Medial meniscus knee surgery: have you had it done? (I have) here's what to expect

[Area5150]

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 you are. Another type of cartilage surgery, less common and one that requires several weeks on crutches and more time spent 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 electrical 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 very 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.

 

[fitnessfreaky]

Wow, my knee just hurts thinking about it!!! I tore my meniscus, petella tendon, and completely tore my MCL and had it operated on and I can remember how horrible rehab was....I don't remember getting any shocks but my knee had a lot of discomfort off and on for the first 3 months. I think it took me about a year to get back to playing shape. Its been fine ever since... Just remember to follow the orders of your PT and doctor... Hopefully, it works out for the best! Good Luck!

 

[Area5150]

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.