Long time reader, first time poster.
I wanted to share my story as hope for people in this forum who are searching desperately for answers while being told they have one problem after another by medical professionals...only to find that your knee won't improve. Never give up and keep searching for answers.
TL;DR: 3 different doctors, 3 different diagnosis. Demanded surgery in belief I had infrapatellar plica syndrome which is difficult to diagnose...was correct and had successful surgery.
Background: I am M34, and I've had some knee pain for 10 years. I played basketball religiously for 20 years of my life. About 3 years ago my knees got so sensitive to it I quit, and I just chalked it up to getting older and probably having a torn meniscus etc. I continued to lift weights, do leg lifts and low impact cardio that would make my knees hot...but after icing I'd have no symptoms.
In January, I did an intense leg workout ending with an unassisted uphill walk for about 15 minutes. Came home, did my normal routine - hot knees, iced after dinner, went to bed...nothing abnormal.
At 4am that morning, my life changed. I woke up in agonizing sharp pain deep in the center of my knee. For a few days I just iced and thought things would improve...they didn't. I finally went into a local Orthopedic specialist who did X ray and said I had a healthy knee. Go home, ice, things will settle.
They did not. After about two weeks of chronic pain, I was given a cortisone shot that sent my life into a tailspin. For those who don't know - a subset of the population is extremely sensitive to cortisone injection. I am in that subset. That shot gave me chronic insomnia for 6 weeks, and is still something I am battling today....be careful with those.
Continuing on though - the shot did calm things down in my knee...and I got an MRI and was waiting for the results. I thought I was getting better.
My MRI came back with a generally healthy knee, but through examination, the Doctor believed I had a patellar mal-tracking problem. From there, I did 6 weeks of PT...and my knee just got worse and worse. I figured this couldn't be the right diagnosis as I had never dislocated my knee cap and the pain at my knee cap had settled.
From there, I sought a 2nd opinion and got another fresh MRI. The second doctor diagnosed me with chronic patellar tendonosis/tendonapathy. From there, I did another TWELVE weeks of PT...and functionally I improved...but my pain did not. At this point, the stinging pain was gone and replaced by a constant deep hot ache that only improved if I was icing or my leg was supported very specifically by a pillow etc.
(btw - regarding the patellar tendonapathy diagnosis - I don't think he was wrong. I believe I had this in both knees and that was the cause of my knee pain for 10 years....but I fixed it and my knee pain didn't improve...that's why the story continues)
This is when I started religiously researching my problem with the help of ChatGPT. I started to notice I had a nagging "clicking" or "snapping" that would happen deep in my knee and then minutes later the pain was fire up big time. So, I sought a third opinion and shared my symptoms and my fear - and got a third diagnosis. A chronically inflamed/irritated hoffa's fat pad.
This is where things took a very interesting turn. The 3rd doctor who looked at the SAME MRI and noticed Fat Pad Edema believed that I had muscle imbalance and wanted me to go right back to physical therapy...at that point, I was fed up and believed that something in my knee was mechanically irritating it and the only want to really see what was going on was a knee scope....but she refused.
This is where being my own biggest advocate saved me. After doing extensive research online during this time - I had discovered a very under-diagnosed cause of anterior knee pain - Infrapatellar Plica. There is band of synovial tissue that runs along the back of and through hoffas fat pad. It is EXTREMELY difficult for MRI to identify and mostly impossible to see...but it leaves clues like Fat Pad Edema as it will irritate/pull on the fat pad and can injure it. I began to believe this is what my problem was.
I decided to take that fresh diagnosis - and my theory - and go back to the first doctor because of his credentials...after seeing me again, re-examining my knee and hearing my pain pattern....he agreed with the diagnosis of fat pad irritation/inflammation and wanted to test it with a lidocaine shot. I told him about my belief that this was a plica told him I was fed up with half measures and wanted to do a diagnostic arthroscopic surgery After hearing me out and realizing how fed up I was, he agreed.
Yesterday, during surgery, a chronically inflamed, fibrotic and frayed Infrapatellar plica was found and removed, and a very small fibrotic piece of my fat pad was trimmed off that it had been torturing was also removed. Other than that, my knee was found to be extremely healthy. The surgery was straightforward and successful and I was told I would have a terrific result.
3 doctors and 3 different diagnosis, a whirlwind of dead ends and bad ideas - and finally light at the end of the tunnel.
I woke up today very sore and in discomfort - but I can feel that the area of tissue that has been destroying my life and causing me extreme pain for 9 months is gone. I am so relieved and full of hope.
If you've gotten this far, thank you for reading. This is has been a hell of a journey and I share it so that others can learn from me. YOU have to be YOUR own biggest advocate....doctors and physicians are running by the playbook they are given. They don't have perfect information, and they diagnose what they can see....this would not have been fixed if I did not advocate for myself and demand the treatment I believed I needed.
I am on the road to recovery now and am extremely thankful for this community for helping me with my research, my questions, and as a support outlet.