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Dr. Chip
Dr. Chip, Board Certified Physician
Category: Medical
Satisfied Customers: 27483
Experience:  20 yrs. in practice, includinge surgery, general medicine, addiction medicine and pain.
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My husband had an arthroscopy on his right knee on June 18.

Customer Question

My husband had an arthroscopy on his right knee on June 18. All went well for about three days, then swelling and fierce pain set in, alleviated only by strong painkillers every few hours. There is noticeable swelling below the kneecap and on the outside of the whole knee area, now seeming to become harder than before.
The surgeon, whom he has visited twice since the operation, claims he is mystified by all of this and attributes it to my husband's warfarin intake (stopped for four days before the operation, then resumed), but we're unconvinced and most concerned that things seem to be heading in quite the wrong direction.
Can you please advise? Thank you.
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. Chip replied 1 year ago.
Hi. Sorry to hear about this. Did he get either x-rays or an MRI of the knee after this occurred?
Dr. Chip, Board Certified Physician
Category: Medical
Satisfied Customers: 27483
Experience: 20 yrs. in practice, includinge surgery, general medicine, addiction medicine and pain.
Dr. Chip and 2 other Medical Specialists are ready to help you
Expert:  Dr. Chip replied 1 year ago.
Just use respond to expert to reply Deirdre
Customer: replied 1 year ago.

No, no imaging was done after the operation.

Expert:  Dr. Chip replied 1 year ago.
OK Is the knee warm to the touch? Any redness or discoloration?
Customer: replied 1 year ago.

The knee is somewhat warm to the touch but not really red or discoloured.

Expert:  Dr. Chip replied 1 year ago.

OK Deirdre, We can continue after this if you'd like.

Two possibilities here--

One would be a large hematoma--blood collection from the warfarin he was on even if it were stopped before the surgery.

But the other more concerning possibility would be a septic joint--an infection,

I personally would get an MRI of the knee and consider a needle aspiration to see what kind of fluid is in there and to get it cultured since he may need antibiotics for this.

He needs to discuss this with his surgeon

Customer: replied 1 year ago.

Why would the swelling be getting firmer to the touch? The pain level doesn't seem to be decreasing. There's also a firm swelling behind the knee that I forgot to mention.

Expert:  Dr. Chip replied 1 year ago.

Any significan amount of fluid in the knee joint can cause a firm feeling to the swelling.

Also if there's a swelling behind the knee he may have a Baker's cyst back there, although I would assume that would have shown up on the pre-operative MRI

Customer: replied 1 year ago.

Can you please tell me if this is an urgent matter? It's now Tuesday afternoon and my husband's next appointment with his surgeon isn't until Friday lunchtime?

I'm most concerned, particularly as we specifically asked for imaging when we last saw the surgeon (yesterday morning), but he said he didn't think it was necessary. He did mention the possibility of a hospital admission for IV administration of antibiotics, but as we're paying for all of this privately out of our own pocket (to avoid the 18-month waiting time for surgery), we're rather scared of further costs!

Expert:  Dr. Chip replied 1 year ago.
I would consider it urgent if it happens to be a septic joint and there's no way to tell that without the scan and the aspiration. Sorry about the payment problem but I just don't think this should be a wait-and-see situation
Customer: replied 1 year ago.

Thank you for your helpful responses so far. I think we're nearly there now.

I've just taken my husband's temperature and find it slightly raised from his normal, which is 36.2. At the moment it's registering as 37.6c. At what point should we be alarmed? As things stand, we're just a bit concerned.

Expert:  Dr. Chip replied 1 year ago.
Well, if his temperature spikes to over 38.5 I would be worried

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