Pain walking 4 months after partial-meniscectomy

[Yogalover]

Hi all,
I had a partial lateral meniscectomy in mid-June, and rehab was going fine for the first months. Then, I started to develop sharp pain under the knee cap as well as pain above the patella (where the quad tendon inserts).

Here is the things that I have tried for the last 2 months:
Physical therapy (to strengthen quad muscles as well as hip muscles)
Shoe inserts
Chiropractic sessions (where my hips were adjusted)

After 2 months, my PT says that I will get better and that I have patellar femoral syndrome. I am frustrated that I have not gotten better, even though I have been doing the exercises. I am not even thinking about running or jumping, but I would like to walk pain-free... Today, I had to stop walking after just a short 20 minute walk.

I am very frustrated, and am wondering if I will be stuck with chronic knee pain. My OS and PT told me that I have Patello-femoral syndrome, but why don't I get better with the treatment? I'm thinking that I might have retorn my meniscus? Should I demand another MRI?

Anyone have had experiences just like me, or has some advice?
Thank you,
Formerly active female (I'm only 39 years old).

[JaneDown]

Hi Yogalover
exactly a year ago today I had a partial lateral meniscectomy in both knees. I had about 25% of the meniscus removed both sides and was expecting to be up and about within about a week as all the pre-surgery information had said I would be! In reality I was on crutches for about 2 months, was in severe pain (much, much worse than pre-surgery!) for about 3 months...then gradually from January onwards (so after 3 months) I started to be able to walk to do the school drop-off and pick-up on my own without crutches but was still extremeley limited in what I could do. I had physio-therapy, hydrotherapy and was doing my own home exercises but still had severe muscle wastage which was making the recovery very slow. Gradually as life had to get back to normality and I just had to drive again and walk again and could no longer rely on friends and family to do stuff for me the thigh strength started to come back. It was about 6 months before I could walk up and down stairs without holding onto the wall and banister to take all my weight off the knees. A year has passed and I would say I am still in worse shape than I was before the surgery (ie my knee-pain is no better it's just different, and is sometimes worse). I still cannot kneel, can't jump as seem to have lost the "spring" in my legs!
BUT....whilst I do not think the surgery actually helped me I am now able to do most things I need to do without problem. I don't run (but didn't before surgery!)...but I am able to look after my two children with all the "running around" that involves and my flexion and extension are back to normal.
I honestly think that once you have knee surgery it is a little unrealistic to think you'll be back to normal in anything less than 6 months. When you think about what went on inside your knee, you might only have small holes on the outside but your knee went through a pretty brutal time with all parts of it being poked and prodded and swelled up with saline etc! So please don't think that because my story is not exactly positive that yours will be the same, the vast majority of people who have knee surgery are perfectly happy with the resluts. But it will take time to heal inside, you may develop a little internal scar tissue, all of these things mean your knee may never feel totally pain-free 100% of the time. But hopefully in a couple of months you will feel very different to how things feel now.
Sorry if my story isn't particularly positive but actually I am astounded at how good my knees feel some days compared to the "dark days" of the months following surgery when I beleived I'd never walk again!!
I hope things get better for you soon
Jane

[JaneDown]

By the way, I meant to mention in my post that I am 41 so I was 40 when I had the surgery and whilst obviously we are not old (!!!), neither are our knees that young! And I believe that recovery from surgery gets harder as you get older so maybe being 40 (or in your case 39!) means that you should expect your recovery to be a little longer than the average...
jane

[Yogalover]

Hi Jane,
Just wanted to thank you for your info and support! It really helps talking to someone who has been going through the same thing...
I know what you are talking about the lack of the ability to jump - it feels weird to be stuck to the ground... But at this point I am not even hoping to run or jump, just walking without pain would be nice...
Doris

[luisa2552]

Hi Doris,
I too am a formerly active female (43 years young) and am 7 weeks post microfracture and partial menisectomy. i m not having the problem you are having, but my pre-teen daughter struggled for years with patellar-femoral syndrome. She's an active basketball player and wne through a huge growth spurt that triggered the pain in her knees. She always had pain, and at it's worst had to stop playing ball because she couldn't jump. Her GP just wrote it off as growing pains. We finally took her to a fantastic orthopedic surgeon who diagnosed the PFS. To our amazement, the treatment (besides icing after exercise) were these little straps she wore around her knees, just under her kneecap. They did wonders! she was back playing ball in no time. She's 13 now, almost 5'10 and doesn't need the straps as much as she used to...only during really intense workouts. Ask your doc about them. Good luck!

[kreitler7]

Just a question, are you still doing Yoga?  Some yoga can be pretty tough on the body so you should definitely be careful with that.

Honestly, 4 months is not a long time.  Just keep doing your PT.  Keep exercising.  If it gets too painful, then stop for the day.  But remember that some pain is ok.  Just keep plugging away.

If you are overweight (I have no idea if you are or not) you should definitely focus on losing weight.  That will make all of the difference in the world.

I had my surgery 3 years ago now and every now and then I have some weird pops and aches happening.  They usually go away after a while. 

I think it is unreasonable for you to expect to be pain free in your knee.  There will always be some pain because it has been altered now.  You will need to live with some degree of daily pain in your knee. 

The last thing you should be thinking about is more surgery.

Good luck.

[Yogalover]

Hi Kreiton,
No, I had to give up yoga since the surgery since too many poses are painful (all the warrior-poses) - the few yoga poses that I can still do I am still doing at home. Part of the problem is (per PT) is that my knee is pretty flexible but that I am very unstable - unfortunately I can't currently do the strengthening exercises since they give me a lot of pain - those who are in my situation know is a vicious circle...

Yes, I know that a certain degree of pain is expected but this is really bad pain, and I can't walk more than 10-20 minutes and then I have to stop - this is extremely limiting for a person as you can imagine.

Thank you for your help though.
Doris

[ARippleEffect]

Have you tried stretching while your exercising.  Sometimes what happens is that the muscle over compensate.  For example the quadriceps could be over firing because the calf is too tight.  The next time your out walking, try these 3 stretches, they'll take less than 1 min total.

1.  Stretch the gastroc (calf muscle).  Place the ball of you foot on a curb or wall and keep your heel on the ground. Do not hang your heels from the curb, this only make the muscle tighter.  Hold for only 5 seconds, and repeat one more time.

2.  Sitting pull your knee up to you chest and grab under the ball of you foot, and pull it up to you shin. Still keep the heel grounded to the ground.  Hold again for 5 seconds and repeat once.

3.  Standing, place the leg (with pain) about a step in front.  Pull you toes and ball of the foot up, keep the heel grounded and the knee straight.  Push you hips back, which the back will bend naturally for balance.  You should feel a stretch behind and just below the back of you knee. If you feel it going up the back of the leg stand more upright, so the stretch remains behind and below the back of the knee.  Hold for 5 secons and repeat.

Continue to walk and repeat the cycle every 3 to 5 mins (or when needed). This might help in creating the muscle to balance back out.

[kreitler7]

Yup, stretching is key.

[BlackMagic]

Hi Yoga,

I had a partial menisectomy in Mid July & have had the exact same sympthoms as you!!.
I went back to my consultant who gave me a new MRI scan (which proved to be inconclusive due to the knee being still very swollen).
He put me on a course of anti inflamatries for 3 weeks to see if that would help. After a few days all seemed great - I got more knee bend & less tightness & pain.  After a week however all the pain & movement restriction was back.
After 2 weeks I returned to the consultant who said he'd have to have another look inside the knee.
A 2nd arthroscopy followed. I came out of surgery and after a few hours I went to the loo unassisted. This was something that I couldn't do without crutches after the 1st op! The consultant told me that the meniscus had in fact re-torn!!! He explained that all surgeons will try to take as little as possible away when performing partial menisectomy to benefit the patient in the long run & that maybe he didn't take enough. He took no chances this time & removed a larger amount of meniscus. My tear was a radial  tear (apparently tough one to repair).
9 days after the 2nd surgery although nowhere near recovery, everything about this period is much much better than the 1st recovery period. I can walk up & down stairs with only mild disomfort & I am very positive that in the next 6 weeks I will be much closer to my pre-tear state. (I aim to be golfing again by December - something I 've not done since June)
My advice is to go & get a 2nd MRI & if you have to have exploritory surgery - I did & a new tear was found.  Good luck 

[dubsey]

Hi Yogalover

I had an almost identical experience as Black Magic, only it took me 4 months following initial surgery before I eventually insisted on a 2nd MRI because I was convinced I still had a tear in my meniscus.  I was proved right - the surgeon had not taken enough meniscus and had left a tear in there.  If in any doubt at all, get another scan straight away, otherwise you will end up putting in a huge amount of effort to get your knee back to normal as I did with my physio and end up getting nowhere which is ridiculously frustrating.

I've had 3 knee ops now, an ACL reconstruction and then 2 meniscectomies.  You will recover, but it will probably take longer than you anticipate.  I thought it would only take 6-8 weeks from my meniscectomy - it ended up taking 4 months to get back to full fitness and back on the football pitch. This was despite going to physio 3 times a week and they gym on 2-3 of the other days so manage your expectations about when you will feel strong in your knee again.  However, like everyone else has said here, no knee ever feels the same again after surgery, it's not nice, but it's something you have to learn to live with.

[Dizzi]

Hi Guys,

This is my first post here...I just found this site and have been reading your posts (with some dismay, I have to admit!).

I've had moderate osteoarthritis - predominantly in my hands and a little in my toe joints for a number of years, however, it had not significantly affected my knees, other than a little stiffness expected with age (ahem...54...groan!)

I first experienced pain and swelling in my LEFT knee in June 2007 and after five months of hobbling about visiting various specialists, an MRI scan revealed a lateral meniscal tear. I had a partial meniscectomy in mid November 2007. Happily, the scan revealed that mechanically the knee joint was sound with no evidence of arthritis.  Recovery, however, was much slower than I'd been led to believe and therefore expected; the swelling was substantial, persistent and the range of movement was limited.

On a number of occasions over the next 18 months or so, when the swelling and pain became really debilitating I had the fluid drained and a  cortisone/cortisone-type injection.  On every occasion, there was a marked improvement but, over time my knee inevitably deteriorated. I hobbled on.

Eventually, I damaged my RIGHT knee ( dancing at a house party!) and this time the MRI scan revealed later tears to both knees, together with significant lateral wear and tear damage in my LEFT knee.  At the beginning of September this year I had bi-lateral arthroscopies and partial meniscectomies.

The surgery confirmed that my LEFT knee was sound mechanically - no wear and tear. Unfortunately it also confirmed that I would need a partial knee replacement in my RIGHT knee. 

This time around, recovery of my RIGHT knee has been fantastic.  After just over 2 months it has healed really well (touch wood).  There is still some stiffness and pain and it hurts to walk down stairs (especially in heels!!). However, considering I will eventually need a partial replacement, l'm pleased with the progress.

But, my LEFT knee - supposedly "sound" - has yet again been a nightmare!.  Three weeks after surgery it was so horribly swollen and painful I went back to see my OS.  He was satisfied that there was no infection, however, decided to drain off the fluid and give me (yet another) coirtisone injection.  However, the150 ml or so of fluid he drew off from my knee was an alarming dark red! It emerged that 'd had a post-op bleed into the joint and this has prevented the healing process.

Over the next couple of weeks my knee gradually improved and I grew quietly optimistic that it was settling down.  Distressingly, however, over the past fortnight is has deteriorated daily and is now, yet again, red, swollen and painful. 

I'm going back to see my OS this morning, I have to say I'm feeling really pessamistic and in despair.  Has anyone else had a similar experience?  Is there any hope of  returning to relative normality and regaining some degree of meaningful functionality?

I tell you guys...I'm normally a very up-beat, up-and-at-em person.  This has me beat! 

Thanks for listening, Dizzi x

[Yogalover]

Hi all,
I appreciate all your replies and support!

I just wanted to post an update about my knee since it might be helpful to some of you reading my post.

After things turned so bad for my knee, I stopped Physical Therapy. I then bought a brace (which was actually not recommended by the PT since it causes muscle athropy) since I NEEDED to be able to walk due to an upcoming trip to Europe, and my doctor prescribed Voltaren. I used the brace and voltaren for about 3 weeks. During this time, I actually had to walk a lot since I was on my trip. I am so glad that I used the brace for a while - I don't know why it was not recommended to me... Without it, I would hardly walk for 20 minutes. If you can hardly walk due to knee pain, I think you need to protect the knee for a while until things calm down!

After the 3 weeks, I was able to stop using the brace, and my knee pain calmed down. Now, I just started to use the elliptical machine last week - I started with 5 minutes, increasing by 5 minutes/day and today I was on the elliptical trainer for 30 minutes. So far, my knee feels good. I still feel more unstable on the knee where I had the surgery on so I know that I am not out of the woods. I also am doing some leg strengthening with the leg press. What I will refuse to do are squats - I think this caused my misery in the first place, and I believe that physical therapists focus too much on them - this was at least the case for me. I believe that one of my physical therapists failed to recognize that I have tendonitis and should be resting my knee for a while instead of asking me to do strenghtening and squats.

Anyway, I still have a long recovery ahead of me - I might even go back to PT when I feel ready since my knee still is more unstable. I guess PT is great, but not when you recover (like me) from tendonitis. For now, I will continue doing the elliptical trainer and leg press. Hopefully I won't need a second surgery like some of you!

Good luck to all of you!

[vikki]

Just reading through this thread having joined the forum earlier this evening.  Thanks for the tip about the brace - I am nine weeks post- partial medial menisectomy and feel I'm getting worse rather than better.  I think I will talk to my physio about a brace taking the strain so-to-speak for a while to let my knee calm down.
Vikki

[meniscus2]

Any chance you are still checking this site?  I am your age, going through the exact same thing that you did.  I am wondering how you are doing a year later.  I would love to hear from you.  Am concerned this is as good as it gets.

I, too, was extremely active and now and benched.  Struggling!

Please respond if you read this! 

I hope you have improved since last year!

[mom2angels]

I just turned 42. I am not over-active, but I am a HS math teacher, so I am on my feet all day from 7:30 am to 3:30 pm. I am overweight (by around 50-60 lbs). One week before school restarted I found out I had a complex tear in the meniscus of my right knee. I was going to try and wait surgery out until Thanksgiving break, because the surgeon said I would be on crutches about 3 days and out of work for a week. By the end of September, I was in more pain in my left knee than my right, so he ordered an MRI. There was a tear in the meniscus of the left knee (he said it was a mirror image of the right tear). I was going to try and wait it out still, but by the end of October, I could barely make it on my feet by the end of each school day. I scheduled surgery for Oct. 27th.

The day came and went, fairly uneventfully. They said the surgery went well and sent me home with pain killers and instructions to remove bandages in three days. On Saturday evening, the bandages were removed (which felt wonderful, except my left calf had a perma-charlie horse). Sunday, I was walking on my crutches just fine and even sitting in a normal chair able to work and watch TV.

Monday was my post op appointment, at which I mentioned the charlie horse. He ordered a doppler due to the suspicion of a blood clot. I have no family history of blood clots, nor have I ever had any (to my knowledge) after previous surgeries. The doppler confirmed the blood clot in my left calf. I was immediately sent to my "family practitioner" for treatment. I was put on Lovonox shots and Coumadin tablets. The shots lasted through Saturday.

Two days after I was put on this blood thinning regimen, my left knee's left incision buckled outwardly, as if it were swollen and inflamed. I could not walk at all on my left leg and my right knee was swollen very badly, that walking on it made me cry. I saw me FP and he said the left knee was infected and put me on antibiotics immediately. I saw my OS the next day and he said it was NOT infected and to NOT take the antibiotics. I still could not walk well.

Another few days passed (about 5) and I was still in pain in both legs. I continued to get the runaround from both the FP and the OS (each contradicting the other). Being on Coumadin, I am not able to take anything but regular Tylenol. By the end of that week, I insisted on seeing the OS again, because at this point the left leg started feeling good, but I could not lift my right leg up when in a flat back position. It was like cement. He said he'd bet there was no fluid on the knee, but he'd aspirate anyway to see. He got out 11ccs, which was not much, he said. My right knee felt better the next day.

I have been out of work since the 27th of October. What should have been a week has turned into a whole month of missed work, confused patient care, non-communicating doctors, and frustrated family members and employers. I told the doctors I had to get back to work (I cannot afford to keep being out).

Today, 11/28/11, was my first day back at school teaching. I am still on crutches, as walking unaided is still very difficult. I can, but only for about 5-10 paces. After that, my right knee buckles and locks and I cannot balance well. My right knee is still swollen, no matter how much I ice. The swelling is finally going down a little, but it is still fairly significant (my pant legs are very tight on the right side, but not the left). I cannot bend either leg for longer than a few minutes. The left leg will get "stuck" if bent for too long.

How much longer will I have to endure the embarrassment of walking on crutches? How much longer will my knee be swollen? I was informed "1 week, 2 at most." I have done everything every has told me to do, and nothing works.

Not to mention, I cannot even sleep through the night anymore. I am up nearly every 2 hours with aches or pains ... or potty needs. This ... is getting old!