I took the plunge, Lateral Meniscus Transplant + OATs

[AndrewC]

Very brief note update.

Diet went well, basically ate calorie maintenance and didn't lose or put on weight as best I can tell.  Probably a beneficial move in body composition.  Knee swelling is good but by instinct is that going full keto didn't have much if any impact from that angle, so will likely stay low carb but increase protein for better muscle gain and retention.  Eating once a day is convenient and has really helped cut down on unhealthy snacking.

I have had a session with a Neural Kinetic Therapy (NKT) professional and they have deemed that the impact if the surgery has left a neural lag / road block that needs retraining and stimulating to get full proprioception of my leg again.  After 1 session I think I am seeing a difference, she wants me to lay off the lower body work and hockey for 2 months to give this a go, so no sport until April.  Excited that this might be the bit I was missing.

Will update probably at the end of that treatment.

Please keep the updates coming! Im enjoying reading your progression!! Sounds like it is going very well.

I am probably going to have to travel this route myself at some point not too far away. It seems a very long road 

[LateralMeniscusIssuesGuy]

Hey AndrewC,

It is a very long road, and I'm running out of road hahaha!

So NKT is legit, I feel the treatment is really switching on my movement chain, she is very happy with my progress.  She does note there have been internal structural changes from the meniscus but I am sloe to being able to move to impact movement training with her.  She has done sufficient work on me that she has permissioned me to get back to lower body weights, where I had stopped that for 2 months.

I do feel the best I have felt since surgery, knee feels the most versatile and normal it has.  Its not aggravation free, if I do overdo it I sense a reactionary swelling occurring inside even through it isn't visible, or if it is, barely.  Its feels obvious to me that I needed this surgery given the situation I got myself into, and that I picked the right surgeon, but its still not clear how versatile I will be in future, will I, another year from now perhaps, be a fully operational athlete, or am I reaching the limits of my recovery, and should stay away from impact and explosive fast movement, living a very normal active life without excessive exercise / sport.  I still don't know, I still train very often and watch what I eat and take buckets of supplements, so I'm in a good place mentally, and physically I guess (to look at I function really well and look fine) but I am still short of the nirvana.

I plan to have a followup 2yr MRI in a couple of months to see for all the hiccups and scares, whether the meniscus and OATs are still fine.  If they are, thats a tremendous green light to not be put off but the lumps and bumps.  I participating in a national championship and played a fair bit of my sport in the last year, if the scan comes up fine I'll be so relieved and allow more activity little by little and tackle pains that onset with my NKT and FRC trainers.

Hope that's helpful, not a very technical update, but essentially at 21 months I'm doing well physically and mentally, but still think this is a 2 year process, minimum.

[LateralMeniscusIssuesGuy]

Hi all,

More or less my 2yr update.  Just came back from the surgeon office after reviewing my recent MRI.  For what its worth the MRIs indicate my plug and meniscus are as good as the day they were put in, I have a full thickness continuous articular cartilage surface where I had the grade 4 (full thickness) defect, and the meniscus is in place with no signs of tears.

Its a great relief to hear that, as I do get episodes of light swelling, which was the indicator I ignored before this surgery, where it was trying to tell me I was chewing through my articular cartilage.  My Osteopath (and NKT specialist) has different theories on the source of the swelling, but is really happy with my function, and believes as long as we tackles compensations and imbalances as they crop up, I should be a very capable man, able to participate in sport in a balanced way.

I have played in another tournament since my last post, and training ice hockey without significant issues.  My tolerance for playing is increasing gradually, seemingly to no detriment of my knee architecture.  I'm on of the 9 out of 10 for whom a MT improves their life (Tim's statistics).  I am very fortunate to be able to afford all the supplements and additional treatment I have, I can't say definitively but my instinct is they all help.

As such, for now, I am very happy, will continue my daily work to improve (which I have come to enjoy) and hope for a fun filled future.  Tim has recommended either Lipogems or nStride as possible injections to get the capsule to settle down even more, as things are improving I'm unsure whether to invest and risk it at the moment so will do some reading.  If anyone has any opinions I would be grateful.  For the avoidance of any doubt I still don't run or jump really, I didn't train those yet and may never again, I am choosing my battles, and to return to my sport is my number 1 goal.

Its a long road, but for me and my set of circumstances I seem to have satisfactorily salvaged the situation.

JT

[Samiul27]

Hi all,

More or less my 2yr update.  Just came back from the surgeon office after reviewing my recent MRI.  For what its worth the MRIs indicate my plug and meniscus are as good as the day they were put in, I have a full thickness continuous articular cartilage surface where I had the grade 4 (full thickness) defect, and the meniscus is in place with no signs of tears.

Its a great relief to hear that, as I do get episodes of light swelling, which was the indicator I ignored before this surgery, where it was trying to tell me I was chewing through my articular cartilage.  My Osteopath (and NKT specialist) has different theories on the source of the swelling, but is really happy with my function, and believes as long as we tackles compensations and imbalances as they crop up, I should be a very capable man, able to participate in sport in a balanced way.

I have played in another tournament since my last post, and training ice hockey without significant issues.  My tolerance for playing is increasing gradually, seemingly to no detriment of my knee architecture.  I'm on of the 9 out of 10 for whom a MT improves their life (Tim's statistics).  I am very fortunate to be able to afford all the supplements and additional treatment I have, I can't say definitively but my instinct is they all help.

As such, for now, I am very happy, will continue my daily work to improve (which I have come to enjoy) and hope for a fun filled future.  Tim has recommended either Lipogems or nStride as possible injections to get the capsule to settle down even more, as things are improving I'm unsure whether to invest and risk it at the moment so will do some reading.  If anyone has any opinions I would be grateful.  For the avoidance of any doubt I still don't run or jump really, I didn't train those yet and may never again, I am choosing my battles, and to return to my sport is my number 1 goal.

Its a long road, but for me and my set of circumstances I seem to have satisfactorily salvaged the situation.

JT

How much did you pay for the procedure with Tim Spalding?

[LateralMeniscusIssuesGuy]

Hi, I didn't pay, I had Bupa health insurance, I don't know what cost would have been billed to me if I weren't covered.

[xbrett82]

Very brief note update.

Diet went well, basically ate calorie maintenance and didn't lose or put on weight as best I can tell.  Probably a beneficial move in body composition.  Knee swelling is good but by instinct is that going full keto didn't have much if any impact from that angle, so will likely stay low carb but increase protein for better muscle gain and retention.  Eating once a day is convenient and has really helped cut down on unhealthy snacking.

I have had a session with a Neural Kinetic Therapy (NKT) professional and they have deemed that the impact if the surgery has left a neural lag / road block that needs retraining and stimulating to get full proprioception of my leg again.  After 1 session I think I am seeing a difference, she wants me to lay off the lower body work and hockey for 2 months to give this a go, so no sport until April.  Excited that this might be the bit I was missing.

Will update probably at the end of that treatment.

Hey, so I am getting a lateral meniscus transplant in about a month. I'd love to ask you some questions. shoot me an email if you get this: [email protected]

[LateralMeniscusIssuesGuy]

Happy to send you an email, however if you have any questions you feel happy to share online, the community might benefit from us discussing your questions and concerns.

As a 2.25yr update, things are going really well.  Ice hockey is getting better, any subtle pain is normally reducing.  I am as convinced as I have ever been that pain manifestations are due to function and muscle imbalances that my Osteo (Sue) does amazing work to fix.  I'm being asked to compete at national level by many teams now as I am 'back' in their eyes despite my age.  I have lost 5 years of my sport due to the initial tear and processes since then, looking forward to the future with real enthusiasm now, hope to have my children play with me.

I will say you have to straddle the line between being cautious and not being consumed by worry.  Pains and mishaps occur, but have faith they aren't major and really invest in someone like Sue to manage you though the years after the operation.  I still am selective about the activies I engage in, but that is also responsible given im 36 now, not a spring chicken.  I'm not participating in a 5k run with my friends today, as it just seems to risky atm.

Those who read the whole post might recall when my surgeon told me about a rugby player he treated who returned to national level after 2.5years.  Given where I am now, that does feel like the time frame required for me to also feel not just strong and durable, but able to express my strength quickly with control (i.e. power).

In summary I have occasional pains, I have driven my family mad with my time demands to get myself fit and healthy, I do 30 mins of work every morning in the gym from my osteo, then an hour of gym, then stick to an anti-imflammatory diet, and structure many life choices towards the protection and betterment of my knee.  This scale of commitment won't be appropriate for everyone.  But maybe I am an average or below average healer, and so that scale won't be necessary for others.

[AndrewC]

Happy to send you an email, however if you have any questions you feel happy to share online, the community might benefit from us discussing your questions and concerns.

As a 2.25yr update, things are going really well.  Ice hockey is getting better, any subtle pain is normally reducing.  I am as convinced as I have ever been that pain manifestations are due to function and muscle imbalances that my Osteo (Sue) does amazing work to fix.  I'm being asked to compete at national level by many teams now as I am 'back' in their eyes despite my age.  I have lost 5 years of my sport due to the initial tear and processes since then, looking forward to the future with real enthusiasm now, hope to have my children play with me.

I will say you have to straddle the line between being cautious and not being consumed by worry.  Pains and mishaps occur, but have faith they aren't major and really invest in someone like Sue to manage you though the years after the operation.  I still am selective about the activies I engage in, but that is also responsible given im 36 now, not a spring chicken.  I'm not participating in a 5k run with my friends today, as it just seems to risky atm.

Those who read the whole post might recall when my surgeon told me about a rugby player he treated who returned to national level after 2.5years.  Given where I am now, that does feel like the time frame required for me to also feel not just strong and durable, but able to express my strength quickly with control (i.e. power).

In summary I have occasional pains, I have driven my family mad with my time demands to get myself fit and healthy, I do 30 mins of work every morning in the gym from my osteo, then an hour of gym, then stick to an anti-imflammatory diet, and structure many life choices towards the protection and betterment of my knee.  This scale of commitment won't be appropriate for everyone.  But maybe I am an average or below average healer, and so that scale won't be necessary for others.

Thanks for all the updates, very interesting to hear them.
I see, BUPA would for sure be a massive bonus !!! I believe the transplant is in the region of £15k with Tim Spalding ++ extras and on costs (for the person who asked) but this is just what I heard, I am not in the position of needing one it seems (or not yet..).

Had an operation a few days ago with Prof Nick London who is a top tier knee man as well, and although its early days in my recovery, I have a feeling he may have worked some of his notorious magic (lovely chap for anyone else considering him as a surgeon).
Not spoken to him post surgery (was 1.5 hours ish I think) but the constant pain I had behind the knee is not there (its more a post arthro ache!) and the feeling of a steak knife rubbing on my tendons behind the knee is for sure not there... The notes say repairs to lateral and medial meniscus from tear caused by sport injury (could be trimming most likely) but there is no other issues noted and no followup instructions except an appointment with him in a few months....

So... we shall see. Hopefully this will buy me some time, will see what the follow up appointment says! Sorry for the off topic - I still have Tim Spalding as my last chance saloon!

[left knee]

thanks for all the updates. 18/12 out and it has been long recovery. Still get intermittent swelling depending on activity but varied. Can occur after a day in work, but might not occur after an hour on the cross trainer. I am hoping with time this will settle down fingers crossed. Im about 8 months behind you lateral meniscus guy so fingers crossed. Like you I always viewed that 2 years would give a good picture of where I am at. I had a relook arthroscopy recently to investigate this intermittent swelling as MRI wasn't conclusive. Thankfully meniscus looks normal, no tears , and looks like native meniscus. So that is very positive. I spoke to a friend who is 7 years out with procedure, who said their knee is better at 7 years than at 2 years out so hopefully things keep improving. As I said previously I have new aches and pains, but arthritic pain definitely gone. Golfing is much better . The aim is to get back snowboarding/skiing but time will tell. One last question for lateral meniscus guy. The functional brace you bought for hockey what the name of it? I have the Donjoy offloaded which I wore post op and was wondering what one did you get

[LateralMeniscusIssuesGuy]

2.75Y update:

I think I can say with confidence now that this surgery combination certainly requires a long rehab period.  Thankfully I can report that I am back to competitive sport, perhaps able to represent Great Britain again in 2021.  My knee feels very good most of the time.  I will likely always be sensible with my choice of activities, and imagine I will have to keep seeing my spectacular Osteopath forever, but being able to play sport and be uninhibited for family and work life is a true blessing.

I still don’t run or jump, I am entirely specialised to my sport (dropping from my feet to my knees, and maintaining a squat position), but imagine if my focus had been different, I may have been able to do those other things.  It seems likely to me that anyone going through this has a particular activity in mind they miss or want to be able to continue to participate in, to be focused on that and not being greedy for everything has worked so far for me.

Right now I have zero swelling.  My scar mobilisation is very good, however I continue to work on it, my Osteo believes the mixed nerve signals in that area are responsible for muscle imbalances and compensations I frequently develop, so we keep working on them.  Legs look identical.  Pain can manifest and ALWAYS in my lateral compartment making me think I have gone too far or finally compromised the repair, however via Osteo we have always established a potential cause of the pain, given me exercises (strengthening, movement pattern, specific massage, specific stretching instructions) and within 2 weeks the pain and or swelling is gone.  It is truly remarkable.  My Osteo is not generally a fan of surgery, I wish she had been in my life on my coaching staff a decade ago.  Others who have pain or believe procedures have been failures, and Osteo like her can change your life.

I continue to take a mountain of supplements every day, gym every day (45 mins of which are my Osteo exercises) and eat as well as I can, I’m even investing in expensive new equipment this week, that is how confident I am in my recovery and likelihood I will be able to continue playing in the future.

The brace I use for sport is the CTI OA CUSTOM https://www.biodynamictech.com/cti-oa-custom/ and I am confident it makes sport safer for me, hopefully reducing the peak forces through my knee.  I paid £700 for it from a very good fitter in the UK who did a 3D scan of my leg to get the right shape.

I am tempted to have a 3yr MRI with Tim Spalding, but if things carry on as they are at the moment, I see no need.  My Osteo has said regardless of what a scan shows, she plans to keep me mobile and operating properly without pain, so why have a scan.

[daugule]

Dear JT
Thanks for sharing your story! I had a medial meniscus transplant a few months ago. Your suggestions are helpful.