Knee swollen, tore ACL and Meniscus

Bones, joints and muscles
1

Hey All,

I decided to start off with my first post hoping I can get as much as support that I could from all the experts in here. Basically, I'm 30 yo (not overweight) right now and I injured my left knee 15 years ago while playing football. If I recall correctly, I was making a "volley" stunt with my left knee as the supporting leg and I twisted it. Then I was out for the entire game and as it was painful and swollen, once the swell subsided I was able to walk normally and then I remembered my knee suddenly gave way when I was walking, it happened only 2-3 times since the first injury (first few months). 

At that point of time, I went to see an OS and he arranged a MRI scan for my left knee and results that came back was a partial torn on meniscus and the doctor said surgery wasn't required, got prescribed with anti inflammatory and that was it. I slowly regain my knee strength by jogging, running and eventually return to playing football, cycling, basketball and even gym with very little soreness everytime after I played. Usually the soreness last for few minutes and not much pain. I'm able to walk normally and run but the only thing that I can't really perform was squating/kneeling and walking down the stairs.. it will usually give me some pain or some funny feeling on my knee. Other than that, my knee feels pretty stable. 

So fast forward.. 5 years ago (around 2011), my knee swelled and I was a bit concern as it rarely swells and so I made another visit to hosp, went to see a different doctor this time and he ordered another MRI scan for me and results came back pretty much same and he said it was partial tear and doesn't need any surgical intervention unless the pain doesn't subside but this time he extracted the fluid from my knee to reduce the swelling. Results were significantly good, I'm able to walk normally since then and no more swelling, I still go to the gym and workout as usual with very little sore/pain each time after workout (usually soreness lasts for 5-10 minutes after stationary cycled) and then it goes off. 

Recently, I changed job and stop hitting a gym due to work commitment for about a year and then few months back I experienced some slight pain and my knee flares up and swollen pretty often. It goes off and keeps coming back so I went to see a different doctor this time and he ordered another MRI for me and based on the results, it shown some 'loose body' around my joint which may be the reason why my knee keeps flaring up and there are some gap within my joint, I guess certain piece of my meniscus is missing. So he suggested for surgery to remove the debris and I went to look for second opinion and the OS came back with the same recommendation but he said I tore my ACL too. I guess I'm all set now with not much options left, an ACL reconstruction using hamstring graft and meniscus repair. So here are my questions - 

My surgery is scheduled around March and I was thinking if I should bring it forward? I'm currently under prehab as my quads are weak but each time after prehab, my knee gets flare up and swollen again, should I just stop doing anything and let the swell subside and go for surgery with not up-to-par quads? My hamstring is pretty tight and painful at times too, happened 2-3 weeks ago which is the most worrying as I read in the forum here, some people have problems with hamstring after post-op. 

As I don't feel any pain previously and not much of mechanical problems with my knee, however I do feel some clicking on my knee and occasionally a floating object around my joints at times. I can't really flex my knee to 0 degrees which has been like that for quite sometime. I'm really worried if I have damaged my knee. Can that damage been accessed through MRI? or it has to be scoped?

Lastly, now my good knee is giving me some minor problems. I have not injured it before, no twisting, no swelling but I noticed everytime after walking down stairs, I feel soreness on my quads tendon/meniscus area (slightly upper right side of my patella) - not sure what is it called. Am I overusing my good knee? MRI screening comes back all normal.

Thanks,

Hertz

2

I'm sorry, but my experience only lies in total knee replacements due to arthritis.

Hope you find what you're looking for.

3

I was wondering if you have seen a sports medicine specialist. Your initial injury was from football, and those in sports medicine have a real knack for knowing exactly how to proceed with treatment.

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As far as your good knee.....as you favor the bad one you are probably putting a strain or unusual activity causing discomfort. Back up to the original problem. Its pretty obvious its going to get worse until you have it repaired. I gue$ my approach woyld be to get it over with and start the rehab ASAP. You didn't say where you are located but if its winter where you are you can have it done now and be back on your feet come warm weather. The meniscus is pretty much a straight out deal with regular therapy for a short time but the ACL is another deal a nd depending on the extent can be a bitlonger and more difficult. I'm on the my 5th rehab and during that time I was in therapy with a Div 1 lady basketball player c who had a severe ACL and she was really intense in rehab and was looking at a year before she could get back in the game. On the other hand, I worked out with a high school soccer player who was in her 3rd rehab from lesser ACL damage and she was about 6 months. She had a twin sister that had just finished her 2nd so they must have some sort of genetic weakness. My sister in law tore her meniscus in 2014 Just before a scheduled trip to Europe on a river boat xruise. She got an injection so she could go as they had already paid the full fare and then she had surgery 2 weeks after getting home. She didn't go on any of the strenuous hikes and shopping tours and iced her leg on every possible occassion. She made a full recovery in about 90 days and she was 75 at the time but a very active 75. One word of caution....rehab just as you are advised. One of the big problems with knee surgery of any kind, people feel the need to the make y p for lost time a cause themselves problems and setbacks. Take it slow and steady. Too many reps, too much weights, trying to become mobile without use of assistive devices, on÷lint befor the Dr approves it and in general, becoming your own therapist is bad news. You will get a tremendous amt of advice and encouragement from this site because everyone knows what you're going through from personal experience. Keep us advised. Th e re are people on here from about a dozen different countries so you'll see a number of different protocols for the same thing. Personally I have had 11 surgeries and radiation on this leg in the last 13 1/2 years. I'm from the middle of the US. and been on here through 3 surgeries over the little more than a year. I feel like several of these folks are life long friends. One other little extra benefit.......some fAntastic humor and really good stories to help lighten the load.

5

Hey Hertz...

First of all, YES a MRI does indeed tell the doctors whether a TKR is required.

However unless you were Michael Jordan and because of your age, (30) they'd usually wait and try easy, less invasive procedures. Starting with;

A) a cortisone shot followed by...

B) aspirating your knee.

If those things don't improve your knees they may need to do...

C) a simple outpatient scoping of the knee...

D) a simple outpatient meniscus repair, or..

E) an ACL/PCL/ICL...A-anterior B-posterior Interior Cruciate Ligament repair

Worst case scenario would be a Total or Partial knee replacement. However from what you wrote i would think the first 5 options would be where they'd start with a young athlete as yourself.

Hope all goes well...

David ( teaching tennis pro from Chicago)

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David.....hadn't heard from you for several weeks. Where do you stand now with your situation. Last I recall you were waiting for the decision to schedule the tkr. From the looks of things you won't be getting in any outdoor tennis. Talked to my grandson who lives up close to Wrigley Field and has to walk a block or two to catch the transportation downtown to his job, the morning hike has been a little uncomfortable the last couple of weeks. Hope things are going well for to you. A week from next thurs I am having my 1st cataract repaired and on Feb 5, I'm getting my 79th birthday present from medicare, cataract surgery. My opthamologist told me a year ago I was due but because of the staph infection and all the surgery and rehab I had to go through last year I put it off. Its not that I was having trouble seeing to drive, I was having trou le finding my car when it was out of the garage. Hope all is going better for you now

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Should have read.....on the 555th I'm getting an injection in my good knee as all of last years surgeries caused me to put too much strain on the leg and got it inflammedto a point therapy and antiinflammatories aren't getting it anmore

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Evening OFGUY...4 days ago i had my hip replaced. Was spooked at first but it went beautifully.

Spent 1 night in the hospital and home the next. Started pt at home and I'm already walking, albeit slowly and carefully.

Once the hip is 100% i need to go back in for the TKR of the left knee. They said they needed to do the hip first as it is important to have solid strong hips before the knee can be done.

So it looks like 2016 will be a year of rehab and healing.

I have a feeling i may never see a tennis court again

But the US multi-state lotto has rolled over to a RECORD SETTING $1BILLION this coming Saturday.

So after i win I'm opening my own state of the art tennis center to rival that of Wimbledon!

Lol

Thanks for your concern, and wish me much Saturday. The odds of winning are probably 100 billion to 1.

But if you don't play they won't pay. Lol

It's fun to dream meanwhile!

Take Care

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Hi All! 

Thanks for all the replies, eventually I went to see a few doctors and told them I dislocated my knee long time ago and apparently it's not my ACL or MCL, it looks I have chipped bone from my patella/cartilage and it's floating around and damaged my articular cartilage slightly. 

A doctor suggested to do perform a loose body removal, multiple drillings and lateral release but I don't feel any instability on my kneecap. So I went to see another doctor who just want to perform the minimal by loose body removal and re-assess how bad is my cartilage.. from MRI it looks premature ostheoarthritis seen but not sure how bad is it. Do you think I'm heading at the right direction? Just perform an athroscopy to remove loose body and re-assess the damage again and see what's next is best?

Thanks!!

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That would be the way I would go. You hate to think about having to have another go around later on because you took the conservative approach and it wasn't enough but on the other hand, why go all out if you don't have to. 30 years ago I was on one of those outdoor adventure team building retreats about this time of year. It was in New Mexico at a little higher altitude and we got just enough overnight snow to be messy. We were climbing a 40' wall and I up between 30 and 35' when I had a rather long distance to cover and m y boot slipped off the peg causing my knee to twist and I dropped in a free fall (i was being supported by a harness and the people on the ground holding into the ropes. Sudden severe pain and by the time I got back on the ground the swelling had started. The got me back to my cabin an started icing. 2 days later we headed home. 1st a 3 he bus ride and the a couple hour flight. I had notified my Dr a 62nd they had me scheduled with an ortho as soon as I got home. As it turned out. I had chipped a tiny piece of bone and it was being held on by a little piece of cartilage. Every time my knee bent that little fragment of bone was caught in the joint and rubbing. It felt like I had a piece of flint in there. Within a couple of days they scoped it and polished it up a bit. A few days on crutches and an added prescription knee brace. Plus a few weeks healing and I was back going strong. By early March I was back on the golf course again.

11

That sounds exactly what I'm going through except that mine was actually diagnosed after 15 years later but it didn't give me much problem back then.. I was devastated that they actually missed this out in the MRI findings back then.. sigh