Anyone had a torn meniscus cartilage + arthroscopy
Jack Hughes
Posts: 1,262
in General Chat
I've been to the consultant, and have a diagnosis. A torn cartilage - surgery required (i.e. it won't just go away).
[Aside from the fact that the Insurance won't cover that surgeon in that hospital (although they do cover investigations in that hospital. Sigh)... so now have the headache of having to shop round for someone else, equally competent, to do it]
Just to recap, in case anyone has the same symptoms.
1) No traumatic injury (i.e. no rugby tackle, ski crash etc). Just running.
2) The knee started feeling a bit sore once I up the distance/volume - e.g. fine up to an 8 mile run, but longer runs the knee would feel a bit "tender" while running
3) Possibly twisted it a bit when running on Ice over the winter.
4) Late January, a 5K road race - it started to hurt and a bit of swelling.
5) 1st February. A cross country race. Really swelled up.
6) Physio and a suggestion that it was a medial ligament strain.
7) No running (just swimming, cycling, rowing, weights) until 11th April (a week before first Duathlon). Exercises for knee, quads, glutes, adductors.
8) A 5K race (unlucky for some). Followed by massive swelling (so impossible to move the knee).
9) Nothing since.
Symptoms:
A little bit of tenderness
Massive swelling (but some hours after completing the run)
Pain. Enough pain to wake you up in the night when you roll over.
The pain is on the inside of the right knee. There is a pressure point about the size of a finger tip where it hurts.
The pain gets a bit better, but never goes. A small run (e.g. from one side of a running track to another, from platform 6 to platform 1 at Leeds station) is enough to bring back swelling and pain. Swimming is fine. Cycling the knee just feels "weak" rather than painful when under load - e.g. seated up a hill in a big gear.
Some swelling is always present.
Symptoms not present - No instability (I have pretty good core strength and do lots of exercises which probably covers that up). No locking.
Key indicators that lead to the diagnosis:
The swelling. The swelling is not good and indicates that something is wrong - rather than an overuse injury.
The sore point on the left side of the knee bang in the centre - this is a cyst caused by the fluid leaking.
There is a tear in the cartilage - the disk of tissue that supports the top leg bone on the bottom leg bone. There is an increase in fluid in an attempt to compensate for the lack of support caused by the broken cartilage. The fluid leaks out through the tear which causes the swelling - and the cyst.
Once the cartilage is damaged - it doesn't get better in most cases (in a small percentage it can be repaired < 5% IIRC).
So.. if I want to be able to run again, I need the op. Once corrected, running should be OK (cycle machine after 6 days or so, running again in a week or two - from the time of the op, of course. Cross trainer a bit in between. So If I can get it done soon, then Ilkley Tri in September is still on!)
OK - that's the story. Anyone been through anything similar. Good results? bad Results? I should have another 15 years of service out of the knee before it starts to cause problems again...
[Meanwhile, I might have found a cheaper surgeon....]
[Aside from the fact that the Insurance won't cover that surgeon in that hospital (although they do cover investigations in that hospital. Sigh)... so now have the headache of having to shop round for someone else, equally competent, to do it]
Just to recap, in case anyone has the same symptoms.
1) No traumatic injury (i.e. no rugby tackle, ski crash etc). Just running.
2) The knee started feeling a bit sore once I up the distance/volume - e.g. fine up to an 8 mile run, but longer runs the knee would feel a bit "tender" while running
3) Possibly twisted it a bit when running on Ice over the winter.
4) Late January, a 5K road race - it started to hurt and a bit of swelling.
5) 1st February. A cross country race. Really swelled up.
6) Physio and a suggestion that it was a medial ligament strain.
7) No running (just swimming, cycling, rowing, weights) until 11th April (a week before first Duathlon). Exercises for knee, quads, glutes, adductors.
8) A 5K race (unlucky for some). Followed by massive swelling (so impossible to move the knee).
9) Nothing since.
Symptoms:
A little bit of tenderness
Massive swelling (but some hours after completing the run)
Pain. Enough pain to wake you up in the night when you roll over.
The pain is on the inside of the right knee. There is a pressure point about the size of a finger tip where it hurts.
The pain gets a bit better, but never goes. A small run (e.g. from one side of a running track to another, from platform 6 to platform 1 at Leeds station) is enough to bring back swelling and pain. Swimming is fine. Cycling the knee just feels "weak" rather than painful when under load - e.g. seated up a hill in a big gear.
Some swelling is always present.
Symptoms not present - No instability (I have pretty good core strength and do lots of exercises which probably covers that up). No locking.
Key indicators that lead to the diagnosis:
The swelling. The swelling is not good and indicates that something is wrong - rather than an overuse injury.
The sore point on the left side of the knee bang in the centre - this is a cyst caused by the fluid leaking.
There is a tear in the cartilage - the disk of tissue that supports the top leg bone on the bottom leg bone. There is an increase in fluid in an attempt to compensate for the lack of support caused by the broken cartilage. The fluid leaks out through the tear which causes the swelling - and the cyst.
Once the cartilage is damaged - it doesn't get better in most cases (in a small percentage it can be repaired < 5% IIRC).
So.. if I want to be able to run again, I need the op. Once corrected, running should be OK (cycle machine after 6 days or so, running again in a week or two - from the time of the op, of course. Cross trainer a bit in between. So If I can get it done soon, then Ilkley Tri in September is still on!)
OK - that's the story. Anyone been through anything similar. Good results? bad Results? I should have another 15 years of service out of the knee before it starts to cause problems again...
[Meanwhile, I might have found a cheaper surgeon....]
0
Comments
I have two friends who had the same operation within a couple of months of each other. One followed the medics & physios advice but on the cautious side & slowly got back into training. Three years on he has no issues with his knee and can quite happily run whatever (up to marathon) distances he wants. The other started training again when he felt "OK". Within 6 months he was back to where he started. He walks with a permanent hobble and is in pain when it is very cold or damp. He will need a knee replacement to walk properly again.
Learning from their experiences follow the medics & physios advice, don't rush & probably don't make plans that put you under pressure to do the wrong thing. Missing Ilkley Tri is one thing but missing the rest of your tri career would be far worse. The odd break never did anyone any harm.
Best of luck with the op
If it were me, id be taking a lot of time off, very slowly building it up.
Thanks for that - both stories are useful - that I will be able to do what I want to, and the other - to take care. Thanks again - it's been getting me down a bit - not had a general anaesthetic since I was a kid - and to be honest, all the pain and frustration has been building up a bit. So feeling quite a bit down at the moment - so your response means a lot more than you might think!
Where are you having the procedure done ? Do you know yet ? Why can't that Surgeon do it ? I know you said about insurance but why can't he ? Push for it, go with what your comfortable with.
Make sure you ask about the surgeons previous patients and their outcomes. Make sure you tell him that Tri's are your life and you need it to be tri strong not just wak about strong post op.
Finding a cheaper surgeon is cool but is he as good ? You can always pay the difference between the two doc's out of your own pocket if you feel strongly that the 1st one is better. Your insurance will allow this.
Best of luck and keep us up to date
Why won't your insurance co pay? It isn't PPP is it? I would write to them and see what they say - it could be very distressing and inconvienent for you to go to another surgeon now, play that up. Particularly now you have the rapport and trust built up. If you want that surgeon i'd seriously consider questioning if there is any way that they will pay for it - it could be the case of upping your premium for increased cover, more per month but you have the surgery where and by whom you wanted. And if not, see if there is any way you can complain about it...sorry this is starting to sound like work now so i'll stop.
When i was a little younger i massively overtrained and was prone to injury (see my other post on ankle injuries) primarily from running in boots carrying a heavy pack. As a result i picked up this injury whislt rock-climbing - my knee couldn't take the lateral force and gave way sideways reulting in meniscal tear.
I was operatedby the NHS, then saw unit physio and NHS phsysio - both of whom were pretty gash. I wanted to get back on form ASAP and tracked down a highly reputable sports physio (who at the time was working for the england footy team at Lilleshall and Gladitors TV show!).
He really was excellent and gave me a series of very specific exercises and strength training routines. Fortunately i've had very little problems since.
Definitely track down a specific sport physio - I'm really lucky our local NHS physio is sport mad
I have experience of both sides - I'm an orthopaedic Hip & Knee surgeon (based in Portsmouth so prob no good to you) but had my knee scoped for almost exactly the same problem as you 9 years ago. I've had no problems since. I would definitely check out your surgeon but knee arthroscopy is an extremely commonly performed op. If you want any info have a look at my website www.hipandkneeadvice.com which should answer all your questions. From a rehab viewpoint, you can start non-impact activity usually from about week 3-4 but it depends on the exact findings at surgery. Running should be gradually introduced from week 6 onwards.
Good luck!
I've got a day of 1st July (could have been earlier, but work commitments.. and one of the reasons why work pay the insurance is so that we can fit in things like this around work).
Generally, I'm a great believer in the NHS... but for sporting injuries, I don't really think it caters for those..
Work has insurance. And I would recommend anyone doing this sort of thing to look into getting some insurance.
The problem was, as we've now found out, the insurance isn't really that good - you are restricted, heavily, it turns out, in what hospitals you can use for any surgery.
The insurance was happy to fund the consultation - I had gone for a surgeon with a strong sports injury background. But he wouldn't operate at a hospital on the Aviva's list, and they wouldn't let me make up the difference. Also, the surgeon was too expensive for them, so I would have had to pay extra.
Anyway, I think I've found a surgeon who is OK - fits within their fee structure, and will perform it at the local NHS trust hospital. And the date is good.
So, I think I am all set to go - just in time to get both MRSA and swine 'flu!
Meanwhile, I will try to keep my motivation levels up - see what sort of performance I can squeeze out of the knee on the bike - it doesn't hurt that much (although it hurts a lot more now that I know it is 'proper'). It will also be nice to have a few benchmarks against which I can measure performance once I return to fitness!
ta muchly!