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Author Topic: injured, MRI, waiting to see the surgeon, UPDATED  (Read 1007 times)

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Offline helluvaman

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injured, MRI, waiting to see the surgeon, UPDATED
« on: November 22, 2010, 05:27:03 AM »
I had a mis-step going down a flight of stairs carrying a heavy tool, 3 steps from the bottom. I essentially landed on both knees with the right one taking the brunt of the fall.
It hurt, but I've had much worse falls, or so I believed.
Minor discomfort during the rest of the day, and I awakened to a cantalope sized knee the next morning.
Saw the company physician that morning and had a MRI that night.
It will be 2 weeks before I can see my preferred Ortho, so I am wondering if anyone can shed some light as to what I might be up against.

MRI results are:
 MCL strain, grade II
 PCL tear, grade III  (curious as to the difference between strain and tear?)
 Calf muscle strain
 medial meniscus, posterior horn tear
 medial miniscus, ext longitudinal tear.

I hope I've got my terms correct in my notes

Anyone have a comment?
« Last Edit: November 22, 2010, 09:23:58 PM by helluvaman »

Offline tenisfan

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Re: injured, MRI, waiting to see the surgeon
« Reply #1 on: November 22, 2010, 06:03:35 AM »
Well i am no expert but you might have to have surgery to fix your meniscus. You have two tears going on. The other tear you have in your Posterior cruciate could heal on its own, and may not need to be fixed. I think it depends on where the tear actually is. The difference between a strain and a tear is with a strain you just really stretched the cruciate and the calf muscle  and that can heal, where as a tear probably will not heal. Hope that makes since!!!!
2006 right knee surgery, meniscus
2008 left knee lateral release,  meniscus
2009 microfracture left knee, lateral meniscus,  fragment
2009 cartilage transplant oats
2010 loose fragment removal, meniscus fraying,found another defect
2010 oats failed, synvesic injections ,2011 right knee meniscus

Offline Snowy

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Re: injured, MRI, waiting to see the surgeon
« Reply #2 on: November 22, 2010, 06:32:35 PM »
The difference between a strain and a tear is that a tear is a complete rupture, whereas a strain is a partial tear where some of the ligament remains intact. Generally the following rule of thumb applies to MCL tears:

* Grade I tear: small, incomplete tear with minimal symptoms; 1-2 week recovery
* Grade II tear: larger incomplete tear with instability, pain and swelling; 3-4 week recovery
* Grade III tear: complete tear. Significant pain and swelling; recovery 6 weeks+

The good news is that a Grade II MCL tear should recover on its own. The meniscus tears will probably have to be trimmed, which is a fairly straightforward surgery. The PCL tear is the biggest issue; you may need to have it reconstructed, which is a major op with a 6-9 month recovery period. Here's some more info on PCL reconstruction:

http://www.sportsdoc.umn.edu/Patients_Folder/Knee/pcl%20recon/PCLreconstruction.htm
http://orthopedics.about.com/cs/kneeinjuries/a/pcl.htm

As you can see it's not necessarily a given that your OS will want to reconstruct, but that's probably the main thing you want to focus on in your conversation with him/her.
Mar 11: R Biceps femoris tear (skiing)
Jul 10: ACLr (hamstring autograft)
Mar 10: L ACL rupture (skiing)
Feb 06: L partial ACL tear (kickboxing)
Dec 03: R bone edema (motorbike)
Jan 01: R patellar chip (motorbike)
May 93: R ACL sprain (hockey)
Ongoing: bilateral PFS and OA

Offline helluvaman

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Re: injured, MRI, waiting to see the surgeon
« Reply #3 on: November 22, 2010, 09:22:44 PM »
Thanks for the input.
i was going from notes i took when I talked to the company Dr. and I now have the MRI report. Needless to say, it has presented me with more questions

It is mostly gobbldy-gook to me but maybe it willl make sense to some of the experts here

Medial Meniscus; combination of irregular horizontal signal within the root/root horn junction region of the posterior horn and a truncated appearance of the central edge. the truncated appearance ot the miniscus continues throughout the posterior horn. Additionally, a veertical longitudinal peripheral tear is present within the residue tissue of the posterior horn. the longitudinal signal continues into the posterior aspect of the mid body. Truncated appearance of the central edge of the mid body as well.Extending superiorly off of the root of the posterior horn is a curvelinear low signal structure which appears to be a miniscal flap which is flipped into the posterior aspect of theadjacent to the PCL

Ligaments:  Mild to moderate diffuse intrasubstaance increased signal within the fibers of the ACL.
the mid to distal aspect of the PCL appears irregular and edamatous. Likely some intact ligament fibers.
Mild edems signal along the proximal aspect of the MCL
LCL is normal.

impression:

high level of gradeII/grade III sprain of the PCL.
extensive longitudinal type tear of the posterior horn and mid-body of the medial meniscus.
A longitudinal tear is present within the periphery of the residua of the mid-body and a small portion of the under surface of the posterior aspect of the mid-body is flipped into the medial gutter.
Grade I sprain of the proximal aspect of the MCL
Grade I-II strain of the proximal aspect of the lateral head of the gastrocnemius muscle.


Anyone care to translate?

Company Dr. says the ACL is fine, but thats not how i read it.


Thanks in advance 

Offline soozles

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Re: injured, MRI, waiting to see the surgeon, UPDATED
« Reply #4 on: November 23, 2010, 11:39:08 PM »
So the gist of it is your tore your PCL and meniscus. Welcome to the club. I just had my PCL replaced today. The ACL is probably fine, the increased signal means something is most likely going on, but nothing serious, essentially like a bruise. Just to give you a little info, the PCL is much thicker and stronger than the ACL, so a larger force is needed to tear it. It's not a very commonly injured ligament. I had my surgery done at the Hospital for Special Surgery in NY, which is the #1 hospital for orthopedics in the country, and I asked the nurse how common it is that they see my injury there. She said not very common at all, i was the only patient having a ligament reconstruction that day that was completely non weight bearing, everyone else was partial weight bearing from the get go. The PT even made me take off my shoe so I wouldn't accidentally put my foot down, and then all the nurses were asking what happened to my shoe.

People will say you can live without it, and I did for 5 years. But then it got worse and worse and more and more unstable. My opinion is find yourself a surgeon that is experienced in PCL's, even if you have to travel a bit to do it. I personally feel like people say you can live without it because it's not an injury that you see very often, and a lot of surgeons just don't know what to do with it, so people get by, just as they could probably get by with a torn ACL. But just getting by was not enough for me.
May 2005: Torn PCL, misdiagnosed as chondromalacia
April 2010: pain worse, lots of instability
Nov. 23, 2010: PCL reconstruction
progress here: http://pclrecovery.blogspot.com/















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