Hi,

This is going to be a long post, so I'm going to put the question at the beginning, some people may just want to respond to the question, but all the background info is in the rest of the post.  I may have been walking round with a torn medial meniscus for over 25 years (I'm now 48), and now have osteoarthritis.  I'm waiting for referral to a surgeon, for what I assume will be an arthroscopy/meniscectomy.  What are the longer term prospects, given that the injury has been untreated for so long?

Now here's my story:

I have a long history of obesity (from teenage years), punctuated by just a couple of brief periods when I managed to get my weight down.  At my heaviest, 4 years ago, my BMI was 48, just so you get the picture.  At the start of this year it was 47, and today it is 35 and falling - I have finally got my head in the right place, and although I don't know yet what weight I will maintain, I do believe that I'm not going to be obese for much longer, or ever again.

Despite being overweight, I was always very active as a child/teenager, playing a lot of sport at school.  Through university I used a bike as my main form of transport.  In my early twenties, I took up running, and built up to half marathons (I ran 3).  I also dieted strictly, and got my weight into the healthy range.  However, while running one day, I got a sharp pain in my left knee.  It's difficult to remember the exact sequence of events, but on that first occasion I had to hobble home.  I rested for a few days, then ran again - but from then on, I would have episodes of pain that forced me to rest.  I started to regain weight, and the pain got worse/more frequent. I eventually stopped running. 

I did carry on Morris dancing though - very high impact- and while weighing up to 17 stone (BMI 38).  My knees used to feel stiff the day after training.... Then for two days... Then always, and I could barely walk after practice.  I gave up dancing.  When I still had knee pain 6 months later, I went to see my GP, told him about the pain, and that there was a grating sensation when I moved my knees (both of them - but the left was worse).  He did a blood test for RA, which was negative, but did not actually examine my knees.  He told me not to dance.  I was about 31 at that time.  I put on more weight.

At the back end of last year, my knee pain was one of the straws that broke the camels back as far as my weight was concerned.  I decided I needed to sort it out, or I'd be in a mobility scooter in my sixties.  So, I've changed my eating habits, and I now go to the gym 3 x a week, doing strength training and non-impact cardio.  Over the first few months, my knee pain improved considerably.  I started doing some long walks, tried a little bit of running... and spent two weeks in the Lake District, walking up to 10 miles, and doing some pretty significant ascents.  My knees would get sore towards the end of the longer walks, especially coming down the hills. My husband would complain when my pace slowed down, but my legs wouldn't allow me to walk faster.

I had always assumed that my knee pain was osteoarthritis, and that I had done it to myself by starting running when I was very obese.  But given that I had by that stage lost 4 1/2 stone, I thought I ought to really find out for sure what the problem was, so I went to the GP. He examined my knees and said he could find no mechanical problem.  He sent me for an XRay, saying he did not expect to find anything other than mild arthritis, and once that was confirmed, he recommended I should see a sports physio.

The physio examined me, and did some things the GP didn't, including the mcMurray test.  He said he thought I have a small posterior tear in the medial meniscus of my left knee.  He gave me a letter to give the GP, suggesting a referral to a particular surgeon.  So now, I'm waiting.  And researching - and the more I read about medial meniscus tears, the more obvious it seems that that is the problem, and possibly has been all along.

I don't know how bad the arthritis is, no numbers were mentioned - but it is worse in my left knee.  So in some ways, my thinking was right - I did something to my knee by running when I was obese, which has lead to me developing OA at a relatively young age.  But if I had had it treated then, I may not have.... only I didn't realise.

So there we go.... what are the prospects, given I've probably had this injury a long time?  Could my meniscus basically be toast?  I can walk in straight line with virtually no pain, can usually do stairs OK, but can't fully bend the knee, take my weight on it when bent, or "spring" off that leg.  Anything involving twisting or squatting, forget it.  Walking fast hurts, because it means pushing off with the knee fully extended.  And I often get a low-level ache, and find it difficult to find a comfortable position - I have to keep on moving the knee.

I await your combined wisdom with interest, thank you.

Barbara

Thanks for the welcome!

My standing Xrays do show osteoarthritis, though I'm not sure how bad that is..... the fact that, after a week or so *without* either running or a long (10 mile) walk, my level of background pain is minimal, I hope means that the OA is actually not too bad.  I have been doing shorter walks, plus my gym workouts, but giving long walks a miss until I hopefully have surgery.

The physio did the McMurray test, which was positive, and from what I read, that is pretty specific for a medial meniscus tear.  And since I've been reading up about that, it all fits... The things that are painful, and the things I simply can't do.  I'm sort of kicking myself for not seeking medical advice sooner (except I can't really kick myself up the bum with a dodgy meniscus, can I?), because it might have delayed the onset of the OA, which is worse in the left knee.   But there's no use crying over spilt milk - the thing now is to get the best treatment and advice that I can.

I'm running this disaster scenario in my head, in which the GP refuses to refer me, or the surgeon says it's not worth operating because I can cope alright in daily life..... but that's just silly, isn't it?  I've got a problem which is causing me some pain and limitations in things I would like to do, especially more vigorous exercise, which is very important for getting my weight down and keeping it down.  It's interfering with my quality of life.... and there's a fairly routine procedure which has a good chance of improving it considerably.

Barbara