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Decision: Knee Scope or another round of PT
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After 2 weeks off, then one ride (bad result), a cortisone shot a week ago, another week off the bike, then a test ride yesterday (bad), my sports ortho offered a knee scope.

When on that test ride yesterday, I noticed that when under high load (steep climb), my knee goes in slightly at the top of my pedal stroke. Hmm.

MRI (from 2 years ago when symptoms were very similar):
- meniscus fine, tendons fine
- small fissure under knee cap on one side

Symptoms:
- Only very very light dull pain on the bike (maybe a rare sharper twinge, nothing important)
- A greater dull ache after riding
- "Pressure" feeling in the knee when standing, and standing longer = more pressure
- I have a tough time fully straightening my leg when it feels that pressure (it's not locked from straightening, but feels like it's running out of ROM)
- Some stretches, like the ITB stretch where you stand and cross one leg behind you and lean the other way, give mild pain in the outside of the joint
- Same thing with a piriformis stretch -- the stretching side/bent leg will hurt on the outside (or if I lay on my back, and cross that ankle over my other quad)
- Knee cap pops a lot, and definitely more when the above symptoms are present
- Knee cap can be very painful if I kneel on it to do a hip flexor stretch, then it will pop, and be fine

I'm really torn about what to do here. I've had this off/on for a few years. Previous PT wasn't very effective -- it may have been the time off that helped. I crashed on an MTB 23 years ago (wow, time flies!), where my heel was tucked under my butt as I slid. Had it scoped because I couldn't fully straighten it, doc said very little damage at all, just flushed it.

I'm worried about a lengthy recovery for what could be nil gain (if there's nothing in there). On the other hand, it would be cool to know that the meniscus is OK.

I welcome opinions here. Yeah, it's an internet forum, so I recognize what I'm paying for those opinions. I still value hearing them.

Thanks.

**************
Too f@ckin depressed from various injuries to care about having a signature line.

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Last edited by: Aztec: Feb 5, 08 20:26
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Re: Decision: Knee Scope or another round of PT [Aztec] [ In reply to ]
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My view, your recovery time will only be lengthy if your doc finds something that should be fixed. I had a full ACL reconstruction 18 years ago and that was a long recovery. Two years ago I was having some "pain" in that same knee, MRI didn't show any damage, doc offered scope. I had my scope on a Friday, was back at work walking relatively normally on the following Monday. Was cycling 5 days after surgery and was running 10 days after surgery. All after the removal of a benign cycloptic (yeah I didn't know that was possible either) tumor that had grown on the ACL graft and was likely getting pinched and causing the pain I was experiencing. Two years later no pain, so I'd say the decision was well worth it.
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Re: Decision: Knee Scope or another round of PT [Aztec] [ In reply to ]
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I suffered from patellofemoral syndrome and decided to go the surgery route. I had a lateral release and chondroplasty performed.

I had surgery on august 30, 2006. Started running again on Nov 1, and did Oceanside 70.3 in march 07 while running 20-40 miles per week. Recovery can be rapid, but you have to do the work with PT immediately post-op.

I have lots of stuff on my blog about it...just sort my posts by category, "knee surgery".

certainly not suggesting that you get surgery...just relating my experience that a fairly rapid and succesful recovery is possible.

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Re: Decision: Knee Scope or another round of PT [jpflores] [ In reply to ]
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In Reply To:
I suffered from patellofemoral syndrome and decided to go the surgery route. I had a lateral release and chondroplasty performed.

I had surgery on august 30, 2006. Started running again on Nov 1, and did Oceanside 70.3 in march 07 while running 20-40 miles per week. Recovery can be rapid, but you have to do the work with PT immediately post-op.

I have lots of stuff on my blog about it...just sort my posts by category, "knee surgery".

certainly not suggesting that you get surgery...just relating my experience that a fairly rapid and succesful recovery is possible.
With your PFS, did you ever get a stiffness in the knee, so that it was uncomfy to fully straighten your leg? That's the troubling part for me. Post ride, or even just standing around on an off day, it quickly gets that way. I ice it, and bam, it's normal again for awhile. I keep thinking that can't be a meniscus issue. Or can it?

**************
Too f@ckin depressed from various injuries to care about having a signature line.

Sponsored by Blue Shield PPO.
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Re: Decision: Knee Scope or another round of PT [Aztec] [ In reply to ]
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my symptoms were different, so I'm not sure my experience is totally relevant. My knee was fine just standing around....but when running, I had severe pains up my IT band and around my knee. When the leg would load up (just after footstrike) the pain would occur....to the point that I couldn't even lightly jog. Cycling did not bother me interestingly.

I'd seek the counsel of a good doc if I were you..

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Re: Decision: Knee Scope or another round of PT [jpflores] [ In reply to ]
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I have. One 2 years ago (MRI and "chondromalacia" was the outcome). Now a different one, a respected sports ortho who offered the scope. The "pressure" and feeling like I can't easily fully straighten my leg make him think meniscus. Responsiveness to icing makes me think PFS. But I have 0 years of med school, and he has... lots. :-)

**************
Too f@ckin depressed from various injuries to care about having a signature line.

Sponsored by Blue Shield PPO.
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Re: Decision: Knee Scope or another round of PT [Aztec] [ In reply to ]
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If the pain is going to ruin your training...thus ruining your season - do the scope. I had a knee issue (plica...google it) last year and went through 10 weeks of PT only to get about 30% better. In tri's...30% is not going to cut it for me. During the scope last Jan. - my doc cleaned up my knee and noticed my meniscus was weak so he removed some of it. I had a little more recovery time (off bike 2 weeks - run 4 weeks+) but went on to set PR's in a stand alone half as well as a HIM. I had a great season.

Bottom line - if I was facing a scope today...I would schedule it for tomorrow. It's not that bad. YMMV.



******************************************************
Well I believe in God, and the only thing that scares me is Keyser Soze
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Re: Decision: Knee Scope or another round of PT [Keyser_Soze] [ In reply to ]
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Thanks kinda my thinking -- if it turns out to be nothing in there, I need to be off the bike to rest it more anyway. And if he does find a tear (nothing showing on MRI), then it's a "bonus" of sorts.

In other words it SOUNDS like just looking in there isn't going to cost me a bunch more time off than I need to take anyway to rest it and PT it more aggressively?

**************
Too f@ckin depressed from various injuries to care about having a signature line.

Sponsored by Blue Shield PPO.
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Re: Decision: Knee Scope or another round of PT [Aztec] [ In reply to ]
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I had a scope job on my knee nearly 20 years ago to clean up some stuff that was in my left knee - the result of a minor fracturing of the patella a few years prior to that. I was back cycling within a week and running in 2 - 3 weeks. I am not a doc, but my understanding is that if what they do to you with the scope is minor, the recovery can be pretty quick - now if the procedure is moderate to major, that's a different story. An added bonus of the scope is that a good orthopedic surgeon may be able to see things in the joint, that otherwise have not been picked up yet, as a few posters have mentioned.


Steve Fleck @stevefleck | Blog
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Re: Decision: Knee Scope or another round of PT [Aztec] [ In reply to ]
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Your description sounds very similar to my meniscus tear a few years ago. My MRI also showed no tear, but after other treatments, the doc said the only other choice was to go in. I did the epidural, so was awake, as I was for the first. Upon getting in there, his comment was "so much for technology". The MRI missed 2 tears, a flap, and scar tissue. He fixed it, I was running in 2 weeks and had a great season. I water ran a ton pre and post surgery, and it got me in tremendous shape as well. I would say that the PT is only delaying the obvious....get it done, and you'll be running in 2-3 weeks(water run in 2 days). This is the best time of year for the surgery, so you'll be ready for good weather. Good luck!

Gary Geiger
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Re: Decision: Knee Scope or another round of PT [tri-3] [ In reply to ]
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Thanks for all of your opinions and good wishes. The surgeon had a cancellation for tomorrow, so I'm taking that spot. Fingers crossed that something really minor is causing all this havoc, and I can -- for once -- actually get something fixed!!!

**************
Too f@ckin depressed from various injuries to care about having a signature line.

Sponsored by Blue Shield PPO.
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Re: Decision: Knee Scope or another round of PT [Aztec] [ In reply to ]
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Stroke of luck...now you'll know. Best of luck, and you'll be back soon....keep the faith.

Gary Geiger
http://www.geigerphoto.com Professional photographer

TEAM KiWAMi NORTH AMERICA http://www.kiwamitri.com, Rudy Project http://www.rudyprojectusa.com, GU https://guenergy.com/shop/ ; Salming World Ambassador; https://www.shopsalming.com
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Re: Decision: Knee Scope or another round of PT [Aztec] [ In reply to ]
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I've had 3 knee surgeries, 1 of which was an ACL reconstruction and 2 scopes. The last scope was November 4th. I was riding on my trainer in about 3 days, swimming in 7, and running by December 8th. No PT needed given my past experieces and physical condition. I was having alot of pain when doing long runs and it turned out there was some overgrown tissue from my ACL regeneration (I had the cadaver graft) that was lingering in the joint and causing the pain. The doc cleaned that up and he also said I had some roughness on my femur. He cleaned that up with a high speed bone sander tool and I have been running alot better ever since. Best 20 minutes I ever spent knocked out. Good luck tommorow.
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Re: Decision: Knee Scope or another round of PT [Aztec] [ In reply to ]
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My brother had a knee scope after a football injury. He limped out of the hospital but after a bit of recovery he was better than new. It might be a small sacrifice to keep the pain away for good.
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Re: Decision: Knee Scope or another round of PT [Aztec] [ In reply to ]
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I've had a different experience. Went in to have a scarred medial fat pad removed. Doc took care of that, BUT, he also decided to go to work on the underside of my patella because of "flaps." Basically that means I had some frayed cartilage on the underside of the kneecap.

Well... he took a file and filed away the flaps. What ended up being left over was a slight groove running vertically on the underside of my patella. I have kneecap popping and pain that I never had before. Took weeks just to get up and down stairs. Anyway, I'm not the happiest with the results.

Good luck. Outcomes vary.
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Re: Decision: Knee Scope or another round of PT [Aztec] [ In reply to ]
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i had my knee scoped 5 weeks ago today and i ran for the first time this am. i was on the bike within 3 weeks with no pain. x-ray and mri showed nothing and i was beginning to doubt myself. i took 3 months off from running and when i started back it hurt the same. the doc did three things- clean out torn and ravaged cartledge, snip my muniscus, and third take out the plaki that had grown toward the patella and then turned back to the root. sure wish i had done this back in sept but i thought taking the time off was the proper thing to do. b/c the muniscus was so minor i was back in the office the following Monday. the oxycodeine was the worst part of the whole experience. good luck with your decision.
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Re: Decision: Knee Scope or another round of PT [Aztec] [ In reply to ]
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So did you have the knee scoped or not and what was the outcome?
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