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Author Topic: Meniscus Tear  (Read 264 times)

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Offline Magnum777

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Meniscus Tear
« on: May 24, 2018, 02:49:17 PM »
Hi there,

I am an active 51 year old male who has always played sport and have never had any previous injuries with my knees. I had a fall off a fence in December 2016 and tore my meniscus on my right knee in two places. After having an MRI they initially told me there was no tear but after trying rehab for 2-3 months the pain was still there. Another visit to the consultant ensued and he said I'd need an Arthroscopy as he thought there must be a tear.

I had the op in November 2017 where they said that I did indeed have two tears one on the inside and one on the outside. I did all the rehab execises and visits to the physio but I was still troubled with pain and it seemed to be getting worse. I was so frustrated because I tried to do everything correctly in the rehabilitation but I wasn't seeing any improvement at all. I went back to my consultant and he suggested having a cortisone injection (which I know only treats the symptoms not the cause). I had this and for 10 days I was pain free but then it returned and I'm back to square one.

Again I went back to the consultant, had another MRI and now I'm on the waiting list for another op as they have said I have two new tears. My GP has told me that there is a 40% chance that this second op won't be successful so I'm struggling to figure out what to do for the best. Does anyone know whether there is a standard rehabilitation plan for this op? It all seems very hit and miss with the type of exercises recommended and I'm confused as to how quickly to build up strength in the knee. The NHS pyshio was very inexperienced and was looking at YouTube videos for reference when I visited a couple of times! The consultant said to rest it for a while afther the op then go on the exercise bike... but that doesn't tell me for how long I should do it and on what strength setting. I heard someone say that the rule of thumb is that if it hurts then stop but then I'm in pain for most of the time anyway and I don't know whether I'm making it worse by exercising.

I suppose what worries me most is that fact that I'm having to wait at least 4 months for the op and even then I don't know whether it will make it better. Even if it the knee functions at 70-80% I'd be happy because currently its about 30% and its been like that for 18 months. I'm physically fit otherwise so its not like I'm carrying any extra weight. I don't suppose there are any alternative therapies for this type of thing?

Many thanks, Paul.

Offline Vickster

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Re: Meniscus Tear
« Reply #1 on: May 24, 2018, 04:49:48 PM »
Unfortunately, at 51, itís likely your meniscus are degenerate and prone to tearing and especially now theyíve been trimmed and the mechanics of your knee are changed so you need to work in a way that your body gets used to the new normal in a low risk way. Do you also have wear and tear arthritis in the knee?  If not, avoid cortisone if possible as it can damage healthy cartilage

Do you have mechanical issues with range bending and straightening too or is pain the main / only symptom? Is the pain linked to specific activities? Are you sure itís down to the meniscus and not arthritis?

Youíd probably be best paying to see a knee expert Physio privately to be honest. NHS is focused on short term acute back to work type rehab, not chronic long term back to sport. A private Physio will often also have other tools such as acupuncture, taping, ultrasound, deep tissue massage, even water based therapy. Doctors and surgeons are pretty hopeless when it comes to rehab, physios the experts and a private Physio with lots if years under their belt will be far more hands on and experienced and knowledgeable about what is good for specific issues. You need to get all your muscles and gait working properly

Where in the UK are you?

« Last Edit: May 24, 2018, 05:16:09 PM by Vickster »
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline Clarkey

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Re: Meniscus Tear
« Reply #2 on: May 24, 2018, 08:54:37 PM »
Seems a bit drastic that your OS wants to carry out a second surgery in such a short space of time since your last one 6 months ago, your knee will still be traumatised from the recent surgery. There is a positive MRI scan to go on, your OS should try out the none invasive methods of treatment methods before a 2nd surgery within a short space of time is very risky! It takes at least 1 year plus to recovery from a knee arthroscopy, even then the knee will never be 100% again.

Thought NHS OS's are more cautious carrying out surgery if the last scope was carried out in November. Trying none invasive treatment options by sending you for regular physiotherapy sessions or to a sport medicine doctor. My OS this before going for my 3rd scope. Another arthroscopy will create further scar tissue build up, creating a greater increased risk of even further cartilage tears.

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« Last Edit: May 24, 2018, 09:04:13 PM by Clarkey »
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline Magnum777

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Re: Meniscus Tear
« Reply #3 on: May 26, 2018, 04:57:01 PM »
Thank you Vickster & Clarkey for your prompt responses - I really appreciate all your advice. I'm so frustrated with this I can't tell you. I've always had this feeling that the NHS OS wasn't very thorough, he seemed like he was bullying me into having the cortisone injection even though I know they aren't a long term cure.

I know I'm 51 and my bones and body are starting to creak but when I had an X-ray before the initial surgery the doctor said I had very little wear and tear and that the knee was mechanically very sound apart from the tears. He even said to me that after surgery and rehab I could expect to get back to 90% fitness.

I'm from near Leicester and I've even been to see the Leicester Tigers Rugby physio who is very experienced in these types on injuries. I had about 12 sessions with him last year to try and get the knee back to some sort of fitness but everything he tried failed. He used ultrasound, a TENS machine, massaging using some sort of palette implement so as you can imagine I fell like I'm getting absolutely nowhere.

This is not arthritis, I've been told that my range of movement is excellent (I can bend my leg pretty much right back to my bottom) but its just the pain to the inside of the knee and slightly under to the left that is the main issue. My GP said at my age that you don't need to have an accident to get a tear, sometimes they are weak and that they occur naturally. If so, then I will just have to do the best I can and do exercises regularly but not overdo it.

From your suggestions I'm now confused as to whether I should go for another op. I'm on the waiting list but they said it could be another 4 months at least. Is there anyone you might be able to recommend who has extensive experience with these types of injury? Thanks again.

Offline Vickster

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Re: Meniscus Tear
« Reply #4 on: May 26, 2018, 06:05:58 PM »
You say the Physio has extensive experience so why not see him again and your GP is right about the tears. What did the surgeon say about the state of the bone surfaces when he did the scope?

If you want to see a surgeon privately for a second opinion in the Midlands, Tim Spalding in Coventry is among the best (quite long waits potentially even for private appointments)

http://www.kneeguru.co.uk/KNEEnotes/knee-surgeon/dr-mr-tim-spalding?action

Do bear in mind that most private Consultant OS also have an NHS practice so the surgeons are often one in the same

I have arthritis and meniscus tears but also pretty much full ROM too, the wonders if Cycling (except I donít stand on the pedals or grind up hills if at all
possible)

Another op might help although if the ROM is ok and pain is the issue you might well be no better or indeed worse off

Lots of good meniscus resource in the learning portfolio
« Last Edit: May 26, 2018, 06:09:14 PM by Vickster »
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up















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