I had nearly all of my lateral meniscus removed in 2008. I just had an MRI. Thoughts?

Jun 4, 20 14:46

Post #1 of 25 (3148 views)

I was 20 at the time and am 32 now.

I was heavily into cycling up until 2017, as the surgeon at the time suggest I take up but I developed chronic pelvic pain and haven’t been able to ride. I have not been able to figure that pain out after many of visits to various specialists so I have up last year and sold my road bike and took up running.

This year I developed some minor pain after running. Kind of a dull diffuse ache in my right knee. Sometimes feels inside and sometimes outside. Not sure if it is even related to the meniscus removal. Running itself is fine, no pain during only a minor ache after My DR sent me for an X-ray which came back good, no signs of OA. My MRI results came back and are as follows:

“There is a small focus of susceptibility metallic artifact in the anterior distal femur, superior and femoral condyles centrally, slightly towards the medial aspect. Scarring in Hoffas fat related to prior arthroscopicy. The lateral meniscus is markedly diminutive in the anterior and posterior horns and is absent through the body. There is a horizontal tear in the anterior horn meniscal remnant and blunting/irregularity of the posterior horn meniscal remnant. The medial meniscus remains intact.

Cartilage thinning and irregularity in the lateral tibial/femoral compartment more so over the femoral condyle. Cartilage in the medial femoral/tibial is maintained.

Small joint effusion, very small bakers cyst and small amount of fluid or cysistic change extending proximally, posterior to the medial gastrocnemius.

1. Prior arthroscopy with Scaring In Hoffa’s fat
2. Previous lateral menisectomy with absent medial tissue through the body and markedly diminutive anterior and prosthetist horns.
3. Degenerative changes with moderate chondrosis in the lateral tibial/femoral compartment.
4. Small joint effusion. Small bakers cyst. “

My Dr read the above report and suggested that I can keep running 5 and 10ks but to avoid any marathon distances. He said it was better than to be expected 12 years after a near full lateral meniscus removal.

Last edited by: Rbk_3: Jun 4, 20 16:27

Re: I had nearly all of my lateral meniscus removed in 2008. I just had an MRI. Thoughts? [Rbk_3] [ In reply to ]

Jun 4, 20 15:16

Post #2 of 25 (3129 views)

I had a similar surgery when I was in high school(16 years old) and I'm currently 34. Went to my doc a few months ago due to knee irritation. Had an MRI, which showed a really inflamed bakers cyst(similar to yours; when you're missing meniscus, you become more susceptible), along with OA.

Doc told me to stop running altogether. My inflamed bakers cyst was actually from jiu jitsu(which I've since given up) and not running. I got several 2nd opinions from PT's that specialize in running and got the clear to still do 70.3's(I didn't ask about full IM's because that's not my focus). Part of getting the clear from the PT's had to do with my running form-I'm a very forefoot runner, which actually keeps stress off of the knees.

Find a doc or PT that specializes in knee injuries with runners

M.S. x 2; CSCS; ATC/LAT, Functional Movement Specialist, USA Track and Field Level 1

Re: I had nearly all of my lateral meniscus removed in 2008. I just had an MRI. Thoughts? [Rbk_3] [ In reply to ]

Jun 4, 20 18:04

Post #3 of 25 (3093 views)

You have moderate osteoarthritis in the lateral compartment at age 32. You should not run. Period. You'll hear from people here who have OA and run without issue anecdotally. Most (if not all) of them won't be 32. I would not run. Period. I would return to cycling and figure out the source of my pelvic pain through bike fits and a gradual increase in volume year to year, very slowly. FWIW, I'm a seasoned cyclist (Cat 2 roadie and Cat 1 cross racer) and have practiced orthopedics for 10 years as a Physician Assistant. Good luck to you.

Re: I had nearly all of my lateral meniscus removed in 2008. I just had an MRI. Thoughts? [afrizzledfry] [ In reply to ]

Jun 4, 20 18:42

Post #4 of 25 (3066 views)

I’m curious as to your advice on why he shouldn’t run? Do have really have research that shows running equals advanced OA?

Re: I had nearly all of my lateral meniscus removed in 2008. I just had an MRI. Thoughts? [afrizzledfry] [ In reply to ]

Jun 4, 20 19:45

Post #5 of 25 (3033 views)

afrizzledfry wrote:

You have moderate osteoarthritis in the lateral compartment at age 32. You should not run. Period. You'll hear from people here who have OA and run without issue anecdotally. Most (if not all) of them won't be 32. I would not run. Period. I would return to cycling and figure out the source of my pelvic pain through bike fits and a gradual increase in volume year to year, very slowly. FWIW, I'm a seasoned cyclist (Cat 2 roadie and Cat 1 cross racer) and have practiced orthopedics for 10 years as a Physician Assistant. Good luck to you.

I’ve spent 3 years and $1000’s trying to figure out the source of this pelvic pain. Unfortunately cycling just isn’t an option. I can’t even sit on a lot of things with out flaring up

And are you sure moderate equals moderate arthritis? If it was actual moderate arthritis wouldn’t it show on the X-ray? My spacing is still normal. The doctor didn’t mention OA at all in my appointment. He said it things were better than he expected

Per google

“ Stage 3 OA is classified as “moderate” OA. In this stage, the cartilage between bones shows obvious damage, and the space between the bones begins to narrow. People with stage 3 OA of the knee are likely to experience frequent pain when walking, running, bending, or kneeling.

They also may experience joint stiffness after sitting for long periods of time or when waking up in the morning. Joint swelling may be present after extended periods of motion, as well.”

None of that really applies to me. All I have is a mild ache sometimes and never during any activities. I can kneel down fine, I don’t have any clicking or catching and never any stiffness, I have full range of motion.

Re: I had nearly all of my lateral meniscus removed in 2008. I just had an MRI. Thoughts? [Clyde M.] [ In reply to ]

Jun 5, 20 3:58

Post #6 of 25 (2939 views)

Clyde M. wrote:

I had a similar surgery when I was in high school(16 years old) and I'm currently 34. Went to my doc a few months ago due to knee irritation. Had an MRI, which showed a really inflamed bakers cyst(similar to yours; when you're missing meniscus, you become more susceptible), along with OA.

Doc told me to stop running altogether. My inflamed bakers cyst was actually from jiu jitsu(which I've since given up) and not running. I got several 2nd opinions from PT's that specialize in running and got the clear to still do 70.3's(I didn't ask about full IM's because that's not my focus). Part of getting the clear from the PT's had to do with my running form-I'm a very forefoot runner, which actually keeps stress off of the knees.

Find a doc or PT that specializes in knee injuries with runners

How advanced is your OA and what are your symptoms like? Mine is just a minor dull aching after activities, and running itself doesn’t bother me at all.

He made it sound like I have very minor signs of OA, and like I mentioned, not even advanced enough to show any signs on XRay. I have already made an appointment with a PT to discuss this further.

Re: I had nearly all of my lateral meniscus removed in 2008. I just had an MRI. Thoughts? [Rbk_3] [ In reply to ]

Jun 5, 20 6:02

Post #7 of 25 (2889 views)

My OA is minor to moderate. Doesn’t show up much on x ray, but very noticeable on an MRI.

When the bakers cyst was at its worst, the symptoms were pretty bad-joint line pain, instability, lack of range of motion; initially I thought that I had tore more meniscus. But like I said, those were symptoms of the cyst, not the OA.

The cyst calmed down after a few weeks of rest and rehab; also got a series of injections to help lubricate the joint.

After that, the symptoms have been very minor-a little general swelling around the joint(which I’ve had for years) and an occasional dull ache(although that normally comes with periods of inactivity/lack of exercise). I also have a lack of rotational stability, but that doesn’t really affect straight ahead running

M.S. x 2; CSCS; ATC/LAT, Functional Movement Specialist, USA Track and Field Level 1

Re: I had nearly all of my lateral meniscus removed in 2008. I just had an MRI. Thoughts? [Clyde M.] [ In reply to ]

Jun 5, 20 7:21

Post #8 of 25 (2856 views)

Clyde M. wrote:

My OA is minor to moderate. Doesn’t show up much on x ray, but very noticeable on an MRI.

When the bakers cyst was at its worst, the symptoms were pretty bad-joint line pain, instability, lack of range of motion; initially I thought that I had tore more meniscus. But like I said, those were symptoms of the cyst, not the OA.

The cyst calmed down after a few weeks of rest and rehab; also got a series of injections to help lubricate the joint.

After that, the symptoms have been very minor-a little general swelling around the joint(which I’ve had for years) and an occasional dull ache(although that normally comes with periods of inactivity/lack of exercise). I also have a lack of rotational stability, but that doesn’t really affect straight ahead running

What exactly did they inject? Im curious if cortisone would be a good fit. I’ve read it comes with long term side effects.

Re: I had nearly all of my lateral meniscus removed in 2008. I just had an MRI. Thoughts? [Timk] [ In reply to ]

Jun 5, 20 7:34

Post #9 of 25 (2851 views)

Most docs are actually moving away from cortisone, or using it sparingly, because evidence is starting to show that it can be detrimental long term.

My doc used what’s called “visco-supplementation”. It’s provide extra lubrication for the joint.

And I have to firmly disagree with the PA who said don’t run ever. I didn’t mention it earlier, but I have a masters degree in sports medicine and work as an athletic trainer. Things like this can be case by case.

Also, I found a few research articles that actually studied OA and running. They used a control group(those that had OA and didn’t run) and a research group(had OA and did run). I’m both groups the OA did get worse over time(because it’s a degenerative disease) but there was no significant difference between the groups. In fact, many in the running group reported less OA symptoms

M.S. x 2; CSCS; ATC/LAT, Functional Movement Specialist, USA Track and Field Level 1

Re: I had nearly all of my lateral meniscus removed in 2008. I just had an MRI. Thoughts? [Clyde M.] [ In reply to ]

Jun 5, 20 12:41

Post #10 of 25 (2802 views)

Clyde M. wrote:

My OA is minor to moderate. Doesn’t show up much on x ray, but very noticeable on an MRI.

When the bakers cyst was at its worst, the symptoms were pretty bad-joint line pain, instability, lack of range of motion; initially I thought that I had tore more meniscus. But like I said, those were symptoms of the cyst, not the OA.

The cyst calmed down after a few weeks of rest and rehab; also got a series of injections to help lubricate the joint.

After that, the symptoms have been very minor-a little general swelling around the joint(which I’ve had for years) and an occasional dull ache(although that normally comes with periods of inactivity/lack of exercise). I also have a lack of rotational stability, but that doesn’t really affect straight ahead running

So overall, we sound very similar. I plan to keep going with 5k-10ks so long as it is just a minor ache sometimes afterward. I have ran 10 of the last 11 days so maybe need to space it out a little more as I am aching today and was aching last night having a bit of a difficult time getting to sleep. But interesting enough, I am finding after going on long walks is when it aches the most after, more so than runs.

I was up to 215 from 175 when I had to stop biking 3 years ago. Already down 10lb in the last 6 weeks so hopefully as I keep running and get back down to the 170s it will help improve things as well.

My doctor said to check back in 5 years for another X-ray and MRI to see how things are progressing.

Last edited by: Rbk_3: Jun 5, 20 12:43

Re: I had nearly all of my lateral meniscus removed in 2008. I just had an MRI. Thoughts? [Clyde M.] [ In reply to ]

Jun 5, 20 12:45

Post #11 of 25 (2798 views)

Clyde M. wrote:

Most docs are actually moving away from cortisone, or using it sparingly, because evidence is starting to show that it can be detrimental long term.

My doc used what’s called “visco-supplementation”. It’s provide extra lubrication for the joint.

And I have to firmly disagree with the PA who said don’t run ever. I didn’t mention it earlier, but I have a masters degree in sports medicine and work as an athletic trainer. Things like this can be case by case.

Also, I found a few research articles that actually studied OA and running. They used a control group(those that had OA and didn’t run) and a research group(had OA and did run). I’m both groups the OA did get worse over time(because it’s a degenerative disease) but there was no significant difference between the groups. In fact, many in the running group reported less OA symptoms

Did you find the lubricant injection helped much? My Dr suggested it as an option, but my insurance doesn’t cover it and it costs around $500 CND a shot.

Re: I had nearly all of my lateral meniscus removed in 2008. I just had an MRI. Thoughts? [Rbk_3] [ In reply to ]

Jun 5, 20 12:55

Post #12 of 25 (2793 views)

I feel that the shots(it was a series of 3) helped out a bunch. Luckily, my insurances covered it(I only had to pay my regular copay for a specialist, which was $70 each time) and i can get them every 6 months if I need it.

There are several different brands. Some,like the one that I got, is a series of 3 shots, but others provide the same effect with one shot.

If the one that your doc suggested is the one where you only need one shot, then I would definitely say go for it(my co-pays totaled $210, but I would probably pay up to $500 if I had to)

M.S. x 2; CSCS; ATC/LAT, Functional Movement Specialist, USA Track and Field Level 1

Re: I had nearly all of my lateral meniscus removed in 2008. I just had an MRI. Thoughts? [AndrewL] [ In reply to ]

Jun 5, 20 16:16

Post #13 of 25 (2765 views)

I definitely don't, but anecdotally I just don't think it's a good idea based on what I see clinically (I work in adult reconstruction doing ~500 hip and knee replacements annually...50+ year olds with arthritis, many of them with a history of arthroscopies). I doubt there is large scale 30+ year followup data on runners postop s/p partial lateral menisectomy, and if there is I haven't seen it (for or against). He has diffuse early OA in the medial compartment, and apparently some patches of moderate OA as well (moderate chondrosis) according to the radiologist. Weight bearing xrays tend to look good when things are patchy, but I wouldn't let that give me a false sense of security if it were me. Ultimately, I can't predict the future, but I wouldn't take the risk given the delaminating tears and progression that I see in these folks that are now in their later decades of life. Those are my thoughts...take them or leave them. I came out strongly against because I expected the "I still run marathons after my hip replacement" Slowtwitch crowd to chime in ;)

Re: I had nearly all of my lateral meniscus removed in 2008. I just had an MRI. Thoughts? [Clyde M.] [ In reply to ]

Jun 5, 20 16:27

Post #14 of 25 (2756 views)

Clyde M. wrote:

Most docs are actually moving away from cortisone, or using it sparingly, because evidence is starting to show that it can be detrimental long term.

Not true. These injections are still widely used, though there is some evidence they are damaging even at the current accepted rate of one injection every three month being the upper limit. AAHKS still supports their use on a limited basis.

Quote:

My doc used what’s called “visco-supplementation”. It’s provide extra lubrication for the joint.

The data on this treatment's efficacy is minimal at this point. AAHKS recommends against its use as the clinical evidence is overwhelming lacking.

Quote:

And I have to firmly disagree with the PA who said don’t run ever. I didn’t mention it earlier, but I have a masters degree in sports medicine and work as an athletic trainer. Things like this can be case by case.
Also, I found a few research articles that actually studied OA and running. They used a control group(those that had OA and didn’t run) and a research group(had OA and did run). I’m both groups the OA did get worse over time(because it’s a degenerative disease) but there was no significant difference between the groups. In fact, many in the running group reported less OA symptoms

I agree with your first point that things are case by case, and unless that study consists of patients who underwent partial lateral menisectomy around age 20 and subsequently developed early to moderate lateral compartment chrondrosis, I don't think it's particularly relevant to the OP.

Re: I had nearly all of my lateral meniscus removed in 2008. I just had an MRI. Thoughts? [afrizzledfry] [ In reply to ]

Jun 6, 20 13:19

Post #15 of 25 (2686 views)

afrizzledfry wrote:

I definitely don't, but anecdotally I just don't think it's a good idea based on what I see clinically (I work in adult reconstruction doing ~500 hip and knee replacements annually...50+ year olds with arthritis, many of them with a history of arthroscopies). I doubt there is large scale 30+ year followup data on runners postop s/p partial lateral menisectomy, and if there is I haven't seen it (for or against). He has diffuse early OA in the medial compartment, and apparently some patches of moderate OA as well (moderate chondrosis) according to the radiologist. Weight bearing xrays tend to look good when things are patchy, but I wouldn't let that give me a false sense of security if it were me. Ultimately, I can't predict the future, but I wouldn't take the risk given the delaminating tears and progression that I see in these folks that are now in their later decades of life. Those are my thoughts...take them or leave them. I came out strongly against because I expected the "I still run marathons after my hip replacement" Slowtwitch crowd to chime in ;)

I think what I am going to do is run this year, get my weight back down, and re-evalute. I am up from 175 to 215 since I stopped cycling so I need to do something. That extra 40lbs isn't helping things either. I understand it might not be the smartest choice, but I will keep it under 100 miles a month, nothing crazy. Cycling is my real passion and I even spend $6K on a recumbent bike, but it flared my pelvic/lower back pain up just as my regular bike did. I only rode it a few times before taking a huge loss on it and sold my road bike. I have thought about getting out my old hybrid and seeing how a nice slow casual ride would go, but I am afraid of flaring myself up back tpo square one. Overall the pain is managable these days if I watch what I sit on and don't lift too heavy of things. (That's something I didn't mention, I can lift weights either with out flaring the pelvic/lower back pain)

I have also played basketball twice per week from Oct-May since I was 17. That is something that probably should be the first thing I give up. I have never experienced any knee pain after playing ball, though.

As for your work in reconstruction, how is the prognosis for a partial knee replacement down the line vs a full one? It seems my medial compartment is in great shape based on the MRI report.

Last edited by: Rbk_3: Jun 6, 20 13:29

Re: I had nearly all of my lateral meniscus removed in 2008. I just had an MRI. Thoughts? [Rbk_3] [ In reply to ]

Jun 7, 20 9:16

Post #16 of 25 (2619 views)

Rbk_3 wrote:

afrizzledfry wrote:

I definitely don't, but anecdotally I just don't think it's a good idea based on what I see clinically (I work in adult reconstruction doing ~500 hip and knee replacements annually...50+ year olds with arthritis, many of them with a history of arthroscopies). I doubt there is large scale 30+ year followup data on runners postop s/p partial lateral menisectomy, and if there is I haven't seen it (for or against). He has diffuse early OA in the medial compartment, and apparently some patches of moderate OA as well (moderate chondrosis) according to the radiologist. Weight bearing xrays tend to look good when things are patchy, but I wouldn't let that give me a false sense of security if it were me. Ultimately, I can't predict the future, but I wouldn't take the risk given the delaminating tears and progression that I see in these folks that are now in their later decades of life. Those are my thoureughts...take them or leave them. I came out strongly against because I expected the "I still run marathons after my hip replacement" Slowtwitch crowd to chime in ;)

I think what I am going to do is run this year, get my weight back down, and re-evalute. I am up from 175 to 215 since I stopped cycling so I need to do something. That extra 40lbs isn't helping things either. I understand it might not be the smartest choice, but I will keep it under 100 miles a month, nothing crazy. Cycling is my real passion and I even spend $6K on a recumbent bike, but it flared my pelvic/lower back pain up just as my regular bike did. I only rode it a few times before taking a huge loss on it and sold my road bike. I have thought about getting out my old hybrid and seeing how a nice slow casual ride would go, but I am afraid of flaring myself up back tpo square one. Overall the pain is managable these days if I watch what I sit on and don't lift too heavy of things. (That's something I didn't mention, I can lift weights either with out flaring the pelvic/lower back pain)

I have also played basketball twice per week from Oct-May since I was 17. That is something that probably should be the first thing I give up. I have never experienced any knee pain after playing ball, though.

As for your work in reconstruction, how is the prognosis for a partial knee replacement down the line vs a full one? It seems my medial compartment is in great shape based on the MRI report.

My bad- definitely meant *lateral* compartment, not medial in my quoted reply above. That really sucks about your back- sorry to hear and I definitely empathize. I jacked by back up lifting in November (haven't lifted since, hope to start again soon). My Lumbar MRI showed mild OA (it sure didn't feel mild...could barely move for a few days), and PT has helped a lot. But it's still not perfect. If you haven't done PT maybe give it some thought? I sincerely hope you get to a point where you are able to ride again.

Dropping the basketball and the 40 pounds sounds like a great plan- you'll thank yourself later I'm sure. You appear to be a great candidate for a lateral partial knee replacement down the road assuming your medial and patellofemoral joints continue to look good. FWIW, partial is the way to go if you have the option in my opinion. Less pain, more function. Only downside is longevity- it probably won't last as long as a total. Best of luck to you.

Re: I had nearly all of my lateral meniscus removed in 2008. I just had an MRI. Thoughts? [afrizzledfry] [ In reply to ]

Jun 7, 20 11:12

Post #17 of 25 (2608 views)

afrizzledfry wrote:

Rbk_3 wrote:

afrizzledfry wrote:

I definitely don't, but anecdotally I just don't think it's a good idea based on what I see clinically (I work in adult reconstruction doing ~500 hip and knee replacements annually...50+ year olds with arthritis, many of them with a history of arthroscopies). I doubt there is large scale 30+ year followup data on runners postop s/p partial lateral menisectomy, and if there is I haven't seen it (for or against). He has diffuse early OA in the medial compartment, and apparently some patches of moderate OA as well (moderate chondrosis) according to the radiologist. Weight bearing xrays tend to look good when things are patchy, but I wouldn't let that give me a false sense of security if it were me. Ultimately, I can't predict the future, but I wouldn't take the risk given the delaminating tears and progression that I see in these folks that are now in their later decades of life. Those are my thoureughts...take them or leave them. I came out strongly against because I expected the "I still run marathons after my hip replacement" Slowtwitch crowd to chime in ;)

I think what I am going to do is run this year, get my weight back down, and re-evalute. I am up from 175 to 215 since I stopped cycling so I need to do something. That extra 40lbs isn't helping things either. I understand it might not be the smartest choice, but I will keep it under 100 miles a month, nothing crazy. Cycling is my real passion and I even spend $6K on a recumbent bike, but it flared my pelvic/lower back pain up just as my regular bike did. I only rode it a few times before taking a huge loss on it and sold my road bike. I have thought about getting out my old hybrid and seeing how a nice slow casual ride would go, but I am afraid of flaring myself up back tpo square one. Overall the pain is managable these days if I watch what I sit on and don't lift too heavy of things. (That's something I didn't mention, I can lift weights either with out flaring the pelvic/lower back pain)

I have also played basketball twice per week from Oct-May since I was 17. That is something that probably should be the first thing I give up. I have never experienced any knee pain after playing ball, though.

As for your work in reconstruction, how is the prognosis for a partial knee replacement down the line vs a full one? It seems my medial compartment is in great shape based on the MRI report.

My bad- definitely meant *lateral* compartment, not medial in my quoted reply above. That really sucks about your back- sorry to hear and I definitely empathize. I jacked by back up lifting in November (haven't lifted since, hope to start again soon). My Lumbar MRI showed mild OA (it sure didn't feel mild...could barely move for a few days), and PT has helped a lot. But it's still not perfect. If you haven't done PT maybe give it some thought? I sincerely hope you get to a point where you are able to ride again.

Dropping the basketball and the 40 pounds sounds like a great plan- you'll thank yourself later I'm sure. You appear to be a great candidate for a lateral partial knee replacement down the road assuming your medial and patellofemoral joints continue to look good. FWIW, partial is the way to go if you have the option in my opinion. Less pain, more function. Only downside is longevity- it probably won't last as long as a total. Best of luck to you.

Thanks, and hopefully the technology and advancements continue to improve in the next 20-30 years by the time I may need one. Yea I feel like I have tried everything. I have been to multiple physios with various stretching/strengthening, been to multiple pelvic floor pysios (that is one of the more awkward things I have done), multiple chiropractors, an osteopaths, an acupuncturist, a massage therapists, a urologist, and a sports doctor. Pelvic pain is a tricky thing it seems. There are Facebook groups with 1000's of members looking for answers to their pelvic pain just like me. Unfortunately it is not a topic that a lot of research has been done in. There are a few books, such as Headache in the Pelvis I have read also that suggest stretching all the primary movers around the pelvis, which may have helped improve things, not sure, but the second I bike it comes back.

It is a very odd pain because no movement makes it hurt, and it isn't tender anywhere. I could go out and cycle right now but later tonight I would have a deep dull ache in my perineum area that would keep me up at night. It isn't even that painful, really, just constant and miserably annoying when it is flared up.

Last edited by: Rbk_3: Jun 7, 20 11:14

Re: I had nearly all of my lateral meniscus removed in 2008. I just had an MRI. Thoughts? [Rbk_3] [ In reply to ]

Jun 10, 20 15:21

Post #18 of 25 (2520 views)

Rbk_3 wrote:

afrizzledfry wrote:

Rbk_3 wrote:

afrizzledfry wrote:

I definitely don't, but anecdotally I just don't think it's a good idea based on what I see clinically (I work in adult reconstruction doing ~500 hip and knee replacements annually...50+ year olds with arthritis, many of them with a history of arthroscopies). I doubt there is large scale 30+ year followup data on runners postop s/p partial lateral menisectomy, and if there is I haven't seen it (for or against). He has diffuse early OA in the medial compartment, and apparently some patches of moderate OA as well (moderate chondrosis) according to the radiologist. Weight bearing xrays tend to look good when things are patchy, but I wouldn't let that give me a false sense of security if it were me. Ultimately, I can't predict the future, but I wouldn't take the risk given the delaminating tears and progression that I see in these folks that are now in their later decades of life. Those are my thoureughts...take them or leave them. I came out strongly against because I expected the "I still run marathons after my hip replacement" Slowtwitch crowd to chime in ;)

I think what I am going to do is run this year, get my weight back down, and re-evalute. I am up from 175 to 215 since I stopped cycling so I need to do something. That extra 40lbs isn't helping things either. I understand it might not be the smartest choice, but I will keep it under 100 miles a month, nothing crazy. Cycling is my real passion and I even spend $6K on a recumbent bike, but it flared my pelvic/lower back pain up just as my regular bike did. I only rode it a few times before taking a huge loss on it and sold my road bike. I have thought about getting out my old hybrid and seeing how a nice slow casual ride would go, but I am afraid of flaring myself up back tpo square one. Overall the pain is managable these days if I watch what I sit on and don't lift too heavy of things. (That's something I didn't mention, I can lift weights either with out flaring the pelvic/lower back pain)

I have also played basketball twice per week from Oct-May since I was 17. That is something that probably should be the first thing I give up. I have never experienced any knee pain after playing ball, though.

As for your work in reconstruction, how is the prognosis for a partial knee replacement down the line vs a full one? It seems my medial compartment is in great shape based on the MRI report.

My bad- definitely meant *lateral* compartment, not medial in my quoted reply above. That really sucks about your back- sorry to hear and I definitely empathize. I jacked by back up lifting in November (haven't lifted since, hope to start again soon). My Lumbar MRI showed mild OA (it sure didn't feel mild...could barely move for a few days), and PT has helped a lot. But it's still not perfect. If you haven't done PT maybe give it some thought? I sincerely hope you get to a point where you are able to ride again.

Dropping the basketball and the 40 pounds sounds like a great plan- you'll thank yourself later I'm sure. You appear to be a great candidate for a lateral partial knee replacement down the road assuming your medial and patellofemoral joints continue to look good. FWIW, partial is the way to go if you have the option in my opinion. Less pain, more function. Only downside is longevity- it probably won't last as long as a total. Best of luck to you.

Thanks, and hopefully the technology and advancements continue to improve in the next 20-30 years by the time I may need one. Yea I feel like I have tried everything. I have been to multiple physios with various stretching/strengthening, been to multiple pelvic floor pysios (that is one of the more awkward things I have done), multiple chiropractors, an osteopaths, an acupuncturist, a massage therapists, a urologist, and a sports doctor. Pelvic pain is a tricky thing it seems. There are Facebook groups with 1000's of members looking for answers to their pelvic pain just like me. Unfortunately it is not a topic that a lot of research has been done in. There are a few books, such as Headache in the Pelvis I have read also that suggest stretching all the primary movers around the pelvis, which may have helped improve things, not sure, but the second I bike it comes back.

It is a very odd pain because no movement makes it hurt, and it isn't tender anywhere. I could go out and cycle right now but later tonight I would have a deep dull ache in my perineum area that would keep me up at night. It isn't even that painful, really, just constant and miserably annoying when it is flared up.

Interesting. You mentioned back pain as well. Have you seen a neurologist or ortho spine surgeon? How about a true ortho hip specialist? Had a Lumbosacral MRI? Just curious. I'd definitely refer you to one of our spine docs if you came into my clinic with those symptoms.

Re: I had nearly all of my lateral meniscus removed in 2008. I just had an MRI. Thoughts? [Rbk_3] [ In reply to ]

Jun 12, 20 8:54

Post #19 of 25 (2396 views)

Whenever my knee flares up, I simply do days of many many minutes of wallsits. This seems to sort things out. I knock on wood everytime I give out this advice...…

Re: I had nearly all of my lateral meniscus removed in 2008. I just had an MRI. Thoughts? [Rbk_3] [ In reply to ]

Jun 12, 20 11:28

Post #20 of 25 (2379 views)

I have a few comments. I'm no expert but I have had 5 partial meniscectomies (one right, four left): first one in 1990 (age 20), three from 1996-2000, and one with an ACL repair two years ago. I continued to run regularly through 2010 and then spottily since then mainly because I started cycling a ton -- now a cat 2 roadie. I can still run/hike absolutely fine.

Here are my comments:
-- Every single case is different and telling us the MRI report doesn't help all that much. All of these reports sound really bad. Some are actually really bad and some aren't.
-- Things you can do to make the stress on your knee better: (1) lose weight, (2) use a high cushion shoe like Hoka's. If you're going to continue to run regularly on that knee you should consider both of these things not optional.
-- In the mean time I think it's stupid to run on the knee while it's inflamed. Let it heal then try again. Only run as much as your knee can handle. There's no point in forcing the issue. You're only 32 and you don't want to have a seized up knee at 40!
-- On the pelvis, again I don't know anything, but I can't believe it isn't fixable so I would continue to look into it. You're only 32 and you shouldn't be physically unable to ride a bike. Things that come to mind: good PT is number one, and if that doesn't work maybe there's something structurally wrong that can be addressed.

Last edited by: lanierb: Jun 12, 20 11:31

Re: I had nearly all of my lateral meniscus removed in 2008. I just had an MRI. Thoughts? [AndrewL] [ In reply to ]

Jun 12, 20 14:31

Post #21 of 25 (2359 views)

I had similar surgery with meniscus in 1989 in the Navy. I continued running ,playing tennis and some Tri. In 2009 I had a Microfracture surgery on that knee. After that I felt better and got into Ironman. Last year I had my knee replaced and it feels great. I completed FL Ironman 5.5 months after the surgery. I did a walk .5 mile jog two miles and it only added about an hour to my normal time. That said don't think you need a new knee unless you can't sleep at night.

Re: I had nearly all of my lateral meniscus removed in 2008. I just had an MRI. Thoughts? [Clyde M.] [ In reply to ]

Jun 16, 20 20:42

Post #22 of 25 (2266 views)

Clyde M. wrote:

I had a similar surgery when I was in high school(16 years old) and I'm currently 34. Went to my doc a few months ago due to knee irritation. Had an MRI, which showed a really inflamed bakers cyst(similar to yours; when you're missing meniscus, you become more susceptible), along with OA.

Doc told me to stop running altogether. My inflamed bakers cyst was actually from jiu jitsu(which I've since given up) and not running. I got several 2nd opinions from PT's that specialize in running and got the clear to still do 70.3's(I didn't ask about full IM's because that's not my focus). Part of getting the clear from the PT's had to do with my running form-I'm a very forefoot runner, which actually keeps stress off of the knees.

Find a doc or PT that specializes in knee injuries with runners

Just wondering, have you ever looked into a varus-producing osteotomy? Came across a video about Zion Williamson's lateral meniscus surgery by an orthopedic surgeon who actually is in my province, so I reached out and this is what he said. https://www.youtube.com/...xv2lcxSHy99yDoVbPD7j

"First, you should consider getting a rigid, custom unloader brace that will put you into varus (bow-legged), as this will help to open your lateral joint space and reduce the excessive forces that are going through this joint now. Second, if your joint space narrowing is moderately advanced on the lateral side, you may have to consider something more permanent such as a varus-producing osteotomy (where we cut the bone of the femur or tibia) to produce the same effect. Generally, I would stop running or impact activities until you get this sorted out. Removal of the meniscus has altered the mechanical axis of the operated leg, which changes the distribution of the forces through that knee. This is a mechanical problem that requires a mechanical solution. Injections and passive therapeutic modalities are not going to help this problem."

Last edited by: Rbk_3: Jun 16, 20 20:53

Re: I had nearly all of my lateral meniscus removed in 2008. I just had an MRI. Thoughts? [lanierb] [ In reply to ]

Jun 16, 20 20:54

Post #23 of 25 (2259 views)

lanierb wrote:

I have a few comments. I'm no expert but I have had 5 partial meniscectomies (one right, four left): first one in 1990 (age 20), three from 1996-2000, and one with an ACL repair two years ago. I continued to run regularly through 2010 and then spottily since then mainly because I started cycling a ton -- now a cat 2 roadie. I can still run/hike absolutely fine.

Here are my comments:
-- Every single case is different and telling us the MRI report doesn't help all that much. All of these reports sound really bad. Some are actually really bad and some aren't.
-- Things you can do to make the stress on your knee better: (1) lose weight, (2) use a high cushion shoe like Hoka's. If you're going to continue to run regularly on that knee you should consider both of these things not optional.
-- In the mean time I think it's stupid to run on the knee while it's inflamed. Let it heal then try again. Only run as much as your knee can handle. There's no point in forcing the issue. You're only 32 and you don't want to have a seized up knee at 40!
-- On the pelvis, again I don't know anything, but I can't believe it isn't fixable so I would continue to look into it. You're only 32 and you shouldn't be physically unable to ride a bike. Things that come to mind: good PT is number one, and if that doesn't work maybe there's something structurally wrong that can be addressed.

Very glad to hear things are going well for you!

Point 2: I am on the losing weight. Back down under 200lbs. I just bought a pair of Brooks Adreniline's that have a 12mm drop. I will look into Hoka's next time. I also have flat feet, so I need over pronation shoes.

Point 3: The thing is I don't even think it is really inflamed. It isn't tender at all and I have my full ROM. I wonder if it my even be IT band related?

Point 4: Yeah it has to be fixable somehow some way. My forum was very poor and I never stretched or warmed up properly before biking. Has to be something related to tightness/weakness. I just don't know what to attack, and it is hard going to a PT who don't really know what is going on and they are giving recommendations. I will follow them for a few weeks and not see any progress and give up the stretching or stretching exercises they give me.

Re: I had nearly all of my lateral meniscus removed in 2008. I just had an MRI. Thoughts? [Rbk_3] [ In reply to ]

Jun 17, 20 12:56

Post #24 of 25 (2199 views)

Rbk_3 wrote:

Clyde M. wrote:

I had a similar surgery when I was in high school(16 years old) and I'm currently 34. Went to my doc a few months ago due to knee irritation. Had an MRI, which showed a really inflamed bakers cyst(similar to yours; when you're missing meniscus, you become more susceptible), along with OA.

Doc told me to stop running altogether. My inflamed bakers cyst was actually from jiu jitsu(which I've since given up) and not running. I got several 2nd opinions from PT's that specialize in running and got the clear to still do 70.3's(I didn't ask about full IM's because that's not my focus). Part of getting the clear from the PT's had to do with my running form-I'm a very forefoot runner, which actually keeps stress off of the knees.

Find a doc or PT that specializes in knee injuries with runners

Just wondering, have you ever looked into a varus-producing osteotomy? Came across a video about Zion Williamson's lateral meniscus surgery by an orthopedic surgeon who actually is in my province, so I reached out and this is what he said. https://www.youtube.com/...xv2lcxSHy99yDoVbPD7j

"First, you should consider getting a rigid, custom unloader brace that will put you into varus (bow-legged), as this will help to open your lateral joint space and reduce the excessive forces that are going through this joint now. Second, if your joint space narrowing is moderately advanced on the lateral side, you may have to consider something more permanent such as a varus-producing osteotomy (where we cut the bone of the femur or tibia) to produce the same effect. Generally, I would stop running or impact activities until you get this sorted out. Removal of the meniscus has altered the mechanical axis of the operated leg, which changes the distribution of the forces through that knee. This is a mechanical problem that requires a mechanical solution. Injections and passive therapeutic modalities are not going to help this problem."

Even though I had lateral meniscus removed, my OA is in all 3 compartments of the knee.

However, I have found an unloading brace that has hydraulic springs that helps absorb forces

M.S. x 2; CSCS; ATC/LAT, Functional Movement Specialist, USA Track and Field Level 1

Re: I had nearly all of my lateral meniscus removed in 2008. I just had an MRI. Thoughts? [Clyde M.] [ In reply to ]

Jun 17, 20 15:36

Post #25 of 25 (2177 views)

Clyde M. wrote:

Rbk_3 wrote:

Clyde M. wrote:

I had a similar surgery when I was in high school(16 years old) and I'm currently 34. Went to my doc a few months ago due to knee irritation. Had an MRI, which showed a really inflamed bakers cyst(similar to yours; when you're missing meniscus, you become more susceptible), along with OA.

Doc told me to stop running altogether. My inflamed bakers cyst was actually from jiu jitsu(which I've since given up) and not running. I got several 2nd opinions from PT's that specialize in running and got the clear to still do 70.3's(I didn't ask about full IM's because that's not my focus). Part of getting the clear from the PT's had to do with my running form-I'm a very forefoot runner, which actually keeps stress off of the knees.

Find a doc or PT that specializes in knee injuries with runners

Just wondering, have you ever looked into a varus-producing osteotomy? Came across a video about Zion Williamson's lateral meniscus surgery by an orthopedic surgeon who actually is in my province, so I reached out and this is what he said. https://www.youtube.com/...xv2lcxSHy99yDoVbPD7j

"First, you should consider getting a rigid, custom unloader brace that will put you into varus (bow-legged), as this will help to open your lateral joint space and reduce the excessive forces that are going through this joint now. Second, if your joint space narrowing is moderately advanced on the lateral side, you may have to consider something more permanent such as a varus-producing osteotomy (where we cut the bone of the femur or tibia) to produce the same effect. Generally, I would stop running or impact activities until you get this sorted out. Removal of the meniscus has altered the mechanical axis of the operated leg, which changes the distribution of the forces through that knee. This is a mechanical problem that requires a mechanical solution. Injections and passive therapeutic modalities are not going to help this problem."

Even though I had lateral meniscus removed, my OA is in all 3 compartments of the knee.

However, I have found an unloading brace that has hydraulic springs that helps absorb forces

That is unfortunate, sorry to hear it is in all 3, I am lucky in it is just the one for me so I don’t need that drastic of a brace. I got measured up for an Unloader today and if my insurance covers it, I will give it a go. We will see how much they cover though, the custom Ossur One X costs $2000 CND, and the non custom is $1300 which is absurd.

Last edited by: Rbk_3: Jun 17, 20 15:38

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