Advanced degenerative tearing of minisci

Hi everyone.
I’ve always been hard on my body, enjoying snowboarding for 15 years, rockclimbing, running, basketball, slacklining, skate boarding and other sports and hobbies. I’ve sprained my knees and even tore my acl in my left knee but stayed out of the hospital and healed for a couple months. Recently I have been unable to run or snowboard without moderately high levels of pain and inflammation/irritation. I went to the steadman clinic in Vail who are reportedly some of the best knee surgeons in the world. The results of the MRI s indicated and advanced deterioration of the posterior menisci which the doc referred to as “bone to bone”. He then told me I can forget about running for the rest of my life. We scheduled a meniscus cleaning and trimming surgery to remove fragments and hopefully reduce the chronic swelling and pain. They wanted to schedule it asap. Even since then my condition has worsened considerably and now walking is unstable, a little painful and is accompanied by unsettling clicks and catching and weird dull pains and sensations. They didn’t tell me much about my left knee yet, but they seemed surprised when I told them I could trust it. This is no longer the case. It feels pretty bad also. Im 26 and really can’t imagine life without playing hard in the mountains… any information anyone can give ne is very highly appreciated.

You should be able to race bikes without much trouble.

He did say cycling and swimming would be possible. I know many people have been through much tougher losses. For me, this is a huge loss, going from hitting 50+ foot jumps all over the mountain and enjoying 10+ mile runs, to possibly never running or riding again… I just hoped I’d find some new meniscus replacement or surgery out there but everything I read is pretty bleak.

Check out Dr. Kevin Stone in San Francisco. He performs biological knee replacement with cadaver meniscus. Best of luck.

Thank you! I will look into that.

My wife was told she was bone on bone over 8 yrs ago. She is 47 yrs old. She started taking Glucosamine Chondrotin everyday. Within 6 months
we were hiking in the Colorado Mountains like old days. She has to have LOTS of rest on it to keep it from getting inflamed. She was told to ice
it everyday!!! Ice Ice Ice. Inflamation is the enemy. She even trained up to a 10 miler at one point, but that was just asking for trouble.
I had meniscus surgery 3 yrs ago. They removed 20%. It didnt help much. I was told a yr later that I had 2 more tears. I could hardly walk much
less Triathlon, so I scheduled surgery 4 months later. After 4 MONTHS of NO RUNNING. I canceled the surgery because I didnt hurt anymore.
I have since begun to train again. I can swim and bike as much as I want. I must ration my running. I intend to ski next winter. But I would not
dare do jumps. After 40 you just learn to protect your knees.
I was very bummed when I thought I couldnt Tri anymore, very bummed…but I won my first ever age group award the other day. Rest will do wonders.
I hope you heal up.

The ’ bone on bone’ is obviously a problem. That can only be helped by surgery. The secondary effects of the inflamation in the knee can be a significant problem also. This inflamtion leads quickly to muscle imbalance in the lower and upper leg, that then leads to limping which effects the hip(s) function. The longterm implications of that could be just as bad as the knee.

The body will inevitably compensate for the knee during activities, the proprioseptive chaqnges may not be noticable to you. If you can find a good sports massage therapist they could help to minimize the long term effects of the muscle imbalance.

First of all I am sorry for what you are going through at such a young age. Any type of cartilage damage is difficult to deal with especially the menisci due to the knee being such a high impact joint. Artificial menisci cant be created in a lab like artificial bone therefore from this point all you can do is try to achieve a natural regrowth of the cartilage. It will never be the same but fortunately you are young enough that it is possible. The most important thing for you is to is work with a good physical therapist who specializes in this type of rehabilitation. Most physical therapists today have doctorates and are truly the experts on movement. Swimming and cycling will be good methods of rehabilitation to strengthen the muscles supporting your knee and help take impact away from the bone to bone joint. The body can do amazing things when it is forced to compensate for something. Just be patient and do the necessary steps for rehabilitation. In the meantime, follow the RICE principle for pain relief: Rest, Ice, Compression, Elevation. Also, NSAIDS like Advil will help reduce inflammation.

Degenerative tears sometimes referred to as horizontal tears aren’t repairable really. Keeping what meniscus you have has become more and more the standard of care. The days of removing meniscus, esp. degenerative type (like delaminating) overuse injuries simply leads to accelerated arthritis and joint replacement. For most anyway.

For active lifestyle people, many many will show degenerative meniscus changes on MRI, often in the posterior horns.
Other “gifts” from MRI imaging are mild disc bulging seen on spinal studies and fraying/tears on shoulder rotator cuff views. These findings are regularly seen on folks without symptoms for these injuries.

MRI’s don’t lie, they show wear from an active lifestyle. What they show isn’t allways the source of one’s symptoms.
Remember fixing these MRI problems surgically doesn’t allways solve the functional problem.

I would counsel recovery/rehab and modifying your sport activity rather than surgery for most.

From a surgery standpoint if your bone on bone, you would need to have either micro fracture surgery which I’ve successfully had, or a cartilage transplant as a secondary option if the first doesn’t heal correctly.

During the scope they can take a piece of your own cartridge and grow it at a lab to be transplanted at a later date if needed although from what I understand it’s not perfected yet.

On a lighter note there is also Synvisk which is a series of 3 shots that can pad the joint with a lubricant to ease the pain. My parents have used it and we’re happy with results. Last for 6 months

Hey guys. All of your posts have been super helpful and I am grateful for all of you. I had the meniscectomy on Feb 21st. They removed about 80% of my medial and 70% of my lateral. I had to do my physical therapy at home because of my remote location and insurance complications.I have great health insurance but the company is foreign which always makes it a huge pain to get things prepaid or be accepted by US hospitals and facilities. Things are going pretty good for the most part. Im walking limp free and have most of my range of motion back. I could probably even run a short length but wouldn’t try it at this point… I’m learning to do new things in new ways and accept my situation. I’ve looked a bit into platelet rich plasma injections and have heard some pretty great things about it. Dusted off the mountain bike and retired the running shoes. My life and my dreams and my goals really revolved around my ability to hike, run and climb. I wanted to start a camp for troubled youth where they can climb and run and learn to love nature and themselves. I can still live that dream even if my scope has narrowed significantly. Doc said I’d never run again though but I can hike with trekking poles and even snowboard as long as I stay in the deepstuff and out of the air. This bird is pretty grounded but I’m very positive and very grateful for everything I’ve been able to do to this point and excited about life and the future. Thanks guys. I admit that at this point I haven’t researched the issue thoroughly … I think its been the fear of accepting the severity of my situation. I need to get a therapist to work with me. Surgeon said knee braces off no real help for me. Those buffering and lubricating injections sound like they may add some time to my ticking knee bombs. I intend to keep climbing and snowboarding and hiking and more (within reason and moderation ) even if it might discomfort me in the future. Love to everyone. Live in the moment and smile.