UPDATE

So I had arthroscopy surgery on Jan 23rd in Ottawa. My surgeon discovered a complex tear of my medial meniscus posterior horn and mid section and resected the damaged part and left it with a stable rim. He also discovered/removed remnants of a previously resected Plica on the medial side of the knee.

2 weeks after surgery, I am experiencing some sharp, intermittent pain on the medial side below where the VMO muscle inserts, approximately 2cm below. I am also experiencing some significant knee popping/snapping when I move, most likely from swelling. Exactly 2 weeks post Op I am finally able to walk without crutches but I have had a complication.

I was supposed to start physio last week but my PT therapist made me go see a physician for testing due to a very sore calf muscle, and an ultra sound. They found a DVT in my left leg as a complication from the surgery (an inherent risk I am told). The clot is what is causing my very painful calf which most of the time is more painful than the repaired knee.

Treatment for this, in my situation (37 years old, very fit and healthy) is either serial ultrasounds every 5 days and no physical activity or anticoagulation medication. (Hepharine, Coumatin etc) After much deliberation and consultation with 4 different physicians including an internal medicine/vascular expert I have elected to go on anti coagulants (blood thinners) for a minimum of three months. Anyone with experience taking blood thinners, experience with DVT and how it affected your training please tell us your story here.

UPDATE #2

9 months since Surgery. Little progress to report except that I have gained 100% of my range of motion back. Thanks to custom orthotics I am able to spend a lot more time on my feet walking around but I absolutely cannot run and can barely ride. Surgery helped little to be honest nor has rest for the summer.

My symptoms:

My Left patella and knee is very loose. I can actually grab the patella and glide it over the knee joint and it feels gross like sandpaper. When I stand for periods of time, I have burning and throbbing pain under, to the bottom and to the inside of my patella. When I try to cycle, I have a burning joint-line pain, PES pain post ride and also significant pain in the Quad tendon/Rectus Femorus insertion during the ride. I also have a significant palpatable plica going on again. When I straiten my leg while sitting, my patella catches and pops. Almost jumps.

My right knee also shit the bed back in May after pushing some power on a cold, damp morning and hasn't been the same since. It also has a burning sensation in the joinline after cycling but more so this knee has a significant pop also when straitening my knee and/or at the bottom of my pedal stroke during the ride. I am finding lately if I constantly stetch the rectus femorus muscle, the patella in my right knee does not jump near as bad and even stops to jump/pop/catch after 5-7 mins into the ride.

My days as a Cat 2 cyclist are certainly over :-( . My wish is to be able to cycle lots of miles in a season and be able to do my club rides with friends and not walk like a 90 year old.

Seems to me like the main issue is with my Pattella Femoral Ligament, and also perhaps problems with the Sartorious tendon as I have a snapping hip and PES pain. My knee has felt loose for many months and I had/have severe PFS problems. Cortisone was VERY effective for the joint pain but not so much for the PES area. I had new MRIs X2 in Aug, this what is found:

Left Knee:

• re-tear of medial meniscus mid section
• high/lateral patella
• 1/2 thickness wearing of weight bearing MF Condyle
• reminant plica
• troclear dysplasia (sp?)

Right Knee:

• high/lateral patella
• Plica
• slight troclear dysplasia

I am going to try PRP as a last resort. The Dr will inject into the joint, but is not sure whether he will inject outside the joint or not. I would like him to hit the MPFL as well as the Sartorious.

Already started to sell of my cycling stuff. Not looking good at this point, hope you all have better outcomes than I do.

Sorry to hear - I commented earlier in the thread but I have/am in the same boat as you. I had a second meniscus tear after an ACL surgery so my knee was a mess. I decided to have the medial meniscus completely removed as a repair was probably out of the question. It took me almost a year to get back to running and I've had some ups and downs. I never underwent PRP but had a series of Synvisc injections after the menisectomy. The issues with the left knee have compounded some things on the right but I can cope with those. Bottom line is that I've learned to live with the pain and push through it. The next step is a knee replacement so there isn't much else to break at this point.

A couple of suggestions to help your situation:

1) I thought taking time off would help - what I have found is more than a week of inactivity and my quads atrophy so quickly that it effects the knee. I have to stay as active as possible, even if I am experiencing pain and soreness.

2) See if you can get an unloader brace to take the pressure off your medial meniscus - I wear mine at all times when running and it helps. I sometimes wear it on the bike, too. Get one custom fit through your Dr or an orthotics/prosthetics place.

3) The click could be the plica - mine comes and goes but the click is painful and audible. Ice and ibuprofen are the only thing that seems to help.

Good luck - sorry to hear about the continual issues. Feel free to PM me if you want to talk in more specifics.

Yes the unloader brace works great for me, which is hilarious because the therapists said it wouldn't do a thing. I guess that thinking is a result of not having a proper diagnosis.

Ti .... don't underestimate the efficacy of PRP. My Dr in DC is a huge supporter of it and says he sees materially improvements in knees particularly. I had a juvenile cartilage transplant into a grade 4 lesion on my medial condyle (weight bearing) followed by quarterly PRP to help the cartilage growth. Give it a try.

---

Swim - ( x ) All good ( ) In the shop
Bike - ( x ) All good ( ) In the shop
Run - ( ) All good ( x ) In the shop

Yeah I am very keen to do the prp and i will have it Nov 12.

Had my first DNF in a marathon last December as a result of knee pain, which I had ignored through the training. Tried PT, cortisone, then after an MRI decided to have surgery because I could not really even run I had felt I had little to risk. Doc found "and old nasty tear" and some osteoarthritis, which he cleaned up. 3 months out I am still not running, although biking is fine. However, I have just discovered a new PT, and his approach appears to be working, although I am still holding off running on his recommendation.

What I have come to understand that the body, in order to protect the injury, shuts down the muscles. I had atrophy in the injured leg, and a significant muscle imbalance. What that does is force even more stress straight to the joint, resulting in swelling, causing the muscle to shut down...vicious cycle.

This approach to PT is isometric exercises, literally reteaching the muscles to fire. In less than a week I am walking without pain for the first time in 8 months, and my biking has already improved. I am going to go hard on the PT, which can be excruciating, for 12 sessions, then get back to running. Whereas the surgeon suggested I give up marathons, the PT says he can get me back out there. We shall see.

Lessons learned: PT is essential post surgery. I should have been doing these leg strengthening exercises prior to the injury, and will probably need to keep them up for as long as I plan to run.

titemple652, I know I'm bringing up an old thread but I've been doing a search for info about other athletes with knee issues. Your description of the popping in your knee sounds a lot like what my wife has been dealing with. Sorry to bring up an old thread but I was curious if you had any updates as to your progress? I hated reading all the issues you were dealing with so I hope you've had something positive occur in the past few years