Torn meniscus (medial, at root)

Triathlon Forum
1

ST docs (and/or formerly injured people):

hurt my knee skiing last week. just got MRI results/diagnosis today. the wording in the MRI report is as follows:

“complex tear of the posterior horn of the medial meniscus at the root attachment.”

i’ve had a couple of doctor friends say that because of the root involvement, this will probably require surgery. i’m working with a doctor and talking to a surgeon locally as well; just trying to get as much input as possible. any thoughts on surgery, recovery time (back to full training, not just walking around), etc.? anyone else had a similar injury? aside from the meniscus, there’s no ligament damage, just some bruised bones and a strained popliteus.

thanks!

2

I’ve torn the meniscus in both my knees (separate occasions). Both required surgery. First time I went to the surgeon that did my brother’s meniscus and it came out great. They did a trim-job as opposed to trying to repair the meniscus. I was doing PT before the surgery and my recovery time was ~4-6 weeks until I was running/swimming. Did my first sprint tri about 5 months after surgery.

Second time I went to a different surgeon since I wasn’t living in the area anymore and the results were less than great. This one was supposed to be a repair. I either re-torn it or it didn’t heal right, but I still get minor to moderate pain when running. I only did PT post-op this time around.

Moral of the story, find a surgeon that is very good and doesn’t try to repair it. The first surgeon had told me that repairing the meniscus is basically pointless. I think he’s right…

3

thanks. what part did you tear? i’ve been told tearing it at the root can make things a bit tricky.

4

I had surgery last Friday to repair a major lateral and medial meniscus tear and I also had laser repair treatment on the underside of my patella bone. The tears were believed as a result of a bike crash I had last year while racing, where it was believed that I had ‘only’ fractured my L1 vertebrae clean in half. However upon later discussion it also appeared that I had possibly damaged one of the meniscus in the accident too and then as a result due to a change in my gait it had resulted it further damage on the other side of my left knee.

As I said I had the op last Friday and so far the swelling has gone down super quickly and I am able to put weight on it even through I was told not to weight bear. I had compression bandages on for the first 24 hours and then they were removed there were 3 stitches which were covered with small dressings that I can shower with.

The operation was no problems about an 45mins) and I didn’t know anything about it - slept like baby. I did however have stay in over night afterwards due to there being more damage than they expected as it didn’t show up on the MRI. I have been prescribed anti-inflams, antibiotics and anti blood clotting drugs. As from today (4 days after op) I am starting with some very easy resistance band work and I’ll be using my Compex machine in order to stop atrophy. I have an appointment this coming Monday to have the stitches removed and then I hope to get the green light to enter the pool for some running and swimming (with a pull buoy).

Obviously it is too early to say whether it has fully worked yet, but the one thing that has been very clear is that, this wasn’t going to heal on its own (meniscus’ have a notoriously bad blood supply) and surgery for me was the only option. I had been dealing with this injury since last September and I had not realised how bad the pain was every moment of the day, until Saturday morning, the morning after the surgery when I woke to no pain at all and since I am pleased to report the same.

Hopefully I will be running again and being a Star Wars geek (sorry) I’m aiming at the Singapore SW easy effort 4.5km fun run in early May with my wife. After that who knows, but it’ll be just be great to run again, as I really thought my days of lacing up my runners and heading out door were over.

Finger crossed and thank you so far to my doctor who helped me.

I hope you get sorted soon.

Ed

5

Honestly, I’m not sure. I know it was on the inside of both knees, but beyond that I haven’t a clue. I would imagine tearing it at the root makes the tear harder to get to.

6

Glad to hear you’re recovering quickly! I was actually studying abroad in Singapore for the recovery from my first surgery. I think the heat/humidity definitely helped to speed things up.

Question: What was the laser repair treatment for? Was that a separate injury?

7

Search this forum for past post about torn meniscus treatment. Opinion on surgery vs. non surgery treatment is mixed.

I have a tear and so far have used strength exercises especially strengthening the vastus muscle to keep it at bay.

At age 45 I’m going to hold off as long as possible before I go under the knife.

Mine gets sore but it isnt locking out or giving out. When mechanically it starts to effect my life, I’ll reconsider the knife.

Good luck!

Gall

8

ST docs (and/or formerly injured people):

hurt my knee skiing last week. just got MRI results/diagnosis today. the wording in the MRI report is as follows:

“complex tear of the posterior horn of the medial meniscus at the root attachment.”

i’ve had a couple of doctor friends say that because of the root involvement, this will probably require surgery. i’m working with a doctor and talking to a surgeon locally as well; just trying to get as much input as possible. any thoughts on surgery, recovery time (back to full training, not just walking around), etc.? anyone else had a similar injury? aside from the meniscus, there’s no ligament damage, just some bruised bones and a strained popliteus.

thanks!

I hate to say it, but your injury is too complicated to get a true assessment here on Slowtwitch. I’ve have a ton of knee troubles/injuries and truly everyone is different. People will tell you “oh yea, I had torn meniscus and never did anything and it’s great”. Others will say they couldn’t run at all with a meniscus tear. It’s sort of like having two people tear up a newspaper and then compare how each newspaper tore, where it was torn, etc. Recovery times vary because it’s impossible to know what else might be damages.

In my case, I had a major reconstruction which included a prominent medial meniscus bucket-handle tear back in 2011. It was repaired at the time (despite what was previously stated, it was not simply a “waste”. My tear was in “the red” and worthwhile trying to repair–as meniscus cushion is always better than no meniscus). In October, the repair failed and I literally could not run at all. The medial meniscus was torn prominantly, again, although my ACL/MCL were still intact and holding fine. I could walk quickly all I wanted, bike, etc. But running was 100% out of the question. I had surgery on 1/3/2017 to remove the meniscus tear. Doc says that the tear was flapped up under the joint somehow which caused the tremendous pain I felt when trying to run. It would not get better on it’s own.

Additionally, there was quite a bit of other cleanup done during this procedure and I have significant wear in my patellofemoral groove and femoral condyle (sort of going by memory since I don’t have my doc notes in front of me). Long story short, as of Tuesday, I still can’t run for another 5 weeks. I feel fine. My meniscus tear is over and done. But doc is pushing me to refrain from any high impact exercise until mid-march as things continue to heal from his clean up. It’s a very long and frustrating situation for me, as I’ve planned to be running again only a few weeks after surgery.

I am just sharing my situation with you. Everyone is different. My original injury happened in a tackle football injury. I would guess skiing accidents can create all sorts of knee trauma too.

BTW, I’m signed up for IMChoo, so I absolutely plan to be back to full training sooner rather than later…but the timetable is still a bit uncertain.

9

I hate to say it, but your injury is too complicated to get a true assessment here on Slowtwitch. I’ve have a ton of knee troubles/injuries and truly everyone is different. People will tell you “oh yea, I had torn meniscus and never did anything and it’s great”. Others will say they couldn’t run at all with a meniscus tear. It’s sort of like having two people tear up a newspaper and then compare how each newspaper tore, where it was torn, etc. Recovery times vary because it’s impossible to know what else might be damages.

i pretty much figured this, and i’m not relying on ST for any kind of diagnosis or real medical advice. talking to docs/surgeons for that. i was mostly curious if anyone else had dealt with a root tear specifically, just to get a rough sense of what i might be dealing with.

I am just sharing my situation with you. Everyone is different. My original injury happened in a tackle football injury. I would guess skiing accidents can create all sorts of knee trauma too.

of course, understood. hope your knee holds up better going forward. and yeah - i also bruised some bones (“minimal impaction fracture”) and strained a muscle. fun stuff.

10

Glad to hear you’re recovering quickly! I was actually studying abroad in Singapore for the recovery from my first surgery. I think the heat/humidity definitely helped to speed things up.

Question: What was the laser repair treatment for? Was that a separate injury?

The laser surgery was for patellofemoral groove clear up from a touch of early onset arthritis

11

good luck… I’ve done a few 5Ks since mine (and ACL/MCL) but they have not been painless/soreless. I do plan to try a few sprint tri’s this spring and summer and see how it goes.

12

good luck… I’ve done a few 5Ks since mine (and ACL/MCL) but they have not been painless/soreless. I do plan to try a few sprint tri’s this spring and summer and see how it goes.

how long ago was your op?

13

good luck… I’ve done a few 5Ks since mine (and ACL/MCL) but they have not been painless/soreless. I do plan to try a few sprint tri’s this spring and summer and see how it goes.

how long ago was your op? 3+ years I’m mostly a cyclist only now, but have been doing tri’s since the late 80’s… I kinda miss them.

14

I’ve just been diagnosed with medial posterior meniscus root tear and femoral condyle fracture (probably due to the root tear). I won’t get to see the ortho Dr. until August.
I was told that surgery is likely. Could you please give an update of your course of treatment (surgery, non surgery) and the outcome if any. Thank you!

15

Not th OP but I just had meniscus surgery in mid June and I’m back to training already. Highly suggest doing pre-hab to strengthen the muscles so that recovery is quick and easy.

16

I’ve just been diagnosed with medial posterior meniscus root tear and femoral condyle fracture (probably due to the root tear). I won’t get to see the ortho Dr. until August.
I was told that surgery is likely. Could you please give an update of your course of treatment (surgery, non surgery) and the outcome if any. Thank you!

i forgot about this post. sorry to hear about your injury, and happy to give an update on mine.

i consulted with three surgeons - two of whom are probably among the best knee surgeons in the country - and all basically said the same thing: if you’re young and/or active, and if your knee is pretty healthy (aside from the injury), you really don’t have a choice. a torn root is functionally equivalent to not having a meniscus at all, and if you don’t fix it, the joint will deteriorate and there’s a good chance you’ll need a knee replacement.

i had surgery in the middle of february. surgeon said the procedure went well. my only complication was that a nerve running past the knee/across the shin was somehow irritated by the procedure (possibly by the suture anchor in the tibia), which made it very hard/painful to move my lower leg for a while, but that’s not typical, and it’s mostly gone now. expect lots of PT. at first, it was just getting range of motion back, and once that was close to normal, we started working on strength and stability. started run/walk progression about three weeks ago, but i haven’t gotten too far with that; any amount of running/hopping/whatever is still pretty painful. i have a follow up with the surgeon on monday for a full evaluation, so i’ll see what he thinks about that.

the basic timeline is 6 weeks on crutches and about 6 months to return to full activity. i was in the pool less than 4 weeks after surgery (as soon as the incisions healed completely). no kicking (pull buoy only), doing open turns, only pushing off the wall with my right foot (or doing a lot of 25s). a week later, i added a little pool walking to prep for returning to weight bearing. when i started to wean off crutches at the 6-week mark (a process that took another 1-2 weeks), they let me start spinning on a stationary bike, starting with no resistance and building very gradually. flip turns came back around the same time, but carefully, still just pushing off the good leg. treadmill walking started at 7 weeks. from there until 16 weeks, it’s just a gradual progression of strength exercises, bike resistance, elliptical, stair climber, etc…surgeon and PT will guide you.

so…summary: tomorrow will have been 20 weeks since surgery. i can swim as much as i want, and my swimming has definitely improved. i still can’t really run. i can start riding outside tomorrow (just been on the trainer so far), but no clipless pedals, standing, or big climbs for a couple more weeks. it’s a slow process, but theoretically, i should eventually get back to almost 100%.

you said you got a diagnosis, but won’t see ortho doc until august. who diagnosed you? you don’t want to be stressing your knee much without a functional meniscus, so you should see someone - and, if necessary, schedule surgery - as soon as possible.

let me know if you have any other questions, and best of luck!

17

Hell I’ll update too…

did first sprint tri a couple weeks back… no pain but I walked a bit as the terrain was rolling trail (walked downhills for fear of loose footing). Had a soft brace on and felt ok overall. Got on the GameReady ice machine when I got home and very little soreness. Much less then running 5Ks and not getting on the GR anyways. Looking into getting a light/comfy medial offloader to hopefully feel a little more confident on the run and I’m going to try some On Cloud shoes as well.

I’m 3+ years post op… and became primarily a cyclist but trying to get back in. Hoping to do olympic distance one day… half and full days are done.

18

Thank you for your reply. Actually I did see an ortho Dr. thus the MRI and the diagnosis.
In August (earliest available appt) when I’ll see another ortho Dr. to get a 2nd opinion and the one I would like to do the surgery. So yours is a full repair not a partial menisectomy, correct? Sounds like a long road to recovery. Best wishes for a speedy recovery.

19

well, yes, although technically it was both. the main procedure was a repair of the medial posterior root, which was torn pretty much entirely off the tibia. i also had a tear in the body of the meniscus, so he had to remove a bit of material around that.

i’m sure it varies, but yeah, it definitely takes a while. the recovery/PT timeline is pretty strict. it’s a new enough procedure that i don’t think they have a lot of data on outcomes, but generally, return to full activity is expected (eventually).

thanks, and same to you.

20

Research is saying “scopes” and “clean ups” aren’t as effective as we thought they were. More orthos are taking a wait and see approach and turning to conservative management these days. Of course you can find a doc to cut on you. Do your due diligence first.