Dodgy Knees - Torn Meniscus - Additional support & Cycling

[breamster]

Hi All,

I am currently waiting for my 2nd athroscopy on the same knee. The first one lasted about 18 months before the symptoms reoccurred.

Who else has similar problems?

There seems to be a huge selection of knee supports/braces available.

Will a brace be of benefit whilst waiting for the athroscopy?

Will a brace be of benefit after the operation to reduce the strain on my knees?

I would wear the brace for things like gardening, DIY but predominantly for offroad cycling.

Thoughts?

[The_Doc]

A knee brace is many things

I would ask either your consultant or a decent knee/sports physio which one they recommend.

No further advice about your actual condition can realistically be accurate without seeing you in person and knowledge of your previous 'scope.

I use a lot of www.Ossur.co.uk braces, but they range from £30 to £500

[breamster]

The_Doc said:

A knee brace is many things

I would ask either your consultant or a decent knee/sports physio which one they recommend.

No further advice about your actual condition can realistically be accurate without seeing you in person and knowledge of your previous 'scope.

I use a lot of www.Ossur.co.uk braces, but they range from £30 to £500

Hi,

I thought you might say that - I only spoke to the Registrar earlier this week who was not a great deal of help.

The MRI showed up the previous tear and the work that the surgeon had done to my knee previously but it didn't show up much else apparently. Essentially it seems they don't know what is going on until they go in and take a look which is fair enough.

Basically the message was go away, wait for an appointment and have the arthroscopy in about 3-4 months time. His advice was I can ride my bike as much and as hard as I like. It will hurt and it will get inflamed but it won't do any further damage which I don't think is true for one moment.

I asked about the long term prognosis and his response was the generic risks involved with any surgery requiring a general aesthetic. He couldn't answer the specific question or even admit that he didn't know.

I'll try and find a private knee or sports physio locally so see if they can help unless you can recommend anyone local to me near Bournemouth.

Thanks very much for taking the time to respond - I hadn't considered consulting a physio but I will look into it.

[Dogwatch]

Local sports centre/leisure centre may have a physio. One I went to after my hip op worked there part- time and helped me a lot.

[lemmingjames]

Hi dude, i had a 1/3 of my meniscus tissue removed from the outside of my right knee 6/7 years ago now. Went skiing after 10 weeks but probably should have waited until the recommended 12 tbh.

Not sure your age, how screwed up your knees are etc but for day to day stuff/running/almost 2x bodyweight squats etc. ive never needed support. Sure sitting on your haunches can make it stiff but its fine after it you like.

Long distance cycling can inflame it as well but then it could be the sitting position as im on a mtb rather than road bike. But everyone is different.

Anyway, for skiing i have the Mueller HG80 but have found the Shock Doctor 875 better. My former mma instructor (whose knees are worse than mine), is currently swearing by the Active 650(?) knee support (but they wouldnt hold up to the stresses of skiing) for mma/wrestling/bjj training.

Mine started off as a small tear and they ended up removing 1/3.

[breamster]

Thanks for the suggestions - I'll look into them.

I've found a sports physio locally who has been recommended by a couple of friends - I'll be giving them a call on Tuesday.

Approx £40 per session - does that sound reasonable?

[The_Doc]

breamster said:

Thanks for the suggestions - I'll look into them.

I've found a sports physio locally who has been recommended by a couple of friends - I'll be giving them a call on Tuesday.

Approx £40 per session - does that sound reasonable?

Yes, but only if he/she's any good.

Market rate is thereabouts

[Wacky Racer]

I had an arthroscopy about six/seven years ago (I'm 62)....it cured the problem, but the pain has come back the last six months.

I'm very reluctant to have another one in case it makes things worse, I may just put up with pain killers and deep heat rub, as some days it's not too bad.

[breamster]

Well - my little saga continues.

On the waiting list for an arthroscopy and told it will be a 3-4 month waiting list. In the meantime I have seen a sports physio who seems really good.

She has set herself the challenge to convince me in the next 3 months that I don't need an arthroscopy through some pretty strenuous exercises. Meanwhile the date for the arthroscopy comes through in 3 weeks time!! I love the NHS but what do I do now? Go ahead with op or cancel it in the hope the physio can sort me out?!

Ignore me - feel better for having a moan.

[lemmingjames]

from a non medical profession id go with surgery. you can always have physio after which may or may not help you otherwise.

if its torn, from my understanding is that it can always catch on something and aggravate it = inflammation and so on. physio isnt going to get it to rejoin its self back together again.

Alternatively, you could have replacement meniscus but they open up the knee properly and it takes a year to recover, no bending for the first few months etc. This was 'new' technology 7 years ago and so things may have changed now

[The_Doc]

lemmingjames said:

from a non medical profession id go with surgery. you can always have physio after which may or may not help you otherwise.

if its torn, from my understanding is that it can always catch on something and aggravate it = inflammation and so on. physio isnt going to get it to rejoin its self back together again.

Alternatively, you could have replacement meniscus but they open up the knee properly and it takes a year to recover, no bending for the first few months etc. This was 'new' technology 7 years ago and so things may have changed now

replacement meniscus = meniscal transplant

Experimental, just a few guys in UK doing it. Last resort and technically very challenging. Can be done keyhole, doesn't need knee opening up.

[pushthebutton]

The_Doc said:

replacement meniscus = meniscal transplant

Experimental, just a few guys in UK doing it. Last resort and technically very challenging. Can be done keyhole, doesn't need knee opening up.

Is it something you're familiar with? How are the results? It seems like it's been around for 10+ years in the US.

[ubbs]

pushthebutton said:

Is it something you're familiar with? How are the results? It seems like it's been around for 10+ years in the US.

Interesting I go under the knife in a few weeks right knee again I've had countless arthroscopes cartalidge repaired/removed, micro fracture, 2 acl's replaced current one has stretched and is ineffective now, surgeon has suggested stripping some muscle from the outside of the knee and threading it across to the inside for more stability (can't remember what the procedure is called) there is some wear in the joint too, I'm wondering if the procedure you mention will help with the pain I have.

[The_Doc]

Meniscal Transplant - an overview

AmericanAcadamy said:

The research studies that have been done on meniscal transplants are not perfect. Overall, between 21% and 55% of transplants fail within 10 years. Meniscal transplants on the outside (lateral) part of the knee are more successful than those on the inside (medial) of the knee.

Synthetic (artificial) meniscal tissue has been tried, but there is conflicting information at this time.

Meniscal transplants can be quite helpful, but are not a good option for every patient. For patients who are carefully and correctly selected, meniscal transplant surgery can provide significant benefits.

Source: http://orthoinfo.aaos.org/topic.cfm?topic=a00381

But remember, the Americans operate for profit, no surgery = no Porsche for them. This is an overtly unfair statement however, because there are amazing surgeons pioneering things over there (and in Europe, see the Verdonk father and son team https://www.researchgate.net/profile/Gust_Verbrugg... )

That said, it is a new and novel technique. Does it heal in place? Does it function as a spacer? What happens when it extrudes? Do you do it before pain develops, in which case the boat has sailed, or is it too high risk for painless knees?

I'm a specialist in this field, and I don't know the answers to these questions.

we just don't know if it's worth the effort and cost, and exactly how best to do it. Source: http://www.ncbi.nlm.nih.gov/pubmed/24928760

Would I have it done? We'll I'm 39, so probably not, I'd have an osteotomy in preference, but if I was younger....

[breamster]

ubbs said:

Interesting I go under the knife in a few weeks right knee again I've had countless arthroscopes cartalidge repaired/removed, micro fracture, 2 acl's replaced current one has stretched and is ineffective now, surgeon has suggested stripping some muscle from the outside of the knee and threading it across to the inside for more stability (can't remember what the procedure is called) there is some wear in the joint too, I'm wondering if the procedure you mention will help with the pain I have.

Now I feel inadequate! Good luck with the surgery and hope you're back on your feet soon.

[breamster]

lemmingjames said:

from a non medical profession id go with surgery. you can always have physio after which may or may not help you otherwise.

if its torn, from my understanding is that it can always catch on something and aggravate it = inflammation and so on. physio isnt going to get it to rejoin its self back together again.

Alternatively, you could have replacement meniscus but they open up the knee properly and it takes a year to recover, no bending for the first few months etc. This was 'new' technology 7 years ago and so things may have changed now

I am favouring going with the surgery I think. My main reservation is that aside from the old tear the MRI didn't show up a great deal so the athroscopy will be a bit exploratory. This makes me think whatever it is must be relatively minor despite giving me a bit of pain.

[ubbs]

I forgot to mention the mid third patella tendon graft in my left knee

[pushthebutton]

The_Doc said:

ource: http://orthoinfo.aaos.org/topic.cfm?topic=a00381

Thanks for the info.

I've only just remembered that I'd posted in this thread.