The WAITING ROOM > EMERGENCY RESUSC. - crisis room

urgent treatment for detached meniscus, PFS????

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DancingMom:
I saw an OS in June for knee injury on Memorial.  The diagnosis was "detachment of the posterior horn of the medial meniscus" and PFS (I don't really know what that is).  I got my regimen of PT and have been very faithful.

I have just returned from a week-long camp in the mountains of Colorado.  I did some highland dancing while we were gone and flared things up a bit.  All the up-and-down walking didn't help at all.

This mroning I went to the gym and my knee (right) locked up while I was on the stationary bike.  Now I am in a great deal of pain (again) and cannot get in to see the OS for three weeks!

Urgent Questions!
1.  How should I treat my knee until I can see a doc? (brace, ice, elevation, crutches?)

2.  Should I try to find another doc who can see me in less than 3 weeks?

I'm looking forward to some kind words and guidance.

UPDATE:

Got an appointment for Monday with the OS who scoped my shoulder.

Still wondering about interim care.  The knee is very painful - throbbing.  Stairs are totally out of the question.  Using a flexible brace with a "donut" for the kneecap.  Ibuprofen.

dm:
Okay, I thought I'd reply since I've had the same problem. Here's the simple description of what's going on. Think of the meniscus as a slice of orange that's got the points tied down to the top of the lower leg bone. The tie point at the back of the knee has sheared loose. This allows the "orange wedge" to move around when it shouldn't, thus it can get squeezed out to the side or shifted toward the kneecap and pinched up, or moved around any number of interesting ways that its not supposed to, etc.

So, what this means is that any agressive activity is going to increase the chance that the meniscus, which is moving around when it shouldn't, is going to get squeezed or pinched up in a way that can damage it more than it is, and to cause pain to the neighboring bits it being squeezed into. This is why you feel like something keeps getting stuck and unstuck at random intervals, and why you'll randomly get extreme pain spikes, as the meniscus moves where it shouldn't and get squashed and puts pressure on things, which of course complain about it.

I would have asked the therapist about dong pt with an unstable meniscus. You could damage the meniscus more by doing a lot of therapy with it. I personally had gone right into surgery. PFS is patellofemoral syndrome, a "catch-all" phrase for unspecified issues with the patella/femur area. You could have some issue there, but they dont know exactly what until they take a look when they do something about the meniscus.

My advice... you can get by until you see the OS, with a generic support brace for general discomfort, and to take some ibuprofen regularly for the pain /swelling, and to ice it on a daily basis. I'd also avoid any strenous activities, and avoid stairs. Some easy stationary biking might be okay if it doesnt hurt. Use common sense. If it hurts more, don't  do it.

Hopefully the damaage isn't too severe, and they can do a repair, which involves using suture anchors to reattach the meniscus to the bone. This will involve 6-8 weeks on crutches, so the meniscus can reattach. This was the protocol in my case. I had other extenuating circumstances and things didnt work out as planned ,but that's another story.

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