Medial Meniscus Surgery Question

Tore mine in some of the best shape of my life last track season and my college sent me to the orthropedic surgeon to get it checked. Of course he says lets get arthroscopic on it. I talked to a close family friend who is an orthropedic who specializes in sports related injuries and he said don't let them cut because it won't necessarily fix it. I took about 2 months off of it no running at all bust with some mediate cross-training and core work and I have been running fine on it ever since. Occassionally, and I mean very rarely, it gets a sharp pain shooting in it for about a second where it almost feels as if it would give out but it is soon back to normal. I train on it now at about 70-80 miles a week high intensity and I've had no problems. Best of luck to you and whatever you decide to do.

Thanks.

Both my internist and the orthopod think surgery is my only option given the location and type of tear. Orthopod says running again should be no problem.

Anyone else have this and if so what was the effect on returning to running?

Zat0pek, you and I could be twins. Just shy of my 46th birthday I injured my right knee jogging downhill. MRI showed a very small medial meniscus tear as well as a bone bruise. Never had any knee issues before this event.

I'd been seeing an outstanding physical therapist who is a hard core student of our sport. We tried taking time off and 4 months later it is no better. I'll hopefully be tuned up after my scope in about 6 weeks.

Good luck with whatever route you choose.

Orthopod didn't think PT was even an option at this point. PT wouldn't do me any good until after surgery.

On the upside he thought I'd be back up and around in just a few days and after some transitional stuff (PT, bike, etc.) I'd be running again in short order.

Look like I have a date with the knife.

I've had both knees done. The first (my R) was done 10 years ago at age 30. Don't know how I tore it but the day after a particularly hard run, I had sharp pain. Had an MRI that was inconclusive and was sent to PT for MCL sprain. 6 weeks later no improvement. Had the arthroscopy done where the tear was revealed and was back running in 2 weeks.

My left knee was just done 2 months ago. MRI did show the tear this time. Unlike my R knee, I was able continue with some training up until the surgery and was able to resume running within 2 weeks. I've just hit 40 mpw for the second week in a row. The only pain I had was around the small incision points.

My advice - 1.) make sure your surgeon does lots of these - specializes in athletes. 2.) keep active up until the surgery whether its running, biking or doing leg extensions. You won't be able to do anything for 7-10 days after surgery so having strong quads will help you not to atrophy too much. 3.) Dont' waste your time w/ PT 3 x per week. My experience is that these folks are good for people that have had severe injuries (ACL/hip replacement). But for very active runners, they are hard pressed to challenge us. Go once, get the exercises and push yourself.

And BTW - if your meniscus can be repaired vs. cut away (which is what both of my surgeries did), that changes everything I just wrote. Your leg will be basically immobilized for 4-6 weeks (just as it would be for a fracture) and you'll obviously won't be running for a while. Upside to this is that you'll still have 100% of your meniscus.

Good luck.

Zat0pek wrote:

Orthopod didn't think PT was even an option at this point. PT wouldn't do me any good until after surgery.

To clarify I was seeing a PT for calf problems. The knee injury popped up after I finally seemed to get my calf issues under control and was back to running 5 days a week.

Getting old sucks!

Thanks. Mine has to be cut out. I'm staying on crutches and wearing a knee brace until the surgery to minimize any further tearing or damage. Doc says the MRI shows no damage yet except where the tear is and that should make for an even better recovery.

Have the surgery, you will be fine running again. I've had 3 surgeries and I'm running better than ever.

If you can, get into PT prior to the surgery to try and keep your quads and other supporting muscles strong. The stronger they are going in, the easier it will be to rehab the knee afterwards.

Good luck.

lohalloran wrote:

Have the surgery, you will be fine running again. I've had 3 surgeries and I'm running better than ever.

If you can, get into PT prior to the surgery to try and keep your quads and other supporting muscles strong. The stronger they are going in, the easier it will be to rehab the knee afterwards.

Good luck.

I agree with this 100%.

I made the mistake of delaying surgery and suffered even more damage. The thing people ignore is if you end up with flaps on the meniscus or floating bits in the joint that ends up causing more damage. Get enough lose parts floating around and your knee will lock at random and you do fun stuff like fall down stairs.

Defintely follow the recommendation on the PT also. Strong going in, quicker coming out. Do the rehab, particularly the range of motion exercises. They're boring and could be painful but if you don't do them you could end up with a leg that won't go straight. Like me.

Good luck. I combined my torn meniscus with a severed MCL and partially severed ACL. You should have a pretty easy time of it.

i had a lateral tear repaired via 'scope when i was 42.

i was weight bearing in a day. on the bike in a week. running in 3 weeks.

that was more than a dozen marathons ago, no problems with the knee at all.

all depends on the severity of the tear/damage. if it's on the outside of the meniscus, it will heal quickly. if he has to repair any tissue between the bones - inside the joint so to speak - healing will take longer and you might have to be on crutches for a while. don't worry, sounds like that is a very slim possibility

do your rehab, but don't over due. it.

ice will be your knee's new best friend.

i actually tore my acl, nicked my menisucs, and bruised my bone as a freshman in HS (over 12 years ago) when my growth plates were still open, so they couldn't do reconstructive. I actually competed about 3 months later running the 800 with the aid of a brace....fast forward to about 3 years later and I tore the massive amount of scar tissue holding my knee together and ended up with a bucket handle tear in my meniscus that actually needed to be stitched, not just scoped. About 6 months later, I actually was competing again (I was a sprinter all thru college) with no pain or brace. I still run about 20-30 miles a week, and my knee feels fine. I lift more aggressively to keep my hamstrings and quads strong, but have no residual pain even without an acl.

My suggestion: do the surgery...not doing the scope the first time to clean up some of the debris inside my knee just never really felt right (ran XC, played basketball, softball, and ran track). Take some glucosamine/chondroitin pills...they work wonders, too!!

Good Luck!!

I went for surgery this same week last year for a meniscus tear. However, when he got in there, he found it was not torn after all. Rather I had inflamed plica and synovitis (sp). He cleaned it up and I was walking the next day-running 2 weeks or so later-snow skiing 7 weeks. Well, flashforward to the summer and I was hurting again. After two cortisone injections, and another MRI, we decided to go in again. I had it scoped again this past Friday and this time I am doing everything right-icing as recommended, taking it easy, using my crutches, strengthing exercises. The plica came back/became infamed again.

My advice is to take care of yourself after the scope. Do all the little things and be patient.

Best of luck and I'm sure it will work out for you.

To the OP:

Avoid any sort of hamstring exercises, as the posterior horn of the MM is connected to that tendon. You risk more damage that way.

Weightbearing on the knee shouldn't cause any more problems, and you're going to want to do some exercises pre-op, including leg press and/or squats. Try to keep things close-chained (ie, your foot in contact with the ground or a plate, not floating free).

I've treated countless patients who have had a knee scope and the vast majority do very well, including return to running.

Be sure to find out if the surgeon does a repair or just a debridement. A repair means NO WEIGHTBEARING for usually 4 weeks. A debridement means weightbearing as tolerated day after surgery.

Good luck, and make sure you do the physical therapy. Depending on the patient, it's usually 6-8 weeks of no running. You should be able to cross-train, ie bike or pool once your ROM comes back.

Benedict wrote:

3.) Dont' waste your time w/ PT 3 x per week. My experience is that these folks are good for people that have had severe injuries (ACL/hip replacement). But for very active runners, they are hard pressed to challenge us. Go once, get the exercises and push yourself.

You should have found a better physical therapist. I usually have people come 2-3 times per week and if they can handle it I push them very hard with exercises. There are rare cases where I send people away with exercises and have them come back in 3-4 weeks for a follow-up appt.

There are PT's who work more with very sick patients and don't have the knowledge of or experience working with athletes. If you treat people with total knee replacements all day you're not going to know what to do with a runner.

Find a good sports physical therapy clinic and be prepared to have your ass kicked.

Thanks for all the great feedback. Not looking forward to the surgery but all accounts are that it should be a pretty quick recovery and good results from this are the norm.

As for getting strong before surgery, unfortunately that ain't gonna happen. I was in lousy shape and just starting back up when this happened. Surgery is Thursday afternoon.

To the physical therapist who said to avoid hamstring curls...unfortunately, I got this advice too late. As I described in my original post, I did some knee extensions and hamstring curls following my last run, after which my knee was much worse.

My goal right now, with such limited time before surgery, is just not to do any more damage.

This sucks.

I had posterior horn tear in '02, age 45. I tried to come back too quickly and set myself back a couple of extra months. Be patient. I ran over 2700 healthy miles last year if that encourages you.

runguru wrote:

I had posterior horn tear in '02, age 45. I tried to come back too quickly and set myself back a couple of extra months. Be patient. I ran over 2700 healthy miles last year if that encourages you.

That seems to be a common refrain from folks who've had this surgery. Patience isn't my strong suit. Thanks for the reminder.

I know the thread is old, but I am interested to know how your surgery went and what the prognosis is.

After eight months of all kinds of bizarre tendonitis, faschitis, calf spasms, I was two months into recovery running, and I wiped out on the stairs, smashed the knee and broke a big toe.

Medial Ligament or meniscus is just not right, and I cannot bear surgery after eight months of lying around waiting for the tendons and faschia to get better(oh, lying around AND a thousand bucks for docs, laser, PT, orthotics, ART and chiropractic.)I hate PT with all my heart. Can't do weights due to Gr. IV chondral lesions.

Getting old REALLY sucks. I haven't ever been that debilitated and am dreading the thought of meniscus surgery.

Thanks

longwinded wrote:

I know the thread is old, but I am interested to know how your surgery went and what the prognosis is.

After eight months of all kinds of bizarre tendonitis, faschitis, calf spasms, I was two months into recovery running, and I wiped out on the stairs, smashed the knee and broke a big toe.

Medial Ligament or meniscus is just not right, and I cannot bear surgery after eight months of lying around waiting for the tendons and faschia to get better(oh, lying around AND a thousand bucks for docs, laser, PT, orthotics, ART and chiropractic.)I hate PT with all my heart. Can't do weights due to Gr. IV chondral lesions.

Getting old REALLY sucks. I haven't ever been that debilitated and am dreading the thought of meniscus surgery.

Thanks

Thanks for asking. Surgery went GREAT. Doc said that once he got in, the tear was a little worse than what showed on the MRI. However, he said the surface of the bone is still covered by cartilage even after the repair and the prognosis is excellent.

I was walking without a limp after about a week or ten days. I was hiking a 15% grade on my treadmill after two weeks, jogged easily after three weeks, and ran four miles pain free after four weeks. It's been about six weeks now, and I lift, jump rope, run, stretch, do whatever I want.