Meniscus :
Long term outlook? - - Posted by Amanda (Amanda), 9 August 2004
Hi there
I had my lateral meniscus debrided one year and one month ago. Could some of you tell me where you are at now if it has been a year for you too?
The reason I ask is that I still have an achey feeling in the lateral aspect of my knee joint which I didnt have before the operation, and it can increase with activity/standing. Is this normal? I have no probs with ROM or catching etc. I am a 23 yo female. Thanks.
Posted by Ron22 (Ron22), 9 August 2004
hey..it's normal...my lat men tear was in conjunction w/ adn acl and med men but the lat seemed to cause tightness in that area...docs always minumized it...hang in there..listen your your body and give it time..you'll get there...remember it's the end result not the time it takes...especially when you're young and active..wish i had known this before i rushed back too soon too may times
hang in there
best
ron
Posted by Amanda (Amanda), 12 August 2004
Ron, your knee is OK now?
Any others please?
Posted by dutch (dutch), 12 August 2004
Amanda!
I'm a physio in Vail Colorado. I may be able to help you with your questions. After one year, your knee should be fully recovered, yet you could have some scarring that is causing pain with activities. It is good to know whether you have full ROM and when you have your pain. Also, is your kneecap moving well.
Let me know.
Posted by jathib (jathib), 13 August 2004
I tore mine over 30 years ago and have had it removed a piece at a time. Any time you have surgery or an injury like that you're going to have achyness from time to time, probably forever. Your knee is not normal and never will be.
But that doesn't mean your life is over. Keep the knee strong and keep it moving for the rest of your life and you'll prolong its life. Mine has lasted this long with a rebuilt ACL and torn meniscus. I've biked and swam a lot over the years. I'm not pain free all the time but the pain is usually tolerable.
Posted by dutch (dutch), 13 August 2004
Amanda,
I would have to disagree with Jathib. 30 years ago, when they removed meniscii, they usually took the whole thing out, leaving patients vulnerable to degeneration of the articular cartilage. That is probably why he/she is chronically 'achy'. These days, a torn meniscus is spared as much as possble so to protect cartilage and many arthroscopic procedures should leave you paifree to carry on with you normal acitivities. "Just live with it," is no longer an excuse you should have to hear unless someone botched up.
Dirk
Posted by jathib (jathib), 15 August 2004
I tore my meniscus over 30 years ago, but I didn't have surgery at that time for my meniscus. . I left it in there for 17 years and then had only part of it removed. But the pain never went away entirely even though the job wasn't botched. Once part of the cushion is removed the knee deteriorates. But like I said, it doesn't mean you have to stop all activities.
Posted by dutch (dutch), 16 August 2004
You're right Jathib. I have a lot of experience with this surgery and in our clinic close to 100% of our patients are pain free when rehab is complete. I just didn't want to paint Amanda the wrong picture.
Posted by pjays29 (pjays29), 22 August 2004
I'd like to hear more about the long term outlook from people with simple mensicus tears and partial removal. Mine was simple and the acute phase passed quickly but it's really tough to go all out like I used to. Part of my reluctance is fear. How are you all doing at the 3, 6 or 12 month periods?
I am working slowly but surely to regain my former athletic status. My inner and outer thighs are strong and defined. I find that making a wrong move or over doing it is far less costly in the pain department than it was a few weeks/months ago. But still, I have fear for my activities for the long term.
What level of activity can you maintain? How often? What do I do to preserve it? Don't want a total knee replacement at 65. Don't need to run or ski any longer. But am I causing long term damage if I do treadmill, eliptical trainer, stationary bike, swimming, long walks... still having fear and concern although I feel better now than I did before the arthroscopic procedure.
Still insecure...anyone out there in their 50's trying to figure this out?
Posted by jathib (jathib), 22 August 2004
Well, I tore my meniscus at age 15 and I'm 46 now. I've basically had my meniscus removed a piece at a time since then so a knee replacement is certainly in my future. I did stay fairly active but had to give up on basketball, skiing and field hockey in high school. Back in those days physical therapy wasn't stressed as much as it is today so my muscles really atrophied and I never got them back. Now I tell people that they have to keep their knee strong forever. High impact sports like running are going to wear your knee down. My saving grace has been biking. I've had a bike pretty much all my life and it has prolonged the life of my knee without a doubt. Swimming is also great.
It's easy to tear a meniscus again once it's been torn. If you can avoid doing that and keep it moving and strong then you can get a lot of pain free use out of it. You're at risk for getting arthritis no matter what you do but so are people that haven't injured their knees. Keep it moving.
Posted by allstardiva2005 (allstardiva2005), 23 August 2004
well i'm still in the process of finding out:
in 2000, i had surgery to repair a tear in my medial meniscus. in sept of 2003, that part of the meniscus went hypermobile and he internally stitched it back down. by dec, i had retorn it. last monday, i had another scope and found out that the majority of the meniscus left was shredded leaving me w/ only 35% of my anterior meniscus...
hopefully in a couple months, i'll see how i'm feeling- but yeah, the slightest movement for me can tear my meniscus. it doesn't take a big event...
xoxo- Christy
Posted by pjays29 (pjays29), 14 September 2004
Hi everyone and thanks for all your good advice in the recent past. I had a little episode and wanted to hear your impressions about it.
I'm now four months post partical meniscal surgery. I did my therapy diligently and moved on to adding a personal trainer with PT background to my exercise program. Was doing pretty well, treadmill, bike, swimming, weights etc. Could even exercise two days in a row without pain. I'm still not at the intensity as I was before the knee injury but I seem to be getting the benefits of exercise.
Last week I hit tennis balls for about 30 minutes for the first time since the injury and felt fine. The next day I felt fine so I did 20 minutes on the treadmill along with some weights. That night while standing/squatting sort of getting up from a seated position, I felt a bit of pain in the area of where my meniscus was torn/trimmed and heard a popping noice. It's the only time I have ever heard that. I was different from how the tear sounded. I had some pain over the weekend, not anywhere near the original injury and took some Advil. it is feeling better. I suppose I will try some activity today.
I have so much fear about over doing it. What do you think that little episode was about?
Posted by igor (igor), 14 September 2004
Your joint is unstable for up to 6 months after the surgery. So although the noise is definitely not good, it could be bones/kneecap snapping when moving.
In any case, get your os to check it out.. all the best!
Posted by sienna (sienna), 15 September 2004
The popping could just be your joint moving some air/fluid harmlessly around. Although it is usually painless from what I understand. But you said that the pain had settled so as long as you don't have any swelling or hotness or something else, then you are probably fine. I popped my jaw a few weeks ago. Normally it hurts for a couple of hours after but this time it hurt for 2 wks. My theory is that my jaw was tighter than normal because of stress and grinding so that when it popped, it was a release but the muscles were tighter than normal. It is fine now and feels like it wants to pop again.
The pain may just be from your knee trying to readjust itself but can't so easily because of the tight muscles around it, leftover from surgery and rehab. My sports masseur said that popping is fine as long as it is painless. It's the grinding and catching you need to really worry about.
I am curious, does your knee feel better now after it popped? I wish my kneecap would pop but it just won't. Oh well.
As for the fear of reinjury, perhaps a brace may help you feel more secure when doing exercise. I know it's just as hard to get rid of the fear as it is to get rid of the pain.
Posted by pjays29 (pjays29), 15 September 2004
Thanks for your responses, Igor and Sienna...
My knee does feel better three days after popping but I feel like I had a little regression. I agree with several of your comments--my therapy and exercise have made the muscles tight. My tendons that run down the hip area and side of the thigh get painfully tight. I thought maybe it was caused by needing to push my weight upward with my knee cap extended past my foot--a real bad position for knee people.
Anyway, today I swam, did a little stationery bike with low resistance just to get it moving/fluid. Did some strengthening. I was also thinking that maybe my patella sleeve wasn't on correctly when I exercised prior to the pop. Did not need any advil today and occasionally had a little pain along the knee cap. I know from my scope that my knee cap is not perfectly smooth but my doctor thought it was not worth dealing with at this point. Actually he says my other knee cap is a little worse.
For now I'm out of the panic mode and ready to get back into making some progress. People keep telling me it takes a full year at my age so I have to force myself to be patient.
How are you all doing in your recoveries?
Posted by igor (igor), 15 September 2004
Glad to hear you're better!
Myself, I'm doing pretty well.. It's been two months since my surgery, where they took out 50% medial meniscus. Swelling is completely gone, I am back to all my activities (however had to modify my dancing and stretching to minimize load on the knee). Still doing physiotherapy twice a week, but I feel thats more of a formality. Sometimes the knee aches in the morning and after walk/exercise a lot... thats about it! 
Posted by pjays29 (pjays29), 16 September 2004
Igor! You are lucky and probably half my age. I think I made a bad movement that caused this last mishap. I hope it's nothing more. I think we all need to manage our knee weaknesses and it's all too easy to put pressure on our injured areas. I decided that I probably would not rush for another surgery if I did have another tear. I am somewhat discouraged. I'll post another one soon and hopefully I will be in the clear.
Posted by pjays29 (pjays29), 20 September 2004
Hi all...here I am replying to myself....
What do you think the chances are of me tearing my meniscus on the same knee, four months after my first surger y for a tear? I stood up awkwardly and I think I put all the stress on my right knee with the knee extended and bent over (beyond my foot). Seems like a difficult and ridiculous question to be asking and I do have an appointment with my surgeon on Sept 21. I heard a popping sound which was different from the ripping sound when I heard the first tear. I will just shoot myself if I have to go thru this again and have even less physicial ability when I'm done. I am anxiety ridden and really can't cope with the fact that I can't seem to do anything physical these days. While driving to the grocery store today watching all the happy joggers, I just wanted to run them all over with my car. (just kidding. It was just a ridiculous thought I had in my momentary depression)
Ever been there? Advice? Sense of humor/drama anyone
Posted by igor (igor), 20 September 2004
Hey
Re-tearing my meniscus is probably my greatest fear. I was at a concert last week, and instead of having fun in the mush pit I kept touching my knee to check on it. Kept thinking it got swollen again... Mental damage is just as bad as physical.
But I have good news for us both - my physiotherapist says that while a lot of people have meniscus removal, a tiny fraction of them come back with a re-tear. Let's hope its not gonna be us!
Posted by pjays29 (pjays29), 25 September 2004
Went to the doctor and I do not have a new tear. I do have an area of chrondromalacia that I did not know about until now. I am shocked and unhappy about the fact that it is grade 2/3. That's bad, I think!!! The doctor asked me several times before the surgery if a particular area of my knee hurt and it did not. Apparently the "tweak" or pop I heard was a rub against the spot/bump of chrondromalcia.
How does one manage this condition? I hear the surgery is painful and not all that successful. Getting depressed and feeling like I'm on a path to pain and inactivity. The doctor thought I may have had an injury at some point of my life causing this bump inside the knee cap. I might start the Celebrex tomorrow if it's not better. I have been very active my whole life and this is bad news.
Posted by hmaxwell (Heather M.), 26 September 2004
Chondral damage is not necessarily equated with pain. Some people have clinical evidence of osteoarthritis--up to and including bone spurs--that is found during surgery or MRI/x-ray. It does not mean that they have pain. Alternately, you can have an area of minor damage that causes a great deal of pain.
If it doesn't hurt, I wouldn't fix it! You may get some popping now and then--but it could be because the muscles around the knee joint aren't at 100% yet. And Grade II-III chondromalacia is not that bad--it gets a lot worse, trust me. There is no guarantee that your knee will necessarily progress.
Here is a good link with information on chondral damage--keep in mind that this discusses symptomatic damage. Also keep in mind that most people will show evidence of wear and tear in their knees as they get older. It's the way the joint was designed--kind of like wearing down tires on your car, only knees are a bit harder to replace 
http://www.steadman-hawkins.com/knee_chondral/overview.asp
http://www.kneehippain.com/patient/pain/chondromalacia.html
http://www.kneehippain.com/patient/pain/pain_causes.html
Hope some of this information helps. I would stay away from surgery strictly to address chondral damage unless you are looking at a cane or wheelchair as an alternative...it's seldom a straightforward proposition. But the mere presence of chondral damage doesn't necessarily mean anything, except that you are showing some wear and tear on the joint. There is no actual correlation between degree of damage and level of pain. I had Grade IV chondromalacia and was working out and hiking every single day, without more than the occasional twinge. It was only when I tore the meniscus in that knee that I found out what was going on in there.
Heather
Posted by pjays29 (pjays29), 26 September 2004
Thank you Heather. I have heard from you before and it's always great information. Your have been through a lot and it's nice you can pass it over to us. My knee kind of vibrates to the touch and the spot of chrondromalacia never hurt but I think with my recent tweak, I irritated it.
Here is my pattern: My knee gets irritated from the rubbing or blister as your article states and then I go into bursitus which I hate!!!! I have been against taking antinflamatories chronically but maybe I need to to get out of this episode.
Also, I do feel tightness in my knee and that tendon in the front of the knee.
I lost about 5/16 of muscle mass with my surgery and I have regained it now. I don't have a weight issue so I know that's not it. But I sure as hell am getting concerned that I will have one if I can't learn to manage this.
Another thing is that I still am only four months away from my surgery and some say it takes a year for us older folks to recover.
I'm swimming more for my main exercise and doing stationary bike. I really get it now...no running or skiing but I hope to replace those activities with biking and swimming. Ch-ch-ch change.... and we all need to be happy about them. It's hard. Thank you again Heather I hope we hear more about chrondromalacia or whatever the more modern term is.
Posted by Amanda (Amanda), 4 October 2004
Wow, lots of posts in response to my original question! Just though I would let you know that I have found out the reason why I would have been having the ache in the lateral side of my knee long after surgery (had a MRI) is because they left behind most of the horizontal cleavage tear to preserve the rim - which is now giving me even more problems since twisting it. The rim is split in two pieces, top and bottom. So now I have to decide whether I want to remove the rest of the tear - YAY I love these hard decisions NOT!
Posted by pjays29 (pjays29), 15 October 2004
It's way more complicated than I originally thought. You will note from my foot note that I thought my injury was "kid stuff" compared to many and I still know that it is. For me I realize now that it was one incident that got me into this but now I see how all the smaller injuries from sports, childhood, etc come into play. I have some patella rubbing that gets me into trouble and I never noticed that until now.
Still doing better...the injury ocurred about a year ago, had my partial meniscus removal about five months ago. The little "tweaks" I get from a bad movement last for much less time now and I am learning to live with it. Also learning to move and bear weight correctly. Gained only two pounds during this past year and that surprises me since I was so active. I think I am learning to live with it and staying healthy in spite of it. It takes some change and awareness about your body movements.
I am a little pissed off about the cellulite that has developed (never had it until this year at 51) but that might have happened anyway. I find I can do/walk, stand and all those things like a normal person but the sports stuff had to change. I feelin' good again about the long term. Had fear that I would not be able to walk all day on trips to Europe or wherever but I am thinking now that I can. I am happy for my good knee that can bail me out of almost anything.
I guess I am adjusting to the change and getting over the fact that there is some loss. I don't know...ask me tomorrow. Anyone feel this way?
Updated Thu Apr 29 2010
