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Author Topic: Partial Meniscectomy Findings  (Read 267 times)

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Offline Amofortuna

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Partial Meniscectomy Findings
« on: August 13, 2021, 10:56:08 PM »
Hello everyone.

I am a 41 year old male in good shape.  180 pounds, 5'10, fairly athletic build.  I've had knee issues since I was 15...knees would dislocate laterally.  I put on muscle in my late teens and I haven't had any dislocations since then.  However, I can tell my cartilage was degenerating from playing sports. 

I felt a sharp pain on the medial side of my left knee while working out last year.  The sharp pain didn't go away and my knee would fully lock (happened a couple of times when I woke up).  So I saw a knee specialist and had a partial meniscectomy in June.  However, I am still having a lot of pain on the joint line and soreness above the knee.  I am told my knee is still swollen, so that may be the main cause for my current pain (2 months out from the surgery).  I am having issues walking and cannot walk up stairs.  I cannot cut grass or take out garbage, because of the slope and uneven surface outside.  I was in much, much better shape before the surgery (I was easily able to do basic activities).

I have attached a copy of the report from the scope.  What do you guys think?  Are the findings bad?  Do you think I will recover after the surgery?

« Last Edit: August 13, 2021, 11:25:39 PM by Amofortuna »

Offline vickster

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Re: Partial Meniscectomy Findings
« Reply #1 on: August 14, 2021, 08:39:13 AM »
The findings describe quite advanced arthritic changes (chondral defects) throughout the knee, the  medial, lateral and patellofemoral compartments (the second line of the post op findings and the detail below).

The pain you describe may well be a combination of post scope trauma and the wear and damage to the cartilage through the joint (especially the bit on the weight bearing (WB) surface, although none is described as grade 4 (through to the bone). Having the meniscus tears tidied up may also further accelerate the wear as the forces in the knee are changed and some of the cushioning is gone (the meniscus may be torn due to degeneration, happens with age and alongside the cartilage wear).

Are you working with a physical therapist on rehab?  The soreness above the knee could be muscular. Discuss exercise, cycling abd swimming are more knee friendly for rehab and fitness.

Are you taking anti inflammatory medication, using ice, compression to try to reduce the swelling (could be the the surgery as a lot was done but is also a symptom of arthritis).

Have you talked about all of the findings with the surgeon and what it means for the future? You might get relief from hyaluronic acid injections which help lubricate the joint and reduce inflammation in arthritic knees.

Thereís some good info here and elsewhere in the learning portfolio

https://www.kneeguru.co.uk/KNEEnotes/primers/joint-cartilage-osteoarthritis

https://www.kneeguru.co.uk/KNEEnotes/primers/osteoarthritis-management-options

https://www.kneeguru.co.uk/KNEEnotes/primers/meniscus

https://www.kneeguru.co.uk/KNEEnotes/primers/a-z-rehabilitation-exercises


Good luck, best discuss with your care team :)
« Last Edit: August 14, 2021, 08:46:19 AM by vickster »
Came off bike onto concrete 9/9/09 (lat meniscus, lat condyle defect)
LK scopes 8/2/10 & 16/12/10
RK scope 5/2/15 (menisectomy, Hoffaís fat pad trim)
LK scope 10.1.19 medial meniscectomy, trochlea MFX
LK scope 19.4.21 MFX to both condyles & trochlea, patella cartilage shaved, viscoseal, depo-medrone

Offline jgardner

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Re: Partial Meniscectomy Findings
« Reply #2 on: August 14, 2021, 04:12:44 PM »
Hello Amofortuna,

So sorry to hear about your knee distress. I know how much it sucks...despite my advanced age (56), I was in very good physical condition before I was stopped by 2 chondral defects and a meniscus tear of the right knee.

I liked everything vickster wrote.

You asked about hope for recovering from surgery. I think you should still have some. The surgery was more than just a partial meniscectomy...you had debridement of multiple chondral defects. It wouldn't be a shocker for recovery to take longer than 2 months. Physical therapy could be the key...as suggested by vickster.

I think right now you should focus on recovering as best as you can from this surgery. When you are long past this surgery you may want to consider articular cartilage repair options if you are not satisfied with your level of function.

Best of luck!

Jim
12/2018: MRI: Rt Knee Lateral Trochlear Chondral Defect
1/2019: PT and continued running (100-mile race in 6/2019)
11/2020: MRI: Rt Med. Meniscus tear; small chondral defect on med. condyle
12/2020: Mosaicplasty and Partial Meniscectomy
6/2021: Partial Synovectomy, Patella Release, Fat pad resection

Offline Amofortuna

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Re: Partial Meniscectomy Findings
« Reply #3 on: August 15, 2021, 05:46:46 PM »
The findings describe quite advanced arthritic changes (chondral defects) throughout the knee, the  medial, lateral and patellofemoral compartments (the second line of the post op findings and the detail below).

The pain you describe may well be a combination of post scope trauma and the wear and damage to the cartilage through the joint (especially the bit on the weight bearing (WB) surface, although none is described as grade 4 (through to the bone). Having the meniscus tears tidied up may also further accelerate the wear as the forces in the knee are changed and some of the cushioning is gone (the meniscus may be torn due to degeneration, happens with age and alongside the cartilage wear).

Are you working with a physical therapist on rehab?  The soreness above the knee could be muscular. Discuss exercise, cycling abd swimming are more knee friendly for rehab and fitness.

Are you taking anti inflammatory medication, using ice, compression to try to reduce the swelling (could be the the surgery as a lot was done but is also a symptom of arthritis).

Have you talked about all of the findings with the surgeon and what it means for the future? You might get relief from hyaluronic acid injections which help lubricate the joint and reduce inflammation in arthritic knees.

Thereís some good info here and elsewhere in the learning portfolio

https://www.kneeguru.co.uk/KNEEnotes/primers/joint-cartilage-osteoarthritis

https://www.kneeguru.co.uk/KNEEnotes/primers/osteoarthritis-management-options

https://www.kneeguru.co.uk/KNEEnotes/primers/meniscus

https://www.kneeguru.co.uk/KNEEnotes/primers/a-z-rehabilitation-exercises


Good luck, best discuss with your care team :)

Thanks for the reply.

Just an update.  My PT, chiro and surgeon all said the swelling is causing most of my issues.  Yesterday I got my prescription of Naproxen and I feel significantly better today (after only 1 day on it!).  On my good knee, I can feel all the grooves of my tibia and femur.  On my bad knee, itís all squishy and lumpy still, so perhaps swelling is the issue as they said.  Iím hoping after a week on the anti inflammatory pills, I will feel back to normal.  My gait has changed tremendously after 24 hours on the pills already.

How bad is my damage in your opinion? I was very surprised that the tearing was only grade 2/3...I thought I would be grade 4.   My PT works at my surgeons clinic (itís big clinic at a large university) and she specializes in knee OA.  She is saying itís not bad at all and she is extremely confident that I will make a full recovery once the swelling is gone.  Iím not as optimistic as her, but Iím seeing some light today cause of the meds.

Iíve tried Durolane injections throughout the years and didnít find any significant changes.  Have you tried it?
« Last Edit: August 15, 2021, 05:52:09 PM by Amofortuna »

Offline Amofortuna

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Re: Partial Meniscectomy Findings
« Reply #4 on: August 15, 2021, 05:55:12 PM »
Hello Amofortuna,

So sorry to hear about your knee distress. I know how much it sucks...despite my advanced age (56), I was in very good physical condition before I was stopped by 2 chondral defects and a meniscus tear of the right knee.

I liked everything vickster wrote.

You asked about hope for recovering from surgery. I think you should still have some. The surgery was more than just a partial meniscectomy...you had debridement of multiple chondral defects. It wouldn't be a shocker for recovery to take longer than 2 months. Physical therapy could be the key...as suggested by vickster.

I think right now you should focus on recovering as best as you can from this surgery. When you are long past this surgery you may want to consider articular cartilage repair options if you are not satisfied with your level of function.

Best of luck!

Jim

Thanks for the reply.

I thought debridement was the same as a partial meniscetomy (or part of the procedure)?

Offline vickster

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Re: Partial Meniscectomy Findings
« Reply #5 on: August 15, 2021, 06:54:57 PM »
Debridement just means trimming or tidying of ragged bits.  That can be of the meniscus cartilage (the menisectomy) or of ragged articular defects, the arthritic wear and tear of the bone surfaces. There are two types of cartilage in the knee.
In the arthritis primer I linked, I think it gives details of what the different grades of cartilage mean. Grade 4 is the worst and means the subchondral bone (beneath the articular cartilage) is exposed. Grade 2 is mild to moderate, then 3, then 4.

If youíre taking naproxen, make sure you have it with food and a PPI like omelrazole to protect your stomach if taking for more than a few days.
Came off bike onto concrete 9/9/09 (lat meniscus, lat condyle defect)
LK scopes 8/2/10 & 16/12/10
RK scope 5/2/15 (menisectomy, Hoffaís fat pad trim)
LK scope 10.1.19 medial meniscectomy, trochlea MFX
LK scope 19.4.21 MFX to both condyles & trochlea, patella cartilage shaved, viscoseal, depo-medrone















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