Knee: Post Op

I had what was hopefully the final appointment with the orthopedic surgeon on Monday and he released me to start being more active with the knee. the stitches were removed and sutures were glued on to the three incisions on my knee. I was also provided a comparison of what a healthy meniscus looks like and what mind looked like when he got in there with his light and camera. In the image, the healthy meniscus are the top two images. The lower two images are how mine looked.

My meniscus was torn on the medial (inner) part of my knee and bent back 180 degrees causing the pain, which in turn caused the pain and swelling I had been experiencing for 2 months. He trimmed out of the torn piece of meniscus, while preserving a majority of the meniscus on the front and anterior of my knee.

I only worked out once last week after my surgery, doing 30 minutes on an elliptical machine. Last night was the second time I worked out and noticed a firm bump on the front of my knee. Thankfully it coincidences with one of the incisions, so hopefully it’s just a matter of time before than swelling (if that is what it is) decreases and the pain subsides.

I still have pain on the inside of my knee, more where the ligament is located at. I am sure we would have seen something on the MRI, but that pain has not gone away. I will give it 4-6 weeks and if the pain still exists might request my MRI and send it to another doctor for a second opinion. Thankfully I have very little pain now walking up stairs or during my daily routine.

Surgery: The Day After

It’s been just over 24 hours since I had my left knee surgery. While the procedure was considered “minor” by the orthopedic surgeon, it was a considerable tear I was told after the fact. Today, I am really feeling the effects of the surgery. My knee is in tremendous pain, but I am trying to hold off taking the prescribed pain medication (Vicodin). I was told to use them as needed for the pain, but the side effects are not friendly and it would really make me worthless at home.

I have a follow up appointment already scheduled for Monday when he will remove the sutures. While I was up and moving earlier this morning, it wasn’t at a breakneck pace. The release paperwork said to get up and walk, if possible so I did that this morning while running a few errands. It might have been too much as the knee is throbbing as I sit here with two bags of peas keeping it cool.

I might looking into a water aerobic class to start next week, depending on the pain. Very little stress on the knee while in the water and it could provide a nice work out. Not sure how this class will work into my work and personal schedule. As for the exercise, I figure I will take the rest of this week off and hopefully get to the gym on Monday for some weights and maybe 30 minutes of easy bike riding.

I figure a few weeks and the knee will be back to normal and I will be doing everything pain free. Until that time, I will be a bit slowed by the swelling and pain that currently hampers me. Thankfully it was the right decision to get the knee fixed and not live with the pain.

Surgery Today!

Finally! And to think, it only too the medical establishment 2 months to make the correct diagnosis. I probably should have pushed for an MRI sooner, didn’t think the orthopedic would decide to take the easy way out, citing “arthritis” instead of trying to resolve my pain. Only the bright side, he did try to push Big Pharma on me, which I rejected.

I had a pre-operation appointment with the orthopedic surgeon yesterday and he quickly explained the 45 minute procedure to repair…well remove the torn part of the meniscus. Unlike the ACL replacement on my right knee 3 years ago, today’s procedure is “minor” in his words. I should not be couch bound for too long anyway. I am hoping to be back up and walking around later today or tomorrow. At any rate it’s back to work on Thursday, as I am not planning any time off from work.

There will be three arthroscopic incisions made around my knee. Unlike the previous surgery, which required a piece of my patellar tendon to replace the torn ACL, today’s procedure won’t both any of the ligaments, tendons or muscles or so I was told. Hopefully I will still have feeling in the left knee when the procedure is completed. So hopefully by tomorrow the inflammation, swelling and most importantly the pain will be gone and I will be to a pain free lifestyle.

Confirmed Tear

I knew it later that day, when I went to stand up, there was a pop and suddenly I had a sharp pain on the inside of my left knee. This was the result of my first soccer game I had played in close to 8 months. Why I have had to put up with the medical establishment’s red tape for well over a month until FINALLY getting a referral for an MRI. My physical therapist also had good idea my injury was more severe than “osteoarthritis” as my orthopedic surgeon cited, the first time he met with me for about 5 minutes.

I believe today’s appointment with the orthopedic surgeon surpassed that of three other visits in terms of the amount of time he spent with me. He pulled up my MRI and told me the bad news. Much like I confirmed…a month ago, I had torn my meniscus. Do I know my body or what? He went on to explain what a meniscus does and said we had to option for surgery.

Unfortunately the surgery comes at a price. He called the medial meniscus tear “major” in terms of how much of the meniscus is actually remaining, which is very little. The good news, only about 20% of you meniscus provides circulation into the knee, as I understand it. So, while much of the blood flow will be restricted, once the tear is removed, the inflammation should subside and the pain will go away.

The bad news, much chance for arthritis in my knee has increased with the removal of the meniscus, which acts as a shock absorber to cushion the femur and tibia. What a minute? Didn’t he tell me a few months back I already had osteoarthritis? Yeah, he did. I guess the MRI changed his opinion and I was misdiagnosed initially. Of course, I didn’t bring that second meeting up, maybe I should have, but in the end what would I have gained?

So I have elected to have surgery. As explained to me, it’s a 30 minute procedure with 3 incisions around my left kneecap. I will leave the procedure and from his words, be able to walk and put pressure on the knee. I don’t expect to miss, but maybe a single day of work this time around. Unfortunately soccer is not official over. I won’t lace up the boots or don the jersey between the sticks. It’s been fun, but it’s time to get into coaching and let my son have all the fun.

I did find a few articles on a system called FAST-FIX Meniscal Repair System. No idea if this is even an option, but I did find a “technical guide” on how to accomplish the repair, which looks like they tie up the torn portion of the meniscus. Guess I will have to inquire about it.

“Knee-d” More Information

As of today it will have been 4 sessions with the physical therapist encompassing 2 weeks. To date, I have been provided with electric stimulation, ice, ultrasound and a series of strengthening exercises for my left knee. To date, the pain still exists and while the muscles around the knee (quad,hamstring, calf) will eventually get stronger, the cause of the pain still exists. The therapists has mentioned it a few times that she doesn’t believe the underlying cause is osteoarthritis of the left knee.

While the day to day pain has subsided, there is still a pain and terrible popping noise when I walk, this is especially noticeable when climbing stairs. Even sitting with the knee in a bent position or lying down with my legs straight out will eventually increase the severity of pain. While the therapist cannot come out and tell the orthopedic surgeon how to do his job, she does recommend I push for an MRI of the left knee.

On the recommendation of a user at the McDougall Forums, I picked up a book by Pete Egoscue called Pain Free: A Revolutionary Method for Stopping Chronic Pain. This book attempts to get to the root cause of the pain through a series of exercises and stretching routines called “E-cises.” Only a few chapters in and one comments from the author stood out. “The musculoskeletal system’s worst enemy…is the x-ray machine. With one stroke of technological genius, we went from observing the body from the outside with sharp eyes to scrutinizing it with a specialized instrument from inside.” This rings true with my trip to the orthopedic surgeon. A quick 3-4 minute discussion while looking at the x-ray and I was on my way. Never did his hands or eyes feel or see my knee, except via the x-ray.

I won’t take the orthopedic up on his recommendation for a series of injections that may or may not work. That would (if successful) only provide a stop gap and not get to the root cause of the problem, must like Pete Egoscue stresses in his book. Therapy has gone about as far as it can, progress isn’t being made and the therapist recommends “further work up” as she called it. Reading between the lines, she wants to see an MRI.