Orthopedics Questions Orthopaedic Surgeon

What should I do?

I went to the dentist for an infected/impounded wisdom tooth, figured it needed to be pulled as the one below it 34 years earlier. I was prescribed amoxicillin to deal with the inflammation, risk, and soreness before the extraction, 2 or 3 days after finishing the medication my knee swelled up.

The same knee had the exact same reaction 34 years earlier that I had an arthroscopy on as the experts just knew it was a mechanical problem, 5 of them. We managed to convince one to try anything else before surgery. The swelling was drained with a huge syringe and needle extracting a yellow synovial fluid, a few days later it was back. They tried electrical shock stimulating the muscles, there's a name for this therapy, which escapes me. All efforts failed so I had the surgery and they found nothing wrong with it mechanically as the problem was promised. 6 months later, it was good for 34 years until I had the same wisdom tooth problem as the one that was extracted.

36 years I was also prescribed amoxicillin for the inflammation, risk, and soreness before the actual extraction, the most recent wisdom tooth wasn't extracted, soreness and inflammation went away.
I deduced it must be a chemical problem in the knee, a reaction from the medication perhaps. However, the surgery fixed the problem 36 years earlier, albeit 6 months after the surgery that found no mechanical problem causing a large amount of synovial fluid, they called it.

It's been 2 years and it hasn't gone away as if the knee swelling did after surgery, so the saline they pumped into my knee during surgery must have played a role. Do they use anything else for exploratory surgery with the 3 scars I've been left with? I'm starting to wonder if that would help, the saline. I've drained my knee of fluid about a year ago and just kept wearing a brace, which does make it feel better without pain. However, I do believe the brace with its contracting properties has spread the pain to every other joint in my body. Now my right knee has the same symptoms as the original left knee. The pain is becoming unbearable in both knees now and both are swollen, quite large.
What would you do if this made any sense to you?

By the way, after surgery 36 years ago, they drained the knee again of the same amount of fluid, 3 ml or oz, I don't recall, a lot; only it also had blood in the syringe that time. Maybe an allergic reaction causes the fluid to keep being made and now spread. I'm at a loss as to what to do, can anyone help.

Male | 54 years old
Complaint duration: 2 years 3 months
Medications: Atenolol
Conditions: Blood Pressure

2 Answers

You should at least have the fluid removed and sent for examination. It is likely you now have some type of inflammatory arthritis. Blood tests are also indicated before any more tests such as MRI are done.

Christopher B. Michelsen, MD, FAOA, FAAOS, FACS
Thanks for all the information with this difficult problem. It would be very uncommon for the antibiotic to cause an inflammatory reaction in your knee. The buildup of fluid as a result of the inflammation within the knee. The most common reasons are in fact mechanical in origin. It may have been that you had a small amount of cartilage damage 30+ years ago and this led to the inflammation and after the new arthroscopy and washing it out, you had the next 30+ years pain and swelling absent. First thing I would recommend is having it reevaluated. This would involve seeing an orthopedic surgeon probably having radiographs and perhaps the knee drained and the fluid analyzed. I then would consider observation to see if the fluid reoccurred. If the fluid continue to reoccur, I would have a repeat MRI since he’s had improved over the years and can show more specifically whether you have any damage within the. The next recommendation if you can find a surgeon willing to do it would be to simply drain your knee and wash it out using a syringe and needle. This is a little unconventional, but would work in in the case where there’s mild inflammation and cartilage damage and may allow you to avoid any surgery. Finally, the last option would be again on the arthroscopy. These are done much easier than they were 30 years ago with a relatively short downtime unless you have significant damage within the knee. Based on the information you’ve given me, I would definitely have the knee looked at during this time. If you wait too long, you may do more permanent damage and not be able to cure the problem with a simple knee arthroscopy.
Good luck.