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

Discussion in 'Off Topic Chat' started by Wilynn, Jul 13, 2008.

  1. Wilynn

    Wilynn TPF Noob!

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    Tore my knees up pretty good over the years racing motorcycles. Prior to surgery, my knees, for weeks on end, were feeling fantastic, almost bullet proof. Before getting hurt I had been riding bicycles up steep hills as a form of preventive therapy on a weekly basis. Does that sound dumb? Not really. Hillclimbing is not brutal on the knees just as long as you make darn sure you spin the cranks as opposed to mashing down on them. Huge difference between a spinner and a masher. I developed a problem to my knee in March, 2008. The doctor cut a portion of my cartilage out on June 17, 2008 (no stitches, just a trim job, a.k.a. partial meniscectomy), making me as of today approximately 23 days post-op. The procedure 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."

    >10 days post-op 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

    >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 5 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 electrical shocks 0-5 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. Yesterday 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 by people and give up my hobby of taking pictures in urban areas a.k.a. street photography.

    I hope this helps anyone out there who is slated for the same type of surgery. Please leave a comment if you have anything to share, especially if you've been in my shoes and have experience with the same type of surgery.
     
    Last edited: Jul 15, 2008
  2. Easy_Target

    Easy_Target TPF Noob!

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    Hill climbing is rather good, but like you said, ONLY if you do it properly and most people don't, myself included (the chain on my bike slips from the crankset when pedaling hard, disrupting the rhythm).

    "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." I actually understand what most of it means. :mrgreen:

    The "electric shocks" are most certainly irritating and embaressing. Unfortunately I experience it rather often. I've injured both my knees and herniated a disc in my lower back, so I experience it in both knees and my lower back. If I had to describe it, it'd be much like those novelty hand zappers, except the pain sensation is much sharper.

    From my experience, the shocks are most frequent when I've been idle for a while and then become active. I've myself physically active, nothing at a high intensity though. Mostly low to moderate intensity, because for me strenous activity also triggers the shocks.

    To be honest, I don't think those shocks will ever go away. I injured my back about 2.5 years ago and I still get them in my back. I've injured my knees about a dozen times over about 15 years, the most recent being about 2-3 years ago. I still get them in my knee as well.

    Just because the shocks don't stop doesn't mean your life is over and you need to make a drastic change. Despite the number of long term injuries to my body, I still lead my life more or less the same way. The only difference now is that I know where my body's limits are right now and how far I can push. I also know the consequences of pushing it past those limits. You don't need to give up any of those things. For stairs just take them slowly, particularly going down them, that's when I get most of my shocks in the knee and back. Street photography you can also still do, just take it easy on the knees when you're doing it.
     
  3. Wilynn

    Wilynn TPF Noob!

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    A few questions regarding your knee:

    >do you have cartilage problems?

    >do you experience electric shocks in your knee every day, 365 days a year?

    >on the average, how many shocks to your knee do you experience per day?

    Depending on my level of activity, I average about 1 to 6 intense shocks a day, 20 some days post-op.
     
  4. Easy_Target

    Easy_Target TPF Noob!

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    Don't know if I have cartilage problems, I haven't ever had them checked. The one time I did have it checked, the ortho told me it was just tight hip flexors (to which i responded BS). I've been looking for another since.

    It's not everyday, 365. It's probably every 2-3 days, sometimes 3-4. It's only back to back when the weather is humid outside and I'm doing moderate physical activity.

    On days where I do experience the shocks, it can be as little as one to as many as 8. They're either spread apart throughout the day or very close together.
     
  5. jlykins

    jlykins TPF Noob!

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    I have had this same procedure done twice now. The first time was in highschool, and the second time was last year. It sucks having to go through recovery...
     
  6. Wilynn

    Wilynn TPF Noob!

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    jlykins, when you were post-op did you ever experience the electric shocks on a daily basis? An electric shock would be described as an intense #9 level of pain on the 1 to 10 level of pain scale. The electric shock lasts for a split second and then it, for the time being, goes away. And did you have a repair job done to your cartilage or did they cut off excess cartilage a.k.a. a meniscectomy.

    http://www.webmd.com/a-to-z-guides/meniscectomy-for-a-meniscus-tear
     
  7. jlykins

    jlykins TPF Noob!

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    The first time it was just a cut to remove excess. The second time it was a repair. I had that same pain both times after surgery. It slowly went away as I was recovering and going through physical therapy. I still get awfull pain when the temperature changes from hot to cold, and when it rains. Also if I'm down on my knees for an extended period of time (playing horsey for my kids) they hurt really bad when I stand up.
     
  8. Wilynn

    Wilynn TPF Noob!

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    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.
     
  9. Roger

    Roger TPF Noob!

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    you raise an interesting point here about feeling worse after an intense PT session. I had a back injury many years ago and had minor surgery(discectomy), which at the time was the first of it's kind in Australia. Anyway I had a good recovery and have maintained an active lifestyle since, presently going to the gym three times a week. Early in my injury life I had treatment by a physio, who I found to be quite gung-ho and I got worse instead of better. The guy wouldn't listen and insisted things would get worse before they get better, they didn't. I had also been to chiropractors over the years and felt better for the rest of the day after treatment.....then same as usual. Going to an Osteopath was the turning point for me, deep massage followed by manipulation proved helpful. He also advised doing yoga daily to improve mobility, I did this for 18 months to good effect. However I prefer going to the gym doing a combination of some cardio and weights with proper stretching at the end. I should stretch every day but I'm doing okay! I hope you find a regime that works for you, sometimes the 'experts' get it wrong and we need to find the best for ourselves by looking at alternatives. Doctors also can be pessimistic, mine told me at age 40 to prepare for a very limited life. Okay my life is not how it was, but I wouldn't call it severely limited....can't play squash anymore though.
     

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