# Suspect Torn Meniscus



## middleman (22 May 2015)

Have just had a diagnosis of suspected torn meniscus which I think occurred whist playing football about 4 weeks ago. Felt something not quite right and a small pop from my knee joint. Had rested for weeks after, went running a short distance then a bit of hill cycling which resulted in some pain which subsided. Then walking along when there was a loud crack from my knee and instant pain on the inside which has kept up since. Have health insurance so am going for an MRI on it next week. Biggest worry is if I will be able to cycle or not as I'm heading to Majorca in 5 weeks. 

Anybody had this corrected and did it affect your cycling after?


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## vickster (22 May 2015)

You should be able to cycle assuming you can now? but it'll probably hurt especially on hills and there is a risk you'll make the tear worse, meaning it could be harder to fix if you need surgery. If you can't cycle at the moment, can the trip be postponed? It's unlikely to be operated on so quickly even privately. Can you walk on it? Can you bend and straighten the leg fully? Does it buckle or give way? If it's just painful, physio usually before surgery as having meniscus removed increases risk of athrtitis

If you do need an op, make sure it's an experienced knee surgeon who fixes meniscus, no a general orthopaedic guy who dabbles in knees and everything else!!


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## Pat "5mph" (22 May 2015)

I have a lateral tear in my right meniscus, took about 2 years to be able to walk without pain.
Was not cycling at the time, can imagine cycling would be very painful for the first 6 months or so.


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## vickster (22 May 2015)

I've cycled on lateral meniscus tears in both knees, indeed while the left knee was locke, didn't have surgery for 5 months. Certainly cycled in gym then. I have another tear in there now, but mine are degenerate fraying more than the more disabling traumatic type now

The OPs pain on the inside of the knee suggests medial tear rather than lateral and laying football suggests a traumatic tear. I'm guessing he's a bit younger than me too!


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## middleman (22 May 2015)

vickster said:


> You should be able to cycle assuming you can now? but it'll probably hurt especially on hills and there is a risk you'll make the tear worse, meaning it could be harder to fix if you need surgery. If you can't cycle at the moment, can the trip be postponed? It's unlikely to be operated on so quickly even privately. Can you walk on it? Can you bend and straighten the leg fully? Does it buckle or give way? If it's just painful, physio usually before surgery as having meniscus removed increases risk of athrtitis
> 
> If you do need an op, make sure it's an experienced knee surgeon who fixes meniscus, no a general orthopaedic guy who dabbles in knees and everything else!!



It's an experienced orthopaedic surgeon who specialises in knees that looking after it so I'm not worried there. I can walk on it albeit with some pain especially when making certain movements such as getting out of a car or even moving from pedal to pedal. It also stiffens if I am sitting with the leg in one particular position for any period of time. Can straighten it and and bend it, doesn't buckle, was only when pressure was applied to the side that there was severe pain, just a dull pain the rest of the time.
I haven't tried to cycle since the loud crack and swelling from it as I thought it unwise until after the MRI and my next consultation to see exactly what I'm dealing with. Had spoken to another consultant off the record about it and when I asked "can I cycle?" He replied, "Now you're trying to bargain with me" which I assume meant he didn't want to say anything in case I did make it worse.



vickster said:


> I've cycled on lateral meniscus tears in both knees, indeed while the left knee was locke, didn't have surgery for 5 months. Certainly cycled in gym then. I have another tear in there now, but mine are degenerate fraying more than the more disabling traumatic type now
> 
> The OPs pain on the inside of the knee suggests medial tear rather than lateral and laying football suggests a traumatic tear. I'm guessing he's a bit younger than me too!



It was a medial tear that was mentioned, it did happen when I crossed a ball and was my standing leg. I'm tempted to try the turbo but as I said above don't want to make it worse and jeopardise any possibility I might have to avoid surgery. I'm 37, 5'11 and 88 kgs which is slightly heavier than I'd like to be. Best case scenarios for me regarding the trip is that he says I can cycle but to avoid hills and I can choose some flat routes.


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## vickster (22 May 2015)

Sounds promising, if there are no biomechanical issues. Hopefully it'll settle with physio, have you started seeing someone already? Bit depends on what type of tear it is. Is this the first meniscus injury, hopefully if it does need surgery, they only need to trim a little. It might be stitchable although at 37 your meniscus is already ageing

This is quite good for info http://www.kneeguru.co.uk/KNEEnotes/primers/meniscus-primer

Medial tears are more common and better news relatively than lateral 

Do you have travel insurance in case you have to cancel on medical advice after the MRI?


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## middleman (22 May 2015)

vickster said:


> Sounds promising, if there are no biomechanical issues. Hopefully it'll settle with physio, have you started seeing someone already? Bit depends on what type of tear it is. Is this the first meniscus injury, hopefully if it does need surgery, they only need to trim a little. It might be stitchable although at 37 your meniscus is already ageing
> 
> This is quite good for info http://www.kneeguru.co.uk/KNEEnotes/primers/meniscus-primer
> 
> ...



Some more knee reading for me there. Cheers. Have just visited the consultant so far who examined and referred me for the MRI. Will have the review within a week or so. This is the first issue I've had with my knees. He explained that if there is a blood supply to the part which is damaged then he will repair and the rehab is longer and involves physio than if it there is no supply when it will just be a partial removal/trim for which the rehab is relatively short at about 6-8 weeks.

The trip is a family holiday so if I can't cycle I'll just leave the bike behind, drink normal beer rather than the isotonic stuff and rest it as much as I can.


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## MrGrumpy (24 May 2015)

Rest it, would be my advice, enjoy the holiday then do the rehab when you get back, Tore my meniscus over 10 yrs ago, was about 3 -4 months before pain subsided but used the bike as my rehab and just spun easy gears on it. The biggest issue with recovery is confidence in the knee so need to work on it, I did a bit of gym work and cycling and was back playing football with in 4 months. However all depends on how bad the tear is ? I had to go for surgery within the week as I could not bend my knee so now have very little meniscus left in the right side. Also its not uncommon to do ligament damage at the same time, sounds like you were lucky like me ?


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## middleman (25 May 2015)

MrGrumpy said:


> Rest it, would be my advice, enjoy the holiday then do the rehab when you get back, Tore my meniscus over 10 yrs ago, was about 3 -4 months before pain subsided but used the bike as my rehab and just spun easy gears on it. The biggest issue with recovery is confidence in the knee so need to work on it, I did a bit of gym work and cycling and was back playing football with in 4 months. However all depends on how bad the tear is ? I had to go for surgery within the week as I could not bend my knee so now have very little meniscus left in the right side. Also its not uncommon to do ligament damage at the same time, sounds like you were lucky like me ?



Will find out how lucky I was tomorrow but I am reasonably hopeful. Have been able to walk on it without too much pain over the weekend. Going to avoid the football though, give me the best chance. Gym work to strengthen the leg muscles during rehab if possible would be the plan.


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## vickster (26 May 2015)

Work with a physio on the rehab. I was back on the static bike within 2 weeks following my recent arthroscopy


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## middleman (29 May 2015)

vickster said:


> Work with a physio on the rehab. I was back on the static bike within 2 weeks following my recent arthroscopy



Well results are in and unfortunately confirmed "*radial tear at posterior aspect of anterior horn of medial meniscus*". Being told that the surgery is inevitable.

Still planning on some cycling in Majorca but will avoid the mountains  stick to the flat and take it easy, get the op when I return. Consultant says the worst that would probably happen is my knee will lock out. Have no pain in at the moment, just an odd sensation when bending and more clicking than usually expected. He also reckons 2 weeks recovery if everything goes smoothly so that's good. Light swimming and cycling recommended for recovery period.

I know its no major procedure but nobody likes any op  In the words of a Baz Luhrman song "Be kind to your knees, you'll miss them when they're gone" Must be more kind to mine in future.


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## middleman (2 Jun 2015)

vickster said:


> Work with a physio on the rehab. I was back on the static bike within 2 weeks following my recent arthroscopy



@vickster I've had many different stories about this now from work colleagues who have had the procedure done but there is something common in them all. My consultant says that I will be back to normal after 2 weeks and some people return to work within a few days. Everyone I have spoken to says that i have the most optimistic consultant surgeon in the world and that it will be at least 2 months before my knee is back to normal after the op. How long before you would have considered your knee 'back to normal'?


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## vickster (2 Jun 2015)

A couple of months after the most recent op in terms of the knee. BUT I have another issue with that leg which means that I still have pain

After surgery, your knee will never be normal. If meniscus is removed, you open yourself up to arthritis sooner or later so that's something to consider if you can avoid an op

If you do have the op, tell them you'll be off work for at least 2 or 3 weeks. I was back working from home after a week as I had no choice, and I had lots of pain because I couldn't elevate at the desk

It'll depend how you react to the op, how much meniscus is removed, whether any other work is done etc. it's hard to say for sure. I doubt you'd be back to football and the like to any level before 3 months, gentle cycling maybe a month

I had my op, lateral meniscus tidy and fat pad excision on 5 Feb. in addition to whatever I did on the exercise bike, I cycled around 70 miles in March, around 350 in April (oops) and around 450 in May


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## middleman (2 Jun 2015)

Have learned my lesson with regard to football. Not going to be risking doing any more damage to my knees. Cycling and swimming for me from now on. I enjoy both and I wasn't very good at football anyway so that won't be that much of a hardship. 

Thanks I think, looks like I was a bit too keen to get back to things  and the consultant didn't want to burst my bubble.


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## vickster (2 Jun 2015)

I think I missed what you are actually expecting and hoping to be able to do and when

Despite the small incisions, keyhole knee surgery does hurt afterwards, the poor joint goes through quite a trauma. Don't overdo it, assuming you're not 90, your knees need to last you a while yet


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## middleman (2 Jun 2015)

vickster said:


> I think I missed what you are actually expecting and hoping to be able to do and when
> 
> Despite the small incisions, keyhole knee surgery does hurt afterwards, the poor joint goes through quite a trauma. Don't overdo it, assuming you're not 90, your knees need to last you a while yet



I just doubted what the consultant was telling me when I asked how long I would likely be off work during recovery? he said, "I've had self employed builders in here having it done and they are back to work in 2 days". I wouldn't have imagined a builders work to be easy on the knee so going by this I thought I would be back on my bike quicker than others are telling me now.


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## vickster (2 Jun 2015)

My knee surgeon is pretty conservative, he'd have signed me off for 3 weeks, I think it was two this time as I couldn't be off for longer 
... Then again he knows I wreck myself cycling - he was the poor sod who had to clean out the massive infected haematoma on my shin after I was knocked off last February 

There's no point risking a full recovery if you don't have to!


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## Kestevan (2 Jun 2015)

I had a meniscus tear repaired in Feb.

Weight bearing immediately afterwards, but first 2 weeks spent with leg elevated and minimum bend. I had considerable swelling around the joint throughout this period. Physio started after 10 days - but "little and often" with regards the Bike. I was told gentle spinning only with no resistance for 3 weeks, followed by slowly upping the resistance. I was pretty much back to normal riding 5-6 weeks after the opp.

Friend had same operation done early Jan, and is just now starting to ride without discomfort... it was at least 8 weeks for him before the swelling died down to normal levels - he didn't however have the "luxury" of the physio care I received, as this is not normally offered on the NHS in our area.

I'm due back in July for a slightly more serious op - MCL ligament reconstruction..so will probably be looking at 4-6 MONTHS off the bike, so don't feel too bad at losing a couple of weeks


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## vickster (2 Jun 2015)

Meniscus repair, ie. Stitching back together or trim, ie removing the torn bits. There's a big difference in the rehab


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## middleman (2 Jun 2015)

Mine is the trim one, well that's his plan from the MRI anyway.


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## vickster (2 Jun 2015)

At 37 that's normal, meniscus starts to degenerate from age 30 on and becomes hard to stitch. If he's a good surgeon, he'll remove the bare minimum, you want to keep as much as you can! Once a lot is gone especially, the mechanics of the knee alter which can lead to further tears and other issues


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## Glenn (2 Jun 2015)

I had lateral meniscus tear in my right knee about 6 years ago. I havd private health insurance through work, after 4 weeks of physio I was sent to a specialist, an MRI and 4 weeks later I was in hospital for the op. The consultant said I was on the table for 11 minutes in total, he removed approximately 1/3rd of the cartilage, I have before and after photos of the inside of my knee somewhere. 1 hour later I walked out of the hospital unaided after being assessed by the physio, 2 days later I walked about 3 miles, but regretted later.


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## middleman (5 Jun 2015)

Glenn said:


> I had lateral meniscus tear in my right knee about 6 years ago. I havd private health insurance through work, after 4 weeks of physio I was sent to a specialist, an MRI and 4 weeks later I was in hospital for the op. The consultant said I was on the table for 11 minutes in total, he removed approximately 1/3rd of the cartilage, I have before and after photos of the inside of my knee somewhere. 1 hour later I walked out of the hospital unaided after being assessed by the physio, 2 days later I walked about 3 miles, but regretted later.



Longer term, how is the knee?

Part of the problem I think is private health insurance. It can be a blessing or a curse. I think the consultant is so willing to open me up before considering any other option as he gets a nice cheque for it. Having got a few opinions from the people who have had this op I am coming to the conclusion I am being given a very optimistic recovery time indeed. 

I am going to see a very experienced Physiotherapist to see if there is any way of avoiding surgery for now or at least get a second opinion as I still have a full range of movement and have no severe pain to speak of. Will cycle on in the meantime.


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## vickster (5 Jun 2015)

Just tell the consultant you want to wait and try physio. Other than the infected haematoma, the surgeon I see privately has never been in a rush to operate.
Keep the meniscus intact if you can. I didn't have surgery for 5 months with my first year and my knee was locked and couldn't be straightened. I did manage to grind more away but if you've no trapped the tear in the joint that shouldn't happen

Having seen bills, the surgeon and anaesthetist don't actually get that much. The bulk of the 2.5k cost actually goes to the hospital


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## vickster (5 Jun 2015)

@Glenn have you had an X-ray or MRI since to check the joint for arthritis


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## Glenn (5 Jun 2015)

@vickster No, so far I haven't had any further problem with it.


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## Glenn (5 Jun 2015)

@middleman Since the operation, apart from over using it a couple of days later, it has been trouble free. The consultant did say that it would be more prone to another tear now, but touch wood it's fine.


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## middleman (8 Sep 2015)

Just an update to this for anyone searching in future. Was in Majorca, cycled, managed hills but had some pain not from the cycling more after walking or in the pool with my daughter. Jumped holding her in the pool and got the pain on the inside of the knee again so decided to get it sorted when I got home.

Had the operation about 4 weeks ago privately, all went well according to the surgeon. In at 8am, operated at about midday, out at about 5 that evening would have been sooner but blood pressure was low. Swollen and sore for a few days, bandage removed after 2 days, sticky plasters after 5 revealing 2 very small cuts with dissolving stitches. Given exercises to do by the Physio to get range of movement back. Discomfort doing these but have to be done, had painkillers to help with that. 

At this point if I overdo it I do still get discomfort with it so am going to ask what I should do with regard to cycling. Have the bike on the turbo and I think some light spinning at this stage would be good but I'll update how that goes.


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## vickster (8 Sep 2015)

I was back cycling about 4 weeks after my last arthroscopy. The physio had me on the exercise bike after a week
Do what you feel is right, just don't overdo it, start resistance low, do little workouts often


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