Meniscus Tear - Advice Needed

aion2come

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Okay, this sucks. Last year I lost my job and it cost me my elk hunt. This year I tore my meniscus and have trouble doing light walking for more than a couple hours (that's without a pack). I go to my orthopedic guy for the third time this week. Had the knee drained and had a shot. Shot didn't help at all. So I'm looking at either surgery and/or a good knee brace.

For clarity, I always have some discomfort if I am upright, but two things play with my head. 1) occasionally something "catches" in the knee and about sends me to the floor. 2) I have a constant feeling like the front of my knee has no support ... this happens when my leg is almost straight. These two things combine to keep me walking tentatively all the time. Not a good combination when I think of packing a load out of the backcountry.

Any suggestions/comments on either would be appreciated. I don't want to miss this Fall and need to get back to working out.
 

Team4LongGun

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Your doc should be able to read your MRI and determine if your tear will heal on it’s own or require surgery. Based on the tear, you should have been provided timelines on both avenues. If you havent had an MRI, I’d get a new/different doctor.

I would def NOT take advice regarding my health from the internet......
 
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For your future health's sake immediately see a specialist for a second opinion. That shot, if it is steroidal, dramatically weakens your tendons and masks the symptoms of the injury while providing zero repair function. If your meniscus needs repair, don't delay, as you are risking further injury. I would get at least two second opinions as quickly as possible and then immediately take action if surgery is indicated.
 

Agross

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I went through the same thing. I dealt with it for almost two years. Then on the second day of my first ever elk hunt in 2018 I stepped down off some rocks awkwardly and my knee locked back. I knew immediately I just made it alot worse. My hunt was over. Had an mri Then had surgery which I thought would solve the problem. Did it help, yes Did it help alot, no I have been extremely disappointed with the results. I would never go back to the surgeon I had. I still have pain if I twist or turn with my foot planted, if I have my knee bent for too long, or straight for too long, If I sleep on it wrong, and if there is any pressure on the inside of my foot pushing out. I am basically back to dealing with it. It is better than is was before surgery, but not near as much as I thought it would be. They told me there basically isn't a knee brace for this kind of injury. Good luck I hope you have better luck than I did.
 

Poser

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I tore mine in early January. I was off it completely for 10 days and then started squatting again with an empty bar (couldn’t go to parallel at first), added 25# to each workout 3x a week until I got 185#, dropped to 10# jumps to 250# and then 5# jumps back to around 300#. I resumed snowboarding somewhere in there wearing a knee brace and still ended up getting 50 days in this season.

Stress, Recovery, Adaptation cycle: you place a dose of systematic stress on the MCL, you allow sufficient time for recovery, then You increase the stress slightly and repeat. It wasn’t comfortable, it wasn’t pretty at times, it was painful a few times, but I got my knee back to about 85# inside of 2 months. MCL, because is non vascular, will be a slow recovery, though my doctor was thoroughly impressed with my recovery time. It’s still not 100% 4 months later, but I was told to expect to do nothing for 4 months which did not jive with my experience dealing with injuries.
 

Baddog

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Feb 26, 2020
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I had a torn meniscus, dealt with it for 2 years. Had surgery, first week was a real bitch by 8 weeks it felt great. Wish I hadn’t waited. Obviously all tears aren’t created equal. But from what I understand a meniscus tear will not ever heal, it needs trimmed out.
 

Baddog

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Oh talk to a couple different specialists, doesn’t hurt to get 2 or 3 opinions. I’ve had to pay out of pocket a couple times for a 2nd or 3rd opinion on health issues, but the piece of mind in making the decision is worth it.
 

Anvil69

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About a year before I got out of the Marines I injured my right knee fast roping and they just gave me Motrin. It seemed to be ok so I didn’t worry about it, within a year of getting out I really tore the meniscus good and “frayed” my ACL. Had surgery to repair but it never felt right. 2 years later I completely severed my ACL. Another surgery and rehab. Another 2 years later, completely severed again! This time a different surgeon who told me the first surgeries were done wrong! The muscles in my right quad have never fully recovered because I’ve been over compensating with the left leg for so long. It’s been 18 years of almost constant pain since the last surgery, I just don’t trust the MFs to cut on me again to try and fix it! All that to say get several opinions and make sure you rehab the shit out of it after surgery.
 

dieNqvrs

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Sep 17, 2014
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I have torn meniscus in both knees.

Had right knee torn while playing basketball. Had it surgically trimmed within 2 weeks. Healed great and no issues for 10+ years.

Left knee torn packing out a bear I killed. Knew right away something was wrong and traded packs with partner to get out of woods with bear. Decided to refrain from surgery. Been 7 years. Knee clicks and has to be straightened every few minutes. Knee constantly in perpetual pain. Going to have surgery once this covid madness allows me the ability to get it fixed.

Don’t know the answer for you, but figured I’d share my experience. I wouldn’t wait if I had the chance to do it agin on my second.
 

Jherek

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Mike I has some good advice!
unfortunately I'm a pro when it comes to a torn meniscus, and when I say pro it's not a good thing! I'll sum it up as short as I can, Do Tons and tons of research, Not what to do, but, who to talk to. Find the best Dr you possible can, even if that's driving hours. I'm not sure where you live, If you can get to A orthopedic Dr for one of the D1 collages or one of the pro teams do it, even if it's a 6 month waiting list, get on the list, you can always cancel.
I had the clicking pain in my knee, it turned into locking. I went in to our D3 orthopedic surgeon who had a very good reputation,(a town size of 30k) and he did great work on friend's of mine. That guy did so much damage to me, I'll be paying for it the rest of my life!!! My knee locked, I couldn't walk, nothing, I went into the ER on a Friday morning, he sent me home in the same condition, said relax, take some real hot baths and take it easy your knee should slide back in, if it's not better come see me Monday. Nothing changed, They operated Monday, 7 days later rushed into another surgery do to a staph infection. The infection things can happen when you have a surgery. But what screwed me was After I spent 7 days in the hospital for pain controle, and they did almost no PT while I was hospitalized, The average knee needs 115 degrees of motion to walk normal, Mine was at 30. After 6 months on cruches, had to learn how to walk again, and not to mention some of the most I've ever experienced in my life from PT. My knee was encapsulated in scar tissue, everyone's answer was you need to push yourself to your breaking point to bust up the scar tissue, that's the only way things will improve. for 30 days, 5 days a week they strapped me in a passive motion machine and leave me alone for 30 mins with a broom stick to increase the machine when I could handle it. (sounds stupide I know) But when your a 23 year old kid and your Dr and PT tells you what to do you should be able to trust them!

Fast forward a few months, by the grace of God, while in the gym I meet a 19 yrs old girl Who tells me she had a surgery by Dr Patrick McKenzie, He's the Green Bay Packers surgeon and he's now taking walkins.(if a player is down on the field he's one of the guys who runs out, and he's been doing that since the 96 super bowl. They had an opening, the exact day and time of my next scheduled surgery at the vet clinic. I'm in the waited room with one of the Packers starting OL man, I'm thinking okay I'm in good hands finally. First thing he says, Young man, you are in really bad shape, and I'm sorry! He asked what happened, and kept saying, they did what??? Over and over Why did they do that. He didn't want to work on my because of being afraid a lawsuit was coming with my original Dr. I begged him to please try and fix me. A long pause, okay I will, I'll do everything I can, I felt like it was my Dad telling me that. And hedid the best he could with what he had, But because of the infection and lack of PT my knee was already destroyed....

14 yrs later, 7 surgeries I'm 37 and in pain all day everyday, some worse than others. The last scope I had, he said that's it, there's nothing we can do but replace it, you need to wait as long as you can.

Like I was saying find the best Dr you possible can, Not someone who does it all, knees, shoulders, back ect. Find someone who only, or mainly does knees and a lot of them. If you like what you hear, they act like they truely care, and your gut agrees,(DR McKenzie felt like a life long friend, and I trust him with my life) Do what they recommend, fallow PT to the tee, And when you get the Green light, train hard, but smart! Yoga, Pilates, core and you'll be back hunting hard in No time at all!

Sorry so Long winded, I wanted to keep it short. But if I can help someone avoide what delt with. Anyone can PM if they like, or have any qs, I'd be glad to help..

Jamie.
 

jdmaxwell

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Mar 8, 2014
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Tore my meniscus. Hobbled around over a year with it.
Had surgery to trim, then they found no cartilage left in knee while in their, so they drilled holes in my femur to for scar tissue. That's all I got in that knee.

But has been way better for me since surgery years ago.
 
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I’ve had 5 meniscus surgeries resulting from a car accident when I was 12. starting with scoping and trimming a few times which basically did nothing other than form scar tissue and numbness. After healing from the 3rd one I could only move the joint about 50 degrees. The forth surgery was with a highly recommended surgeon who decided I needed a lateral release which was the worst. He cut a ligament and casted me in a hyper extended state for 2 weeks, followed by a brace for another 6. Being in that cast made me wish I didn’t have a leg it was that uncomfortable. The last surgery I ended up with a meniscus transplant and finally have as close to a normal knee as I’ve know since pre accident. I’ve met people who claim to have had tears and a scope had them back to normal in a few weeks. That was not my case but hopefully will be yours. I would quit the bandaid shots/drainages and get to a known specialist ASAP and possibly even a second opinion before going under the knife. I believe if I would have had the right surgeon the first time things would have been a lot better for me. Just sitting here I can feel tightness and a certain fatigue in my knee that never goes away. I can do everything I want, run, snowboard, heavy hiking/backpacking, you name it but I always pay with some extent of pain.
 
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I went 8 years with a torn meniscus - constant pain, 4 doctors were not helpful over that span. Called it bursitis!

finally got one of the doctors to take an MRI, once they got a picture and gave me options I opted to have it completely removed!

5 years later - All good!Surgeon did say I will likely need a knee replacement in 20 years - till then I’ll take what I can get!
 

Poser

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I went 8 years with a torn meniscus - constant pain, 4 doctors were not helpful over that span. Called it bursitis!

finally got one of the doctors to take an MRI, once they got a picture and gave me options I opted to have it completely removed!

5 years later - All good!Surgeon did say I will likely need a knee replacement in 20 years - till then I’ll take what I can get!

Why did You have to convince a Dr to do an MRI? I went to my Dr the next day, had a knee evaluation, he said “you have an injury which may or may not require surgery, here are 3 options at 3 different price points for MRIs: if you want to run it through your insurance, use this one, if you want to pay out of pocket, this one will be your cheapest option.” My Dr was looking at the MRI results within 3 days of the injury.
 
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I was always convinced it was not a deep knee injury, especially since the doctors acted like what I had was not serious over the years I went in.

yes it hurt something terrible, but I just became numb to the pain and got used to it. it wasn't until I got into a car accident that I decided enough was enough it was getting a closer look.

in my lifetime, Ive been to the doctor only a handful of times, (albeit to the same small doctors office) all 3 doctors came up with bursitis, it wasn't until the last year I went to the office a new doctor had taken up shop. he immediately ordered an MRI after seeing over the years nothing was improving - he was shocked that it wasn't caught sooner.

oh well!
 

Agross

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Why did You have to convince a Dr to do an MRI? I went to my Dr the next day, had a knee evaluation, he said “you have an injury which may or may not require surgery, here are 3 options at 3 different price points for MRIs: if you want to run it through your insurance, use this one, if you want to pay out of pocket, this one will be your cheapest option.” My Dr was looking at the MRI results within 3 days of the injury.
Hearing stuff like this pisses me off. I had a helluva time getting an mri had to jump through a bunch of hoops before I could be approved for the mri I had to have 6 physical therapy sessions before I could be approved for the mri if the pt recommended it I knew my knee was torn I told the pt that He said I don't think its torn When they went to schedule my appointments They asked how far apart I wanted them I was so pissed at this point I said 6 days in a row I wanted to get it done over the winter while I was off work The last two visits they had me doing exercises for " in case I needed surgery"
 
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2 scenarios IMO:

Older patient or patient is grossly nonactive: wait and see approach is the way to go and the lowest risk. Includes knee injection (steroid or nonsteroid sometimes both) and PT. Depending on patient, sometimes the risk of surgery outweigh the benefits and ortho still won't do surgery. They opt to medically manage the patient at this point.

Very young, very active, athlete, hunter, packer, laborer, etc.: Reasonable in most cases to do a trial which may or may not included intraarticular joint injection and PT. If the tear is of enough significance ortho may opt for surgery as the primary recommendation because the probability of successfully rehabbing the knee is very low. In the conservative arm, if therapy and/or injection fails you are looking at repair, in most cases. Start the healing process, PT, and hopefully you can resume full activities. Assumption: meniscus tear on MRI interpreted by ortho as needing repair.

What I don't like in your history is the feeling of instability and catching. I would not mountain hunt or pack loads with that knee. Risk is too high. Problem with meniscus, is blood supply is very poor, they just don't heal well on their own. For this reason, ortho doesn't put it back together, they trim the detached portion.

FYI: steroids are potent inflammatory reducers. It is true they can/do thin tendons. One time intraarticular steroid injection, when compared to risk of surgery, is very low-risk, and worth the trial in most cases. Obviously, discuss risk/benefit with your doc based on your case. If it does nothing or therapeutically doesn't meet your expectation, IMO, it does suggest you may need more invasive intervention to get you on track.

I agree with the above, it's your knee, never hurts to get a 2nd opinion. I also agree, get a knee specialist with good recommendations, if you decide on surgery.
 
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I tore my meniscus on both sides, along with my ACL, and some other damage about a year ago. Put off surgery until "after hunting season".... 🙄 so had surgery for everything in the beginning of December.

Takeaways: YOU NEED AN MRI. If you haven't had this, you don't know what is wrong for sure. Also, getting an MRI will give you information, but may or may not tell you the extent of the damage to your meniscus. The amount/type of damage will determine how they will fix it, which in turn will determine what your recovery looks like... I had one side trimmed, but stitches put in the other side to try and preserve as much of the meniscus as possible. The stitches meant 8 weeks on non load-bearing instead of a couple of weeks (or less). Hopefully, the short term pain in the ass will be a benefit for the long term use of my knee.
 
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