Torn medial meniscus

[cjrich]

Hi all

Just found out I need arthroscopic surgery to repair a torn medial meniscus in my right knee. Happened playing soccer in December. Been riding with it without too much discomfort and doc says I can continue to ride, but atm I can't run, crouch or walk on uneven ground (bush walking).

Anyone here know how long the recovery might be and how long I may be off the bike after the surgery.

Cheers
CJ

[malnar]

I had a meniscus repair years ago & my leg was immobilised in a cast for 5 weeks to allow the repair to 'take'. They said there's very little blood flow in the meniscus so it takes ages to heal. This was about 15 years ago so procedures may be different. If they decide repair is not possible you should be on the bike in about a week/when the fluid disappears. Good luck.

[winstonw]

google it. there's heaps of info.
all depends on where and what type of tear it is. some are just cut and canned. others are stitched back onto the tibial plateau.
outcomes are variable. often the ACL, MCL, and cartilage have also been compromised.

just don't expect to go back to playing soccer or rugby and being bullet proof, no matter what your surgeon says.

[nathp]

Had mine done in the army, just a scrape and stitch. Made me walk back to the accommodation lines afterwards (about 500m) and was back in the gym slowly a few weeks later doing basic stuff no big load bearing for a month or so.

As stated all depends on what they do, take it slow and easy.

[fixedlegs2012]

Had mien done two years ago now, depends how bad the tear is, if its not too bad they can stich it back up if not then they will cut the torn bit off. With mine they cut the torn part off. I was in a cast for a week, crutches for 6 weeks, and physio for 3 months, twice a week. My tear drop part of your quadracep developed atrophy from non use, this took a long while before I was able to do squats again. 12 months and still wasn't 100%. I started swimming once the cast came off, non weight bearing exercises helped, also used a rubber band and did quad exercises. No alcohol either, alocohol doesnt help recovery time.

[cjrich]

Thanks for replying guys.

Hope I can get in to see the specialist soon, wanna get it fixed ASAP. Only been my GP so far and had an MRI last week. Did find an interesting video on YouTube which shows the actual arthrosopic procedure on a real patient.

I'm not in a health fund so will have to either fork out at least a couple of grand, or go in the waiting list.

At almost 45 years of age I guess my days of heavy impact sports are over, too much of these sports when I was younger is starting to take it toll. Time to start preserving the body i think, one of the reasons I took up cycling at 40. Funny thing is that this injury happened during a fun casual game of soccer with some work mates, but they are much younger and seem to get injured just as much.

Cheers
CJ

[scotto]

Couple of grand.... Lol
Maybe 10 years ago

[trailgumby]

I had a bucket handle tear in my right lateral meniscus. The "repair" was to gobble the torn bit out with some rotary chewy thing, I seriously regret having it done. As it turns out, it was ridiculously unnecessary, orthotics would have fixed the knee instability issues.

So beware orthopedic surgeons - to him with a hammer, every problem is a nail.

As to your question, figure on six months for full recovery. The stretching of your ligaments as they pull and stretch yoru knee and pump it full of fluid to make room for the rotary chewy thing to do its work takes awhile to be undone and go back to its usual tightness.

Movement in rotation was particularly problematic for me, I used to get sharp stabbing pains from time to time up until the six months mark when winding up to pivot the surfboard on the back fins when surfing. I didn't cycle back then. Twisting the knee to dismount from clipless pedals would have been a nightmare I suspect.

Explain your concerns to the carpenter and maybe get a second opinion. If the repair is a genuine repair (eg, rejoining the torn parts) instead of a removal and tidy up, I'd be more open to it, but otherwise it might just pay you to wait the six months and see what improvement you get naturally.

I might have the video floating around here still, somewhere, if you're interested. I only had the stomach to watch it once.

[trailgumby]

Time to start preserving the body i think, one of the reasons I took up cycling at 40. Funny thing is that this injury happened during a fun casual game of soccer with some work mates, but they are much younger and seem to get injured just as much.

One of the reasons I declined to join my local soccer club in the over-40s. They were a friendly and welcoming bunch. I was tempted.

Then I saw a match. Our guys were fine, played in the right spirit, although the braggadocio acceptance of injuries as part of the game I found a little disturbing.

But then I saw a couple of self-styled "hard nuts" in the opposition team were deliberately trying to take people out with rough tackles, and were not being restrained by their team mates nor the refs. If you didn't have the skill to avoid being taken down you were in trouble. I was disgusted by the attitude. No, thanks.

I was contracting back then. No work no pay. Not for me.

[cjrich]

Thanks trailgumby, as usual you're post is very informative.

Rang the specialist this morning to make an appointment, WHAT THE, 4 months before he can see me. Have asked my GP to refer me to another specialist.

[cjrich]

Well I had my knee operation 2 days ago. Ended up paying myself because didn't want to wait 18 months in the public system. Back to the docs next Thursday, hoping he'll say i can get on the trainer doing some easy spinning in a couple of weeks. Really hate not being able to ride, but gotta think long term.
CJ

[foo on patrol]

Thanks trailgumby, as usual you're post is very informative.

Rang the specialist this morning to make an appointment, WHAT THE, 4 months before he can see me. Have asked my GP to refer me to another specialist.

Isn't that crap?

Hope all works out well for you.

Foo

[Tokyochiq]

Well I had my knee operation 2 days ago. Ended up paying myself because didn't want to wait 18 months in the public system. Back to the docs next Thursday, hoping he'll say i can get on the trainer doing some easy spinning in a couple of weeks. Really hate not being able to ride, but gotta think long term.
CJ

Good to hear you've had it done. Had mine done a couple of years ago - if you're serious about your riding maybe even spend some cash on a few physio appts once you get the go ahead from the doc, always worth it to make sure you get full mobility and equal power distribution.

[moosterbounce]

Can you give us some more detail? What sort of tear, prognosis, rehab time etc? Realize this may be a little early in your "journey" but interested in what is said.

I'm speaking to my physio this week re referral to a knee man.

[eeksll]

I'd also be interested in recovery and rehab time.

My referred surgeon has suggested a wait and see .. but not to stop exercising unless it hurts. So i can still ride and run.

[Dr_Mutley]

I had a bucket handle tear in my right lateral meniscus. The "repair" was to gobble the torn bit out with some rotary chewy thing, I seriously regret having it done. As it turns out, it was ridiculously unnecessary, orthotics would have fixed the knee instability issues.

Can u explain the reasoning behind this, and how orthotics would've fixed your problem? Acute bucket handle tears of either meniscus are usually fairly resistant to any sort of remedy except surgical repair/removal. Chronic degenerative tears in the older population less so...

[lgbran]

Torn right cartilage in the 1980's.. quick easy recovery I was young lol managed to run 2 marathons with a dicky rolling leg action ( didn't do any physio).
Torn left knee cartilage in the late 1990's slower recovery managed 1 more marathon.. Discovered cycling 1999.
Over the years right leg pain now late 2013 looking at getting right hip resurface ( my right hip has been compensating for my right knee over the years).
I've been told I'll be able to run again after the hip resurfacing but will be grateful just to get a leg over the top tube and keep on riding pain free.
Wish I'd discovered cycling years ago instead of doing lots of long slow hard runs.
Your knees are never the same again.

[trailgumby]

I had a bucket handle tear in my right lateral meniscus. The "repair" was to gobble the torn bit out with some rotary chewy thing, I seriously regret having it done. As it turns out, it was ridiculously unnecessary, orthotics would have fixed the knee instability issues.

Can u explain the reasoning behind this, and how orthotics would've fixed your problem? Acute bucket handle tears of either meniscus are usually fairly resistant to any sort of remedy except surgical repair/removal. Chronic degenerative tears in the older population less so...

My presentation symptoms were:
* pain in right knee medial ligaments, often ocurring when walking up and down stairs repeatedly.
* unable to walk on uneven ground without right medial knee pain
* right knee locking up if kneeling and sitting on heels

Operation didn't fix any of those issues. Surgeon said he'd hoped the "repair" (see notes on what he *actually* did above) would resolve the knee instability.

What the real issue was is this:
* Foot pronates inwards under load
* Knee turns inward
* strain on medial ligaments

Getting orthotics stopped the foot pronating. The knee now folds in the correct axis. Knee pain resolved.

However, the orthotics were not helpful for cycling, as I have a varus forefoot, and the heels don't really come into play.

When I worked out I had a varus forefoot, installation of both shims supplied with the Specialized BG insoles stopped my knee swinging inwards, making it much easier to keep the knee in alignment with my ankle.

The third presentation symptom I avoid simply by not sitting on my heels.

Bear in mind my meniscus issues were a "bucket handle tear" of the lateral not the medial.

[winstonw]

I had a bucket handle tear in my right lateral meniscus. The "repair" was to gobble the torn bit out with some rotary chewy thing, I seriously regret having it done. As it turns out, it was ridiculously unnecessary, orthotics would have fixed the knee instability issues.

Can u explain the reasoning behind this, and how orthotics would've fixed your problem? Acute bucket handle tears of either meniscus are usually fairly resistant to any sort of remedy except surgical repair/removal. Chronic degenerative tears in the older population less so...

Getting orthotics stopped the foot pronating. The knee now folds in the correct axis. Knee pain resolved.

However, the orthotics were not helpful for cycling, as I have a varus forefoot, and the heels don't really come into play.

When I worked out I had a varus forefoot, installation of both shims supplied with the Specialized BG insoles stopped my knee swinging inwards, making it much easier to keep the knee in alignment with my ankle.

The third presentation symptom I avoid simply by not sitting on my heels.

Bear in mind my meniscus issues were a "bucket handle tear" of the lateral not the medial.

...and this is a presentation I see time and time again, day after day....though because I don't "sell" myself as a bike guru, many cyclists take more note of Cycling's super coaches, who don't 'believe' in varus wedges. incidentally, the medial mensicus usually cops a beating with varus forefoot (forefoot pronation, excessive tibial internal rotation), in addition to exacerbating ITB friction band syndrome, superficial peroneal nerve irritation, and subluxed fibula head or lateral malleolus, general peroneal mm tendonitis, and MT5 base chronic pain.

nevertheless, I attended a MRI dinner/workshop last night where a well respected orthopod held the floor. In his humble opinion, moderate to severe lateral meniscus bucket tears have a very poor prognosis if not repaired (the lateral compartment cartilage degenerates at an astounding rate). though from the sounds of your op, you didn't have a "repair".

btw, I am a genuine admirer of Specialized's BG efforts.

[trailgumby]

btw, I am a genuine admirer of Specialized's BG efforts.

Myself as well. Hopefully they will continue to develop this as a niche for themselves, based on sound research. They deserve the rewards. Hopefully they will avoid the temptation to descend into a war of marketing spin in future years when others observe their success and try to join the bandwagon.

[Dr_Mutley]

btw, I am a genuine admirer of Specialized's BG efforts.

Apparently they are terrible because of the material challenge principle? Lol

I've got the Spec BG green insoles in my sidis and have found them cheaper, and streets ahead of esoles or G8s

[moosterbounce]

Permission to hijack thread

Got my MRI results yesterday. Oblique tear in medial meniscus in posterior horn and body associated with relatively large parameniscal cyst. Mild patella chondral degeneration too which I don't think is related. All other bits fine

Anyway, see surgeon in August and I'm guessing that because cyst is on the large side and that I can't manage a full trip round the isles at Coles without being in eye watering pain (and that's not pushing the trolley - that's heaps worse!!), that surgery will be my only option.

From what I've read, I'm above average - only 5% or so of tears get a cyst. These average 0.3-7mm. I'm just over 20mm.

I am finding the wait frustrating. I want to know what needs doing and start working out my recovery strategy. Also finding it difficult to curb "regular exercise eating habits"

[Crunchy_NuT]

I just made a trek to Geelong for a meeting with the specialist for the same reason - my pain is there but only if I really give my knee the hard yards and sometimes pain will flame up and be intense for a week or so -- last time was the reason I got onto something with the doctors as it was the worst I have ever had pain wise

long story short, the surgery is only a lifestyle thing eg. pain relief -- will not magically make my knee better as such, purely relief...so I've decided to hold off for now until my flare up's get more common, just glad that private health is on my side being able to pick and choose my timings

we wont go into how I was told my knee is stuffed and will likely need a replacement in my twilight years

[moosterbounce]

That's bad news Crunchy. Mine isn't stuffed, but my doc thinks it's been knackered for a while. He's got me on crutches to stop further damage, but only when it's bad (similar flare ups to you) or I need to walk more than 200m. My flare ups come at about 500m unfortunately. He says these are probably caused by something moving which apart from not being normal, may chip other bits. That said, he's only read the MRI report and isn't a knee guru. I trust him though so swimming only and using the crutches.

Apart from the mental trauma of a knee replacement, they are brilliant these days. Dad was telling me tonight about a mate in his 70s who had it done 6 weeks ago. No limp now and had been back on the golf course. Sometimes I think the larger things are easier for healing and fixing than the littlE ones.

Good luck with your management strategy

[Crunchy_NuT]

You got the disc with your images on it? I wouldn't mind seeing an image or two, you sound like you're more advanced in the pain department than I am