about the surgery outcomes. I'm not going to consider the injections unless PT doesn't help and I am in the same pain level.

Thanks again!

amielynn, I've trodden this same path. Knee pain which wasn't helped by the biologic, x-rays that showed nothing, steroid injections didn't help and MRI 's which showed some soft tissue damage = a surgical review with an orthopod who would not "go in" and was adamant it was inflammatory PsA. He was right!

tntlamb recommended the same knee supports to me ... the ones I ended up with are slightly more substantial but not too bracing, just comforting and supportive. I worked hard on the PT as well. It helped. Then my biologic dose was increased and within a couple of months my knees were, and still are, pretty much pain free so long as I don't squat/kneel. And I've got nice strong muscles.

So don't give up hope, you're at the corner and just about to turn it.

Thanks Jules.

It's a very long corner.... the Ortho did say he thinks it is the PsA and the patellar misalignment playing against each other. One inflames the other and so on. I do see my rheumy next month and we will have to talk about medication. I've had some fatigue creep back, some tenderness, and brain fog. It's a bit at a time but it is building up. Hopefully with these two doctors I can find a small amount of relief.

Thanks for your support Jules. It's nice to know someone has walked this path before, though I wish you hadn't.

To have doctors who don't dismiss your pain and discomfort and are willing to work with you to pick up and examine under every stone are worth their weight in gold. I had patella misalignment many, many years before my PsA and had some physio and that was the end of that. I guess when PsA then does come along it's going to pick any slightly weak spot to do it's worst. I hope you get the same relief from the knee pain that I've had.

I hope so too Jules.. I'm st the point where a walker or wheelchair seems like my only option. I walk around the house grabbing onto things. I feel frail and I hate it. I am determined to ease my knee pain, if only by a little. When I was in college I saw a orthopedists about my knees and he gave me the same hoop-la that I am sure your first doctor gave you. I gave up then. After my son was born the pain increased, due to the misalignment becoming more misaligned, and I was sure I would never find relief for any of my symptoms. Now I feel a bad bit hopeful and that's the most hopeful I have felt in 15 years.

Thank you ladies and gents for listening to all my whining and questions. You all are my rock (and as my husbands says) I am your hard place.