12 month post meniscus surgery in a lot of pain - suggestions

[fithy]

So history of my knees are that I have been playing basketball now for 25+years and Im now 44.
 
I did develop severe patella tendinitis, which ended up having to have a patella tendon reconstruction when I was 33. This was successful, and after 6 months of rehab and rest I was able to resume playing basketball again and my knee was great!

This lasted until I was 43 and I managed to macerate the lateral anterior horn meniscus in my left knee (got bumped while pivoting doing a drop step fade away - bucket was good!). I had surgery a month later where they trimmed the macerated meniscus and was told it was all good, and with rehab I should be back to playing again pain free in about 8 weeks. This didnt happen.

I did as told and came back to basketball gently which lasted all of about 3 weeks. It was progressively getting worse each week, so I stopped and continued rehab for another 8 weeks before trying again. I was only playing 1 game a week, and did this for about 12 weeks till the end of the season but by then it was very painful so I stopped with the intention of taking 6 months off and then trying again. I went and saw another orthopedic surgeon (the one who did the original patella recon), but he told me there is nothing that can be done. He said that the meniscus is like a flat tyre now and gives no support, and that I now have a space between the articulating surfaces and the force transfer with each jump and step is knocking the surfaces together leading to inflammation, pain and swelling. I did try to play a game to help out a friend who was short on numbers, and it hurt to play, and has been aching and painful since.

Im at the point where it is now restricting me from being active. Id like to realistically be able to play basketball again to some extent, but Id even settle for it being pain free just for day to day activities.

Are there any special procedures or operations that can fix this? Has anyone else had similar problems like this before.

Thanks
 

 I played a game last week after 4 months off, and it was still painful, and the next day it blew up 

[John42]

Hi Fithy

Sorry to learn of your ongoing problems, but this injury will noy go away with ball games.

So now is the time to retire froom active sport.

Best/JohnK Manchester UK

[LateralMeniscusIssuesGuy]

Hi Fithy,

It seems that a persons response to having a partial meniscus removal is random.  Some can have no issues, presumably as they retain sufficient joint spacingbetween their articular surfaces due to lucky bone architecture (i.e. bow legged or vice versa depending on the part of meniscus removed) or movement patterns that tend to not reduce the joint spacing further in the compromised compartment.  I wasn't lucky and like you had to give up on sport after a partial lateral meniscus removal, and then 2 years later, after trying to return to sport but lots of reactive swelling, I had managed to completely wear through my articular cartilage.

I think you have a few things you can try.  If i could go back in time with my current knowledge I would seek out my current Osteopath (she has additional specialisations in Neural Kinetic Training (NKT) and Functional Range Control (FRC)) and have her figure out if anything could be done with respect to my movement patterns and body condition to relieve stress in knee.  I'm amazing how much positive progress I have had since investing time with her, the last year has been trans-formative.

If that is exhausted I think you would be talking about attempting a unloader sport brace (I wear an ossur Custom OA CTI brace), hopeful that it can create the necessary joint spacing for you when occasionally playing.  I have one and wear as an instrance policy to prevent an abrupt collapse of my lateral compartment if someone bashes into me (I am an ice hockey goaltender).

Last resort (as it should be) is surgery.  Perhaps others would consider types of injections but my experience with injections is just steroid joint injections, which I regret.  You might be talking about a meniscus transplant but, having gone down that route myself, I am finally match fit and it has been 2.5year post surgery, so a massive chunk of time and takes over your life, so a decision to be taken only if sport "is your life" essentially.  Even if you are prepared for that time investment, the outcomes of surgery won't always be better than your current circumstance, so you are rolling the dice.

Hope that's helpful, I am a strong believer that the right Osteopath can do lots to help someone.

Regards
James