Health – Knee pain an eye opener

I gave up writing this column because I had run out of things that were wrong with me, but I’m back in business. 

In 2020 I was doing my usual stride around the Ōrewa Estuary when my left knee started to hurt. No injury, no unusual activity and a dead flat path. I was pretty disappointed because I felt my legs were one part of me that was going to continue to function into my old age. I hobbled the last part of the path, went home and waited for it to get better.   

For a few weeks I had sleep-disrupting night pain and eye-watering agony when I twisted the joint, and then it settled down to nuisance discomfort and low grade swelling. After three months I was getting frustrated so arranged an MRI which showed so much damage in there I could hardly believe it: cracked cartilages and joint surface, inflamed ligaments and fluid.

How could this possibly happen? I was fully functional one minute, and then the next I had a munted joint. Clearly something degenerative had been happening for a long time, without my knowledge or permission, and then there was a catastrophic failure like the metal fatigue that causes a bridge to collapse. 

My friendly orthopaedic surgeon said he could do an arthroscopic tidy up job, with modest expectations and the likelihood of a complete replacement at a later date. I would have gone with this, but I found a skilled physio who did something magical with it, gave me some exercises and brought me back from the brink. Surgery was postponed and things slowly started to get better. 

This got me thinking about all those ACC claims that are turned down because the respective area shows wear and tear. Unlike me, most of those people had a clear event which triggered their symptoms, so it seems on the face of it that this would satisfy ACC’s definition of personal injury by accident. It certainly sounds logical to me and I have supported dozens of patients in their efforts to get ACC cover. But no. It turns out frequently there is a pre-existing disease process happening, with no symptoms at all, until the straw and camel’s back principle comes into play. 

In any case, I continue to learn on the job, often through self-observation. Eighteen months later my knee still hurts, but I can live with it  and I’ve found another way to empathise with my patients. 

Editor’s note Hibiscus Matters welcomes Dr Peter Hall of The Doctors in Whangaparāoa back to our Health column.