Medial meniscus repair

[BeckyNC]

Anyone have experience with arthroscopic surgery to repair a medial meniscus tear (cartilage in knee)? I am having surgery on Weds morning and was just wondering how much pain to expect afterwards and how long it might take to be back at 100%. I know some of this varies from person to person and depends on age. I will be starting PT on Friday! The surgeon has already discussed this with me, but I would like to hear it directly from someoen who has gone through this type of surgery.

Believe-it-or-not, I think this cartilage tear occurred when I was walking Tae! When I first got her, she would take off after squirrels and cats. I was totally unprepared! Now I know what to expect--and she is a bit calmer. Anyhow, there were several occasions when I was descending a steep hill in my neighborhood and I had to brace myself with my right leg. I remember having knee pain afterwards. The pain got really bad at the end of June. PT didn't help and an MRI revealed a large tear.

Thanks!

 

[Austin's Mom]

I haven't had it done but my best friend did and it wasn't that bad. Sending speedy healing vibes that your surgery will go well and you'll be feeling great in no time!

 

[Lael]

Becky,

I have had this surgery performed a total of 3 times: twice on my right knee and once on my left knee, all due to lateral patellar dislocation (ouch!). The first surgery was at a tender age of 13. I have studied the knee since 4th grade after my first dislocation. My surgeon in Seattle, WA is one of the best knee specialists in the US and had educated me quite a bit over the last 11 years of PT and surgeries ... in order to help my knee caps stay put! In addition, I studied biology and did a case study of a meniscus tear as a project in Human Anatomy Lab my senior year. So... I hope I can have some info to help put you at ease.

If your knee is has not been recently acutely injured, extremely swollen and you can't walk or lift your straight leg while sitting, than you will probably recover from the surgery very quickly. Sometimes they can repair the meniscus by stitching the tear. However, many times they will have to cut the tear out in a 'moon' shape.

After surgery, you will recover your range of motion and strength much faster if you keep the swelling down. The general rule for this is 'RICE', in order of importance:

R - REST
I - Ice (at LEAST 5x/day for 20 minutes exactly)
C - Compression
E - Elevation (knee and ankle above your heart as much as possible)

If you are religious to do those four things, your swelling will go down sooner and stay down, and your range of motion will improve much faster. (Your therapist will probably tell you all of this. )

When the knee joint is even slightly swollen, the muscles around the knee are inhibited, making it harder to strengthen them. Because of this, my experience of recovering from this surgery is a delicate balance of 'RICE' and exercises. You want to strengthen, but you also are healing at the same time. However, all of my surgeries were within 1 week of a traumatic acute injury which usually included a tear of a ligament ... which meant I had to recover from more than just the evasiveness of the surgery (which isn't so bad with arthoscopic).

Expect to be slowed down quite a bit for 6-8 weeks, but if you take care of the inflamation and strengthening, you'll do just fine.

 

[BeckyNC]

Thanks!

Chris--thanks for your healing vibes!

Catherine--thanks for the info. The surgeon had told me I must plan to be in bed or on the couch with my knee elevated and iced for 48 hours. I suspect I injured myself back in January, as I had some pain then, but it came and went until June, when I had a week of bad pain. Then it came and went, but it was clear something was wrong. I went to see my doctor in mid-July. My knee is swollen, but not noticeably. In fact, I had no idea it was until the PT pointed it out during my PT attempt (before we knew there was a tear).

As you said, the surgeon will either try to mend the tear or trim the meniscus, but I think he will trim. He said I have a BAT (big ass tear) and actually showed it to me on the MRI. It looked impressive, but then, I have no basis for comparison!

Did you have a lot of pain after surgery?

Did you have general or local anesthesia or an epidural? My surgeon wants to go with general, but I so do not want general. I'm not the type who must always be in control, but general is a total loss of control, which gives me the willies. I've had it before, but I was much younger, so it was no big deal at the time.

Is it realistic to think I can walk Tae again by Monday (day 4-5 post surgery)? The surgeon said a short walk would be fine, so that's my plan.

My aunt, who's about 70 just called to tell me she had a medical meniscus repair 10 years ago. She was not given crutches and a week later walked 3 miles in NY and developed major pain (she told me to take it easy, which I have every intention of doing). She also told me she never had PT. The whole scenario sounds strange, but she is a very well-educated nurse who has actually written several nursing texts. Otherwise, I'd think she had forgotten some of the experience!

Are you able to be very active right now? Do you have any pain? I'm relatively certain I'll be good to go once I recover. The surgeon did tell me that as a result of this injury I could expect to have arthritis in the knee when I am older. I already have mild arthritis in this same knee (which I need to tell the PT) and I'm only 33 and keep quite active!

Thanks for sharing your knowledge and experiences.

Becky

PS
Catherine--I just looked at your "profile" and saw you are getting a MSN with studies in Healthcare Admin. Are you at U of Washington? I actually have a Master of Healthcare Admin (no nursing component) from UNC-CH. I seem to remember that UW has good health sciences. Do you plan to go into nursing admin? I work in clinical research (drug safety), which is really fun and interesting. Of the 5 of us in my group, I am the only one who's not an RN or PA. I love listening to everyone's hospital stories!

 

[Scrapper's Mom]

My hubby had this surgery, once on each knee. One time he had general anesthesia, the other time, he had the epidural. You recover a lot faster from the epidural, though you have to be awake during the surgery, but he liked that. Maybe you can go over with the surgeon the reason he wants one over the other. It didn't take hubby very long to be back and moving around afterwards, a little bit of physical therapy and then back to normal. You literally have three bandaids on your knee when they are done. It's pretty amazing. You'll be surprised how quickly you recover.
Best wishes!!

 

[Lael]

Did you have a lot of pain after surgery?

To be totally honest, yes. In fact, usually the 8 weeks after that surgery were HELL. Keep in mind that I had other injuries to heal from. With each dislocation, I tore up my medial meniscus, medial collateral ligament, and my patellar cartilage. So it was swollen, unstable, and hurt like hell. (Thankfully I never tore my ACL.) Although you will have some pain from the incisions and the cutting of the meniscus, you'll probably not experience the pain I did. It's a pretty quick recovery.

Did you have general or local anesthesia or an epidural? My surgeon wants to go with general, but I so do not want general.

My surgeon did not have a preference. He told me that it takes longer to recover from the general anesthesia than the epidural. However, you will have a spinal headache from the epidural, which he said can make the recovery process hard as well. I chose general for that reason - and I didn't want to be awake. You should do what you are most comfortable with. Keep in mind that if you're surgeon has a preference, there may be a good reason - I'd personally go with his preference unless I was completely uncomfortable with it.

Is it realistic to think I can walk Tae again by Monday (day 4-5 post surgery)?

I would say no. But 10-14 days might be more realistic. Again, I'm a HUGE advocate of rest, rest, and more rest for the first week or 10 days. See how you feel, and if you have doubts, ask your doctor. You'll know if you overdo it - those knees don't have a problem speaking up if they are upset.

Are you able to be very active right now? Do you have any pain?

I am very active! But due to the patellar cartilage damage, actual damage to the patella itself, and my 'cut-down' meniscus ... I do have some limitations. My surgeon says that it's psychological, but after 7 dislocations ... you'd think one's psyche would start to figure out "don't do that". :rolleyes: I have a daily exercise program to keep my knees strong. I do a lot of biking, hiking, swimming and yoga. I do not play soccer, basketball or volleyball anymore (it's just not worth it). So I'm still very active, but I cannot play all the sports I used to. I also stopped running, since it was hard on my knees.

Anyhow, I hope my answers can help some. As far as knee surgeries go, this one isn't bad at all. Yes, the arthritus thing is inevitable. But taking glucosamine every day is the only thing (I know of) that can help support our cartilage as we age and help minimize arthritus.

Good Luck! Let us know how it goes and how you are feeling.

Cat

PS: UW has EXCELLENT health sciences. I started my undergrad there, and got an enormous foundation of chemistry, biology and even math. I finished at WSU (Go Cougs!). WSU has one of the top undergraduate anatomy labs in the nation (who knew?) and I LOOOVED it. I got my degree in Biology, with no thought of Nursing. Now, I'm finishing up my pre-reqs to apply to the Alternate-Entry MSN program at the University of Texas at Austin (very good School of Nursing). I'm working full-time, so it's a slow process. This program is for anyone with a Bachelors (BA, BBA, BS, BFA ... anything) who wants to get a MSN. I'm ahead of the game with pre-reqs, but still probably won't apply until next fall. One of the options is Health Admin., and I think that's what I'd like to do. I have the first year of the MSN to really decide, which is a rigorous 2 semesters that ends in taking the RN board exam. The following 4 semesters are coursework & clinical work while working as an RN.

 

[craZ4HERKIE]

Becky...I myself have never endured any such thing.However my co-workers wife just had this surgery performed a couple of months ago.The 1st couple of weeks were tough going....and it was mainly her fault!She was still trying to do everything she did before her surgery....and the main thing she wasn't doing was elevating her leg....so she had swelling for a little extra time than normal.But now she's perfectly fine....once she got over the swelling it was downhill from there!

Do you have someone that is going to help take care of Tae for you?Because I hate to envision you trying to walk her just after surgery!Hopefully she'll know that Mommie's not up to par and will help take care of you!

And I just wanted to send some quick healing vibes your way....hope you're off to a speedy recovery!

 

[BeckyNC]

Thanks to everyone for your responses! I am having a hectic evening, but just had to check things out on BW for a moment!

I do have someone to walk Tae. I have hired these women who have a business called Happy Dog (happydogNC.com). They will walk her once a day for 5 days. After which time the doc says I can take her for short walks. If that turns out to be too difficult, I will try to extend them. They will walk Tae between 1 and 3, so I think we can get by with only one walk. She normally gets an early morning and early evening walk, but I'm thinking if she plays soccer some in the house in the evenings, she'll ge OK. I have one of those basketball sized tennis balls from Target and she head butts it and bites it sending it all over the place. That seems to tire her out (yeah!!!). We'll see. My mom will also be here for a bit (awwww), so she will take Tae out for potty trips until I am functional.

I'll write more later....post surgery.

 

[BeckyNC]

Post surgery report

I wanted to thank everyone again for the responses!

My surgery went really well on Weds. The procedure itself took only 20 min and I was out for about an hour. I ended up having general anesthesia, but was not intubated (which I was hoping to avoid) since the procedure was so short and so little anesthesia was needed.

I was very good about icing for the first 48 hours, as instructed. I've done some icing since, but mostly at night. My knee is so swollen, you can't even tell I have one! I feel as if bending my knee might cause it to explode (lovely thought), but I barely have any pain now, other than the fact my knee is very stiff. I have my first physical therapy appointment tomorrow.

I extended my dog walker through tomorrow, then I'll play it by ear! Poor Miss Tae, she does not understand why I can't walk her and looks at me in a questioning way. She's getting great walks, though. The past three days the dog walker has brought another dog, which is great for Tae and today she took her jogging. She thinks Tae is really cute (a distinct bonus), and spend a lot of time playing with her. She told me today that Tae has a good bite inhibition--such a complement to me, though I had nothing to do with it. I also found this very positive b/c her original family took her home at 6 weeks.

 

[Lael]

Becky,

I think you will find you will recover much faster if you take the icing very seriously. I can't stress this enough. If the swelling isn't taken seriously, you can end up with 'water on the knee', which is basically where the fluid in the knee begins to solidify and then it remains there permanently ... inhibiting your range of motion. You'll also end up with more scar tissue than you want.

Icing just at night is not only not enough, it's probably not enough to do much at all.

Sorry for the sermon - you probably know this. I just hate to see you go through more frustration than is necessary. ESPECIALLY if you start walking Tae again so soon ...