MRI Results

[Jeff Weir]

A few weeks ago I noticed that there was swelling just below my kneecap (very little discomfort). Saw my GP and she ordered a MRI. I appears that I have a medial meniscal tear (what ever that is). Will be seeing a Orthopedic Doc in the next couple of weeks to discuss the next step. Does anyone have any idea of what I might be in for? I assume treatment will be dependant upon the location of the tear, which I do not know yet.
Any thoughts or suggestions would be appreciated.

Jeff

PS: Is this something that Kevan or Sandy could take care of for me? X-Acto blade and a flashlight?????

[Ginger]

Depends on where it is, if they can fix it, or if they just trim it.

My favorite online-ortho reference, it certainly gives you a place to start asking questions from (go back up to the index and root around a bit) and basic treatment protocols and whatnot:

http://www.wheelessonline.com/ortho/repair_of_the_torn_meniscus


Misery loves company Read everything here with a HUGE grain of salt. I believe in patient advocacy and patient rights...but some of these people live here and spread some questionable information...
http://www.factotem.org/cgi-bin/kneebbs.pl/#219020

[Kevan]

with my circular saw. Got a small tripod we can jury-rig? Pick out some bar tape and I'll have you hobbling around better than a Kellogg wrapped unicycle.

Stop kicking your dog and your knee will start feeling better.

[Ginger]

Tip of the day: Knees take a long time to recover from that sort of thing...

January surgery doesn't work. I was forced to wait until January after injuring myself in October and I'm just getting back to getting miles in. So far I have 300 for the year...I usually have 300 by the end of Feburary.

If surgery happens, best case scenario, you're back on the bike in 6 weeks. Worst case scenario you're looking at perhaps 3-6 weeks of recovery and then 10-14 weeks of PT until you can really start riding. You can ride before that...but results vary. I've had one of each. One I was off the bike for 8 weeks total, the other I was off the leg for three weeks then in PT for 10-14 weeks, then released to continue working it on my own. November doesn't seem to be a bad month even though you'll have to go through PT during the holidays...

[Frank]

I had knee pain for much of a riding season in my right knee a few years ago. The pain was worse after a long ride or consecutive days of riding. Didn't bother me much on the bike, but more after I got home and was sitting around or at night in bed.

I didn't want to quit riding so waited until late fall to have an MRI. MRI showed rather severely torn medial meniscus, so had arthroscopic surgery (had them put me out) and eleven days later I was riding the bike on the road. I have not experienced any problems at all with the knee since the surgery and that has been 5 years or so ago.

A few hints: Make sure you ask around and find a surgeon who does these
procedures and is successful. Ask local cyclists and runners about their experience with the surgeon you are considering. Talk to the surgeon in advance and see if he is familar with bicycling-related injuries and techniques on avoiding them. Ask him about rehab and what you can do in advance of the surgery. Let them put you under so you are more comfortable. Don't be like me in that the afternoon of my surgery I was feeling so pain- free I wanted to toss the crutches, but that was some surgery drugs kidding me. Use the pain pills and rest for a couple of days. Be patient for a couple of months and don't push big gears or go too hard on steep hills. Keep your knee covered in warmer weather than you used to. Take glucosamine if you think it will help. Make sure your saddle isn't too low. Finally, if you have a significant other, milk the injury for all you can, including using rehab as an excuse to ride more often!

It was a relatively easy surgery (would say easy but any surgery that
happens to me isn't easy...other folk's surgeries are easy ;) ) and I
would not hesitate to do it again should the need arise.

[Ginger]

I'd say don't let them put you out. It takes longer to get out of the spinal that day so it messes up the hospital's recovery rotation, but you don't get as messed up...of course, I've had 5 surgeries now and two of them were general...general anesthesia really screws my brain up for 6 months or so...
And don't get snowed...

I find I recover best if I just get the spinal, last time I went in thinking I wanted to watch, like I did the last one but then the doc was winging the leg around breaking up the scar tissue..I suppose he was checking that I had full range of motion? I could feel it...ouch. Then I realized that they were harvesting a tendon...it was gonna be bloody...Put me to sleep, I don't want to watch this one. Few more drops and boom, out go the lights. Just sedation, and I came out of it fairly well. It *is* weird when you can't move your legs in recovery though...

MRIs are not conclusive. They never really know what they're going to find in there until they go look, so prepare your doc for any eventuality. You probably don't have to, but if you need an ACL graft once he gets in there? You want to have planned that out ahead of time just in case. You don't want to go through surgery twice just because you didn't agree before hand what the doc could do.

But your doc will go over all that.

Ask lots of questions. Some docs are very proactive, others aren't. With this last knee one doc wanted me immobilized for six weeks, the one I went with wanted me moving ASAP. I agree with Frank on finding a doc. And a physical therapist. Mosts docs have PTs they like to work with.

Get in to PT before your surgery too. The more you do for the knee before the surgery, the easier it is after the surgery.

Good luck!

[Ken Robb]

I've had both knees done for this. My doc likes his patients awake and he rigs a second tv screen so you can see what he sees while he works.
No pain during surgery but I'm allergic to percodan and drugs of that type so I was pretty uncomfortable for a couple of weeks after surgery.
My doc recommended cycling for re-hab as long as I didn't mash big gears.
This is how I became a cyclist instead of a tennis player.
Get it fixed ASAP because the torn meniscus can scratch the smooth surfaces it is there to cushion.

[pale scotsman]

Hi Jeff - I have a medial meniscus tear and had a bruised fib or tib, can't remember which one almost 3 years ago. Was scheduled for surgery and chickened out. I may have it repaired someday if it bothers me, but I'm fine now. Squating for long periods of time or standing on my knees hurts but if I refrain from that it's no problem. The medial meniscus has no blood supply so unless it's hairy bad, ie ripped to shreds and impeding range of motion I'd just live with it.

The recovery took a while but I've gained strength and speed since the accident, mountain bike btw. My ortho doc was all over the surgery route but my buddy the non personal ortho doc said I made the wise choice. Don't do it unless you really have to. My .02 Alabamian, and just because I live here doesn't mean I'm from here... ;)

[2LeftCleats]

I'm an internist, not an orthopedist, but I see a fair no. of meniscal tears in my practice. I've also had 4 arthroscopies for tears in my knees, so I've had a couple of different perspectives. Sometimes, with patience, the discomfort goes away, especially in less physically active folks, and surgery isn't a necessity. In runners, I think most will come to arthroscopy. In a cyclist, maybe some time off and rehab spent strengthening quads can eliminate the need for anything invasive, but if you're a vigorous cyclist, I imagine the conservative approach won't be satisfactory. I've had both general and local anesthesia for this and don't really think there's a lot of difference. The effects of general don't usually last more than a day, and you may have some throat irritation from the endotracheal tube. I had remarkably little discomfort after, and it's hard to resist the temptation to be up right away. (The ortho guys like them iced and elevated for several days to prevent bleeding). After that, as others have mentioned, it's important to do the rehab exercises, since it's amazing how rapidly the quads atrophy.

[Louis]

Based on personal experience with my knees I have come to two conclusions:

1) What they think they see in the MRI is not always what they find when they go in with the ‘scope.

2) Orthopedic surgeons tend to go for surgery as the first option. I think it should be the last option.

As a result, I am now much more skeptical of what they say compared to years ago, when I would trust them. I ask lots of questions and do my own research. Get multiple expert opinions before going under the knife.

Louis

[Jeff Weir]

I just want to say thanks to everybody that has offered personal stories, advice and suggestions. Your comments are really appreciated. I'll be seeing the ortho doc in a few weeks..keeping my fingers crossed that it's not going to turn into a big deal!
Thanks again,
Jeff

[dave thompson]

Jeff: Just remember that I get all your bikes!

[Ken Robb]

I must add about my own experience: When I tore the first one I could not believe there was really anything wrong as it didn't hurt much at the time and it felt better after laying off tennis for a couple of weeks. When I played again it hurt and swelled a bit so I iced it and rested again--back to tennis w/the same results. I thought maybe this was God's way of telling me I was finally old enough for golf so off to the course. WRONG!!!!!! the side loads of a golf swing were agonizing. HMMMMMMMMm -maybe see the Doc who said get surgery or give up athletics. He said he found some scoring of the patellar surfaces from the torn and roughed up meniscus that might prevent a perfect surgical fix. It actually came out fine.

After a couple of months of rehab (lots of easy spinnig on my MB3) I was back on the tennis court where I immediately tore my other meniscus and with my fresh experience I recognized the feeling right away. I was operated on in 3 days and the recovery was much quicker and I can't even tell that I ever had any problem with that knee whereas I have to be careful about kneeling and things with the other one.

I guess you can tell that I wouldn't recommend the "wait and see" approach as it can also be the "wait and damage your knee some more" approach.

[paulh]

Send a video to Sen. Bill Frist, M.D. He's great at long distance diagnosis!

[Needs Help]

lol.

But..but..the balloon. She follows the movement of the balloon with her head. That shows awareness. Autopsy results: she was blind. Sad all around.