anyone have a meniscus REPAIR?

[3wing]

My tear was around 1.5 inches around the exterior of my left medial meniscus - it looked pretty bad on the MRI and the scope - but I don't have anything to compare it to.

I definitely have been keeping the leg raised above the heart and have been taking it easy. I also have been taking 800 mg of ibuprofen every 8 hours to help as an anti-inflammatory.

Thanks for the kind thoughts - same to you as we all go through this fun process of PT!

[upallnight]

3wing...just read your blog -- did you actually have a buckethandle tear that didn't flip? lucky!

mine flipped....pain was brutal and there is no way that i could have gone more than the 16h i lasted between time of injury & surgery.

yikes!

[altagirl]

3wing...just read your blog -- did you actually have a buckethandle tear that didn't flip? lucky!

mine flipped....pain was brutal and there is no way that i could have gone more than the 16h i lasted between time of injury & surgery.

yikes!

Oh sure you can. Do it on a Saturday afternoon so you can't possibly see a surgeon until Monday. You just sit and try not to move at all for 3 days straight.

[upallnight]

Oh sure you can. Do it on a Saturday afternoon so you can't possibly see a surgeon until Monday. You just sit and try not to move at all for 3 days straight.

True....'cept my fiancee was out of town, pretty much all of my friends were either in Moab, AK, or just out of dodge...and I had one puppy (who happened to be sick at the time) going nuts....

I was out of options!

<all the above is true>

[3wing]

ended up not being a bucket handle tear - just a long medial tear. Lucky me by the sounds of your experiences!!

My first PT appt isn't until this coming Monday - anything I can be doing in the meantime to help my knee between now and then? I'm already doing leg raises, heel slides, and flexing it with my ankle on a rolled towel.

Thanks!!

[upallnight]

ended up not being a bucket handle tear - just a long medial tear. Lucky me by the sounds of your experiences!!

My first PT appt isn't until this coming Monday - anything I can be doing in the meantime to help my knee between now and then? I'm already doing leg raises, heel slides, and flexing it with my ankle on a rolled towel.

Thanks!!

Like I said above, get the swelling down as much as possible...that is the total key.

You have better ROM than I did, so some of the stretches I had to do may be way less than you need.

Most of all.....TAKE IT EASY with stuff. It's super-easy to overdo it, apparently, with meniscus repairs.

Seems like you can't go wrong with:
1) Flexing your quads as much as possible
2) Pumping your calves
3) Tracing the alphabet with your toes
4) laying with your back on the ground and leg propped up against a wall (good for reducing swelling)...and letting the weight of your leg gradually bring your knee toward your chest with your heel still on the wall.

I'm not going to say to do any more as it may or may not be counterproductive...but in my extreme case of limited mobility, those were all good (after long conversations with my PT), so I'd say that will not have a negative affect for you.

Maybe you could call your PT and find out what you can do to prepare? I really wouldn't do too much without professional guidance.

Good luck! I'm sure you're going to be fine and ahead of me in recovery.

[upallnight]

Oh...one more thing for ya...

pretty much every exercise has me flex the quad before moving the leg in a straight position. Keep that in mind when you are, say, getting up out of a chair with your leg elevated (i.e., lowering it to the floor from the elevated position).

[upallnight]

Update:
3 weeks + 1 day post-op & 5th day after starting PT -- was able to make a full rotation on the bike today, and I'm psyched. (For a few days, I had been pedaling back and forth until hitting the limit at either end.)

I felt like this was a big step....felt like I could get into a rhythm and get some fluid moving out & blood pumping in my knee.

I wasn't able to measure it, but later in the session I felt lik I was getting about 0-110 ROM.

[upallnight]

1 month post-op (yesterday) I took my 1st step w/o crutches.
Next day (today) i walked a mile on the treadmill w/o crutches or holding the handrail.

Small steps!

[bobbert]

Hi upallnight. I was hoping you could up date us on your progress. I had my
medial meniscus (bucket handle tear) repaired 10 days ago. There was also
some cutting and removal of the lateral meniscus.

Thanks!

[upallnight]

Hey, bobbert--
Well, let's see...I'm at 7 weeks post-op. I had some setbacks, but I think I'm back on-track.

At 1 mo, my doctor cleared me to get off crutches as soon as I could. Within 2 days, I was able to walk 1 mile on the treadmill without holding on (took me 1 hour!!). I was working on PT at least 2-3h/day. Unfortunately, this coincided with a business trip to Arizona, so I was stuck sitting around for long periods (and unable to elevate + ice).

Basically, I pushed it a bit too hard. My phys therapist's thinking is that athletic individuals have a "line". If you push right up to this line, you are a little sore, but the soreness goes away before the next day. If you push over the line, you need to taper off.

Well, I definitely pushed over the line (as is not uncommon with such an approach -- it's hard to *always* get it right). Had to go back to crutches to give my knee a break. Also, there was a miscommunication between my doctor & the phys therapist. Due to the location of the repair (closer to the anterior side of the meniscus), the doc did not want me to do any weight-bearing with the leg bent beyond 45* -- for 3 months. I had been doing some weight-bearing to about 60* for a week before we got this news. Ugh.

After a week of this "rest" (crutches, continued light exercise + all the cycling I can do) -- and being depressed/worried that the miscommunication might have lead to damage --I seem to be back on the upswing again.

I'm off crutches, but I'm super-diligent about wrapping the knee after activity (to reduce swelling), and icing/elevating.

ROM seems good. The doc says that 0-120 ROM is "normal" after 2 months. I'm pretty close to it with another 10 days to go.

If I had just one piece of advice to give, it would be to *be patient*. That is probably the biggest challenge I've had to deal with during this process. It's not my forte.

After my setbacks, I'm more aware that just because the knee feels good and capable of "just a bit more", there's no reason to push it. I work out every day, so there's always tomorrow for a little more progress. (This is not to say to be lazy -- be diligent, but not "aggressive".)

If you've read this whole thread, you know my thoughts on doing everything possible to stay off your leg & get swelling down during those initial weeks.

If you have a posterior injury, you can progress toward weight-bearing a bit sooner. Another complication for me (in addition to the anterior-thang) was that my repair was a rather "delicate" one. (I am told that some are less delicate if they occur in areas with a bit better blood flow.)

Take it slow -- small steps. Let your body guide you in the process -- be sure to give it 24h to respond to what you're doing to see if there are any residual effects even if something doesn't bother you while in the moment.

My doc initially told me I'd have a "full recovery in 3 months", but my PT says that, realistically, I won't be climbing hard again for 5-6 months. I think the reason for the discrepancy is that the doctor's "full recovery" simply means that 3 months is the end of the protective phase for meniscus repairs. You are *allowed* to do everything, but that doesn't mean you *can* do everything.

Good luck with your recovery.

I hope at least some of this was helpful for you. Let us know how you do and feel free to PM if you have some questions that you would rather not post.

[bobbert]

Hi up
I tried to IM you but your space is maxed out. Could you please clear out some old messages or IM me your e-mail address?

Thanks
Bob

[upallnight]

All set, Bob. Sorry...keep hitting the 70 message limit.

[upallnight]

So...I'm a week shy of 3 months post-op, and I've been able to bike outdoors on relatively level, paved roads...moving up to 25 miles/day (on a mountain bike, per my doc's request).

That said, I have pain when doing certain weight-bearing activities to increase my quad strength -- even in the "safe" range (the doc limited my weight-bearing bending to 45*).

My phys therapist is concerned, as am I. I'm bring everyone together for a meeting on Monday. I'm concerned that another surgery may need to be done to see what is going on, as my progress has been minimal lately...and I work extremely hard at therapy daily and follow instructions of the doc & therapist explicitly.

Argh. Recovery from this has been very slow & painful, but the frustrating thing is the "not knowing" element. I'm told by my doc that pain does not necessarily mean the repair is not working, nor does the absence of pain mean it's healing. (There are no nerves in the meniscus.)

Hard to wake up daily and be 100% upbeat and optimistic/ready to go at the rehab when you get no feedback and I am unable to correlate pain I do experience to any activity.



Just venting a bit. Hope things turn out surprisingly well for me on Monday.

[upallnight]

I may be talking to myself here, but I'm hoping that by documenting these steps and my thoughts, it may give someone else guidance with their recovery.

I'm a few days short of 3 months post-op. Today, the doc cleared me to "sensibly" resume all activity.

I told him that I would give up tennis/basketball/soccer (sports involving lots of sharp cutting) if I could return to skiing & climbing at a high level.

He had no explanation for the limiting pain that I have been experiencing, but he said that there is no point at this stage to continuing to limit my activity. Chances are, I will experience some pain and swelling as I try to work through that zone, and if it doesn't get any better in the next 3 weeks, I need to go back and deal with a stronger chance that the repair did not work.

(They would inject something into the joint to try to see if the pain was coming from the tissue, and if it is, then it's back to the OR for me so we can take care of the problem (tissue removal) before we get any closer to the next ski season.)

He did say it would likely take another year before I could no longer tell which one was the injured knee.

So...I feel like today's appointment was a mixed bag. Effectively, it was "We don't know if anything is still wrong, but go out there and test it. You'll know if it tears again."

Don't think I'll be going to S. America to ski this summer; I wouldn't want to be far away from home for my first on-snow test.

I'm pumped up to try to work through the limiting pain; I do hope the repair worked, and that this is just something to work through, as opposed to a sign that I need a meniscectomy (*especially* after all the pain and hard work associated with the repair).

[LeeLau]

Pulling for you bud. Getting old suxor

[upallnight]

Thanks, Lee!

I'm pretty inspired by some folks I know who are older than me and, yet, still getting better/still on the upswing. A buddy who celebrated his 42nd birthday is working on breaking into 5.14 climbing...damn impressive!

I definitely feel I'm a long way from my peak (and hoping it's still ahead of me, not far away in the other direction. )

[Tyrone Shoelaces]

Just finished reading this UAN....best of luck with this. Knees freaking blow....

I have a feeling I'll be going through this again someday as when I got my ACL fixed in Nov. '04, my ortho said that I had a *slight* medial meniscus tear as well. But at the time, he felt that it wasn't serious enough to anything with it at the time. So he just said, "let it be, and come back in and see if it ever starts bothering you and I'll snip it and clean it up". Ughhh...whatever that means. With my level of activity, I know its just a matter of time before I'm back in there [/keepingfingerscrossed]

Anyway, best of luck on the rehab, keep at it, keep getting outside at least, and keep bloggin your experiences here...it definitely helps others. (and helps ya vent too)

[upallnight]

Thanks TS...

For what it's worth, I've read that the success rate of meniscus repairs when coupled with an ACL reconstruction is much higher than that of a straight up meniscus tear.

If the doc only has to do a partial menisectomy for you (I hope they don't have to do anything and that all is OK), the good news is that you are down for a *very* minimal period of time. Some folks walk out of the OR, from what I hear.

That is what I face if they have to go back in to do a 2nd surgery.

The smaller the amount of tissue they remove, the better in the long-term, of course (reduced chance of osteoarthritis).

Thanks for the kind words.

I'm going back in to rehab in a few minutes and am ready to work harder than ever to get this thing figured out. Either I heal or it tears, and if I can just flush out the situation and *know* one way or the other, I can then move on with my life instead of have it be consumed with working hard but wondering if there is a point.

Off to the gym...then for a long bike ride.

[upallnight]

just had a very POSITIVE phys therapy session/workout. i've decided that i AM healed and that there may be pain/discomfort/etc., but i'm going to work through it (just as it was very difficult to work through getting 10 degrees of motion post-op).

i bet the whole world will change when i regain 2 weeks' worth of strength, and the challenges i'll face at that time will make these seem easy.

and if that turns out not to be the case, well, i'll deal will those options as they arise.

no more uncertainty!

(trying "mind over matter" here.... )

[upallnight]

The "believing I am healed" thing is working.

In the last 6 days since my "all-clear" from the doc, I wound up doing a couple MTB rides (~3,000 feet of climbing on 12-15 mile rides), did some easy 1 pitch climbs as well as a half-day climb in the mountains (baxter's pinnacle, for those who know the tetons), a couple hikes, and had 2 solid gym workouts (along with daily at-home strengthening).

Things are looking and feeling good...but if it blows out, better to find out now than closer to ski season.

[beaterdit]

Sounds like you're doing pretty well UAN. I'm encouraged hearing about your difficulties because I'm going through the same thing right now.
I'm nine weeks out of ACL/meniscus repair. I've been walking and road riding for three and I'm up to about 120 miles a weeks on relatively flat roads.
Ever since the first week of walking/riding I've been having episodes of random severe posterior joint line pain (my meniscus repair is medial posterior) associated with movement and/or weight bearing. I've been communicating with my Doc and he and my PT don't seem too concerned, both think pain is normal. I'm stressed because of the severity and quality of the pain (it's like a knife) and I'm concerned that the meniscus repair didn't take or whatever.
Doc says I'm hitting it real hard for nine weeks and some pain is inevitable. He told me not to back off though as long as I listen to my body and keep improving. I know ups and downs are normal but he says the only way to really tell if everything's kosh with the meniscus repair is another scope, at which time the Doc'll remove it if it didn't take and it's definitely way premature for something like that.
My most severe 'incidents' have happened in PT while associated with lateral strength and stability exercises, so now we're just trying to take it easy and not irritate anything. Not only am I starting to worry about my ski season at this point but I can't start my new job if my knee's jacked up so everything's kind of in limbo right now. Frustrating. Anyway, hopefully this is just a bump in the road.
Good luck!

edited for spelling and clarity

[upallnight]

Good luck, foxy!

I've not had an ACL issue, so I can't give any advice there -- but be careful with your meniscus repair. Sounds like you are about 2 months out and it's a posterior repair, so you should generally be OK with it. Just don't rush things.

Apparently, there is something they can inject into the joint to help determine if the meniscus repair did not work -- so you don't necessarily have to get it scoped. However, it sounds like you're more concerned about the ACL graft if I read correctly.

I'll have my fingers crossed for you.

I've been getting stronger every day, and I just did a MTB ride last night (~15 miles w/ 3,500' of climbing in the first 6 miles) in 30 minutes less than it took me just 5 days ago.

I'm going to be a porter for a friend's clients this weekend...hiking up nearly 5,000' vert over 6.5 miles w/ 50+ pounds of their gear. Should be a good test!

[beaterdit]

Whoa!
Yeah that'll be a good test all right.
I'ts actually the meniscus repair I'm concerned about, my new ACL is good to go. I think my problems are muscular now though, and things are improving. Hopefully they'll continue to do so.

Good luck portering.

I wish I could mountainbike.

[upallnight]

Whoa!
Yeah that'll be a good test all right.
I'ts actually the meniscus repair I'm concerned about, my new ACL is good to go. I think my problems are muscular now though, and things are improving. Hopefully they'll continue to do so.

hey, foxy... sorry, your mention of the failure of the 'graft' confused me. did you somehow have a meniscus graft? (i -- perhaps mistakenly -- associate 'grafting' with the ACL.)

ask your doctor about a non-surgically-invasive way to test the meniscus repair. as you probably ascertained from my posts, i was not in great shape for the first three (protective) months. the doctor then said to go test it out and if i still had major problems over the next 3 weeks (=nearly 4 months post-op), then come see him for the injection/test, which would indicate the need to go back in -- not just for a scope but for another attempt at repair or a removal.

what i'm trying to say, though, is to be patient.

i also learned that the restrictions my doctor placed on me during the protective phase had a big mental impact. i often wondered whether the sensations i was feeling meant the repair was tearing out. when the doc told me it "was as healed as it would ever be", i had a mental shift. where i had previously backed off of pain, i said to myself, 'OK... when you get to the pain, work through it -- there's no damage you can do.'

that did wonders. i can tolerate pain, but i learned that the combination of pain + being in a state of unknown healing was difficult to bear.

now, i figure that i can work through the pain (sensibly), and if i suffer an injury, well...i'm just uncovering something sooner that i would have discovered eventually.

Good luck portering.

thanks...should be fun. normally, that hike is not a big deal (it's the approach to our climbs), but the rehab element ups the ante. getting a little scratch to do my rehab ain't that bad.

I wish I could mountainbike.

soon enough! not sure how the ACL factors in, but my doc cleared me to ride a MTB outside, on level pavement at the 2 mo mark.

the posterior injury *should* have a better chance of healing, and also (statistically) meniscus repairs combined with ACL repairs have a much better track record of healing properly.


Hey, foxy--