# Knee scope done today



## cocheese (Jan 12, 2004)

After over 10 years of dealing with post workout pain, I decided to have my knee scoped. It was not a rash decision. I got a pro fitting and did a lot of physical therapy to try to address the problem. Today was the day and everthing went well. In my MRI, my knee showed no signs of serious structural damage or trauma. This was confirmed by the surgeon. There were two issues that were not picked up by the MRI. One was some softening/deterioration of the meniscus towards the outside of the knee. He cleaned this area up but said that there is not a lot that he can do about deterioration. My dad's menisci are practically gone, so it could just e genetic. He has some kind of pig cartlidge injected into it or someting. The second issue was a depression in the meniscus towards the inside of the knee. This is the area that has been the greatest source of pain and discomfort. He said that the best thing to do in this area would be to try to stimulate the body to fill this area. He poked some holes in this area with a needle saying that I am young (35) and that my body should respond. If I were older he said that he may have removed this part and stitched it together. I am glad that he took a conservative approach.

All of this info is second hand through my wife and the doctor will be calling tomorrow to talk in more detail. I also have a follow up appointment next week.

I am lying on the couch right now, all wrapped and iced up. Now the recovery begins. I want to do this part right. My wife is a nurse and she is keeping a close eye on me.

I will keep you posted on the process as I know that this board was a valuable source of information and support for me leading up to this day.

Thanks to everyone.


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## cocheese (Jan 12, 2004)

Talked to the doc today and I got part of the story wrong. The holes were punched in the area to the outside where I had the deterioration. He said that he could have cut this area away but I would not have had much meniscus remaining, so he just trimmed a little bit of it and tried to stimulate some bloodflow with the holes. He said that the meniscus was quite frayed all the way around, so he slightly cleaned that up. He said that there was quite a bit of scar tissue type buildup all around the joint, so he cleaned that up. Apparently the depression area is in such a place that it cannot be worked on easily and if he were to try to poke holes like in the outside, it would have taken up the whole area. All in all, he said that there were quite a few things there that the MRI showed no signs of whatsoever. Just like I suspected, the "clean" MRI was false. While there were no smoking guns, the MRI did not pick up any of the issues that were revealed with the scope. 

As for the recovery, today I have been taking my scheduled pain meds and things seem to be under control. It doesn't feel good but the pain is certainly manageable. I am doing my exercises and will be in physical therapy next Wednsday.

Both the doc and the nurse called today. It was a nice touch hearing from both of them to ask how things are going. I must say that with all of the complaining that goes on about our medical system, my treatment was fantastic in very way.


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## brownieinSC (Apr 19, 2004)

A good doctor who actually checks up on patients seems hard to find. 
Physical therapy does help a lot. Good luck on your recovery


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## cocheese (Jan 12, 2004)

brownieinSC said:


> A good doctor who actually checks up on patients seems hard to find.
> Physical therapy does help a lot. Good luck on your recovery


Yeah, he's a really good guy and a good doc too. I'm headed to PT on Wed. Thanks, same to you. I've been following your other thread...


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## cocheese (Jan 12, 2004)

Went to the dr. for a follow up today. I got the stitches out and had some tape put over the scars. He explained more about what he did during the procedure. The first thing he did was trim a tear on the lateral side. Next he cleaned up some general fraying around the edges. After that he noticed a soft spot or depression in the medial side. Since this would not have been a good area to trim and sucher, he opted instead to poke some holes with a needle through the medial side of my knee to promote bloodlfow to the damaged area. The last thing he did was remove my medial plica. He said it was very inflamed and irritated and since that had been the major area where I had been experiencing pain, he took it out. He wants to see me back in a month.

It turns out that my range of motion may not be moving along as quickly as it should. I am at about 5 degrees with my leg extended and around 80 degrees with it bent. I'm getting a lot of tightness when bending. I'm not experiencing a lot of prolonged pain only severe tightness. 

Good news is that I am walking with only one crutch and only using it for balance. The weight bearing aspect is fine, only the motion needs work.

Bad news is that after the 2 1/2 hours driving in the car with a ferry ride in between caused my knee to swell pretty bad on the way home. Good thing is, my wife is an RN and she ot me set up with a good wrap, some ice, and pillows to elevate.

I am not through the woods on this thing yet, but minus the swelling today after the drive, everything seems to be moving ahead.

My PT said that the first two weeks of recovery can be a good indicator of how the rest of the recovery will go. I think I'm doing "ok", not great or terrible but somewhere in the middle. Actually, I don't care how long it takes as long as I do it right and build it back up to 100% someday!


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## nnn (Feb 1, 2005)

Hey, I wish you the best in your recovery, it seems like you'll make it through fine !!

Your issue sounds a lot like mine with post exercise pain when my right knee is bent under load, sometimes I get popping/squeaking etc. Been going on like this for a couple of years now and i'm not sure if it's just me pedalling badly or something else as other activities like skiing, free-running, tennis etc don't seem to aggravate it so much....

I'l probably get it looked at externally this summer, though it's a frightening prospect being 21 and having the possibility of maybe losing some tissue


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## cocheese (Jan 12, 2004)

nnn said:


> Hey, I wish you the best in your recovery, it seems like you'll make it through fine !!
> 
> Your issue sounds a lot like mine with post exercise pain when my right knee is bent under load, sometimes I get popping/squeaking etc. Been going on like this for a couple of years now and i'm not sure if it's just me pedalling badly or something else as other activities like skiing, free-running, tennis etc don't seem to aggravate it so much....
> 
> I'l probably get it looked at externally this summer, though it's a frightening prospect being 21 and having the possibility of maybe losing some tissue


Thanks nnn. I'm getting a little more flexibilty out of the knee today and that's all I can really ask for, a little progress.

My knee has been bugging me since I was 24. It just came out of nowhere after a hard ride, so maybe the bike does have something to do with it. I'm not sure if it came from that particular day or not, but it hasn't really been the same since. Last year I started physical therapy and that helped some but never really got to the root of the problem. I am going to start back up wth that PT routine after I finish with the recovery PT.

Have you been to a dr. about it at all? My suggestion would be to at least see dr. about it and go from there. Exhaust all non invasive avenues and use surgery as an absolute last resort. Progress only as you feel comfortable. Good news is you are very young and should be able to fix it or recover quickly.

I'll tell you how my "journey" has gone...

I first noticed the pain back about 1997. Saw an Ortho who did an MRI. Showed clean and he suggested a scope. I denied and wanted to give it some time to see if time would heal it. For many years I lived with the pain associated with a bad knee. Kept me off the bike a lot which I really hated.

Fast forward to 2007. After rationing exercise for so long, decided I HAD to do something to get back on the bike more. Had another MRI, again clean. Ortho suggested a round of intense PT. Ordered Specialized BG shoes and footbed. Got a pro bike fitting and cleat fitting. Did intense PT 2x day for part of a year. Helped some but did not address root of issue. After my right knee started hurting from favoring for years, new years resolution to do the knee in 08. Finally scoped 1/24/08. Showed two tears, fraying, and very irritated medial plica (removed). Currently in recovery. Fingers crossed!  :thumbsup:


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## nnn (Feb 1, 2005)

I haven't really talked to anyone about it as I've always thought it's normal with my routine and I'm pretty young so I didn't think it could be anything serious.

As you say I'll talk to an ortho first and chat about possibile workouts/stretches etc and if that doesn't help it'll have to be echograph or whatever and worst case scenario surgery, though I'll think long and hard about that one, hopefully it doesn't go there


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## cocheese (Jan 12, 2004)

Yeah, the first things to look into would be bike fit cleat placement (if you are using clipless) and things such as that. Those are EASY fixes!

May the force be with you.


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## cocheese (Jan 12, 2004)

Two week update here... I was on the stationary bike today for about 20 minutes. I still have a bit of swelling in the knee, but it feels really good to pedal again. I am at 122 degrees of bend too which is good. My PT says I'm doing well. l'll check back in a week or so.


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## Ray Lee (Aug 17, 2007)

great news, glad to see you back on a bike already

regards
Ray



cocheese said:


> Two week update here... I was on the stationary bike today for about 20 minutes. I still have a bit of swelling in the knee, but it feels really good to pedal again. I am at 122 degrees of bend too which is good. My PT says I'm doing well. l'll check back in a week or so.


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## cocheese (Jan 12, 2004)

Ray Lee said:


> great news, glad to see you back on a bake already
> 
> regards
> Ray


Thanks Ray. Yeah, I'm pretty jazzed about it. I was on the stationary for another 20 minutes today. It feels really, really good to get the legs moving again.


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## consumerbydesign (Jan 27, 2005)

R.O.M. Range of motion can`t be worked on enough. You should be able to pull your leg up and touch your backside with your heel. Full extension, sit with your back against the wall and stretch the hamstring, calf and straighten the knee fully. Work on that 24/7 for the rest of your life. Work up to the point of pain and slightly beyond.
Scar tissue, Sit with your back up against the wall with the knee fully relaxed and full extension, but relaxed.Float your pateller bone around and massage the pateller tendon aggressivly massage all around the knee when driving or working. Can`t be done enough, forever.
Pain killers, use them to reduce inflammation with ice sessions or to get a good nights sleep. Can you rent a knee bending machine? they work great with pain killers while sleeping. Good for the R.O.M.
Dont depend on the physical therapist so much, It is 100% up to you, learn many things from the P.T. Take that knowledge home and get to work/play. 
This might not apply, but it helped me.The best part is biking is the best thing one can do unless of course there is pain biking. Reduce that swelling and ease into it. R.O.M. might be everything. Get an Aquajogger and hit the pool.

.


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## cocheese (Jan 12, 2004)

consumerbydesign said:


> R.O.M. Range of motion can`t be worked on enough. You should be able to pull your leg up and touch your backside with your heel. Full extension, sit with your back against the wall and stretch the hamstring, calf and straighten the knee fully. Work on that 24/7 for the rest of your life. Work up to the point of pain and slightly beyond.
> Scar tissue, Sit with your back up against the wall with the knee fully relaxed and full extension, but relaxed.Float your pateller bone around and massage the pateller tendon aggressivly massage all around the knee when driving or working. Can`t be done enough, forever.
> Pain killers, use them to reduce inflammation with ice sessions or to get a good nights sleep. Can you rent a knee bending machine? they work great with pain killers while sleeping. Good for the R.O.M.
> Dont depend on the physical therapist so much, It is 100% up to you, learn many things from the P.T. Take that knowledge home and get to work/play.
> ...


Thanks for the tips. I was not able to touch my butt with my heel even before surgery, nor can I with my other leg. The ROM is coming back. I was 128 degrees on Friday. I went from 80 to 128 in on week, which is good. I was doing the sttionary, but it kindof made it wewll up so I'm off of it now, as per the PT's instructions. My idea is to et throuh it enough to where the swelling is down and then stop the PT. That's what I did before the surgery, went to the PT and learned the right exercises and stretches and then did them myself. I checked in like once every month or two and went from there. It is a good way to do it. It's too bad that the bike made it swell because it felt really good to get it moving.

I'm just going to have to do this slow and right and not try to rush it. Right now I'm just fighting the muscle tightness and weakness and the swelling. I'm relieved that the ROM has come back the way it has. I'm not through the woods et!


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