Partial meniscus crew... is your knee back to normal?

[glenplake]

I had a partial lateral meniscectomy last year and i'm still having pain. Before surgery it was typical meniscal tear pain (i.e. worse with squatting and twisting) and that went away after the operation. Now, though, I'm unable to completely straighten my leg because it hurts so much. I can't really jump or do anything with explosive extension because i'll be hurting for days after I do this. I can run, bike, etc. though without any pain whatsoever.

Have any of you guys experienced anything like this? I'm thinking that this is a possible second tear not really related to the first one, but I don't know yet; I haven't had a new MRI or scope.

The thing that especially sucks is that I can feel my other knee acting up and am probably going to need surgery on that knee, too.

[Tippster]

Gack.

Mine was torn on the exterior of the meniscus, so got plenty of blood flow and actually healed itself - no surgery, not even a scope. I had to have a Brace on when walking any distance for ~3 months but since then everything's peachy.

[Vinman]

if that were my knee I would be calling my surgeon. Sort of sounds like a failed repair to me. Good luck.

[splat]

http://findarticles.com/p/articles/m...05/ai_n8933580

After removal of the menisci, the contact areas of the femorotibial joint are reduced and the peak stresses on the tibial cartilage are consideration increased.3,11,12 There is overwhelming evidence that meniscectomy leads to degeneration of the joint.13-16 Removal of increasing amounts of tissue from the central part of the body of the meniscus results in a progressive increase in the peak stress in the tibial plateau in vitro.17 Thus partial meniscectomy should give better results than total meniscectomy. Clinicians have noticed, however, a high incidence of arthritic changes in the joint in mid- and long-term outcome studies of partial meniscectomy. 18-21

A view of what it looks like:

http://www.youtube.com/watch?v=VElp9SpGS-Q

Google has pages of info:

http://www.google.com/search?hl=en&q...earch&aq=f&oq=

edit:
I was getting curiouser and checked out this page:

http://www.ncbi.nlm.nih.gov/pubmed/9775028?ordinalpos=1&itool=EntrezSystem2.PEntrez.P ubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pu bmed_Discovery_RA&linkpos=2&log$=relatedarticles&l ogdbfrom=pubmed


Service d'Orthopédie Traumatologie, Centre Hospitalier de Versailles, Le Chesnay.

The authors report 4 cases of rapid lateral femoro-tibial chondrolysis following arthroscopic lateral meniscectomy. All patients were young athletes. At the time of meniscectomy, the cartilage of the lateral compartment was normal. Only one meniscectomy was done with the Ho Yag laser. Clinical symptoms were always identical: pain and important swelling, persisting despite intra articular injections of corticosteroids. A second-look arthroscopy was performed after a mean delay of 6 months (5 to 8), showing numerous cartilaginous debris floating in the joint (like in a chondromatosis disease) and a severe cartilaginous damage in the lateral compartment (grade 3 or 4). Swelling disappeared after arthroscopic lavage followed in two cases by a non weight bearing period of one to two months. But X-rays always demonstrated a narrowing of the lateral joint line on flexion-full weight bearing AP views. Rapid chondrolysis is a rare and severe complication of lateral meniscectomy. The etiology, which is mechanical, is not known. It probably represents an acute form of chronic, slow chondrolysis which is frequent after lateral meniscectomy. Rapid chondrolysis should be treated urgently by the following protocol: arthroscopic lavage, intra articular injections of corticosteroids and non weight bearing period.

[axebiker]

I had mine done about 15 years ago - medial and lateral tears - about 30%. It's never been "as good" since the injury. I did have one of the "good doctors" do mine - he's one of the guys who works with pro sports teams. One of these days I'll probably need it cleaned up again.

[RedWolf]

I had mine done a year and a half ago, and it felt brand new except if I played basketball/ran/or hiked a lot downhill. Then I was sore the next day, but it was never something that a couple Ibuprofen didn't take care of it. Felt, that is, until I blew my ACL a couple of weeks ago. Now it feels like hell.

[skibuminwyo]

I had mine done six or seven years ago. I was still in high school when I had it done. It has never been as good as it once was. There is definitely some ouch moments and movements. I think, though, that it is about ready to go under the knife again. They should probably just hack my leg off right above my knee and start all over. It has always been a problem. Just playing armhair QB, but maybe you tore something in there again? Good luck, knees suck!

[Deep Days]

This seems like as good a place to post as any, being that I'm having post-op pain for a lateral meniscectomy:

Does lateral meniscus damage ever manifest as mostly medial pain? I've got some really confusing shit going on, to the extent that it hurts to walk up stairs, and I can't do a single-leg squad on my affected leg. This is a right leg, 6 months out from a partial lateral meniscus repair (peripheral tear, I think). 4 months out, I was jumping off of 8 and 10 stairs to concrete with zero pain. I started skiing hard over thanksgiving, and this inexplicable pain has arisen in the last week, about. It feels like tendinitis or something on my vastus medialis (the pain is localized to the insertion of some quadriceps muscle on the medial side), and it aches like all fucking hell when I sit with it flexed (even just 45 degrees) for any extended period of time. However, when I sit with it extended on an ottoman or something for a while, I feel strain where my lateral meniscus is... I don't remember doing anything acute to it, so this is all very strange.

Worth going to get an MRI? Or worse... not skiing?

[glenplake]

This seems like as good a place to post as any, being that I'm having post-op pain for a lateral meniscectomy:

Does lateral meniscus damage ever manifest as mostly medial pain? I've got some really confusing shit going on, to the extent that it hurts to walk up stairs, and I can't do a single-leg squad on my affected leg. This is a right leg, 6 months out from a partial lateral meniscus repair (peripheral tear, I think). 4 months out, I was jumping off of 8 and 10 stairs to concrete with zero pain. I started skiing hard over thanksgiving, and this inexplicable pain has arisen in the last week, about. It feels like tendinitis or something on my vastus medialis (the pain is localized to the insertion of some quadriceps muscle on the medial side), and it aches like all fucking hell when I sit with it flexed (even just 45 degrees) for any extended period of time. However, when I sit with it extended on an ottoman or something for a while, I feel strain where my lateral meniscus is... I don't remember doing anything acute to it, so this is all very strange.

Worth going to get an MRI? Or worse... not skiing?

Can I ask why you were jumping off of 8 and 10 stair sets?

I'm no orthopod, but I think the symptoms you're describing can be something more simple like patellofemoral pain syndrome or something more serious like a new tear in the medial meniscus. You're probably deconditioned at least a little bit, so something like PF syndrome could certainly fit the bill. Weak quadriceps muscles can cause an unequal distribution of forces over the patella (knee-cap) and this can cause a resulting pain with symptoms similar to what you've described. Obviously, though, the other entity you want to worry about is a medial tear of your meniscus. I know when I tore my meniscus that any bent-knee activity was searingly painful. I also had considerable joint-line pain.

I think the unfortunate nature of knee injuries is that symptoms can be similar for different injuries. Have you had any significant new swelling? This might be more indicative of a tear. What about pain with rotational movements (you can test this with maneuvers like McMurray's test)? You can check out the McMurray's test here: http://www.youtube.com/watch?v=IwBW-X4n1fU Is the pain more localized to the knee-cap or is it a deeper pain?

Also, when you mention the straight leg on the ottoman, I experience something similar. I'm not sure if it's "normal" but this may be something that is felt after surgery and possibly not related to your other symptoms.

Hope this is somewhat helpful. Hopefully it's just overuse/deconditioned pain and that some time in the weight room can fix it. If you're really worried or having excessive pain, then get an MRI so you can put your mind at ease or find out what the problem is. Since you're post-surgery, it might be a bit difficult to interpret the lateral meniscus anatomy but I would think that the medial anatomy should be easily visualized and normal-appearing. Maybe PM one of the radiologists on here for their thoughts, though.

[Vinman]

This seems like as good a place to post as any, being that I'm having post-op pain for a lateral meniscectomy:

Does lateral meniscus damage ever manifest as mostly medial pain? I've got some really confusing shit going on, to the extent that it hurts to walk up stairs, and I can't do a single-leg squad on my affected leg. This is a right leg, 6 months out from a partial lateral meniscus repair (peripheral tear, I think). 4 months out, I was jumping off of 8 and 10 stairs to concrete with zero pain. I started skiing hard over thanksgiving, and this inexplicable pain has arisen in the last week, about. It feels like tendinitis or something on my vastus medialis (the pain is localized to the insertion of some quadriceps muscle on the medial side), and it aches like all fucking hell when I sit with it flexed (even just 45 degrees) for any extended period of time. However, when I sit with it extended on an ottoman or something for a while, I feel strain where my lateral meniscus is... I don't remember doing anything acute to it, so this is all very strange.

Worth going to get an MRI? Or worse... not skiing?

my guess is more patello-femoral and or tendonosis vs. any meniscal pathology but it may be worth getting it checked out by your ortho/sports med doc.

[Deep Days]

Jumping off of 8 and 10 stairs to get ready for jumping off cliffs. Builds character, and maybe bone density in my spine.

I've definitely had a little lateral pain in the last couple days. I skied pretty hard on Sunday and today, and I noticed very little difference in my skiing (except that I can't land drops for shit now, and the weakness/pain in my right quads may be a factor). However, the drive home ACHED. There is a bit of new swelling, but not an exorbitant amount. Just enough to make the medial side look a tad puffy. The swelling is concentrated just medial to the patella

I'm noticing upon palpation (fiddling around with the joint before I fell asleep last night) that the most intense pain is on the medial tibia, just medial to the apex of the patella. I stretched my quads pretty intensely last night, and I had a little less residual pain today.

I'd like to pry, though: what does one do for patello-femoral syndrome? Cortizone injection into the joint? Intense rehab? Both? Go to the circus?

I'll probably get checked out when I go home for break (Monday), trying to rule out a medial meniscus tear (or maybe even lateral), but some info on where to find out about patellofemoral pain would be awesome. Thanks so much for the help, guys. Very stoked to find out recently that I can still ski, and ski moderately well.

[Vinman]

PCS will show up as pain under or just next to the patella. Painfull wit sitting for prolonged time walking stairs skiing maybe can cause swelling. Tight hammys and quads are common and or history of previous injury. Easily confused with meniscal test by inexperienced professionals and the everyday joe.

You have symptoms of both and should get an exam.

[SeatownSlackey]

was diagnosed w/ pfs years ago in high school. my doc back then attributed it paritally to having a muscular imbalance or basically the outside of my quads were stronger & tighter than my inner thigh thus pulling the kneecap to the outside causing the pain.

no shot. just strectching and hitting the gym to work the inner thighs. it wasn't noticable by two seasons later.

[Roxtar]

if that were my knee I would be calling my surgeon. Sort of sounds like a failed repair to me. Good luck.

2x
I've been scoped 3 times for meniscus tears.
Never anything like that.
Month or so, pretty much good as new.

[Deep Days]

My orthopod today said I had (have) an inflamed/irritated plica (plika? Whatever the synovial band is just under the patella). Gave me a cortizone shot from the lateral side to ease the medial pain. Says the only exercise I can do until skiing 10 days from now is walking and walking and walking. No stair climbing or resistance with a flexed knee. Which makes sense, I guess... Reeeeally hoping it's that simple. Recently, I DID ski for 2 good solid days with absolutely negligible pain. Which was sweet.