# To scope or not to scope (torn meniscus)



## NE_fsrxc (Jul 21, 2006)

Just found out that the pain I have after 4 miles into a ride is the result of a torn meniscus (layer of tissues between the leg bones in your knee that provides padding, etc.). My doc. wants to go in arthroscopically to remove any fragments that may be in there and causing mechanical issues when I move my knee. Seems loose piece could be causing a "catching" sensation and a popping sound when I'm moving my knee, especially while riding. Anyone out there been in the same quandry? I could have the procedure, or rely on further PT and strengthening to reduce the effects. What I'm afraid of is if the surgery will A.) be effective enough to enable me to hammer up hills in a racing situation, and B.) not make the issue worse and make the recovery all for nothing. 

I'd love some different perspectives on this if anyone has some to offer. 

Thanks!


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## thetreadway (Jun 29, 2007)

I just had an ACL reconstruction and from talking to people and doctors it seems that meniscus repair is pretty common and usually has good results. I was lucky that when the doc got into my knee it was just ACL and no meniscus damage. I'm 30 and the doc said he also removed a fair bit of arthritis from behind my kneecap while he was in there. I think the PT would be significantly faster with the meniscus scope than with my ACL and hamstring graft. Does the doc say not fixing it could lead to greater problems in the future? Does it cause pain or just popping and catching?


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## NE_fsrxc (Jul 21, 2006)

Yes, definitely pain. Not really any catching or popping when I ride. I talked to my doctor today and he is confident someone in my condition and age (34), and having not other knee issues (hopefully) at the moment should recover pretty quickly. I thought I had some issues with chondromalacia, which is fairly common in runners (which I don't do a lot of). We'd discussed that as a diagnosis...kneecap possibly out of alignment due to muscle strength imbalance, etc. I think he'll explore a little while in there and, like you said, possibly remove any suspected arthritic material as well.


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## Atomick (Apr 22, 2008)

My GF had both a meniscus repair AND an ACL allograft (dead guy ligament!) in the same year, same knee. The first meniscus repair/arthroscopy was a piece of cake, and recovery was taken very seriously and therefore was trouble-free. Plus we got a narrated video to watch afterwards, which was rad! 

Out of curiosity, NE_fsrxc, where _specifically_ is your pain from riding? Above/below/outside/behind the kneecap?


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## NE_fsrxc (Jul 21, 2006)

The pain is usually right under my kneecap of my right knee. If not, slightly to the inside just a little. Only hurts when i've been on the bike for about 4 miles. Til then it usually feels fine. And it doesn't hurt when i'm walking or running. A sudden forceful push downward can cause a small twinge of pain. But all in all, its usually when riding.


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## Atomick (Apr 22, 2008)

Thanks for the details - I, myself, get occassional pains ABOVE my left patella, and I can't figure if it's a joint, stress from underdeveloped quads, ligaments, or what. Doesn't sound related to your issue. I appreciate the info.


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## Chapped (o) Hole (Nov 13, 2007)

I have had my right knee scoped 3 times. I no longer have any meniscus left and have the early signs arthritis. I went through all of the same symptoms and I can tell you that no amount of conditioning will help. You need to have the knee scoped to remove the torn segments otherwise they will continue to float in and out of the joint causing a locking and popping sensation. Recovery now days is a couple of weeks. After my last surgery I was walking the next day. Unfortunately this is a problem that will more than likely trouble you forever. Suck it up and have it done now and you will be back on your bike in no time. Good luck.


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## cocheese (Jan 12, 2004)

I had clean MRI's but had a scope anyway. The doc found 2 tears and a nasty medial plica which he removed. The lateral tear was able to be cleaned up pretty easily anddoes not give me anymore pain. The medial tear is more of a weak spot in the middle of the meniscus and he said that if he removed it I would have no meniscus at all. It has been 3.5 months and I am still doing my PT every day, without fail. I'm not back to 100% bya longshot. In the end, I'm glad that I had it done because things are better than before surgery, but the jury is till out on the whole thing. I'm just not far enough along and the medial side is still hurting the way it did before surgery. I had a couple of years of intensive PT before having it scoped. The PT felt good but never helped with the knee issues. The surgery helped but as not a magic bullet or anything. I'm still working at it every day, religously. I've heard some folks just hop back on their bike, but it totally depends on what you have done. My doc said that I had a lot of irritated tussue in my knee which he removed. The two tears he worked on, combined with the plica and other irritated tissue being removed all added up to quite a bit to recover from. Honestly, I have good days and bad days. I cannot stand around for long periods of time anymore. My knee hates that now. Anyway, good luck with it and if you get it done, take it slow afterwards. Don't try to rush back into it.


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## coryell (Mar 9, 2008)

Last November I had a pretty bad wreck leaving me with a deep punture wound, fractured femur, and torn meniscus. Neither the fracture or torn meniscus was discovered in the emergency room. After about a month of many sleepless nights and still having a considerable amount of swelling I returned to the doctors. The doctor ordered an MRI which revealed the fracture and torn meniscus. So, for teatment of the meniscus I have never had any scoping done on my knee. My orthopedic surgeon felt that the problem could be corrected by physical therapy alone. He gave me some progressive exersices intended to correct the tracking, petelar glide, of my knee. It took several weeks but the popping went away and now have no problems with my knee. My doctor seemed to feel that if surgery can be avoided and the problem can be corrected through PT than PT is the way to go. Surgery can often lead to more problems latter down the road.


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## presslab (Jan 5, 2007)

I had my knee scoped and got to watch the monitor.  The torn meniscus delaminated and looked like shredded cotton balls. Removing the torn part will do nothing but good, there is no way that it is helping the joint; where mine was torn, on the outside, it won't heal on it's own. If it was on the inside there is a chance of it healing once they stitch it back together. I think the surgery was all of 10 minutes long and I was walking fine after 2 days. They removed 25% of my lateral meniscus.

My pain after injury was both inside the joint, which was my meniscus, and on my kneecap, which for some reason I have patella-femoral syndrome. PFS just means my kneecap isn't aligned right any more. The meniscus pain WAS gone but I think I have reinjured the knee and torn more meniscus because of my torn ACL.


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## mlepito (May 1, 2007)

If your knee is not locking then PT can be very effective. The scope will help with a fast recovery, however when they remove parts of the meniscus it can accelerate degeneration in the knee. So you have to take that into account. Usually the scope is a very easy surgery with a high success rate. But they must remove the torn segment, so you will have less meniscus to help with shock absorption. How long have you had the PT for?


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## Amber (Nov 21, 2005)

I had my knee scoped 2 years ago when I was 30. Had the same symptoms as you and put up with it for a year before I got it done. Was back on the bike in no time. I have fully recovered without any PT and now stomp up 1/2hr firebreak climbs every or every second day with no bother.


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## Sandiman (Aug 22, 2007)

NE_fsrxc said:


> My doc. wants to go in arthroscopically to remove any fragments that may be in there and causing mechanical issues when I move my knee. Seems loose piece could be causing a "catching" sensation and a popping sound when I'm moving my knee, especially while riding. Anyone out there been in the same quandry? I'd love some different perspectives on this if anyone has some to offer.


Yes, I'm in the same boat: http://forums.mtbr.com/showthread.php?t=433280


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## RickC5 (Sep 23, 2004)

I'm in EXACTLY the same boat! Had an MRI done on my right knee and all the docs agree that I've torn the meniscus on the back side, which aches a bit when I do lots of walking. A compound tear no less. The surgen's PA said having the knee scoped was up to me. However, if a loose particle gets into the joint and "locks up" the knee, then it will need emergency surgery. No popping during movement.

I have another consultation with the surgeon soon and we'll see what his opinion is.

Whatever the final decision, I would sure prefer to wait on the surgery until this coming winter, when recovery won't affect riding.

At this time, I'm forbidden (by the docs and my wife) from riding for another week. Too much damage from my last crash that needs to heal first.

Sheesh what a mess!


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## Sandiman (Aug 22, 2007)

To answer the thread starters question, it depends on several things:

>would you be having a partial or full meniscectomy? (Huge difference)

>or are you having a repair job? (Another big difference)

Depending on your answer, you'd have several options to explore before you had arthroscopic surgery.


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## Frankinnj (Dec 29, 2006)

I had a torn medial meniscus, that had been bothering me for about 2 years. I had it scoped a year ago January. I could not mountain bike for about 4 months during the recovery period. About a month into recovery I was allowed to go on a stationary bike or road bike. I say get it done! The doctors removed the meniscus altogether. It has been well over a year since the surgery and I have no pain whatsoever. I am stronger at climbing now than I was before the surgery, probably cuz I have no pain now. The rehab sucks cuz you have to stay off it so long, but long term I am definately glad I did it.


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