Just got the results from the MRI today. I’ve known something was “wrong” with my knee for a while. Denial and HTFU seemed to work for a few weeks/months. Now it’s time to move onto the next phase and get this taken care of. Background- 49 year old (young) female who had a great year of HIM’s planned. Right now I’m still hoping to salvage some of the season. Looks like Galveston, Eagleman and BLST will be out. I would like to at least be able to race at Boulder this year.
So- slowtwitchers- MD’s and MD wanna be what do you think?
MRI results?Impressions:
Impression:
Lateral femorotibal compartment osteoarthrosis with grade 3/4 chondromalacia of the posterior lateral tibial plateau
Extensive degenerative horizontal tear throughout the lateral meniscus posterior horn and body with additional longitudinal tear of the anterior body- anterior horn junction.
Low grade partial thickness chondral fissuring with mild underlying cystic change of the inferior lateral patellar facet
Mild proximal patellar tendonitis
Exactly how long do you think I will be out? Is this an average tear? Bad?
Should I just give up triathlons and take up knitting? Just kidding? While recovering from foot surgery a few years ago, I started competitive shooting just to stay busy and sane.
When can I swim? Not opposed to aqua jogging if that will get things back on track sooner.
Ideas? Honest opinions?
Meeting with the orthopod on Monday. Sports Rehab Dr. gave me the results of the test today. My plan is to have surgery as soon as possible.
I’m not in any pain at all. The knee just feels unstable with certain sudden lateral movements such as volleyball. The swelling, locking and stiffness have basically disappeared since I stopped running on 4/9.
I’ve never had any problems with my knees before this injury. The injury is the result of moving 350lb basketball goals at work every day for two weeks in January. The goals are on rollers but it still put a lot of strain on my left knee. Initially we thought it was ITBS because of the symptoms. I’ve been able to cycle and swim without any problems.
Ok, I’ll play. Pedalhead was blunt but not far off. A degenerative meniscus tear alone is treatable both with and without surgery. Unfortunately, meniscal pathology alone is rare in our age group (we are the same age). Indeed, the grade 3/4 chondromalacia is radiologist speak for osteoarthritis with grade 4 meaning articular cartilage loss down to bone. And degenerative articular cartilage damage is forever. (Traumatic and/or focal loss has restorative options: micro-fracture, carticel, OATS, allograft).
And, sorry to be negative, but in my experience, lateral (as opposed to medial) sided meniscal tears, specifically with significant OA, have a poorer prognosis. That compartment just seems to progress more rapidly, especially in women.
But that doesn’t mean you can’t run. You may have to lower your expectations and manage the discomfort along with managing the osteoarthritis. Hopefully, your orthopedic surgeon is a runner :-). Good luck.
Standard practice after meniscectomy is to advise against running. Sorry if I was too blunt, but you ought to be prepared for that advice if you choose surgery. For example, 2 women friends of mine recently had arthroscopic surgery for lateral meniscal tears less severe than yours. They are 3 days and 8 days postop. One is older (56) than you. She had 30% meniscectomy and still hopes to run Western States 100 in June despite advice against it. The other (21) was running 35 mpw. Although only 5% of her meniscus was removed, the surgeon advised not more than 15 mpw.
(Please tell me that you are kidding. Wouldn’t they have mentioned this at the doctors office today?
sorry about your knee, but i am going thru something similar but male age 65.
on the good news i had 60% of medial posterior horn removed on right knee in 2006 and still bike pretty good and run well for age too. did 5k portion of sprint sub 24 last august. doctor at time said i would have oa but to date my knee is fine though i can tell on high humidity days and i have to be careful with muscles and massage them religiously (think my vmo shutdown when knee injured). anyway right knee seems fine given the scope of surgery which occurred nearly two years after i first suspected something, but doctor said was pf syndrome…my ass.
however, i experienced what i thought was itb on left knee recently. the pt said work on stretches and i think i did them so rigorously (bending knee) to hit upper quad and tfl that i believe i have exacerbated my left meniscus which at age 65 would likely be considered degenerative.
a question for you is can you run without pain, i can, but the next day it hurts which makes me think it is meniscus as opposed to popliteal strain or minor acl tear?
bending my knee to max hurts, but riding bike, going up and down stairs, no problems. a 5 mile hike does produce some soreness around knee.
can you briefly describe your symptoms as i have doctor appt on apr 3.
one thing i wonder if you have considered is regenexx? google them, they have a location in tx, but main hq is colorado. i may start thread on regenexx success in a moment or two.
Not sure this helps, but 46 yo male with quite a few hard years since joining the Marine Corp at 17. I’m a pretty active guy and after some time off this winter I managed to tear my left meniscus right before new years and my right on a short run a month ago. I had a menisectomy on the right this past Tuesday and it went very well. I did not have a repair. Here was my injury on the right:
Tear of the body of the medial meniscus with displaced fragment into the medial gutter.
Mild MCL sprain.
Small ganglion subjacent to degenerative changes in the tibiofibular joint.
Small suprapatellar joint effusion.
I was able to walk on Tuesday after the surgery, but did use a crutch for stability. I had no real pain and did not take any of the oxycodone prescribed. I walked a fair amount yesterday and the right knee feels more stiff than anything. I was told I could do some leg lifts, but that’s really it until PT starts. I will also be scheduling my left knee to be done in a few weeks.It is my understanding I will be back to almost 100% in a few months time. With that said, I have adjusted my expectations for very little running this year and a lot of cycling. Everyone is different, but if I take it easy (at least running-wise) for 6 months and recover right, I am hoping I extend my fitness routine for many more years. One year off for n good ones is a good trade-off.
The only advice I will give is to stay active right up to your surgery. I skied (with braces) the week before, cycled both days the weekend before and lifted the morning of. Finally, listen to your body, you know what you can and should do.
Ok, I’ll play. Pedalhead was blunt but not far off. A degenerative meniscus tear alone is treatable both with and without surgery. Unfortunately, meniscal pathology alone is rare in our age group (we are the same age). Indeed, the grade 3/4 chondromalacia is radiologist speak for osteoarthritis with grade 4 meaning articular cartilage loss down to bone. And degenerative articular cartilage damage is forever. (Traumatic and/or focal loss has restorative options: micro-fracture, carticel, OATS, allograft).
And, sorry to be negative, but in my experience, lateral (as opposed to medial) sided meniscal tears, specifically with significant OA, have a poorer prognosis. That compartment just seems to progress more rapidly, especially in women.
But that doesn’t mean you can’t run. You may have to lower your expectations and manage the discomfort along with managing the osteoarthritis. Hopefully, your orthopedic surgeon is a runner :-). Good luck.
I was going to say, I would imagine that the OA would end up causing more issues long term than the tear. I hate to hear this, mainly because I am avoiding talking to my MD about my knee. He gets it, he is a runner and understands my concerns about finally “knowing”. Keep us posted.
And Pedalhead was blunt, but in reality, most surgeons will give advice against running because it is what is considered to be best practice based on the evidence they currently have. The ones that work in sports med are a bit more lenient I have found.
In your case due to the extensive damage you may be recommended to have surgery, but I think the above is important information. With OA, once you have it, you have it. BUT pain (and swelling) is a great signal to listen to. With OA our rehabilitation goal is to get you as strong and balanced muscularly as possible to decrease the stress on the effected joint. Make sure your gait mechanics are as perfect as possible. When the knee swells or you are painful, you have overdone it. This is the time to go back to “if it hurts don’t do it.” Pain in a joint with OA means potentially furthering the damage.
Having said this, I have a lot of people who run on knees like yours. Pain free and happy. ST might blow up when I say this, but you actually might look into the Hoka’s or similar shoe for improved shock absorption.
For triathlon, if you decide to attempt to keep running you may have to change your run training to decrease the stress on a daily basis.
There are also bracing options out there for OA in the knee: in your case you would look for a lateral unloader brace - decreases the stress on the lateral compartment.
Well thankfully the Slowtwitch MD’s and MD wanna-a-be’s were WRONG in their online diagnosis that I would not never run again. Thank you for taking the time to answer my questions. Given the information that you were given the initial diagnosis was the same as my surgeons when he saw the MRI. However, once we got into surgery the osteoarthritis was not as bad as shown on the MRI. The doctor was very surprised. He had also given me the running death sentence pre-surgery.
I’m now 12 days post op. Immediately felt 95% better after surgery. A few days after the surgery, I was back on the bike for ROM exercises and PT. Right now I’m up to daily 2X20 easy bike, PT and starting back at the pool. Everything is going better than expected. I will be able to run again. The doctor (who treats runners/athletes) has not given any limitations or warnings regarding running in the future.
You received some good information on this thread.
Thanks for the post, because I learned a lot.
FYI – I had very similar knee issues. Could hardly walk a few months before LPIM. I focused on indoor bike training instead of surgery. It’s been two years and my knee is very strong. I also completed LPIM. My time wasn’t great, but I finished it.
Au contraire. Going on the information you gave us, our opinions were in line with the initial impressions of your MD and surgeon. My point was, in fact, that you would be “advised” to quit running due to the OA, not that you couldn’t run in spite of it. Well anyway, all’s well that ends well. Good luck with your PT and hopefully, knee pain will be a minor issue down the road. Truthfully, I didn’t think pain would stop you from running… not with your HTFU attitude.
Well thankfully the Slowtwitch MD’s and MD wanna-a-be’s were WRONG in their online diagnosis that I would not never run again. Thank you for taking the time to answer my questions. Given the information that you were given the initial diagnosis was the same as my surgeons when he saw the MRI. However, once we got into surgery the osteoarthritis was not as bad as shown on the MRI. The doctor was very surprised. He had also given me the running death sentence pre-surgery.
It’s always nice when the doctor is wrong!
I am not a doctor, so I do not know specifically what 1 through 4 mean.
However, I did have torn meniscus diagnosed this week 1 year ago. BTW, I was 43 and a lifetime athlete (Div 1 college football player, heavy wieghtlifting from age 14 to 36, and then triathlon) The first doctor (A non sports medicine guy) told me to rest and do nothing. I did this for a few weeks and found out swimming fine, biking fine, running NO! So I found out I had access tp one of the best Sports Medicine Doctors in the world, and we did surgery the second week of June last year. Day 1 after surgery 10 minutes on the bike trainer by Day 5 30 minutes on the bike trainer and I was running in a couple of weeks. By Sept I was back to speed, and raced a sprint tri.
So long story short find the best “Sports” Doctor you can, get it evaluated, if it needs to be clipped? Get it clipped and keep going with your sporting life.
Today, I can barely remember which knee it was.
Sheesh. You know people did take the time out to earnestly and honestly respond to you.
But in fact, they were “right” given the info that you presented at time. It is not fair, to call “wrong” based on results found after the fact. The info you originally presented for discussion was later found to be not as severe.
