Meniscus Repair - Ever Have One?

[ChrisB]

Hey gang, I'm queued up for a repair to a small tear in my meniscus in a few weeks. It will be arthroscopic under general anesthesia.

Have any of you had this fix? If so, what was your recovery like?

I want to get back on the trails ASAP!! Thanks.

 

[dug]

Not me, personally, but my mother had hers done in her early 60's and was back hiking in under two months.

 

[TCD]

Several previous threads about this; also there is lots of research out there. Make sure you've done your homework. Is it a "repair" or a "clean up"?

"Repair" of meniscus tears involves trying to suture the tear closed. It involves very long recovery times (to allow for the very slow healing of connective tissue). Also is usually only done in young people (like high school and college athletes) who will heal more quickly. Has poor success rates in older patients.

"Clean up" involves removing loose flaps, and smoothing the edges of the tear. No repair is actually going on. The clean up surgery is much more common than the repair surgery. Clean up works in the short term to reduce symptoms and allow more pain free activity. But at least one long term study has shown that knee function a few years later is the same, whether clean up surgery was done or not. In many cases (not all, of course) the knee apparently "cleans itself up" over a period of time. So the bottom line for the clean up, in many cases, is taking the risk of surgery in order for the knee to feel better in 2 weeks, instead of 9 months.

(I have not had any knee surgery. I do have meniscus tears in both knees, significant in the left and very slight in the right, from about ten years ago. I studied all this back then, and made the decision not to have a scope clean up procedure. My left knee pain got worse for a few months after the injury, and then gradually got better by itself as I continued normal activity, including skiing, running, hiking, climbing, biking, etc.. More recently (the last five years) I have given up the running on the advice of the doc, who said it would increase wear and tear and shorten the time to when I would need a total knee. But at least right now (age 65) everything feels great, and I think the total knee is still quite a few years away.)

 

[TEO]

Not me, personally, but my mother had hers done in her early 60's and was back hiking in under two months.

Dug, unless they were very gentle, easy hikes, I think that you are mistaken. Your mother almost surely a meniscectomy, where they remove the torn part. The recovery from a meniscus repair is significantly longer than two months.

ChrisB, if you're talking about an actual meniscus repair, which is more and more common, and not a meniscectomy, then yes, I had a meniscus repair a couple of years ago. It's a pretty serious recovery, as you really have to baby the repair for the first couple of months, and then it will take a considerable amount of time and effort to rebuild your muscle mass, especially in your quads. I actually had less mobility in the weeks after my meniscus repair than I did after my earlier ACL reconstruction, however, overall the meniscus repair was, for me, a much easier recovery. While YMMV based on your orthopedist, I essentially wasn't able to drive for at least 6 weeks, maybe longer, because of the brace. (I was able to do short, local drives around town, with no passengers, but it required left-foot braking and using the accelerator pedal-arm above instead of the pedal itself, because you can't bend your knee when weight-bearing. While I was good at this and got used to it, it's definitely not something to be done on highways.)

You should expect it to take at least 6-9 months, maybe as long as a year, to get back to full strength. You lose a lot of muscle mass and that takes time to rebuild. The biggest thing is to be patient, be diligent with your PT, and remember that while the recovery is long, you will get better. I hiked the Doubleheads almost three months to the day, Randolph & Crescent three-and-a-half months post-surgery, and did a Adk. 46er work day—light stuff only—six months out, but these may have been earlier than what my orthopedist would have recommended.

 

[TEO]

"Repair" of meniscus tears involves trying to suture the tear closed. It involves very long recovery times (to allow for the very slow healing of connective tissue). Also is usually only done in young people (like high school and college athletes) who will heal more quickly. Has poor success rates in older patients.

TCD, this is no longer the case. The repair technique has improved such that they are now doing a repair—suturing the tear—much more frequently and in much older patients, e.g. 50 and maybe even 60-year-olds.

I've had two knee surgeries and what I've read and heard from doctors is that avoiding surgery, if possible, is the best course. (This is true for ACL injuries, too. There are even top Alpine World Cup racers who race with torn ACLs.) However, sometimes as was my case, the meniscus gets folded over, severely hampering ambulation, and you need to have surgery.

 

[sierra]

I had it done. I was walking when I got home and my recovering was pretty easy. No pain meds needed even the day of. I started walking right away, half mile for week, then a mile for a week or two, then just kept increasing my mileage. I had it done at 55 for what that's worth.

 

[TEO]

I had it done. I was walking when I got home and my recovering was pretty easy. No pain meds needed even the day of. I started walking right away, half mile for week, then a mile for a week or two, then just kept increasing my mileage. I had it done at 55 for what that's worth.

You did not have a meniscus repair, you had a meniscectomy. The recovery is much, much quicker and easier for a meniscectomy.

 

[ChrisB]

Thanks for the replies folks. I appreciate it. I did search the site for meniscus and see that Stan, Sierra, Bob Kitteridge and others have at one time or another grappled with this common problem.

My tear is a 150mm on the medial (inside) of the right knee. As I continued with my three-mile hill workouts it has gotten worse, to the point where I can no longer do the down part due to pain that then lingers post workout.

My MRI revealed that the torn flap folded inward against the bone and now the bone shows bruising that might be the real source of the pain. I'm gonna get it fixed in a week and the doc says I'll walk out of the procedure sans crutches. I have PT scheduled the next day and for the following two weeks.

The ortho doing the fix repaired my torn rotator cuff three years ago and I have 100% in that fly casting shoulder now. Hope he still has the touch!

 

[David Metsky]

I had a torn flap removed about 5 years ago. I did require crutches and had some significant swelling, but was able to fully recover since then. Don't skimp on the PT! I tried that and it didn't go well. Get all the PT you can and do the exercises.

 

[TCD]

TCD, this is no longer the case. The repair technique has improved such that they are now doing a repair—suturing the tear—much more frequently and in much older patients, e.g. 50 and maybe even 60-year-olds.

I've had two knee surgeries and what I've read and heard from doctors is that avoiding surgery, if possible, is the best course. (This is true for ACL injuries, too. There are even top Alpine World Cup racers who race with torn ACLs.) However, sometimes as was my case, the meniscus gets folded over, severely hampering ambulation, and you need to have surgery.

Thanks. Yes, I do see this in more recent articles. Certainly when I was looking at this about ten years ago, the repair techniques at that time had poor success in older folks, and my ortho advised me to avoid that surgery. But as with all things medical, there has been a lot of technological progress! That's good news for those who do need an actual repair.

 

[TCD]

ChrisB, I hope you have a good result and a quick recovery!

 

[TEO]

. . . and the doc says I'll walk out of the procedure sans crutches. I have PT scheduled the next day and for the following two weeks.

This means that your ortho is planning to do a meniscectomy, not a repair. Good luck! You should be back in the saddle in no time.

 

[Peakbagr]

I've done it. My provider allowed unlimited PT so I did 3x/week for a few months. The way to go. My PT was right on the money. She said start easy on climbing after 6-8wks, non challenging trails or woods road. And 100% correct when she told me descending would be much more challenging that climbing. ChrisB, sent you a PM. - Alan