anyone have a meniscus REPAIR?

[upallnight]

I just had a meniscus repair (10 days post-op.).

I'm on crutches and am allowed to put 5% weight on it. Swelling is coming down with continued ice & elevation, and pain is finally getting a little less.

I have about 5 degrees of motion....definitely a little depressing/scary. The doc said I am allowed to bend my knee passively, but it would be "like bending a grapfruit." It really won't bend.... much and it seems like in this short a time my leg muscles have already become jelly. Should I be trying to bend it more? I've stopped trying.

I go in for my next appointment on Monday.

Also, I was sad to read this today: "Unfortunately, although it is technically possible to repair a torn meniscus, repair of the tear does not mean the healing will always occur. Your physician has no control over the body's ability to heal a tear. Therefore, if healing does not occur, the arthroscopic procedure will need to be repeated. Patients are usually on significant activity restrictions for a minimum of 3 months after surgery to allow for maturation of the healing process."

I knew that healing would be >3 mo, but I didn't know that it might not heal.

[altagirl]

I just had a repair of a buckethandle tear of the posterior horn of my medial meniscus 6 weeks ago.

I was zero weight bearing for 2 weeks than gradually increasing to full weight bearing after four weeks.

I kept it elevated as much as possible and wore a surgical stocking for compression for the first 4 weeks. This really helped with keeping the swelling down, and I didn't lose any range of motion from the beginning. I went to PT at 7 days post op and had about 0-120 degrees or ROM. Which shocked my surgeon - he had said I could do gentle stretching with no pressure and I guess he wasn't expecting anything near that.

If you're having trouble with ROM, I'd suspect it's from swelling and what you really need to work on is that - through elevation, compression, ice, eating right (low sodium and things like fresh pineapple help), edema massage, etc.

Have you been going to physical therapy? I know it seems like there's not much you can do at this point, but they can help with both the atrophy and swelling, so I think it's very much worth it.

I'm now able to do elliptical trainer/stationary bike for about 45 min at a time, and my doc gave me the okay to ride my mountain bike this weekend on smooth surfaces. It's feeling pretty good so far, but it's easy to get nervous about every little twinge, wondering if something bad happened. The other day I had a major shooting pain when I spun around in a swivel chair at my desk. Luckily I stopped having a panic attack when I realized the pain was in my upper shin and figured out it was my hamstring where it attaches into the bone. (Which felt fine again after 24 hours). But it's nerve wracking to worry about every little thing.

[caddah]

You can do exercises to help keep your muscles in shape with out bending your knee. get on the stright leg raises and quad sets and do as many as possible. see if you can count to a million.

just about everyone who has been through a major knee problem probably wishes they would have done more of these exercises in the beggining becuase your muscles really do dissapear fast.

[upallnight]

Have you been going to physical therapy? I know it seems like there's not much you can do at this point, but they can help with both the atrophy and swelling, so I think it's very much worth it.

My doc hasn't suggested/talked to me about PT yet -- I go back on Monday for my 2 week post-op, so I presume we'll talk about it then.

Is that ridiculous that we didn't talk about it? I am supposed to be on crutches for the first month (toe-touch weight bearing at the moment, more to come next week?).

I feel weird because I read that you had PT, edema massage, some e-stimulation....and I have none of that. Am I behind "schedule"?

[upallnight]

You can do exercises to help keep your muscles in shape with out bending your knee. get on the stright leg raises and quad sets and do as many as possible. see if you can count to a million.

just about everyone who has been through a major knee problem probably wishes they would have done more of these exercises in the beggining becuase your muscles really do dissapear fast.

Really? Can I do such things when the join is swollen and painful?

I guess I could do straight-leg raises while poised on my crutches as the pain from lifting the leg is finally no longer excruciating....

...but also a "meniscus repair" is listed as extremely delicate in all I read about recovery, so I don't want to do any damage before its time. Seems like it's not a case of working as hard as possible and being agressive with the PT, but that's just from reading on the internet.

[upallnight]

I don't have the strength to lift my extended leg even a few mm off the ground when sitting down.

Not sure why that is.

[caddah]

straight leg raises can be dificult after surgury. I remember having the physical therapist in the hospital while I was still in a very sensitive state tell me to try quad sets and do alot of them. just trying to contract your quad muscle can be painful, but it helps it stay awake and keeps it from atrofying a little bit. if you can do quad sets with out too much pain, then your probably good to try stright leg raises. I had a very hard time doing them at first. I had an external fixator on my leg that my PT actually used as a handle to pick up my leg and help me do SLR's. so dont be too bumbed that you cant lift your leg.

[upallnight]

Thanks for the vote of confidence -- that makes me rest a bit easier.

Quad sets = just flexing the quad? I have been trying that (not enough); I will do more.

[schindlerpiste]

Like AG, I am constantly wearing my TED. Also, I have a cyrocuff wrapped around my knee at all times. 10 days post-op w/ no P/t or stretching seems odd. You must be severely atrophied. I am seven days post-op for repair and partial removal of a complex flap tear of the posterior horn of the medial meniscus with chondromalacia, and today will be my third day of P/t. Yesterday, at P/T, I was able to slowly ride the stationary bike for 10 mins. (A full revolution was not easy, buy I did manage 2 miles).
Did you have an open surgery, or arthroscopy? I can see no R.O.M. at this point with an open surgery, but with arthroscopy, you should really try to get some mobility in the knee. Of course, ask your doctor specific questions about your concerns. However, just as important as exercise, is getting the swelling down. Use plenty of ice, and use a TED (surgical stocking). If you are that immobile, you don't want clots to form. ALso, consider anti-inflamatories and glucosamine.

[altagirl]

Really? Can I do such things when the join is swollen and painful?

I guess I could do straight-leg raises while poised on my crutches as the pain from lifting the leg is finally no longer excruciating....

...but also a "meniscus repair" is listed as extremely delicate in all I read about recovery, so I don't want to do any damage before its time. Seems like it's not a case of working as hard as possible and being agressive with the PT, but that's just from reading on the internet.

I did straight leg raises and quad sets from day one, but I asked my doctor about it in the recovery room - he didn't bring it up.

And for straight leg raises, you generally want to be sitting on the floor, good leg bent, contract the quad and raise your leg up. You can do them standing, but that's going to be worse for swelling and less resistance so they'd be super easy.

Do quad sets and calf pumps all the time (at least a set an hour whenever you're awake) to keep the blood flowing.

[upallnight]

I've been wearing a compression stocking + using an ice pack (cryocuff? it pumps cold water in and out of a "bladder"). the swelling is really coming down, finally.

I had arthroscopic surgery.

I trace the alphabet with my toe once or twice an hour, I move around with toe touch pressure (on crutches)....and since yesterday I am doing the quad sets/flexes and such that you and AG recommended. Will try leg raises today.

I have been massaging my leg, too, to try to keep blood flowing.

Wow....I feel now that I am going to have a big setback as a result of not having PT starting almost immediately. I would have thought my doc would be pretty aware of that -- he knows I am extremely active.

There is still alot of soreness around the surgical site (particularly at the front of the shin, but even that is getting better, slowly.

I'll have to wait until Monday to talk to my doctor, at which time I will have plenty of questions....

but this thread is making me feel like I'm pretty far behind. I just tried today and I can bend my knee (passively) maybe 15 degrees...but then the pain gets pretty strong (feels like stitches pulling apart (I know that is not happening, but that's the sensation) or really tight skin...).

Maybe I just have to go through that pain?

Thanks!

Like AG, I am constantly wearing my TED. Also, I have a cyrocuff wrapped around my knee at all times. 10 days post-op w/ no P/t or stretching seems odd. You must be severely atrophied. I am seven days post-op for repair and partial removal of a complex flap tear of the posterior horn of the medial meniscus with chondromalacia, and today will be my third day of P/t. Yesterday, at P/T, I was able to slowly ride the stationary bike for 10 mins. (A full revolution was not easy, buy I did manage 2 miles).
Did you have an open surgery, or arthroscopy? I can see no R.O.M. at this point with an open surgery, but with arthroscopy, you should really try to get some mobility in the knee. Of course, ask your doctor specific questions about your concerns. However, just as important as exercise, is getting the swelling down. Use plenty of ice, and use a TED (surgical stocking). If you are that immobile, you don't want clots to form. ALso, consider anti-inflamatories and glucosamine.

[upallnight]

Just moved my appointment up to tomorrow....so that will get me in 3 days sooner.

[schindlerpiste]

Just moved my appointment up to tomorrow....so that will get me in 3 days sooner.

I think you did the right thing by moving up the appointment. Let the Dr. know that you would rather be active than passive. I'm sure that there is a reason for you're course of treatment. Everyone is different. If there is a reason for the passive treatment, make sure that you know what it is (an report back).

[upallnight]

Will do. I'm going to prepare a list of questions tonight to be sure I don't forget any. So far, I have:

* Why is my range of motion so limited?
* When can I begin PT?
* Why have you not suggested any PT to this point (2 weeks post-op)?
* I read that repairs do not always heal and that the procedure must sometimes be repeated. What is the frequency of this? Should I be concerned?
* Even if I don't begin full PT, are there exercises or stretches I am allowed to begin that can prevent full atrophy of the surrounding muscles (even if not working the knee)?
* The biggest: What can I do now to make my recovery most efficient in the long-term?
* Can I go to S America this year to ski?

[StokeSmack]

I've been wearing a compression stocking + using an ice pack (cryocuff? it pumps cold water in and out of a "bladder"). the swelling is really coming down, finally.

I had arthroscopic surgery.

I trace the alphabet with my toe once or twice an hour, I move around with toe touch pressure (on crutches)....and since yesterday I am doing the quad sets/flexes and such that you and AG recommended. Will try leg raises today.

I have been massaging my leg, too, to try to keep blood flowing.

Wow....I feel now that I am going to have a big setback as a result of not having PT starting almost immediately. I would have thought my doc would be pretty aware of that -- he knows I am extremely active.

There is still alot of soreness around the surgical site (particularly at the front of the shin, but even that is getting better, slowly.

I'll have to wait until Monday to talk to my doctor, at which time I will have plenty of questions....

but this thread is making me feel like I'm pretty far behind. I just tried today and I can bend my knee (passively) maybe 15 degrees...but then the pain gets pretty strong (feels like stitches pulling apart (I know that is not happening, but that's the sensation) or really tight skin...).

Maybe I just have to go through that pain?

Thanks!

I had men repair and ACl autograft two weeks ago today. I did less pre-op PT than many of the smarter folks on this board, but got some good advice here. The day after surgery, I was doing straight leg lifts but had little ROM. The week after I had the ROM to 85. Been wearing the cuff almost all the time. Two weeks later, ROM is 125 (but still 0 the ostrich way, unfortunately), doing straight and sideways lifts with 5 pds, and using the big rubber band calf-inator. So, it will come, but just be patient and keep active. The only thing that bothers me now is that because of the men repair I still will have to be on crutches for a few more weeks. If it were just the ACL, I'd be walking now. MY PT said now is the time to watch out for... when you feel like you can do stuff but really shouldn't.

[upallnight]

I had men repair and ACl autograft two weeks ago today. I did less pre-op PT than many of the smarter folks on this board, but got some good advice here. The day after surgery, I was doing straight leg lifts but had little ROM. The week after I had the ROM to 85. Been wearing the cuff almost all the time. Two weeks later, ROM is 125 (but still 0 the ostrich way, unfortunately), doing straight and sideways lifts with 5 pds, and using the big rubber band calf-inator. So, it will come, but just be patient and keep active. The only thing that bothers me now is that because of the men repair I still will have to be on crutches for a few more weeks. If it were just the ACL, I'd be walking now. MY PT said now is the time to watch out for... when you feel like you can do stuff but really shouldn't.

I had about 12h between my injury & the time of surgery...so not much chance for pre-op PT. That said....it's interested that alot of people are posting stuff about early PT w/ meniscus repair because most of the stuff i'm reading says the repair is extremely delicate and to take it verrrry slow...

That's why I'm confused -- it's the conflicting stuff. I should have more to report tomorrow.

[altagirl]

I had about 12h between my injury & the time of surgery...so not much chance for pre-op PT. That said....it's interested that alot of people are posting stuff about early PT w/ meniscus repair because most of the stuff i'm reading says the repair is extremely delicate and to take it verrrry slow...

That's why I'm confused -- it's the conflicting stuff. I should have more to report tomorrow.

You do have to take it very slow. But quad sets and straight leg raises are virtually nothing. E-stim does nothing but help get rid of swelling. There's no weight or strain on the meniscus from that. Compared to the PT you would be doing right away from a partial menisectomy or an ACL with no meniscus damage it's hardly anything at all.

[upallnight]

You do have to take it very slow. But quad sets and straight leg raises are virtually nothing. E-stim does nothing but help get rid of swelling. There's no weight or strain on the meniscus from that. Compared to the PT you would be doing right away from a partial menisectomy or an ACL with no meniscus damage it's hardly anything at all.

Thanks! This is truly helpful -- I'm sorry for being (1) a little paranoid/cautious and (2) confused by some of the terminology. I'm totally new to PT ... and new to ski injuries (this is my first ever...I've been lucky).

[altagirl]

Thanks! This is truly helpful -- I'm sorry for being (1) a little paranoid/cautious and (2) confused by some of the terminology. I'm totally new to PT ... and new to ski injuries (this is my first ever...I've been lucky).

That's totally understandable. Plus you hear a lot of nonsense from people who don't understand that there is a difference between a meniscus repair and a partial menisectomy ("I had a meniscus tear and they scoped it and "fixed" it so that's the same as "repaired" right??"). And you do have to be really careful with a repair. But physical therapy still helps - it's just restricted for a while.

[upallnight]

OK...got some more info after my visit with the doc today.

One point that may or may not be of-interest: He is a physician for the US Ski Team (and apparently travels with them to S America). He knows my activity level and level of sports-related aggressiveness re: skiing/climbing/biking, in particular.

First off, there is still alot of swelling in my knee which, to him, is actually good. He said some docs will drain the knee, but he doesn't believe in it. This is causing the limited range of motion -- but my extremely limited range did have him a little concerned.

My particular repair was pretty delicate, even as far as repairs go. There is a chance it may not heal (as with all repairs),and the problem is that you just never know if it healed or not...until it tears again. In that event, the only course of action is to remove it (not what I want).

It's pretty unlikely for anything bad to happen in the first 3 mo as the sutures are really strong in holding things together.

He said that docs have differing professional opinions on the subject -- some say no weight bearing whatsoever, others move to weight bearing pretty quick. His experience in the middle of that range has served his patients well.

That said...as of now (2 weeks post-op), he wants me moving to 50% weight-bearing w/ crutches. At around a month, he will quickly move me off crutches.

No one was concerned with the atrophy (they are confident it will come back and feel there is not much to prevent it at this stage)...and they said that I will get much of my range of motion back with the first 2 P.T. visits.

I'm imaging those 2 PT visits will be pretty rough.

He did still suggest ice and elevation, so I'll stick with that.

His experience suggests that someone with this injury *probably* shouldn't play basketball or soccer if they don't mind giving that up, as he has seen that tends to be much more likely to cause bigger problems. (I have no problem giving up either if it means I can still be hardcore at my chosen sports.)

If all goes smooth, I could be riding a bike on level ground @ 4 weeks...and I would be clear to ski and climb at 3 months.

One question I need to think about is that if I try to reward/motivate myself with a trip to the Southern Hemisphere to ski....is that wise because what if I get injured right away and am 1,000s of miles from home? It doesn't seem like there's a way to "gradually" ramp up and test the repair little-by-little...you just have to get into the bigger stuff and find out what happens.

Hmm.

Thanks for the opinions and information you have posted. I hope this is information someone may find useful.

I definitely feel more at ease after this visit. My head started to spin thinking I was way behind, but now I am reassured just hearing once again about the range of severity, even within this one injury.

[72Twenty]

Your avatar wierds me out.

I tore mine in high school playing football. I had it repaired and now about 14 years later it still bugs me. After surgery I could not put weight on my leg for 6 weeks and did some pretty nasty PT. Lotsa pain. I was trying to get back to football condition as fast as I could though. I still have an ache in there though now.

[upallnight]

Your avatar wierds me out.

The avatar is getting alot of feedback.

I tore mine in high school playing football. I had it repaired and now about 14 years later it still bugs me. After surgery I could not put weight on my leg for 6 weeks and did some pretty nasty PT. Lotsa pain. I was trying to get back to football condition as fast as I could though. I still have an ache in there though now.

Thanks for the encouraging report!

I'm hoping that much has changed in 14 years...but I know there are no guarantees with this surgery. The alternative is having tissue removed which, to quote my doc, is the first step in the end of your knee.

I go in for my first day of PT tomorrow...my therapist feels like he will have me doing a rotation on the bike within 2 sessions....and my doc feels like i can bike, ski, and climb as hard as i want in 3 mo. He thinks I can bike level ground in 2 more weeks (I'll be full weight-bearing/no crutches in 2 weeks).

Hmm...

The steps my therapist and doc suggested on Friday have brought swelling wayyyy down. Anxious for tomorrow....

[3wing]

I had medial meniscus repair on Friday the 28th (3 days ago). My doc recommended immedidate weight bearing as comfort would allow. She obviously wants me to be on the cautious side - but definitely was saying to use it if it felt comfortable.

My ROM is around 90 degrees at the moment - I haven't started PT yet - but just got my script for it today and will begin either tomorrow or Wednesday. It's definitely a bit swollen and sore. If you care to read all about it - I've blogged about it here: www.3wing.net/blog

Good luck - keep us updated.

[upallnight]

Just back from my first session of PT.... I almost made it to 90 degrees ROM!!! I am super-psyched and super-relieved.

I was told today that immediate weight-bearing probably means the tear was on the "less" serious side, which is a great thing for you, 3wing!

Sometimes you don't get to full weight-bearing for 8 weeks (super conservative, serious tear). I'm in the middle.

As reported above, I had virtually no ROM until the weekend. Through working hardcore on the swelling, I was able to get to about 15 degrees ROM. It was definitely a huge relief as it was not normal to have such a limited range -- my mind was spinning thinking, "What if I can't bend my knee? It feels like wood -- the sensation is off...", etc. I knew they *might* have to go in and do more surgery.

I'm so happy to get some motion back. I'm ready to work as hard as possible (without risking further injury) to get back ASAP.

Should progress to losing the crutches in under two weeks...and maybe even bike outside in 3 weeks or so. Hm.

[upallnight]

I had medial meniscus repair on Friday the 28th (3 days ago). My doc recommended immedidate weight bearing as comfort would allow. She obviously wants me to be on the cautious side - but definitely was saying to use it if it felt comfortable.

My ROM is around 90 degrees at the moment - I haven't started PT yet - but just got my script for it today and will begin either tomorrow or Wednesday. It's definitely a bit swollen and sore. If you care to read all about it - I've blogged about it here: www.3wing.net/blog

Good luck - keep us updated.

3wing:
My experience over the past few weeks reveals two things:

1) Get rid of the swelling as much as possible...at all costs. Ice and elevate with your knee above your heart and your toes above your knee. Pump your calves as much as possible. Flex your quads if possible.

You probably know all that....but it wasn't hammered into me as much as it should have been. (I had my knee around heart level....my toes were a bit lower than my knee....definitely set me back.)

2) Ibuprofen (I am taking 3200mg/day) helps reduce swelling. Also, avoid eating foods that are high in sodium (= more swelling).

3) Be super careful to ensure there is no pivot/rotation when you are weight-bearing (e.g., getting up from a chair)...as that is the one thing that could pull out the repair.

Again, you probably know all this...but I'm just saying it as I wish someone had hammered this into me. I was told (rapidly) a few things by my doc in a post-op visit, but I was out of my gourd in pain so they didn't sink in...and then I called in a few days later to get the straight story & the nurse told me "no ibuprofen". I think this set me back just a bit -- and definitelyoculd have eased my pain over the first two weeks.

I wish they had just printed a sheet with #1 & #2 above and given it to me to take hom e from the hospital, instead of a sheet with much irrelevant info on it.

Good luck! I'm pulling for you and the others who posted in this thread as I work through my own PT.