Elenz looked at the x-rays and said "a picture is worth a thousand words". He went on to explain what was going on with the knee, he said it was severly arthritic and was "amazed" that I could do what I do and that he "admired" me for it. He said really the only option was knee replacement and there were no tune-ups that were viable. He doesn't do replacements but would put me in touch with someone who did. We went on to discuss my leg in general, and Elenz suggested/offered cortisone injections before events to help manage pain but he said that wasn't a solution and couldn't be used longterm.
He also observed that even knee replacement wouldn't be simple due to the scaring on and around the knee. He also said he saw little point in resetting the leg, which was re-assuring, as the guy in NY who I saw in 2006 was fixated about fixing the leg.
Pretty much I knew all this, and the people I'd talked/joked with about this, I said that what I wanted was someone who'd give me cortisone injections. I guess I was being realistic, what I was hoping for was some minor miracle that Elenz could do something that wouldn't stop me training etc. Oh well.
What was interesting is Elenz had old-fashioned x-rays and didn't mention the CPPD, I didn't ask. Up in NY when I last saw a consultant in 2006, he used a scanner and high-def screen to review them on. You could see inside the knees much more clearly. I'm sure Elenz is right, but it's an interesting comparison.
So, shots it is. I guess for $203 it was not the win I'd expect but comforting to get a 2nd opinion. Oh well.
Next up: Less than 12-hours to the full list of IM Hawaii lottery winners on ironman.com