# Medial meniscus knee surgery: have you had it done? (I have) here's an overview



## Sandiman (Aug 22, 2007)

Tore my knees up pretty good over the years racing motorcycles. Prior to surgery on June 17, 2008, I remember thinking in early March, 2008 about how my knees for weeks on end were feeling fantastic, almost bullet proof. And then later that same month I injured my left knee. Before getting hurt I had been riding bicycles up steep hills on a weekly basis as a form of preventive therapy. I was an ardent, dedicated hillclimber, minus the gas engine. Does that sound dumb for someone whose had three, maybe four knee surgeries over the years on both knees? I can understand if it does sound dumb. But hillclimbing is not as brutal on the knees as you might think it'd be. Well it can be, and then again it's a godsend. That's right, a godsend. You just just have to make darn sure that you spin the cranks as opposed to mashing down on them. Huge difference between a spinner and a masher. But that's another subject altogether.

So I developed a problem in my knee in late March, 2008. As a result of that injury, the doctor cut my cartilage on June 17, 2008 making me as of today approximately 29 days post-op. This cut/hatchet job is common and is called a _meniscectomy_. That's a fancy word for a cut job. The doctor does not sew the cartilage to the bone in a meniscectomy, he just cuts away useless, dangling cartilage. The doctor did not cut out my entire cartilage, so I had what's called a _partial meniscectomy_, thank god. A partial meniscectomy is bad enough, and depending on the individual, might or might not be problematic down the road. A _full meniscectomy_ is bad news no matter who the person is. Another type of cartilage surgery, less common and one that requires several weeks on crutches and more time in the operating room, is a cartilage repair. In a CR the doctor uses thread and sews the cartilage to the bone. With a CR you cannot put any weight on your injured leg for at least a couple of weeks, if not longer.

The surgical procedure performed on me in San Diego, California on 7-17-08 and as stated word for word in the O.R. report (brace yourself for some big words that are foreign to everyday normal people): _Arthroscopic guided chondroplasty of medial femoral condyle of left knee, removal of multiple chondral loose bodies of left knee, and partial medial meniscectomy of left knee. _

Here's an overview of what went down and what's going on:

>10 days post-op, June 27, 2008, I met with the the doctor for the first time since surgery. Here are some things he stated: "Here's a picture of the inside of your knee. (He hands me a picture taken during the surgery. It shows the dreaded bucket handle.) You can take that with you. And the reason for that is there are some changes in your knee that we can't make better with arthroscopic surgery. If you look at the picture you can see underneath your kneecap where the kneecap and thighbone...it looks pretty good...normal cartilage. As we come around to the inside part, medial condlye, inside part...you have both cartilage and exposed bone. The area at the end of your thigh bone, that cartilage is gone. You do not have bone on bone. There's still cartilage left on the other side and on the top of your shinbone. There's a meniscus partially left inbetween, and then, unfortunately, the exposed bone under your thigh bone."

>bad news: He went on to say that the chances for a complete recovery are only 50/50, thanks to the dreaded bucket handle. As bad as a bucket handle is, the doctor said I'm not bone-on-bone, which is good, I guess. But what I do have is a hole in my cartilage with bone that is forever exposed. You can't put a patch on it.

>i do not yet have my natural walk or gait back yet. My leg is stiff and I still walk with a very noticeable limp. I started PT last week. I'm making improvements in nice, small, daily chunks, thankfully. On days like that the sky is blue and I see a light at the end of the tunnel. The PT allows me to ride the stationary bicycle, but not a road bike. He started me with isometrics but we have yet to use any ankle weights. Right now we're focusing on getting my range of motion back and flexing my quad muscle

>i was full weight bearing on post-op day two or three. I got rid of the crutches around day three post-op. I did not rush it. After surgery they put me in the recovery room. They then gave a paper to my friend that said I could stand on both legs without crutches in two or three days

>up until post-op day ten I stayed at home and was completely sedentary. Nine days post-op presented nothing unusual in the pain department. Note that I was either in bed, sitting on a chair or up and about hobbling around fixing something to eat but I never once left my apartment. I was prescribed Vicodin for pain, but I never took any. On post-op day ten I started to go outside as it was time for me to go see my surgeon. All I did that day was go see him and then later go to the supermarket. It was then later that day that I started to experience for the first time what I call "electric shocks" to my injured knee. On a scale of 1 to 10 the electric shock produces a level 9 feeling of pain. You definitely don't want to be carrying a carton of eggs or step in the shower or fire a gun at a target when you get one of these electric shocks. The shock lasts for only a split second and is gone as quickly as it appeared but make no mistake, it's painful. Guess you could say that it feels like a very quick and hard bee sting. Only once did I get an electric shock in a public place and it was kinda embarrassing. You grimace a little and you might say 'ouch' out loud and then you are just as quickly composed and feeling fine leaving people wondering what the heck that little display of pain was all about

>ever since day 10 post-op I average anywhere between 2 and 7 electric shocks a day, with a rare day when they are not felt. (I don't take any OTC or prescription meds, it's too soon for that, gotta give PT a chance). The $100 question is whether or not the electric shocks will go away once all the swelling goes down and once I get my full range of motion along with my strength back. (yes, knee still a little swollen 20+ days post-op!) Then again maybe the electric shock is something that'll never go away and is due to the dreaded buckethandle. Which means they'll have to either shoot some lubricants in my knee (Synvisc, hyaluronic acid or corticosteroids) or give me either a full or partial knee replacement. Ultimately the question might come down to whether or not I want to live with the electric shocks 2-7 times a day on a daily basis and become a fanatical day-in, day-out gum chewer. I guess I can always bite down on chewing gum whenever I get an electric shock. I do know that the more I stay in bed off my feet, the less the shocks materialize. When I get on my high horse and start moving around, i.e, to go swimming, to go ride the stationary bicycle, to go do my PT excercises, to go to the store, or any day that combines all of that stuff along with a lot of limping around, I can expect to feel more shocks either on that day or the day after, which is a residual effect, I believe

>all in all if it wasn't for the electric shocks I'd say that my rate of progress has been very good and that I'm very pleased and pleasantly surprised with how well things are going in my first week of physical therapy, 20+ days post-op. Specifically, though my leg is still stiff and I walk with a limp, I have equal weight distribution over both of my legs. However, the electric shock matter leaves a huge question mark hanging over my head and I have no idea when, or if, the electric shock issue will ever be resolved. Last Saturday was a very bad day as I had a record 7 or 8 electric shocks all in just one day. On days like that there is no hope, no light at the end of the tunnel. If the shocks don't go away, I'll have to make a radical change in lifestyle. I'll have to avoid going down a stairway, avoid going to certain public venues, avoid being in an area where I'm surrounded in a crowd of unknown people and give up my hobby of taking pictures in urban areas a.k.a. street photography.

Knee injuries are common. I hope this helps anyone out there who is slated to have a meniscectomy. Please leave a comment if you've been in my shoes and have experience with the same type of surgery. Since I'm in week two of physical therapy, and 29 days post-op, I'd like to get a feel for what might lie ahead.


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## Sandiman (Aug 22, 2007)

Update: I had a partial meniscectomy on my left knee on June 17, 2008. As of today July 23rd I am 36 days post-op.

Yesterday on July 22, 2008 I started week three of physical therapy. On July 17, week two of PT, my physical therapist presented me with a brand new excercise that I found remarkably enjoyable. Upon presentation and almost as soon as I performed the first set, I felt deep down inside that this new excercise was going to be a major ally in my fight to regain normal functionality. I felt this new excercise was going to help speed up the recovery process. I really had nothing concrete to base that on, other than a gut feeling that I derived whenever I performed the excercise and the fact that I enjoyed the tangible feeling the new excercise provided to my knee and leg whenever I performed it. I was truly infatuated with the new excercise as much as a love struck high school freshman is with a senior cheerleader.

The next day on July 18 I started to notice both a significant decrease in the frequency and severity of the electric shocks. Now the electric shocks were no stronger than a 4 or 5, on a scale of 1 to 10 with 10 being unbearable and 1 being faint. I even had one day where I did not experience any electric shocks whatsoever, which was a first for me, though I really couldn't put a whole lot of stock into that particular day as I was not very active and I had only eight hours of wake time. Despite that, because of the sudden drop off in the severity and frequency of the electric shocks over a five day period of time, I was elated by the new and sudden turn of events. I thought that I had turned a corner or that, quite possibly, the worst was behind me. I thought that I had leapfrogged forward and made a huge surge upward in my recovery. Adding to the heightened optimism was the fact that right around July 20th it appeared as if my gait was almost back to normal and that my limp was approximately 75% gone.

Overall, the feeling was exhilarating. I felt like I was on the verge of getting my freedom back. Keep in mind that since the onset of this injury in March of 2008, I have been limited to staying at home with the exception of an occasional jaunt to the store to aquire food. Due to the unexpected positve change, I soon expected to be running the streets again, taking pictures with my camera of this and that, and riding a bicycle up steep hills like I used to do. Most of those good feelings, and the improved state of physcial condition, lasted a full five days or all the way up to the beginning of a session I had with my physical therapist in week three of PT. And then just like that those good feelings disappeared and were replaced with dejection.

Yesterday on July 22 I started week three of PT. The therapist hammered away at my knee during that session, especially on one excercise I call 'mashdowns'. That's when he has me lie flat on my back with both legs straight out. He rolls a towel up and places it under my ankle. This props my lower thigh, knee, calf and ankle up in the air, a couple of inches up off of the table. He then puts both of his hands and a good portion of his bodyweight directly over the center of my surgically repaired knee and presses down as hard as I can stand it. Sometimes he uses a slight pumping motion, up and down - up and down. If you visualize someone rendering CPR to a person in distress then you've got a good idea of what a mashdown looks like. This excercise is a hyperextender that is supposed to make the injured leg as straight as a long rifle or as straight as it was before surgery. In yesterdays session he put a lot of work, time, energy and effort into the mashdown excercise. I'll note that up until that point in time I had been religously doing my battery of excercises at home as prescribed by the physical therapist.

During that session and after that session the electric shocks came back in severity at a pain level of 8 or 9. And when I walked out of that session I started to limp again. All of this ocurred yesterday in week three of PT. A day later I still limp. Despite the dutiful effort the PT applied to my knee while doing the mashdowns, I feel that I may have taken a step backward in my road to recovery. I have a feeling my physical therapist will disagree with that opinion when I go back and see him on Friday July 25, 2008. Because of the disappointing turn of events, I am not motivated to do any of the core home excercises this week. Except for my appointment with my physical therapist later this week, I feel like I just want to back off 100% and not do any excercises at home.

My unwillingness to perform any rehabilitation excercises is limited to the next few days, but not beyond as I am inclined to being involved with physical activity, it makes up a major portion of my lifestyle, and I want to do whatever it takes to get my knee 100% healthy, if possible. My unwillingness also stems from the idea that it appears as if the heavy labor that was dealt my knee yesterday, on the surface, appears to have reinstituted both the severity and frequency of the electric shocks, along with resurrecting the limp. And so my gut is telling me to treat it not like a newborn but like a little child: back off on physical activity including the rehab excercises at least for the next few days. Or in other words, less is more.


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## mtnboi68 (Jul 31, 2007)

*Brutal electric shocks!*

Sandiman, your story is a brutal one, and I hope you've recovered more fully since your last post on this thread. I'm waiting for my appointment with the orthropod in 1 1/2 weeks to find out what is going on with my left knee. Right now I suspect it's a partial lateral meniscus tear, but I won't know until I see the doc.

My story: biked the trails fairly hard last spring/summer. Crashed many times and I believe at some point I suffered this injury. Initially thought I had sprained my knee. I think I had some initial swelling but disregarded that. Seemed like the knee got better within a couple of weeks. Then I began to notice the 'electric shocks' while carrying heavy loads up stairs. Almost enough to drop me (9ish on pain scale), but the pain left as fast as it came. Also began to favor my right leg, by putting the majority of my weight there. Still was in denial and disregarded any pain ("quit being a pvssy - get tough" - duh). Continued to ride trails but felt like my knee was a bit gimpy. No electric shock. Again, I dismissed it as just me being weak.

Last month I went snowboarding for the first time this season. Was fine on the easy stuff - i.e. the blue slopes. The second I tried a black diamond run I was back in the pain locker. The first mogul I maneuvered on brought back that electric shock (10 on the pain scale) and dropped me. I had to heelside it down the rest of the run and knew something was wrong.

I did some research on the 'internets' and self-diagnosed myself as having ITBS. Started doing stretches, bought a foam roller, iced my knee. I thought the knee was slowly improving.

Last Saturday I did a fairly strenuous (but short) winter trail ride with a few gnarly technical sections. Knee felt gimpy, but no shock. Went home and did the R.I.C.E. thing. On Sunday I went snowboarding at a local resort to prepare for a hardcore session coming up next week with some pals - two days at Silverton Mtn. in southern CO - a black diamond/double black diamond experience, avalanche gear required, guide-led. Amazingly steep slopes and killer pow. I knew I was pushing my luck with only a couple of days out on the board prior, but I wanted to push the envelope to get ready.

Again, at the local area, I was fine on any slope without moguls, although a bit hesitant. Then hit a mogul run and experienced two electric shocks trying to cut a line through the bumps - dropped me to the ground both times. I knew I was toast. Goodbye $260 reservation to Silverton. Goodbye snowboarding (at least for the immediate future). Hello orthopedic surgeon and possible MRI/arthoscopy. I'm hoping for the best outcome possible - some PT and rest, but I'm dreading that upcoming appointment. My regular doc (an internist) said I had less stability in the left knee than in my uninjured right knee.

However I can support myself on the left knee with little or no pain. No clicking in the knee. Just the electric shock with any kind of hard impact and sometimes a low level ache when flexing my left leg greater than 45 degrees.

Any insight/suggestions out there? Thanks for reading.


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## X02Supermodel (Dec 23, 2008)

Ooouch! I had that done on my left knee last jan 18 '08. Not fun. 

I crashed pretty good and landed on my left knee. I kept having issues with it after my crash. Didn't think to much about it. I delt with the electric shocks anytime I put any weight on it, mainly getting in/out of my car and up/down stairs. It brought me down several times and wasn't healing in a timely matter for me. I finally went to doc. got the whole check up on my knee. X rays then MRI and he found I had torn my medial meniscus. 

I had the arthroscopic surgery. They just trimmed the tear and got the loose stuff out. I got lucky (maybe) they didn't repair it because that would have taken a really long time to heal.

I healed super fast. I felt really solid and started to wein myself off my cruthces on my own within a few days. I tested pain to see how far I could push myself untill it hurt. I started my indoor training rides a week to the day after my surgery. I went really slow. Just enough to get blood flowing, get my heart rate up a little. The movement helped with the stiffness. I could barly make it one revolution around because it was so stiff at first but it loosened up and I felt soo much better after riding. A week and half later I went in for my post op and my doc was floored that first of all, I was off crutches already, second I took my own stiches out and third I was riding again so soon! My doc was thrilled I was doing so well!

I had a super easy fast recovery. I wasn't allowed to race this past season untill cross in oct. Perfect timing!! I did ride all summer as usuall. I raced cross and had awesome luck! No probs what so ever. Mount and dismount were a breeze, jumping and running with my bike didn't effect my knee at all  

Then it got cold, real cold and real pain started to come back. Late november and early december was terrible. I thought I screwed it up from cross racing. Last few races hurt a lot. Season ended and my pain continued untill mid dec. Then it just went away!?! I had no idea what is going on. If cross racing injured it again then my knee prob would have given me issues from the first few races but it didn't bother me untill the last few. I think it was actually from the change of weather. 

I have started my indoor training and again, absolutely no problems. Working pretty hard on it, no pain yet. I think, i hope, it is only from being so cold out. After winter came and settled in my knee pain is now gone :thumbsup: back to riding! 

I wonder if I would be better off if they had repaired it vs trim it? Sometimes it is really sore and sometimes its totally fine. I'm glad it went as well as it did. From all the research I did I think it is an overrated injury. It is pretty common thing to happen and relatively easy to fix!
Good luck to you!


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## mtnboi68 (Jul 31, 2007)

Thanks for your account of your injury. If that's what I've got, it sounds encouraging with the down time. Waiting for my orthopod appt. (next Monday) is killin' me!


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## X02Supermodel (Dec 23, 2008)

No prob. Remember they always over kill things. Ooo yeaa you'll have 6 months recovery crutches for 2 months physical therapy won't be back riding for a year. They always do that so if you heal faster then you are happy. They always plan for the worst. 

The anathesia was the worst in my opinion. They underestimated the dosage i needed. I dont know why. They knew my height and weight. I am really thin compared to my height but still i have no idea what went wrong (dont mean to scare you). They gave me the first dose and my whole body felt like i was on fire. It was the worst pain I ever felt. I was crying and so upset. The nurses were like its ok youll be out in a min and i wasn't!!! I was only half out of it and like omg im dieing. I felt really really drunk in so much pain. My cest was on fire it was terrible! But then they gave me more and i was out! lol Scary but i was ok. That was the worst part of the whole surgery and recovery!


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## shmrcksean (Jun 15, 2004)

Sandiman...hope that knee gets better for you. I just had ACL reconstruction a week ago and am recovering well. The MRI showed I had torn my meniscus too but when the ortho went in he said the meniscus was perfect. I'm glad as I've heard the meniscus can hurt a lot more than the ACL repair.



X02Supermodel said:


> The anathesia was the worst in my opinion. They underestimated the dosage i needed. I dont know why. They knew my height and weight. I am really thin compared to my height but still i have no idea what went wrong (dont mean to scare you). They gave me the first dose and my whole body felt like i was on fire. It was the worst pain I ever felt.


That's scary about the anesthesia. I thought that was the most stressful part going into surgery...never know what's going to happen when they start pumping stuff into your veins through an IV. Luckily, my anesthesiologist was awesome. When I came out of it, it felt like I had the best 2 hour nap of my life. No residual grogginess, nausea, or any side effects.


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## X02Supermodel (Dec 23, 2008)

I know it's kinda scary. Like that movie awake or something. You are half way knocked out but still feel stuff and think but can't communicate. Thats what i was freaked out about.

My nurse felt so bad for me she was hugging me and was like omg im soo sorry hun! I know it hurts you'll be ok in one minute then i was out! I woke up fine as well. In pain but ok. I felt like I had a good nap to. I came to really fast. The nurses had it easy bec i was coherent right out of surgery and talking and laughing being my usuall smart @$$ no grogginess either. I guess most people have problems waking up from being put under? Thats what my doc told me but he knew i'd be ok, sort of.

My doc called it...he was like shes going to wake up right away sooner than we expect no issues but flip out. I was like FOOOOODDD!!! Pain killers NOW!!!! I was so hungry after. I got home and ate so much then felt really sick from all the pain killers haha. 

Getting knocked out was the worst part of my expierence. Thats it. Like I said before...i think the miniscus surgery is over rated and a lot eaiser to deal with than people (docs, nurses etc) say it is. :skep: 

Keep us updated !


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## mtnboi68 (Jul 31, 2007)

*my update*

MRI has confirmed that I have a torn medial meniscus and damaged cartilage on the back of my patella. Left knee.

I get surgery next week, should be on crutches for one day, 4-6 weeks 'till full recovery. Yay! At least I have some closure a month after first getting consulted.

Thanks for the previous feedback.


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## X02Supermodel (Dec 23, 2008)

Yea whatev. You will bounce back so fast and have no probs healing!! 

I had loose stuff behind my knee cap as well. They had a hard time getting to it. I guess I have tight knee caps so they said they pried it off to get it out of there but it wasn't an issue. 

But seriously, like I already said, it's over rated and they always tell you the worst case senario so you are happy with them when you heal before they told you. Good luck! I totally milked evey minute of it to lol

Use good judgement and get on your bike on a trainer (don't clip in) and just pedal. The movement helped me so much. My knee felt so much better after I spun for an hour or so. A small increased heart rate got my blood moving and I felt way better. My knee and my spirits because I was actually doing something now lol

Good luck !


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