Meniscal Repair - Success or Failure??

[danfitz06]

Hi There,
I had my right medial meniscus repaired Sept 28th and am approaching my 3 month mark.

I am still experiencing pain and am concerned that the repair was not successful.

I was immobilized after the surgery for 2 weeks.
Then in a brace at 45 degrees and later to 90 degrees range of motion.
I am still am in the brace, though I expected to be able to ditch it in mid December.

After the surgery, I was on crutches with the immobilizer and brace for a total of 7 weeks in total before being weened of the crutches for short walks etc.

I thought that I was making progress and even had two fairly good PT sessions in my 4th week of therapy but then suffered a setback. I requested a special appt from the doc whereupon he informed me that the repair has not yet healed.

He does not think that the repair is ruptured or torn but instructed me to be more careful with the injury.

Is 3 months a long time to not be feeling like I'm on the right track? I'm 30, I used to play sports and cycle and box and now I'm superdiscouraged.

I feel significantly worse than I did before the surgery and cannot get around nearly as well I did.

Thanks for any advice you can offer.

DF

[Nettan]

Have any Mri been done to confirm if it still holds ?
Meniscusrepair take time to heal and you have to be careful after, so it doesn't have to be the worst.
Hope it's a success.

HUGS NETTAN 

[danfitz06]

Thanks for your reply Nettan -
The doc suggested that an MRI would only show the same as before the surgery so he does not thing this will tell us much.

What he did mention was going in arthroscopically to see if the repair was still good.

Other than that, he said to take it easy on the repair, continue with physical therapy until the end of January. I've taken a week off between Christmas and New Years, and am trying to ice and relax as much as I can during my down time out of respect for the repair.

Thanks,
Dan

[jb-knee-geek]

hi danfit, that sounds about right. An MRI may show some confusing results since the meniscus has been recently operated on. MRI is a good diagnostic for many things but for meniscus damage it's not 100%

Seems like them poking around may be the only method to know for sure.

what did he say about the 3 month mark for the repair being "successful"?

keep us posted and good luck.

[danfitz06]

Thanks again for the feedback and support.

The doc indicated that sometimes it can take a long time for the heal. But didn't get into specifics about whether or not I should be completely healed by 3 months. Just that it wasn't healed yet.

I just had a physical therapy session tonight and the doc passed along via the therapist that he thought we were on the right track. And my pt person actually introduced a new activity (stepping up on a stool - which is something I had not done since prior to surgery).

I'm hoping that's a vote of confidence that I am indeed on the right track. I felt a little discomfort but nothing major. So I was happy with tonight's session.

I also just bought 10 visits to a pool so I can do some water therapy, that will hopefully be of some benefit.

[Pile]

hi DF!

i had the same surgery on sept. 15....i still feel the odd bit of pain/discomfort since the surgery, mostly on the side that the tear/repair had occurred, but nothing that worries me too much.  one afternoon recently my cat decided to step out in front of me as i was walking down the hall and i bent my knee very quickly...felt a horrible pain, like a really intense burning sensation...i was terrified that i had 'undone' something that the surgery had fixed.  luckily the pain didn't last long and i didn't experience any major swelling or anything.  i think it was just the shock to the joint being bent further than it had in awhile.

my physio is progressing well also...i'm getting my range of motion back quicker than i thought i would --- can straighten my leg almost fully and am working hard on the bending part which has been a bit more difficult    just working hard on getting my muscle strength back as well.  my understanding is that it is up to 6 months until things may be back to "normal" so i'm just taking it all very slowly.

sounds like you are doing everything right! 

take care and good luck with your rehab!

Jane

[alwayssky]

I had a meniscus repair (yes, a repair) in May and was off crutches after 4 weeks of being non-weight bearing.  By August, my knee was good as new.  I had no pain until I fell on it in late August.  I'm surprised that yours isn't healed yet.

[fireftr]

I had my medial meniscus repaired on Aug 23rd after being immobilized with a tibial plateau fracture for 8 weeks. I started therapy right after surgery and it was very slow going at first because of the muscle atrophy but then I started to get stronger every week. It's been 4 months and it still hurts, it's still swollen, I have this weird lump under my quad tendon that hurts and most of the pain is behind my knee. My range of motion was coming back right on track until about a month ago and then it started to get tougher to straighten it. I can get to zero but it takes forever, especially after I'm sitting for more than a few minutes. And my knee overall just feels stiff, I don't know if the repair failed or not but I get some popping sounds coming from it. I see the OS on Jan 14th and I can't wait to see what she says. Does anyone else have any Repair recovery stories?

[danfitz06]

Yes, more meniscal repair success stories would be great! :-)

I too experience most of my pain behind the knee and I have a small lump behind my knee that I had prior to surgery (but it does not hurt).

I am also wrestling a little bit with some muscle atrophy. Over the past few weeks, I've experienced some pain in my quad and my calf based on inactivity. This is getting a little bit better now that I've been hitting the pool etc. My range of motion is pretty good now also - althought the doc has not given me the green light on my brace to open it up altogether.

Has anyone heard of nutritional supplements to aid in the repair process? A friend at the gym yesterday suggested that a protein supplement might help in expediting the healing process?

Thanks!

Dan

[SETClassA]

I had my medial meniscus repaired on Aug 23rd after being immobilized with a tibial plateau fracture for 8 weeks. I started therapy right after surgery and it was very slow going at first because of the muscle atrophy but then I started to get stronger every week. It's been 4 months and it still hurts, it's still swollen, I have this weird lump under my quad tendon that hurts and most of the pain is behind my knee. My range of motion was coming back right on track until about a month ago and then it started to get tougher to straighten it. I can get to zero but it takes forever, especially after I'm sitting for more than a few minutes. And my knee overall just feels stiff, I don't know if the repair failed or not but I get some popping sounds coming from it. I see the OS on Jan 14th and I can't wait to see what she says. Does anyone else have any Repair recovery stories?

Hi danfitz and fireftr

I had my medial meniscus transplant in Jan 04 and then had a setback, which required the removal of 50% of the transplant in June of 04.  After a great year of cycling in 2005, I began to have pain behind the kneecap in October.  This was particularly noticeable when peddling from the top dead center position to about 2 o’clock.  Stairs of course, were also getting difficult.  When I took time off, this seemed to worsen the situation.  In my case, any period in which there was any lack of physical activity made my knee feel worse, particularly stiffness.  I had MRI in December and there was possibility of tear in the lateral meniscus. Just had surgery on December 21 and found both medial and lateral sides fine.  Unfortunately, there was some bone softening just under the kneecap.  I believe they did something called micro fracturing in this area in hopes that the holes would generate a blood supply, which would in turn cause cartilage formation.  Doc suspects that this was most likely due to my long recovery period.   Anyways, I am restricted to crutches for 4-6 weeks with no muscle use or bearing past 10 degrees.  Depending on strength of my leg at 4-week appointment, he may put me into some sort of range of motion restrictive brace.  Despite these setbacks, both the medial and lateral sides are performing, as they should. I feel really lucky. 


In my situation lack of activity was my greatest enemy. This is also true with respect to the leg stretching exercises. If I do not do them, I defiantly feel the difference. For me, just getting out on the bike for 3 to 4 times a week, whether, it meant a lazy 10-mile ride or a lung exploding 30 miles of CT hills is necessary maintenance for my knee.  I also set goals for riding in three charitable events this summer at 50K, 50 miles and 100K just to keep me honest and really appreciate how lucky I am.

The muscle atrophy and weakness seemed to take forever to overcome.  Until mid summer 05, I felt a tremendous lag in my “Altered States (sci fi movie with William Hurt)” leg.  Then one day, it just sort of turned itself on and became part of the ride instead of being on the ride.   

[ener_G]

I had a minor meniscus repair surgery about a month ago and I was able to get off the crutches about 2 days later.  I have been careful ever since my surgery and asked a lot of questions in the post-op appointment.  I'm currently strengthening my legs via exercise bike, stretches (back against the wall-type), and elliptical machine.  My next step is to increase my times in the machines and start hopping on the ground and walking leading up to jogging.  I have been icing my knee after workouts and my knee has not swollen nor have I had too much pain.  The Nurse Practictioner told me that I should encounter some sort of pain but thats only because my knee is trying to get used to my normal activities.  (i'm an avid basketball player)  I'm a little hesitant about starting to run and jump, but a step at a time is always the way to go.  Well this is my $.02

[Claret_dub]

Hi

In July I had a Bucket handle Tear removed arthroscopically on my firht knee. The OS told me when I woke up that I had a "huge" tear but that the surgery went fine. He told me to start putting weight on my leg straight away and I walked out of the hospital without any crutches or Brace.

I was given a few exercises that I was to do each day and I went back to see the Os 1 week later and he was happy with the progress.I had no stiches and only 2 tiny scars on my knee. He told me to increase the reps on the exercises and also gave me a few more to do. I was only experiencing minor pain when I tried to straighten the leg fully or bend at more than 120 degree. The OS told me to take it easy for a few wks and then return if I had any problems.

After 6 wks I still had a some slight pain and problems trying to get a full bend in the knee and I also had some swelling so I went back to see the OS. He said everything looked fine and then mentioned that I should already have started PT even though he never mentioned this to me before hand.(I was still just doing the original exercises that he gave me)

So I began attending a PT clinic 2 - 3 times per week and there was an improvement in the range of movement after about 5 sessions, but I was still getting some swelling. The PT says this was due in part to tightness of other leg muscles/lower back etc. The PT suggested that I try to beging very light jogging sessions, which I did but I felt pain in the knee and it swelled up straight away so I stopped. Eventually I got to the stage about the end of Oct when I was able to jog with some slight pain whenever my injured leg touched the ground but I had no swelling, the PT told me that I had to run through the pain to get the knee back in full action.... this I thought was a bit odd ...but I did it and after about 2 wks the pain when runnig stopped and I also had no swelling. So I was ready to begin football training again!

I was able to increase the intensity of the training both on the field and in the gym but I felt that I couldn't sprint at 100% ... this was not because of any pain but I felt like my right knee was too "tight". I also had a problem with the knee "clicking" when I was cycling in the gym. I assumed that these symptoms would eventually go away and I was not having any real problems football training, in fact I could tackle and kick the ball with my right foot without any real problems.

However, then I began to

[Claret_dub]

Hi

In July I had a Bucket handle Tear removed arthroscopically on my firht knee. The OS told me when I woke up that I had a "huge" tear but that the surgery went fine. He told me to start putting weight on my leg straight away and I walked out of the hospital without any crutches or Brace.

I was given a few exercises that I was to do each day and I went back to see the Os 1 week later and he was happy with the progress.I had no stiches and only 2 tiny scars on my knee. He told me to increase the reps on the exercises and also gave me a few more to do. I was only experiencing minor pain when I tried to straighten the leg fully or bend at more than 120 degree. The OS told me to take it easy for a few wks and then return if I had any problems.

After 6 wks I still had a some slight pain and problems trying to get a full bend in the knee and I also had some swelling so I went back to see the OS. He said everything looked fine and then mentioned that I should already have started PT even though he never mentioned this to me before hand.(I was still just doing the original exercises that he gave me)

So I began attending a PT clinic 2 - 3 times per week and there was an improvement in the range of movement after about 5 sessions, but I was still getting some swelling. The PT says this was due in part to tightness of other leg muscles/lower back etc. The PT suggested that I try to beging very light jogging sessions, which I did but I felt pain in the knee and it swelled up straight away so I stopped. Eventually I got to the stage about the end of Oct when I was able to jog with some slight pain whenever my injured leg touched the ground but I had no swelling, the PT told me that I had to run through the pain to get the knee back in full action.... this I thought was a bit odd ...but I did it and after about 2 wks the pain when runnig stopped and I also had no swelling. So I was ready to begin football training again!

I was able to increase the intensity of the training both on the field and in the gym but I felt that I couldn't sprint at 100% ... this was not because of any pain but I felt like my right knee was too "tight". I also had a problem with the knee "clicking" when I was cycling in the gym. I assumed that these symptoms would eventually go away and I was not having any real problems football training, in fact I could tackle and kick the ball with my right foot without any real problems.

However approx end of Nov, I began to get some pain in the knee and this increased to the stage where I would be really sore if I jogged for even 20 seconds. And now sometimes when I move from a standing position I get a really sharp pain in the knee. And If I walk for any length of time the knee begins to click and becomes really sore and fells really weak.

As I was on vacation for the last month I have just rested the knee in terms of exercises/training in the hope that it might recover. But At this stage I can only walk for short distances and cannot cycle at all with out clicking and pain. I am due to see the OS next week again but I would like to know if anybody has any suggestions as to what might have gone wrong with my recovery. I did not have any sudden major impact on the knee like a tackle or a fall that caused the pain to come back.

I'd appreciate your comments.

Cheers