medial meniscus tear

Nov 23, 13 7:23

Post #1 of 62 Views: 11359

Ok so Ive read about other people's tears and Ive decided every case is different. A lot of it depends on how healthy your knees are to begin with. So here is my story. Ive been racing for over 20 years Im 47. Ive never had an injury thats taken me out for any length of time. This year while racing Lake Placid I tore my hamstring on my left leg it was low - close to the back of my knee and healed quite well on its own. Now here it is November and Im preparing for AR Worlds in Costa Rica. A 9 day adventure race. I headed out for what should have been a straight forward hike last weekend and I slipped and fell on some wet rocks and hurt my knee. It twisted in when I slipped. It was a slick day with rain and a lot of rocks and patchy ice. I fell 2 or 3 more times on the rocks and ice. It seemed the more careful I was the worse it went. Anyway the knee started clicking and felt weird and hurt. We finished the hike out even running on the smoother stuff at the end just to get done since it was cold and rainy and we were ready to be done. On the drive home it swelled up like crazy and the pain got worse. By the time I got home and went to bed it was aching so much and it hurt a lot to bend it.
I had an MRI done on Tuesday and it shows an Oblique tear in the medial meniscus with a partially detached displaced fragment extending into the inferomedial gutter.
MCL sprain
moderate joint effusion with periarticular edema
edema surrounding both retinaculum without evidence of a tear
lobulated cyct deep to the pes anserine tendons suggestive of bursitis.
It also says the fat pads are intact and all the tendons are intact.
Im quite sure the edma references are because the injury was fresh. Yesterday I had a cortisone injection with some fluid drained out. Only 8cc's it was clear.
What does anyone have for experience with this type of thing? There is no running involved in this race and I do not plan on running any time before I go. The race starts on December 3rd.
Trailqueen

Re: medial meniscus tear [Trailqueen] [ In reply to ]

Nov 23, 13 9:12

Post #2 of 62 Views: 11335

I've had two medial meniscus tears. First was 18yrs ago playing college soccer and was combined with a major ACL tear, partial MCL tear, and ruptured cyst. Had ACL reconstruction and meniscus cleaned up. Came back fine with minor swelling due largely to meniscus tear, but wasn't inhibited at all.

Fast forward 6yrs and I retore my meniscus in same place (also playing soccer). Had it cleaned up via scope and was told by doc that I'm missing 1.5cm of my meniscus and shouldn't ever run more than a few miles at a time for fear of further injury and having to have full meniscus replacement (it's very close to bone on bone).

So, I took it very easy for a few years, then met my girlfriend (now wife) in grad school who I started running with fairly regularly. Since then (I'm now 38) I haven't stopped...doing a couple IMs, 25+ HIMs, and lots of running races. I still get some swelling after hard workouts, but knock on wood have been able to do most everything I want, so long as it's in a straight line. I can't play soccer, basketball or tennis as it swells terribly and takes me weeks to recover and I probably shouldn't snowboard, but some things are worth the pain and swelling afterwards. :)

Like you said, every situation is different and I just feel blessed that after my second tear and doctor's warning not to run, I'm still able to train and race tri. I also take glucosamine daily which seems to help.

Good luck!

Last edited by: sailnfast: Nov 23, 13 9:15

Re: medial meniscus tear [sailnfast] [ In reply to ]

Nov 24, 13 12:06

Post #3 of 62 Views: 11271

Im not sure how big the tear is but the doc said its a pretty good tear. The report says with detached piece. Im assuming thats what they would remove with scoping it. I also guess that getting it done sooner rather than later is the best option.

Re: medial meniscus tear [Trailqueen] [ In reply to ]

Nov 25, 13 7:37

Post #4 of 62 Views: 11196

Sooner rather than later is probably a good idea. I've had multiple tears accompanied by repairs and a complete removal on the medial side of my left knee. While recovery is short and a meniscus tear is less severe than a ligament tear, the long term issues are what you need to be worried about. You might be able to get it repaired and have no long term issues but if you race on it and tear it worse repair might now be an option.

Re: medial meniscus tear [Trailqueen] [ In reply to ]

Nov 25, 13 9:47

Post #5 of 62 Views: 11170

Trailqueen wrote:

Im not sure how big the tear is but the doc said its a pretty good tear. The report says with detached piece. Im assuming thats what they would remove with scoping it. I also guess that getting it done sooner rather than later is the best option.

I had something similar to what you are describing at about your age, which was 5 years ago. I went to the doctor because in a race I turned a corner and my left knee wasn't there for an instant. I went down hard. Over the next couple of weeks it would happen under high load - a sharp down hill turn to the right - and I started to hesitate.

I went to 3 doctors that wanted to do different things. Two of them told me I was too old to get it fixed and that my running days were over. A guy named Stevenson, that used to be on the Jets staff, finally told me all that was needed was a little snip to remove the flap, PT, OTC Orthotics, and finally a slight modification in my running.

I still have pain in that knee from time to time, and I will never go under 3 hours in the marathon again, but I do just fine otherwise.

"...the street finds its own uses for things"

Re: medial meniscus tear [AutomaticJack] [ In reply to ]

Nov 25, 13 10:09

Post #6 of 62 Views: 11160

Thanks for all the good advice. Im quite sure now the race is out. Im waiting to find out about surgery soon so that I can get on to getting better. Some things are not worth the risk. Saddly.

Re: medial meniscus tear [Trailqueen] [ In reply to ]

Nov 25, 13 10:42

Post #7 of 62 Views: 11145

I had a tear in January 2012 and put off surgery as I couldn't believe a little fall would create a surgery situation. I spent a lot of money on massage and PT but finally went under the knife in September 2012. It's all good now.
But what I wanted to say is that between January and September I continued to run - it was painful and really slowed me down - but activity was doable. I'm not sure of your situation is but perhaps it's still possible to do the event with a bit of drugs. My doc seemed to think I couldn't make it worse by continuing to run.

Good luck.

Wanda

Re: medial meniscus tear [Trailqueen] [ In reply to ]

Nov 25, 13 10:59

Post #8 of 62 Views: 11131

at age 58 had medial tear; they operated and took 60% of posterior horn. it took a while to get running, about 6 weeks. but the other leg compensated so i had PF issues in the nonoperated knee until at age 64. had mri that showed medial tears in that leg. since i was much older the doc did not think we needed to operate since it was not clicking and locking.....just degenerative tears. and operating at that age almost guarantees OA, which was already there. options? quit running or maybe try prp. i had been researching stem cell and prp (regenexx website) and decided to get the stem cell and prp at emory university which is close to home. while their procedure is not as high powered at regenexx sounds, it really has helped my knee especially with OA. i had that procedure mid september with follow up just prp in late october. i started running about 2 weeks ago and so far so good (actually excellent as the knee is much better).

the knee that was operated on is good for shorter runs ie 6-8 miles. no more IM for me. if i had it to do all over again, i would have tried stem cell and prp before taking out such a large chunk of the meniscus. i first tore it in 04 and used celebrex to get me thru an IM and ran for another 2 years roughly before it locked on me.

i would look hard at prp and stem cell. if you get surgery, be careful returning as the good leg may compensate which puts more load on the good knee. even subltly.

good luck

Re: medial meniscus tear [Wanda] [ In reply to ]

Nov 25, 13 11:26

Post #9 of 62 Views: 11122

Yes Ive had conflicting reports about causing or not causing more damage. What struck home with me is the detatched fragment in there could rip up more meniscus and cause a bigger rip and more irritation than what is already there. I dont want to risk that. Ive considered the option of doing the race and taking a lot of pain meds and anti- inflammatories but it seems like just going on a 9 day sufferfest rather than a 9 day race that could be fun. Besides the risk of more injury on an already compromised situation.

Re: medial meniscus tear [Trailqueen] [ In reply to ]

Nov 26, 13 11:35

Post #10 of 62 Views: 11049

I tore my medial meniscus while jumping rope (yes, with all the things I have done, it was jumping rope and landing weird that did it). It hurt pretty good for a few days, then started to feel better so I tried a run, only made it a few minutes. This continued on for awhile, I'd let it stop hurting, but as soon as I tried to run it would just come back. I then went skiing for the first time, I was a bit worried since my knee was already hurting but since it was the pounding of running that made it hurt I figured I'd be okay. Of course, I twist my knee because I am learning and huge pain follows, I just knew I messed it up good. As I gingerly try to get down the mountain the pain subsides, I stop anyway figuring it was because I was still warmed up and I'd be suffering later and the next day. Amazingly, no pain that night, and the next day my knee felt better than it had in months. Started running again without issues after. Only healing ski crash ever???

I did end up having an MRI in the knee for another issue (turned out to be quad tendonitis) and they noted a parrot beak tear. The flap must have been folded over on itself or extending out and the slight twist of the knee while skiing somehow put it back in place. The ortho wanted to schedule surgery soon or at end of season, I said no thank you and have been running on it fine. I did play some basketball and it hurt for a good week, so it looks like it is straight line only for me.

You could always do the race and hope for a healing fall! Not likely, but as long as there is a flap of tissue that is causing friction, I just can't see anything getting better.

Re: medial meniscus tear [tyrod1] [ In reply to ]

Nov 26, 13 14:03

Post #11 of 62 Views: 11017

Do you have the Dr name or website for Emory? I am going to get PRP locally (MSP) with the hope that will help with issues I've had recently. The Dr mentioned an osteotomy to me this morning as a possible solution for my knee issues. I'm going to exhaust all the options before I look at that. I'm only 35 but I've now had a complete menisectomy on the medial meniscus. I've had repairs on the lateral with a partial menisectomy so I'm buying time until a replacement. I was able to get about 6 months of very limited running in after the last surgery (Feb 2013) but I've now got pain constantly regardless of activity type or level. I had an MRI a few days ago and there was no other damage so the Dr thinks the pounding on the medial side is catching up with me. I've had 2 ACL reconstructions in the same knee, too.

Re: medial meniscus tear [Trailqueen] [ In reply to ]

Nov 26, 13 15:24

Post #12 of 62 Views: 11004

I had a tear in May of 2012 from running hard downhill in a trail race and it just 'popped', stopped me for a minute but I finished the race, swelling in the days after. Cortisone worked well for me until this past August. Knee pain on the long runs after 10 miles, scaled all mileage back and went ahead with the half marathon. I ran really well until the last two miles when it decided it had had enough. Have an MRI scheduled. Not sure the cortisone will work for a second time, hoping to avoid surgery until I can't. Cycled more this past month, hurts when I bike hard though. Time to do something about it.

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Re: medial meniscus tear [MDM1978] [ In reply to ]

Nov 26, 13 15:56

Post #13 of 62 Views: 10993

sent you pm....needed to add you have to make sure leg muscles are working optimally as i think pain signals screws up muscle firing. that is just my opinion not from doc. anyway muscle imbalances can greatly impact how we function.

Re: medial meniscus tear [MDM1978] [ In reply to ]

Nov 27, 13 7:34

Post #14 of 62 Views: 10941

MDM1978 wrote:

Do you have the Dr name or website for Emory? I am going to get PRP locally (MSP) with the hope that will help with issues I've had recently. The Dr mentioned an osteotomy to me this morning as a possible solution for my knee issues. I'm going to exhaust all the options before I look at that. I'm only 35 but I've now had a complete menisectomy on the medial meniscus. I've had repairs on the lateral with a partial menisectomy so I'm buying time until a replacement. I was able to get about 6 months of very limited running in after the last surgery (Feb 2013) but I've now got pain constantly regardless of activity type or level. I had an MRI a few days ago and there was no other damage so the Dr thinks the pounding on the medial side is catching up with me. I've had 2 ACL reconstructions in the same knee, too.

An osteotomy is not as bad as one might think :-) I am about a bajillion times happier after mine than I was before it. And, frankly, if you've had any cartilage/ligament work, recovery will be much easier than those (IMO. And, well, assuming there are no complications. But even WITH complications, I didn't find it that bad). Although if you have bi-lateral damage (is your medial injury on the same knee as the lateral?), that's considered a pretty big contraindication, unless the second compartment damage is minimal.

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Re: medial meniscus tear [Trailqueen] [ In reply to ]

Nov 27, 13 11:05

Post #15 of 62 Views: 10914

I tore my left ACL, MCL and medial meniscus years ago. I rehabbed and came back stronger. Almost a year to the date, I tore my right ACL, MCL and medial meniscus. Again, rehabbed and came back fine. Since then I have had multiple meniscus tears with only a couple times of having them snipped. The second surgery was only because I had meniscus wrapping around my reconstructed ACL (patella tendon) and the doc obviously recognized it would weaken the ACL. Since, I have taken collagen and had cortisone shots where needed...I have a few dingleberries based on the recent MRI, but did a 70.3 and a marathon without too many issues.

It sounds like if the swelling goes down (not horribly bad with 8cc's of clear fluid), and a bit of rest, you could likely do it, but eventually, it will likely need to be snipped. You can come back from a scope so quickly anymore...I walked in without the ability to squat down and walked out feeling a lot better.

Good luck, hopefully it starts feeling better, but with an MCL sprain and the meniscus tear, it will not be comfortable...it will likely feel like there is a rubber band in your knee stretching and snapping and will have some interior flimsiness with the MCL sprain...

Re: medial meniscus tear [mmrocker13] [ In reply to ]

Nov 27, 13 11:14

Post #16 of 62 Views: 10910

The lateral side is pretty good - I had 2 small repairs on it and they shaved off about 15% as the damage was to the posterior edge. The MRI last week showed the lateral side still looks good and that is why the Dr mentioned as osteotomy. I'm glad to hear you didn't think it was too bad because it sounds horrifying to me. Sounds like the recovery is similar in time to the ACL so at least I have experience there.

I'm taking all of December off and going to have a PRP injection later this month with hopes that will help. I have an unloader brace that I'm going to use when I slowly get back into action. It didn't seem to really help in the past but it can't hurt.

To the op - good look with everything and let us know how it goes.

Happy Thanksgiving to everyone.

Re: medial meniscus tear [ejharrington79] [ In reply to ]

Nov 29, 13 6:13

Post #17 of 62 Views: 10864

all the recurrences make me nervous. I wonder why the other knee goes? imbalance? have people experienced this when they have had the surgery and without? im told that if you dont have the surgery you will have an imbalance so its better to have it.
Ive been told now that the tear is 40-50% and thats big!!! I opted not to do the race. I had to make a tough decision for the safety of myself and my team. I could not imagine what could happen if we were out in the mountains after 2-3 days hiking in and the knee locked up or I could not go on. At that point the whole team is stopped. It just made no sense and in the end of it, it would have been selfish to go. They did manage to replace me.
Not only that but I sure hope I have many more races ahead of me. Im signed up for 2 ironmans this coming year and a few halves. I dont want to jeopardize my whole season and as it is Im not sure what this is all going to bring.
As of right now there is no swelling and no pain. Im happy about that. I just didnt have time to test things out and be sure it was going to be ok. Saddly my flight was this morning and here I am sitting on the computer and not on that plane.

Re: medial meniscus tear [Trailqueen] [ In reply to ]

Nov 29, 13 7:13

Post #18 of 62 Views: 10841

Likely favoring the injured knee and causing issues on the other. Sorry to hear you had to make such a difficult decision. However, you have the right focus with so many other races in 2014. Best of luck!

Re: medial meniscus tear [ejharrington79] [ In reply to ]

Nov 29, 13 8:24

Post #19 of 62 Views: 10829

thank you.

Re: medial meniscus tear [Trailqueen] [ In reply to ]

Nov 29, 13 16:43

Post #20 of 62 Views: 10773

I had a tear with a flap that was catching and needed to be trimmed. I had the surgery on Sept 10, 2010 and by Thanksgiving I ran my annual 10K 2-seconds slower than the year before. Its been a few years but below are a few things that really helped me the most:

Game-Time Ice Machine - my knee was like a waterbed post surgery and after 1 session my swelling was reduced by a factor of 50. Find a PT location that offers this machine!
Slide board: I purchased one for about $200 and it really helped build my ad/adductors. As triathletes we do so much flexion/extension and not so much side-to-side.
Start short and increase running milage very very slowly. I cannot overemphasize this point enough!

Good luck and let us know how you're improving.

Re: medial meniscus tear [DC Pattie] [ In reply to ]

Nov 30, 13 6:23

Post #21 of 62 Views: 10710

Thank you for that!! Gives me hope! Right now I need hope.

Re: medial meniscus tear [Trailqueen] [ In reply to ]

Dec 2, 13 12:46

Post #22 of 62 Views: 10627

I just got this diagnosis on Friday past; medial meniscus tear. My podiatrist found it after ordering an MRI of the knee, now I'm waiting an additional week and a half to see the orthopod. In the meantime, more of nothing but swimming.

This is about to ruin a ski trip for me (January, reservations made already), and I'm wondering whether I'll be able to run again. The bike doesn't bother it much, and swimming not at all. However improving my swim split by swimming all the time won't mean a dang thing if I have to DNF when I get off the bike.

Other than a dull pain though, it ONLY hurts when I run.

I could use some hope myself. Fingers crossed for a good diagnosis, but the doctor doesn't seem to be in too much of a hurry to move it along. I'd go under the knife tomorrow if I could start my recovery sooner....

Re: medial meniscus tear [benjpi] [ In reply to ]

Dec 2, 13 15:18

Post #23 of 62 Views: 10597

If this is your first injury to that knee and they can repair the tear the long term prognosis is very good. Give it the time to heal and rehab accordingly and you'll be OK. No need to lose hope yet!

Re: medial meniscus tear [benjpi] [ In reply to ]

Dec 2, 13 16:03

Post #24 of 62 Views: 10587

Don't lose hope. 3 1/2 years ago I had medial meniscus tear on my right knee trimmed and have done two ironmans and many shorter distance events since. 3 weeks ago today I had the left knee done as well. Last Thursday and again today I slowly ran 3 miles. I'll be 60 years old at the end of this month. Keep in the best shape you can before surgery. Find a good PT and ice & ibuprofen are your best friends. I also walk every today to help build strength.

Re: medial meniscus tear [tricut1] [ In reply to ]

Dec 2, 13 17:36

Post #25 of 62 Views: 10568

Thanks for all the positive vibes, they help. I'm personally a big fan of PT; I had a guy that helped me get over some ITB issues back in my MTB racing days.

Great to hear that you are all recovering well, and that you're able to run so soon afterwards. I'll keep my fingers crossed!

Re: medial meniscus tear [MDM1978] [ In reply to ]

Dec 2, 13 17:36

Post #26 of 62 Views: 5804

MDM1978 wrote:

Do you have the Dr name or website for Emory? I am going to get PRP locally (MSP) with the hope that will help with issues I've had recently. The Dr mentioned an osteotomy to me this morning as a possible solution for my knee issues. I'm going to exhaust all the options before I look at that. I'm only 35 but I've now had a complete menisectomy on the medial meniscus. I've had repairs on the lateral with a partial menisectomy so I'm buying time until a replacement. I was able to get about 6 months of very limited running in after the last surgery (Feb 2013) but I've now got pain constantly regardless of activity type or level. I had an MRI a few days ago and there was no other damage so the Dr thinks the pounding on the medial side is catching up with me. I've had 2 ACL reconstructions in the same knee, too.

Osteotomy may be a good choice for you.

I had one in an effort to put off knee replacement....but I'm a lot older than you at 52 but had surgery at 50. At your age keeping your knee as long as possible should be the goal.

Re: medial meniscus tear [benjpi] [ In reply to ]

Dec 10, 13 10:11

Post #27 of 62 Views: 5763

Thanks everyone for sharing your experiences and good advice. I have been to the ortho. doc and to PT and they both feel that my knee might be ok with the tear. The doc said it looks like there is a tear that is just lying there flat. He did not agree that there is a flap for sure on the MRI. He thinks that it looks like a thickening but not necessarily a flap. He said I could be feeling and presenting good because of the cortisone shot. He told me to push the knee between now and the first of the year and see how it goes. If its bad then it will be surgery. Both the PT and the doc think its possible I irritated something that was already there.
Ive been biking on the trainer and swimming all pretty easy with no pain. Slight ache when I push it more. Ive now run a few times up to 4 miles. No pain running this am 4 miles. Im icing after the workouts. No drugs.
Am I wasting time not having the surgery? I dont want to lose my whole season when it could be avoided. But I dont really want to lose 50% of my meniscus either.
I am doing the rehab PT exercises. Some days I think oh great its good and other days I think its not. Sometimes it feels so weird walking on it like its ot right. Im still walking so carefully. and its still uncomfortable sleeping - not pain but not comfortable.

Re: medial meniscus tear [Trailqueen] [ In reply to ]

Dec 15, 13 6:59

Post #28 of 62 Views: 5728

Has anyone had the collagen meniscal implant done? My ortho tells me my right medial meniscus as a horizontal tear, probably not repairable. I suppose the good news was that wasn't what was bothering my running; it seems I have a good old-fashioned case of runner's knee. Direct pressure to the inside of my knee at the office produced no pain - so really the ortho told me not to worry about it. But I will, nonetheless...

So I started researching, as I'm not overly fond of the idea of having it removed - seems that a good precursor to arthritis if the shock-absorbing meniscus is just removed. I found that there are two things done to replace them these days: dead-guy parts and this collagen structural implant. The collagen implant seems to have a weird history with the FDA, and the company that makes it is now based in Germany - it seems the surgery is more available overseas.

I'm not opposed to the idea of travel medicine if the prognosis is better. Has anyone here had one of these?

ben

Re: medial meniscus tear [benjpi] [ In reply to ]

Dec 15, 13 8:52

Post #29 of 62 Views: 5725

Yes if its not bothering you leave it in there. thats my understanding. A friend of mine had the implants done and it got infected. The best outcomes seem to not be surgery. But if you have to you have to.
I will worry about mine too! I hope that I start to worry less over time and maybe its good to worry now. Find a good PT.

Re: medial meniscus tear [Trailqueen] [ In reply to ]

Dec 15, 13 9:41

Post #30 of 62 Views: 5719

Thanks.

I really don't want to give up triathlons. I love them more than any other form of racing I've done, and they're family-friendly to boot. I start PT tomorrow; one of the nice things about living near a big city (Philly) is the number of options available. My ortho doctor (a cyclist) recommended this place.

The infection thing with the implant is worrisome, but I suppose I'll cross that bridge if I come to it. I just don't like the idea of removal, so I guess I'll keep digging for information to arm myself. Maybe not an immediate concern, but it might be in the future.

Good luck with your injury, and I hope your season comes together!

ben

Re: medial meniscus tear [benjpi] [ In reply to ]

Dec 15, 13 13:40

Post #31 of 62 Views: 5707

Good luck! PT should help. I guess if its not to big a tear and its really painful and clicking locking then surgery for removal is the best option. clicking and locking is rubbing on the bone and that is bad so at that point I don't think you have much of a choice. I know a lot of people that have had it done and are fine. my problem is that its big! I total get the tri thing. I love it too and can not imagine my life without it.
let me know how it goes. I'd be interested to hear. I will do the same.

Re: medial meniscus tear [KathyG] [ In reply to ]

Dec 20, 13 11:35

Post #32 of 62 Views: 5658

I saw my Dr this morning because the knee is not behaving at all the last few weeks. It's getting tough to ride the trainer without significant pain during and after the ride. I received a cortisone injection to try and get some of the swelling down. The medial and lateral plica are both inflammed and swollen. They catch when I walk which is a little disconcerting.

I'm in the process of seeking a couple of other opinions but I trust my Dr when he told me I have a couple of choices - 1) Grin and bare it with ice, ibrupofen and limited activity or, 2) Look into the osteotomy and a possible meniscal transplant. I'm taking 2400 mg advil per day so I don't think grin and bare it is a long term option. My quad has started to atrophy due to limited activity the last 6 weeks, too. I won't do a meniscal transplant as it seems like the outcomes are only good if you give up running completely after the surgery.

Long story, but what was your recovery? My Dr said 8 weeks until the fracture heals but he'd release me to full activity at that point. He said the muscles will need rehab/recovery for probably 6 months but the fracture healing is the key. He said it's about 75-80% success rate and it might buy me 7-10 years.

Thoughts?

Re: medial meniscus tear [Trailqueen] [ In reply to ]

Dec 20, 13 12:01

Post #33 of 62 Views: 5652

What were you doing in the race that led to your injury?

Re: medial meniscus tear [MDM1978] [ In reply to ]

Dec 20, 13 13:50

Post #34 of 62 Views: 5645

sorry it's bothering you so much. That is a LOT of advil!!!

I'm in PT now, but more for the "runner's knee" than the meniscus issues. They hurt on both sides (now that I can assign THAT random knee pain to something) - but I had just always assigned a certain amount of knee pain to just be old & a few pounds heavier than I should be. I think that with the catch thing, you'll need to do surgery at some point. I can't imagine that bit banging around in there is doing you any favors.

Thanks too for the info on the dead-guy parts. I'd been looking into that a bit since I'm (a hypochondriac) concerned that mine will require surgery at some point, but I didn't know that they'd require me to give up running either.

good luck!

Re: medial meniscus tear [MDM1978] [ In reply to ]

Dec 20, 13 15:34

Post #35 of 62 Views: 5640

MDM1978 wrote:

I saw my Dr this morning because the knee is not behaving at all the last few weeks. It's getting tough to ride the trainer without significant pain during and after the ride. I received a cortisone injection to try and get some of the swelling down. The medial and lateral plica are both inflammed and swollen. They catch when I walk which is a little disconcerting.

I'm in the process of seeking a couple of other opinions but I trust my Dr when he told me I have a couple of choices - 1) Grin and bare it with ice, ibrupofen and limited activity or, 2) Look into the osteotomy and a possible meniscal transplant. I'm taking 2400 mg advil per day so I don't think grin and bare it is a long term option. My quad has started to atrophy due to limited activity the last 6 weeks, too. I won't do a meniscal transplant as it seems like the outcomes are only good if you give up running completely after the surgery.

Long story, but what was your recovery? My Dr said 8 weeks until the fracture heals but he'd release me to full activity at that point. He said the muscles will need rehab/recovery for probably 6 months but the fracture healing is the key. He said it's about 75-80% success rate and it might buy me 7-10 years.

Thoughts?

I had surgery 12/11 and 6/12 my bone was not fully healed which is somewhat expected since I had plate put in one for HTO and one for TTO.

It took a full year to have my leg not to feel off and a bit of discomfort.

Looked up in my blog

I was given permission to walk at 8 weeks; 3 days post surgery. I had been on crutches with foot touching but not any weight since surgery.

Saw my Ortho for 10 week post op visit....72 days since surgery

I'm doing remarkably well
Takes fully year to recovery
Recovery depends on getting muscle back & I'm doing well with that
I can do any non weight bearing activity, ice after workouts
Avoid cutting or anything that will torque my knee....up and down and forward is good
My Proprioception will be better than last 2 years once healed but not as good as pre injury
50% of folks have hardware/plate removed can be done around 9 months depending on healing; day surgery and no need for crutches use same incision
Scar on thigh has keloid due to tension but was closed same as shin incision
Try cortisone on keloid
Need to get new cycling and run/walk orthotics since alignment is different
No alleve for another month
Got a copy of my surgical report
chatted about my impatience with recovery, he said I'm a driven endurance athlete missing my endorphins but am on front end of recovery.

I hope to get 8-10 years. Look and read the studies which I found interesting.

My recovery we hampered by the underlying issue that caused some/part of my knee issues flared up 3-5 months post op and I'm still dealing with it but overall I'm glad I had the surgery. Return to my pre surgery health and training hasn't happened as I had hoped. I have signed up for some races this year for a goal but not sure I'll be able to do them.

Want to know more PM me.

Re: medial meniscus tear [benjpi] [ In reply to ]

Jan 22, 14 15:35

Post #36 of 62 Views: 5525

Reviving this thread because I have a medial meniscus hole or tear. Not sure which yet.

Backstory: Strength training and was doing box step-ups and when I came back down I locked my knee instead of letting it flex to absorb the impact. Unfortunately I also had weights in my hands so that added extra pounds. Sharp pain for a couple days, rested, two weeks later I ran a half marathon. Some pains at mile 10-11 but nothing serious. Took two weeks off completely because I was lazy. Ran a 12k and felt fine. Another 10 days off because I was really kicking back. Ran on Dec 29th and my knee locked and was so painful I couldn't run. Was 2 miles from home and had to walk. Really painful. My entire leg was on fire by the time I got home.

Saw a sports med doc that next Monday and he was able to generate a lot of pain with seemingly little movement. He said conservative treatment is PT for a couple weeks to see if it feels better or go right for the MRI.

I chose PT because my deductible just kicked in, of course. My knee feels better but not perfect. Now I'm wondering at what point do I throw in the towel and get the MRI? I've worked with my PT on and off for 10+ years for random things. He agreed that PT first was the right approach since I'll need it regardless of what the MRI says.

The only activity I'm doing is swimming with a pull buoy. Tried the recumbent bike and my knee hurt so I stopped.

Should I give in and get the MRI or doing a couple more weeks of PT? I'll talk to my PT as well next week but I'm always interested in multiple POV.

----------------------------------------------------------------------
Jen

"In order to keep a true perspective on one's importance, everyone should have a dog that worships him and a cat that will ignore him." - Dereke Bruce

Re: medial meniscus tear [JenSw] [ In reply to ]

Jan 22, 14 18:14

Post #37 of 62 Views: 5509

JenSw wrote:

Reviving this thread because I have a medial meniscus hole or tear. Not sure which yet.

Backstory: Strength training and was doing box step-ups and when I came back down I locked my knee instead of letting it flex to absorb the impact. Unfortunately I also had weights in my hands so that added extra pounds. Sharp pain for a couple days, rested, two weeks later I ran a half marathon. Some pains at mile 10-11 but nothing serious. Took two weeks off completely because I was lazy. Ran a 12k and felt fine. Another 10 days off because I was really kicking back. Ran on Dec 29th and my knee locked and was so painful I couldn't run. Was 2 miles from home and had to walk. Really painful. My entire leg was on fire by the time I got home.

Saw a sports med doc that next Monday and he was able to generate a lot of pain with seemingly little movement. He said conservative treatment is PT for a couple weeks to see if it feels better or go right for the MRI.

I chose PT because my deductible just kicked in, of course. My knee feels better but not perfect. Now I'm wondering at what point do I throw in the towel and get the MRI? I've worked with my PT on and off for 10+ years for random things. He agreed that PT first was the right approach since I'll need it regardless of what the MRI says.

The only activity I'm doing is swimming with a pull buoy. Tried the recumbent bike and my knee hurt so I stopped.

Should I give in and get the MRI or doing a couple more weeks of PT? I'll talk to my PT as well next week but I'm always interested in multiple POV.

-----

Easy for me to say get an MRI 'cause down here mine only cost $190 but it is better to know what is going on than put it off.I know you don't want to get surgery but you may need it so go see what is wrong.I've had two knee surgeries and my knee is just fine ,now if they could have sucked away all the pudge while they were at it I'd be back running as well as ever. ;-)

---

Re: medial meniscus tear [MDM1978] [ In reply to ]

Jan 23, 14 3:44

Post #38 of 62 Views: 5491

MDM1978 wrote:

I won't do a meniscal transplant as it seems like the outcomes are only good if you give up running completely after the surgery.

Long story, but what was your recovery? My Dr said 8 weeks until the fracture heals but he'd release me to full activity at that point. He said the muscles will need rehab/recovery for probably 6 months but the fracture healing is the key. He said it's about 75-80% success rate and it might buy me 7-10 years.

Thoughts?

Not Kathy, but if I had been a candidate for transplant, I would have considered it...not concurrent to my DFO, but following it.

If your articular cartilage damage is minor, I'd try the transplant first.

Have you tried a prescription unloader? My Advice would be to try that first for awhile. If it gives you relief, then look into surgery.

I had a DFO, and while different slightly from an HTO, (femur, and longer recovery protocol), I would do it again in a heartbeat, even with the complications. It is, though, a last resort.

mmm-mmm-Momo Charms
Handmade beverage charms, jewelry, and miscellanea
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Last edited by: mmrocker13: Jan 23, 14 3:46

Re: medial meniscus tear [JenSw] [ In reply to ]

Jan 23, 14 5:11

Post #39 of 62 Views: 5484

Jen, a good sports med Ortho can diagnosis most knee issues w/o an MRI. Did you see a sports med ortho or a different sports med type doc?

If you end up getting an MRI, costs can vary greatly even being in your network. I had two MRIs in the same year one was $4000 as in network approved cost and the nother one $400.....10x as much. University teaching hospitals I found were the most expensive and free standing independent facility was the least expensive.

Re: medial meniscus tear [mmrocker13] [ In reply to ]

Jan 23, 14 5:57

Post #40 of 62 Views: 5476

Great advice - thanks. I saw my doc again a couple of weeks ago and he did a cortisone injection to try and get some swelling out of the joint. That helped a bit and has let me get back on the bike and in the pool. I tried some very light jogging the other day and that was absolutely out of the question.

I have a prescription unloader and I started using at again at all times. I had only been using it if I tried to run. I now use it while on the bike and any other workouts where I'm putting any sort of load on my knee. It seems to help so I'll keep with it.

My plan right now is to continue to bike and swim, see if I can get a couple of sprint races is this summer, and look for surgery in the fall. I might as well be recovering as the weather gets cold. I spent a couple of summers ago recovering from an ACL and that was miserable. I'll have to wait and see how things progress as I pickup up the biking this spring.

Re: medial meniscus tear [MDM1978] [ In reply to ]

Jan 23, 14 6:26

Post #41 of 62 Views: 5470

I will say, having had a bunch of other procedures done prior to the DFO, cartilage/soft tissue stuff is (IMO) a harder recovery than the bone surgery was. It was a longish recovery, but pretty straightforward. Surgery was January of 2010, in bed until aprilish (<--not typical), crutches thru May, then cane. First easy ride outdoors in July. Was able to ride again with no restrictions by fall of that year. Started back VERY slowly in Marchish 2011 run/walking.

For me, the most painful thing wasn't the DFO itself--it was the second femur break that happened after...which also made the recovery even longer (doubled it, basically, and put me on a few months of bed rest). All that aside, still, it was worth it, and, like I said, fairly straightforward.

It was crazy--having spent most of my life with arthritis/knee pain, I didn't realize how bad it actually hurt until it didn't hurt anymore. :D

mmm-mmm-Momo Charms
Handmade beverage charms, jewelry, and miscellanea
http://momocharms.wordpress.com

Re: medial meniscus tear [KathyG] [ In reply to ]

Jan 23, 14 10:41

Post #42 of 62 Views: 5445

We know there is a tear of some kind but we don't know the extent of it. Partial, full, flap, etc. The results would give us a better idea whether surgery is necessary. His specialty is sports meds with extensive background in knee injuries. He diagnosed it quickly but did say we'd need more info before determining surgery.

I know MRIs vary widely in cost. My insurance has a cost estimator that gives me an idea but I'd follow up with each location to confirm before I head in there.

----------------------------------------------------------------------
Jen

"In order to keep a true perspective on one's importance, everyone should have a dog that worships him and a cat that will ignore him." - Dereke Bruce

Last edited by: JenSw: Jan 23, 14 10:42

Re: medial meniscus tear [JenSw] [ In reply to ]

Feb 4, 14 12:16

Post #43 of 62 Views: 5388

Update: Right knee done; went under the knife last Friday. Off crutches on Saturday, hobbling around fine since then. Knee is the size of a grapefruit under/around kneecap and hurts at the incision points. The rest of it just kind of aches a little bit, but no worse than it had before the surgery. Doc prescribed Vicodin, but I haven't touched it or even Advil. It really doesn't hurt any worse than I've felt after events.

I've been told by my doc to do NOTHING for two weeks. No upper body strength training, no swimming, no nothing. It's going to be a long two weeks...

At this point the left knee hurts more than the right, at least at the very inside where the medial meniscus seems to show itself. I've been loading up the left knee to compensate for not using my right much, but I've not exactly been a stellar patient either. I haven't really been sitting still much (it sucks) and we've got enough snow yesterday to require some shoveling. My self-diagnosis is that the left knee is as damaged as the right one was - but for now I'm going to let the left alone and compare the two. I've a prescription for an MRI in the left knee, but I'm just sitting on it for now.

One of the nurses at the hospital asked if I was an athlete; after saying yes he said "Welcome to the knee pain club" - he was a basketball player who had already had both knees done. I'm hoping for a better outcome than that! I'm thinking of following the "Couch to 5K" program or something like that to get my run mileage back up, once I get the go-ahead to run again. At this point though, I'm not planning on doing any more running than I "need" to.

Re: medial meniscus tear [benjpi] [ In reply to ]

Feb 4, 14 13:07

Post #44 of 62 Views: 5376

So, what did you end up having done? Clean out or clip or repair?

mmm-mmm-Momo Charms
Handmade beverage charms, jewelry, and miscellanea
http://momocharms.wordpress.com

Re: medial meniscus tear [mmrocker13] [ In reply to ]

Feb 4, 14 15:10

Post #45 of 62 Views: 5360

I believe the doc cut out about 30% of the medial meniscus; to clear the horizontal degenerative tear. I asked what he did when I came out of anesthesia, but I was still a bit fuzzy.

I think he left the meaty part behind (the non load bearing part).

From an engineer's point of view, I'm hoping that some portion of it might refill if I'm nice to it. I guess medical research is not in my favor here, but the design doesn't seem to make sense without the ability to regenerate. The sharp inside edge of the meniscus seems designed to be refilled from the meaty part as it wears. I think if it's torn then the tear becomes self-replicating - it creates a stress riser - like a tear in a roll of tape: as you remove more tape, the tear propagates along with the tape being peeled off - but if you start at a clean edge the tear won't be there as it refills.

One can hope, I guess.

Re: medial meniscus tear [Trailqueen] [ In reply to ]

Feb 4, 14 16:21

Post #46 of 62 Views: 5349

Have had two medial tears in right knee with the latter resulting in complete removal. One at age of 16 and another at 23. Fortunately, found a good doc to do a meniscal transplant at 24.

Biggest advice(s):

1 - Find the best PT you can.

2 - Work on support muscles - especially glute med and core (not your abs). Most time the injury doesn't occur or re-occur because the knee or meniscus is weak but what isn't functioning properly elsewhere.

Re: medial meniscus tear [benjpi] [ In reply to ]

Feb 4, 14 17:17

Post #47 of 62 Views: 5337

Well, it's always good to have hope, but no...medical science doesn't really back you up on that one :D

I'm surprised your doc said no anything for two weeks--mine had me doing ROM stuff as soon as I was alert enough to do so for most of my clips, and light spinning with no resistance (or torque from clipping in and out) also. I could swim as soon as my incisions were healed, or if I covered them with tegaderm.

Definitely get in to PT right away, though...it helps a lot. :-)

You'll be back to things just fine, I'm sure--you can get by without a good amount of it (or all of it, if you have to). You are smart in taking it easy, though--no sense rushing.

mmm-mmm-Momo Charms
Handmade beverage charms, jewelry, and miscellanea
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Re: medial meniscus tear [benjpi] [ In reply to ]

Feb 4, 14 17:55

Post #48 of 62 Views: 5330

when they took 60% of my medial posterior horn at age 58, i was doing recumbent biking within 3 days very easy. biking and swimming in about 3 to 4 weeks as i was conservative. i did start running after 6 weeks and i neglected my pt ie doing total knee extensions and making sure the vmo (although hard to isolate when weightlifting) was stronger and firing properly. i should have done more pt. so the consequence was i favored my right knee and the left knee developed PFS. as i said earlier on this thread the left knee showed degenerative tears but being 64 the doc said quit racing, do yoga that taking more meniscus out i'll get more OA, which i was experiencing already. so i did stem cell and prp and the left knee which i could barely bend beyond say 30 degrees is close to 98%. i am waiting for warmer weather and more pt on this leg before running in earnest, but i have tested the knee a time or two by running easy for half a mile and it seems so so much better and no day after complications.

so be careful that your good leg compensates too much for your bad leg. and think about stem cell/prp and run that by your doctor if you good leg goes bad.

good luck. if any consequence i was racing well after the first sugery but at my age if i slacked off on the pt i would soon pay for it. build in time for working on the legs ie foam rolling, trigger point, massage, proper warmup and cool down and keep weight off.

Re: medial meniscus tear [tyrod1] [ In reply to ]

Feb 5, 14 8:53

Post #49 of 62 Views: 5299

So my update is this. I did not have surgery. I have been doing rehab instead. There was fear of hurting my left knee due to favoring it so I have been using the spin scan on the trainer to be sure I dont pedal uneven. I am running a higher cadence and doing drills to get my cadence high for periods of time up to 100. I did some drills getting off my left foot faster to get more pressure on my right and off my left. My left knee had started hurting but now is feeling good.
I am doing my strength work and foam rolling as ordered. I am now up to 15-24 hour weeks of s/b/r. I ran 47 miles last week with a 21 mile long run and got in 287 on the bike the week before. Slight soreness at times but not while training. Its feeling good. Im walking normal. The funny thing was it felt better to run then walk for a while.
Im still very careful with anything that is not straight up back and forth. I dont plan on doing anything different that way maybe forever. I guess time will tell but I do not want to take any risk. As of right now it looks like I will have a racing season this year. Oh ya and I raced a 5k last week that was about 30 seconds off my pr.

Re: medial meniscus tear [benjpi] [ In reply to ]

Feb 5, 14 22:14

Post #50 of 62 Views: 5272

I'm going to schedule the MRI. I'm not in acute pain but I still can't fully straighten my knee and haven't dared run on it. Ugh.

I hope your recovery goes smoothly. I'm sick of sitting around. As soon as I smell spring in the air I will go nuts so if I'm going to have surgery I should do it now.

----------------------------------------------------------------------
Jen

"In order to keep a true perspective on one's importance, everyone should have a dog that worships him and a cat that will ignore him." - Dereke Bruce

Re: medial meniscus tear [tyrod1] [ In reply to ]

Feb 6, 14 13:58

Post #51 of 62 Views: 3484

Wow! I would be very happy to have made it to 58 without needing custom work.

Maybe I missed it before, but it is good to hear that someone has tried the stem cell thing with good success. I'll keep it in mind for later if things don't improve.

Thanks for the advice regarding PT. I'm a big fan of PT based on it helping me with previous injuries, plus I've noticed that at my age (45, still a youngster I guess) that the moment I stop working a muscle group that it just goes away.

I've started trying some foam rolling, to help loosen up the ITB and also for a previous persistent calf issue in my left leg. Personally I find it incredibly painful; like suck-in-my-breath painful, for whatever reason. Lots of folks say it helps, so I'll stick to it.

Again, thanks for the feedback. I appreciate it.

ben

Re: medial meniscus tear [Trailqueen] [ In reply to ]

Feb 6, 14 14:00

Post #52 of 62 Views: 3484

Wow! It sounds like you're doing quite well - I don't think I've ever gotten in a 20-hour week, ever! (I'm a wimp, Olympic distance only for me...)

If you can do a 21 mile long run without an issue, I'd say the PT is working great. Good luck and I hope your season goes well!

Re: medial meniscus tear [benjpi] [ In reply to ]

Feb 6, 14 14:11

Post #53 of 62 Views: 3479

i have several rollers, the best is the rumble roller, but the black foam roller will do. everyone is different but i found this technique works much better than simply rolling and compressing.

https://www.youtube.com/watch?v=SvKyY7wB7V8

chris johnson has tons of free stuff just google chris johnson pt for all kinds of rehab treatments. he does tris too.

and i would be remiss if i did not recommend the mobilitywod website (there is minor charge that u can quit anytime) also his products are top drawer. i just got the battlestar and it is just really good for rolling and flossing (dr. starrett's term for busting up some adhesions).

it will hurt until you break up those adhesions. you have to breathe and not hold your breath when doing the rolling.

best of luck.

Re: medial meniscus tear [JenSw] [ In reply to ]

Feb 6, 14 14:11

Post #54 of 62 Views: 3479

Good luck with the MRI. I wasn't in acute pain either; if I did nothing (couch potato) - then it practically didn't hurt at all. That's one of the reasons I made sure my doc was an athlete - I wanted someone who understood athletes. As my wife can attest, my exercise keeps me sane - I really don't want to think about not being able to run, bike, swim... In fact, my doc was very firm after the surgery to give the post-op instructions to my wife - "Make sure he doesn't do ANYTHING for two weeks!"

Right now the incision points hurt, about 1 week out. I can walk almost without a noticeable limp, and I can bend to just past 90 degrees without significant pain. It feels a little weird if I hyperextend while standing, like it wants to go backwards further than it did before. Not sure what that is. I still tend to favor it on stairs though.

Thanks for the luck, I'll take all I can get. For you - I'd say bite the bullet and get the MRI. Even if the diagnosis is PT rather than cutup - it will still get you going sooner rather than later!

Re: medial meniscus tear [tyrod1] [ In reply to ]

Feb 6, 14 14:18

Post #55 of 62 Views: 3475

thanks for the vid. It made me cringe just watching it..

I need to work on not holding my breath, but the involuntary pain grunts are disconcerting to my remaining family members!

Re: medial meniscus tear [benjpi] [ In reply to ]

Feb 7, 14 9:03

Post #56 of 62 Views: 3447

Thanks Ben. I hope your recovery goes well. Ive heard that people get right back to it once they get the go ahead. Make sure your elevating your leg to keep the swelling down. That speeds up your healing. Swelling is always bad.

Re: medial meniscus tear [benjpi] [ In reply to ]

Feb 7, 14 12:30

Post #57 of 62 Views: 3435

MRI scheduled for Monday. Just stood up from my desk and tweaked it and now I'm limping again.

Dammit.

----------------------------------------------------------------------
Jen

"In order to keep a true perspective on one's importance, everyone should have a dog that worships him and a cat that will ignore him." - Dereke Bruce

Re: medial meniscus tear [JenSw] [ In reply to ]

Feb 11, 14 20:48

Post #58 of 62 Views: 3384

MRI came back clean. No tear! What a relief.

----------------------------------------------------------------------
Jen

"In order to keep a true perspective on one's importance, everyone should have a dog that worships him and a cat that will ignore him." - Dereke Bruce

Re: medial meniscus tear [JenSw] [ In reply to ]

Dec 19, 14 9:36

Post #59 of 62 Views: 2938

You are lucky! I got my MRI back and see the surgeon on Monday to schedule :(

Owner of a few Speed Concepts since 2011.

Re: medial meniscus tear [ttx_tri] [ In reply to ]

Dec 20, 14 15:24

Post #60 of 62 Views: 2894

I've been in PT for almost a year, had cortisone and Euflexxa injections and I'm still in pain. Any activity I do and I'm sore. Even swimming. I am never going to run again.

I'll trade ya.

----------------------------------------------------------------------
Jen

"In order to keep a true perspective on one's importance, everyone should have a dog that worships him and a cat that will ignore him." - Dereke Bruce

Re: medial meniscus tear [JenSw] [ In reply to ]

Dec 20, 14 15:48

Post #61 of 62 Views: 2885

A year in PT? Get a second opinion and the MRI. I told my doc that I want the surgery asap and skip the PT first so I can get back on the training and racing circuit right away. He figured I could be running lightly in a few weeks and back on track by spring ready to race. I just wish I could get the surgery before the end of the year to take advantage of a complete deductible but that more than likely won't happen 😞

Owner of a few Speed Concepts since 2011.

Re: medial meniscus tear [ttx_tri] [ In reply to ]

Dec 20, 14 16:07

Post #62 of 62 Views: 2879

I got the MRI. I am bone on bone OA. There is no acute injury. I also got the second opinion and that's how I ended up getting the injections. Started with cortisone and when that made it feel worse I went with the Euflexxa, a series of 3 injections. That felt good for about a month but as soon as I get my activity level up it hurts all over again.

We've tried all the PT options: Taping, a brace, exercises, massage, complete rest, etc etc etc. You name it, I've done it. I'm working with a personal trainer to do overall strengthening and balance. I'm taking barre method classes which help with strength and balance without impact. I'm swimming with a pull buoy.

I'm now exploring an anti-inflammatory diet in the hopes of reducing some of the pain. No idea if it will work and if it does, how much, but I've run out of ideas.

Good luck with the surgery, I hope it goes well and you are back on the road quickly.

----------------------------------------------------------------------
Jen

"In order to keep a true perspective on one's importance, everyone should have a dog that worships him and a cat that will ignore him." - Dereke Bruce

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