Thread: MCL, meniscus, bum knee issues

Howdy ya'll,
So sprained/tore/whatever my mcl and probably meniscus in May. Ortho thought the mcl would most likely do alright on its own with the meniscus the big long term question.(ie whether i'd have to get it scoped). So i've been riding my bike lots (1-3 hours) daily usually with lots of other rehab stuff and have been working part-time for over a month now (i work on my feet). So the strength is returning although alot slower than i'd like. But the big issue is that it just doesn't feel stable -- like it might buckle or "bloop" just kind of fall apart. Also i still can't quite straighten it out and can't really walk very far although i've had virtually no pain in quite a while. Doc thought ACL/PCL type issues were no problem. Doctor says i've got SOME symptoms that point to a meniscus tear in need of getting scoped/cleaned up but not enough to be able to really tell without an MRI which might not even be able to tell anything anyway.
I should add that i had an almost identical injury ten years ago. Never got an MRI or surgery and did lots of rehab myself and seemed pretty much fine till i hurt it again. Don't have a whole lot of cash -- good ole' fashioned ski bum here -- no insurance either so really don't want to rack up a bunch more doctor bills. I'm seeing an ortho who's willing to work with my financial situation but . . .
So some advice is needed here from those in the know. Is it time to schedule an MRI or maybe just the Arthroscope or is there a reasonable chance it'll be fine given a few more months and intensive rehab.

Your injury sounds very similar to what I was going through last spring / summer after injuring my knee in March. Initially I was unable to walk, etc. for several days. After little progress, I went to my Dr. to see if I needed an MRI. He did not recommend it, but I wish I had gotten one. After a few months of being limited to a bike, I decided to give PT a shot. She recommended the standard stretching, yoga, etc. What made the biggest difference for me was when she did "trigger point dry needle therapy" on my leg / knee. It was extremely painful, but after a few treatments, my flexibility increased significantly and with continued stretching, etc. I was back running. I was able to ski at 100%. The only time I have issues is sometimes when I Mtn. Bike for a long period of time.

I regret not getting an MRI and I think my Dr. recognized the amount of discomfort I was in. You just never know with knees. I just don't want to have issues in 10 years because I didn't take care of it now. Maybe see if you can get a hook-up with PT and see if they can try the trigger point therapy. It made a huge difference for me.

Sorry to hear about your injuries, Nordic. Actual knee instability, esp while cutting, is usually ACL related rather than meniscus related. That being said, buckling of the knee may be due to weakness rather than structural instability. Is your physician feeling any ACL findings on clinical exam? Given the severity of your symptoms, it wouldn't be a bad idea to get an MRI to get a better idea of what is actually going on. For all we know, you may have torn your ACL years ago and this second injury made you more symptomatic. That being said, it's only worth pursuing the MRI if you'd consider a surgery for any significant findings, which makes insurance a big deal. New legislation is forcing insurance companies have to cover pre-existing conditions, which works in your favor, and you can buy a cheaper plan on an insurance exchange in some states (which have high deductibles but won't leave you with the whole bill).

Regardless of what you choose, best of luck....

First, sorry to hear about Your knee. Second, because You have been so dedicated to training and pt. for the past two months and you are still having instability and extension issues, it may be time to go to plan b. (if your doc. does not specialize in knees, perhaps a second opinion from a doc. who does or prepare for a scope). Third, listen to your gut. If your first gut impression is telling you something isn't right, I would certainly listen to that. I was in a similar situation six years ago. I went to see a pt, who said it was probably a meniscal tear and that I would heal on my own with physical therapy. With no improvement after three weeks and in particular, with no improvement of leg extention, I went to see a knee doc. The doc. said that most likely my meniscus was torn and it would require a scope because it was torn in such a way that the torn meniscus chunk was limiting full extention. Upon arthroscopy, the Doc. discovered that the meniscus was fine but I had a grade II ACL tear. The loose chunk of ACL had attatched to the meniscus and would therefore lock my knee out limiting full extention. My strength, extention, flexion was about 90% 2 months post arthroscopy. I am a fan of avoiding arthroscopy but sometimes it is the only solution. Anyway, hope that helps and good luck.

Weeeellll . . .
It's been close to three months now and i'm still walking funny. Went to see the ortho a few days ago again and he still thought the ACL was fine. He still thought it was POSSIBLE that i just needed more P-T/stretching/yoga but thought it was time to seriously consider an MRI and thus arthroscopy if it looked neccessary. Working on finding the cheapest MRI i can but it's definitely in the near future. The issues swascake22 alluded to with funky meniscus chunks glueing themselves onto other stuff definitely makes me wonder. I'll try to update when i know more.

Read my thread on stem cells. I had similar issues, ie, a chumk of meniscus stuck to my chondyle and it was ripping and grinding the meniscus for five months, requiring a removal of 60% of my meniscus on the cleanup. Put my knee 3-4 mm out of line due to my bow leggedness. Stem cells saved my knee and quite possibly my hip, given the wear resultant of all the limping I did. Unless something absolutely requires physical removal/repair, I recommend stem cells. It's like a knee rebuild done right from the inside out in the best fashion possible - on the natch.

Yeah mr. splat, i've checked out your stem-cell post. Sounds pretty incredible, in a good way. I know a guy here in girdwood who just recently had a similar procedure and he's had nothing but good to say about it too. I just scheduled an MRI so going from there . . .
If I had insurance/more cash, I'd have pursued my options aggressively at a sooner time. But poverty's a bitch.

Bump. Pulled some strings. MRI scheduled for this Thursday. . .

Surgery to remove a portion of my medial meniscus scheduled for Sept. 26 . . .

So I had a big "bucket handle tear" removed. I'm a week out from my surgery and the ortho thinks I'll be totally fine with rehab and should even be able to ski by Christmastime. The doc was a bit concerned about cartilage damage prior to surgery but he said it looked great; as did all my ligaments and tendons too. Pretty excited that I finally got this dealt with. Already walking better too! Now I just need to get a second job to pay for all this . . .