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Author Topic: Impending meniscus debridement / removal  (Read 1853 times)

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Offline dyfanevans

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Impending meniscus debridement / removal
« on: February 02, 2012, 02:16:12 PM »
Hi.  I have posted in knee geeks before and had some good advice, so was wondering if anyone could read this and help me out again before undergoing potential surgery?
 
I had medial meniscus repairs done 2 years and 18 months ago.  Unfortunately l am now in the position of potentially undergoing further surgery due to a reoccurence of the injury, and need some advice regarding a potential surgery, and the effects it may have on my future health.
 
Just to give you some background, l had a repair of the medial meniscus in my left knee in summer 2009, which seemed to work and allowed me to begin riding my bike (4/5 times a week - i am/was a competitive cyclist) after a protracted recovery.  Although the repair site never became completely pain free, the level of discomfort experienced following the procedure settled to a point where l was able to resume training for the 2012 road racing season, however over the past few months has become worse.
 
An MRI taken has shown a horizontal oblique tear of the posterior horn of the medial meniscus, although at the time of scan the tear did not pass through to the surface of the meniscus.  Through my own stubbornness to carry on with my cycling (l have had over 2 years away from training and racing), l spoke to a consultant who shared my view that l should put up with the occasional sharp pain, and continual soreness.  Lately however, l'm afraid l have had to give in, as, in addition to the meniscus pain, l have also developed an acutely painful right knee (potentially inflamed fat pad below patella).  My left knee has full range of motion, does not hurt acutely when twisted and loaded, however the knee feels sore, and occasionally swollen, particularly when walking. Cycling does not produce acute pain, just mainly soreness around the joint line, both at the tear site and at the front of the knee (antero-medial).  Although l am aware that this is not a show stopper in and of itself, the ongoing pain (coupled with the new, right knee pain!) is extremely defeating.
 
I have now sought the advice of another, reknowned knee surgeon (Simon Roberts, RJAH Orthopaedic hospital) in order to gain another opinion.  Following my first visit to him, he proposed a partial meniscus trim or removal, and an injection of cortisone into the other knee to settle the inflammtion.  I am due to see him again this Friday to discuss exactly what he will do if l go ahead with the surgery (he did not have all my scans and notes to hand at the time).
 
My question is relating to the health of my knee if l decide to go ahead with the operation.  I am desperate to get pain free and hopefully make a return into my cycling and racing. Prior to my first operation l was riding around 200 miles a week, and competing at 2/3/4 category races, time trials and the occasional XC mountainbike race.  This is the lowest level l want to get back to.  The tears have not been attributed to any acute injury - l became aware of the left knee tear 6 months after the surgery on the other knee had been done. I believe the injury became symptomatic due to my leg muscles deteriorating.
 
Is it possible to return to full health and eventual competition with a partial meniscus removal?  Would l experience any pain / soreness day to day? What is the ongoing prognosis for my knee? (I dont run, play ball sports etc, just cycling, swimming and gymwork for lower body / core work)
 
I realise that it is impossible to answer for specific cases, however l am trying to make the best decision l can. If it helps, l am 28 years old, otherwise fit and well, have good flexibility, strength and musculature (according to my surgeon and various physios).
 
Thanks in advance,
 
Dyfan Evans

Offline mmrocker13

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Re: Impending meniscus debridement / removal
« Reply #1 on: February 04, 2012, 03:06:25 AM »
I've been operating on only a part of a meniscus since I was a kid... and about 2.5 years ago, I actually had all of what was left of the lateral meniscus removed.

I race at the velodrome, do XC MTB, and am a decent time trialist and duathlete quite happily.
89: Pat. dislocation, lat. meniscus tear, femoral OCD lesion
89: debridement, chondroplasty, lateral partial menisectomy
02: partial lat. menisc., debride
02: mfx
09: subtotal menisc., debride, c'plasty
10: scope/debride
10: varus DFO
13: HWR
15: total menisc., debride, c'plasty, notchplasty















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