# Torn Meniscus



## VelvetUnderpants (7 Jan 2023)

Back in Late September of 22 I twisted my left knee whilst on my allotment. It swelled slightly and ached, so I booked an appointment to see my GP he told me to use Diclofenac gel for a couple of weeks and to come and see him if it did not settle down. After a couple of weeks it was still aching, so my GP decided to send me for an MRI scan just to make sure there was nothing untoward.

By the time I had my MRI scan the knee had settled sown and hardly ached, thankfully I still went ahead with it.

On December 2nd I went for a run in the morning and in the evening I attended a free self-defence lesson (Krag Mava) that evening. Afterwards I was tired but felt no significant pain. The following morning I could hardly walk, my knee would make a sickening click if I moved my weight to the left or right and felt like it may give way. I attended A&E and fortunately an orthopaedic doc was on duty at the time. She examined it and said in her opinion I hadn't torn any ligaments, but that she thought I may have torn one of my meniscus. She told me to rest my leg as much as possible, to ice it and take painkillers. She referred me for physio and said they will have a clearer picture once the MRI scan results come through.

I had my first physio last week, the physio had a look and also thought I had torn my meniscus. I was given four exercises to do which consisted of straightening my leg whilst lying on the floor with a foam roller just above and behind my knee and gentle semi squats.

Yesterday my MRI results finally arrived and had a chat with my GP. the findings were:

I have an oblique tear in the posterior third of the medial meniscus extending to the inferior articular surface and to the posterior surface of the posterior horn. There is an associated 15mm multiloculated parameniscal cyst projecting from the posterior horn of the medial meniscus towards the posterior cruciate ligament. The body of the medial meniscus is partially extruded from the joint line.

Everything else appeared normal.

Conclusion was: Medial meniscal tear with a paremeniscal cyst from the posterior horn of the meniscus. Suggest orthopaedic referral.

All of which is mainly gobbledygook to me.

The GP who I saw wasn't that experienced and couldn't answer any of my questions. He said he would make an urgent referral to see an orthopaedic consultant. I asked to be referred to The Royal Orthopaedic Hospital in Birmingham or QE, but he said he couldn't do that, which I found a bit strange, I thought you can choose which hospital you can go to.

Anyhow has anyone on this forum been unfortunate enough to have had a similar injury and if so what was the recovery process like. I asked my physio, and he was reluctant to give me a time span. To be fair, he did not have the MRI scan results when I had my appointment with him.

Many Thanks


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## Ridgeway (7 Jan 2023)

I’ve had 4 operations on my meniscus, 3 on the right and 1 on the left. Right knee i now have no meniscus as they removed so much in the end they removed all of it on the last op. Left knee still has about 70% in there. Mine was almost certainly down to playing a lot of rugby until about 20yrs old.

The best thing I’ve done……… is to cycle !!!

Increases the blood flow to these worn out knackered parts and certainly has helped me a lot. Rarely do i get major issues with my knees although they do remind me they are there after a long ride. I do however avoid kneeling on hard floors, that can be very uncomfortable (floor tiling the shower last year was tricky but i just got some decent tilers knee pads).

The ops were always very easy and recovery fast. Second one i had i drove 1200km 3 days later, just need to bend your leg a bit more often as they get a bit stiff after the op. 

Get then to take a decent bit out of it, my first they skimped and then i needed a second op as first time they didn’t remove enough….. the loose flap was causing the knee to lock and it was chuffing uncomfortable at best…


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## VelvetUnderpants (7 Jan 2023)

Ridgeway said:


> I’ve had 4 operations on my meniscus, 3 on the right and 1 on the left. Right knee i now have no meniscus as they removed so much in the end they removed all of it on the last op. Left knee still has about 70% in there. Mine was almost certainly down to playing a lot of rugby until about 20yrs old.
> 
> The best thing I’ve done……… is to cycle !!!
> 
> ...



I am now 56 years old, and I did a lot of Karate when I was younger, and I'm guessing this was the cause. You're spot on about cycling, I commented to the physio last week that walking anything over 5 mins and my knee starts aching a lot, but cycling is far easier, he replied to keep up the cycling as it will keep my legs strong. He replied, it's easier, as my body weight isn't full loaded onto my injured knee.

If your experience is anything to go by, it looks like it will be surgery. I was hoping it would settle on its own, but once I read the MRI result, I realized this was probably unlikely.

The clicking hurts like thunder when it happens, normally when I am standing in the kitchen preparing a meal, and all it takes is a subtle change in body weight to the left or right and it happens.

I'm currently taking Codeine and paracetamol to manage the pain.

It's just a waiting game now, hopefully an urgent referral will be pretty quick.


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## vickster (8 Jan 2023)

I’m having arthroscopy (privately) on the 16th to deal with lat meniscus tear and a large cyst like yours.
Been troubling me for about 18 months, surgery got postponed from October. Lots of physio and a couple of steroid injections


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## Ridgeway (8 Jan 2023)

After our mid 20’s we don’t have any regeneration abilities on the meniscus, so after that surgery is the only solution. I ignored mine for a while and ignorantly hoping that if i took enough ibuprofen that all would be good…. 

A work colleague who had a skiing accident gave me the number of a nice Ortho surgeon and a couple of weeks later i was hobbling out of his place on crutches having had my right knee operated on. They recommend local anaesthetic but being a complete wuss i opted for full on all occasions. In all cases and even with a full knock out i was in and out in a 1/2 day.

My learning is that the longer you leave it the more damage you eventualy do to your knee and often the more wear and tear you put on your opposite knee as you will undoubtedly compensate with it.

Some decent follow up physio is certainly required, needed to build up the muscles around the knee that you’ve been not using as much and also get back some of the flexibility as well. I found using an exercise bike as recovery helped, little pressure and just turning pedals. Was soon back on the bike outdoors and now my knees are better the more i ride.


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## vickster (8 Jan 2023)

Ridgeway said:


> Get then to take a decent bit out of it, my first they skimped and then i needed a second op as first time they didn’t remove enough….. the loose flap was causing the knee to lock and it was chuffing uncomfortable at best…


They need to take enough but not too much. Loss of meniscus, ie the shock absorber between the shin and thigh bones, is highly correlated with onset of arthritis. If you have none, you are at very high risk of it developing at an earlier age


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## MichaelW2 (8 Jan 2023)

My op went well, 3 weeks to functionally full recovery.
25 years later I can squat down and kneel ok but avoid routine jogging.


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## Ridgeway (8 Jan 2023)

vickster said:


> They need to take enough but not too much. Loss of meniscus, ie the shock absorber between the shin and thigh bones, is highly correlated with onset of arthritis. If you have none, you are at very high risk of it developing at an earlier age



Exactly, think they were a tad too cautious on my first op and hence a second was needed, 6wks later.


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## Time Waster (8 Jan 2023)

I had the op a few years back. I realised I had a problem after walking 25 plus miles rather too quickly with a week's food and backpacking kit. A bit too much as it weighed probably 20kg. I did that due to a storm coming through and I wanted to get to the bunkhouse at the end of Knoydart. That night I was in a bed and after bending my leg I couldn't s straighten it without using my other leg and hands to push it down straight.

It happened again the same night, so back home I saw my gp. After going through the diagnosis stage I had it operated on. After the op I sat around waiting to see what the consultant would say only to have a nurse come in and tell me to dress and go when I'm ready. Seriously my tear was shaved away and I hours I was walking out and going home. Two weeks was back at work taking the train in and walking 20 minutes from the station to work. What surprised me was that I wasn't offered crutches or a stick. They were quote dismissive about that when I asked if i was OK to walk out and without anything to help me. 

Whilst waiting for my op the gp told me to continue cycling. She said the motion puts no twisting stress on the joint but kept it mobile which was very important and would lead to faster recovery. I took the recovery steadily. If I wanted to I could have returned to work in the first week. I was cautious and went for short walks for recovery. Even paced through my house, but that was out of boredom! 

The hospital will see this as bread and butter surgery. They'll probably get it done and send you our quickly. Get it done and take care with your recovery afterwards.


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## MichaelW2 (Monday at 09:19)

How do people with dodgy knees feel about clipless pedals. The twist to release action is the thing I like to avoid, esp under stress and adrenaline.


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## vickster (Monday at 09:32)

MichaelW2 said:


> How do people with dodgy knees feel about clipless pedals. The twist to release action is the thing I like to avoid, esp under stress and adrenaline.



I had to stop using clipless a couple of years ago as I don’t have enough flex in my left knee these days (usually only around 100deg). Could be very painful on the upstroke, better with flats as I can move my foot around and have the pedal under the arch rather than ball of foot 

if you use SPD, you could try the multi release cleats where you can pull up to release?


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## Ridgeway (Monday at 09:52)

MichaelW2 said:


> How do people with dodgy knees feel about clipless pedals. The twist to release action is the thing I like to avoid, esp under stress and adrenaline.



Better for knees as it keeps you pedalling in the correct stroke ie without too much sideways movement/twisting etc (assuming they are correctly fitted)

As to releasing them just set the tension correctly.

I use both 2 bolt and 3 bolt, only use flats on my commuter.


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## vickster (Monday at 10:01)

Ridgeway said:


> Better for knees as it keeps you pedalling in the correct stroke ie without too much sideways movement/twisting etc (assuming they are correctly fitted)
> 
> As to releasing them just set the tension correctly.
> 
> I use both 2 bolt and 3 bolt, only use flats on my commuter.



If you can actually turn the pedal while clipped in!


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## Ridgeway (Monday at 10:50)

vickster said:


> If you can actually turn the pedal while clipped in!



Surely if not then it isn’t fitted correctly ? Unless you need some more flexibility/twisting etc due to the knee issues ?


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## vickster (Monday at 11:10)

Ridgeway said:


> Surely if not then it isn’t fitted correctly ? Unless you need some more flexibility/twisting etc due to the knee issues ?



I simply don't have enough bend/flexibility in my left knee to turn the pedal without severe pain when clipped in with the cleat in the correct position. I have about 100 deg, 90 or so is a minimum to turn a pedal at all. If my foot is further back I can manage, but can't clip in at that position. It might be a muscular issue or it may be to do with the bony changes due to the arthritis - I'll know on Monday after the surgeon has tried to manipulate under anaesthetic. I think probably a mix of the two but bending beyond a certain point hurts like hell


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## Ridgeway (Monday at 11:43)

vickster said:


> I simply don't have enough bend/flexibility in my left knee to turn the pedal without severe pain when clipped in with the cleat in the correct position. I have about 100 deg, 90 or so is a minimum to turn a pedal at all. If my foot is further back I can manage, but can't clip in at that position. It might be a muscular issue or it may be to do with the bony changes due to the arthritis - I'll know on Monday after the surgeon has tried to manipulate under anaesthetic. I think probably a mix of the two but bending beyond a certain point hurts like hell



That makes sense. Hope you can overcome it💪


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## vickster (Monday at 11:44)

Ridgeway said:


> That makes sense. Hope you can overcome it💪



Maybe with a knee replacement although I don’t have enough flexion for one to have a predictable positive outcome!


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## rockyroller (Monday at 13:45)

yes. schedule orthoscopic surgery. everyone's knee is different. my surgery took only 17 minutes. in & out same day. if you have a choice of anesthesia, you don't want to be awake. I was standing on it later that day, even tho it was all wrapped up. I don't remember the recovery but it was much better than living w/ the injury. which the surgeon said was from "a lifetime of activity" 

the surgeon also told me a cpl things
the worst thing for a knee is a deep knee bend with a twist
when using crutches, use 2. don't discard the crutches unless you can walk w/o a limp. aka, if you're limping, you need to use 2 crutches 

if you have any choice of surgeons, get one that operates on athletes


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## vickster (Monday at 14:40)

rockyroller said:


> yes. schedule orthoscopic surgery. everyone's knee is different. my surgery took only 17 minutes. in & out same day. if you have a choice of anesthesia, you don't want to be awake. I was standing on it later that day, even tho it was all wrapped up. I don't remember the recovery but it was much better than living w/ the injury. which the surgeon said was from "a lifetime of activity"
> 
> the surgeon also told me a cpl things
> the worst thing for a knee is a deep knee bend with a twist
> ...



It doesn’t work like that in the UK for elective non emergency surgery on the NHS, you might get referred to a surgeon who decides if surgery is indicated (not all meniscal tears qualify for surgery on NHS), then you are placed on a waiting list and receive a surgery date when one becomes available (could be months). You can expedite the process by going private (probably about 4-5k for the surgeon appointments, Surgery, physio, and choose your surgeon).

You won’t normally get to choose a surgeon for something straightforward, possibly the hospital. Most knee surgeons will operate on younger active people too. 

It’s called arthroscopic surgery (aka keyhole)


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## Ridgeway (Monday at 14:48)

Yep twist and bend is really bad and you become expert at avoiding it in the future especially after the op and after physio.

Yes also used a surgeon that was experienced in ski injuries, seemed very run of the mill for him. Here they offered the op the same week but had to wait until i get get some days off work, the benefits of health insurance 👍🏻


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## rockyroller (Monday at 18:30)

vickster said:


> It’s called arthroscopic surgery (aka keyhole)


ah yes, my mistake, thank you. I had 2 little holes on the front of my knee. 1 for the camera & 1 for the tools. I asked if I could get it on tape & the surgeon said sure! bring a full size VHS tape & I did. back home, I popped a pain killer & watched it w/ my Mother the next day. it was fascinating


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## rockyroller (Monday at 18:32)

Ridgeway said:


> Yep twist and bend is really bad and you become expert at avoiding it in the future especially after the op and after physio.


yep. approx. 27 yrs later ... every morning, I do a deep knee bend squat, to feed the cat. straight down & straight back up

my meniscus tear was a simple torn flap that kept getting in the way during certain movements. the surgeon only had to go in & cut it & scrap it away & vacuumed the loose bits out. knee surgery is bloodless


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## MrGrumpy (Monday at 21:53)

Torn meniscus for me back in 2004 I think ?! Operated on within a week back then. Could not walk/put weight on my leg and it would not straighten so straight to operation . Was back playing football with in 6 months . 

Cycling was my recovery process, I think it helped hugely as well as some light leg presses in the gym . I will admit it’s never been 100% since but I was able to do everything I did before but with mild discomfort time to time.

Fast forward to now and it’s not so good, I have arthritis in the knee , good days and bad . Cycling was ok but increasingly finding things painful . Doctor said no running neither , so I manage dog walks ok but my knee does flare up . I reckon I’ll need a new knee at some point , just hoping to put that off for a while yet .


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## Dogtrousers (Tuesday at 09:24)

MichaelW2 said:


> How do people with dodgy knees feel about clipless pedals. The twist to release action is the thing I like to avoid, esp under stress and adrenaline.



I use and like them. The twisting action is second nature so my foot-brain takes care of it, not my conscious brain.

My knees aren't that dodgy. I had a major op (not meniscus) in about 2006, but mostly they are just cranky old man knees.

To the OP: Be patient, be careful but be positive. Listen to your physio and do your exercises, no matter how silly they seem. Good luck.


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## rockyroller (Tuesday at 11:19)

I use cleated pedals & shoes on my road bike during fair weather months. I have the tension set light so they are easy in, easy out. no affect to my knees at all


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