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I underwent a menisectomy; I still have 75% of my meniscus (confirmed by MRI). No ligament tear. I had little to no osteoarthritis of the knee joint prior to surgery; the x-ray taken after the injury had the following findings: AP, lateral and sunrise views o fhte right knee received on 2/11/10. Mild medial compartment narrowing. Minimal superior patellar spurring. Minimally prominent prefemoral soft tissues.. No acute fracture. Mild lateral patellar spurring. Impressions: Early arthrosis in the patellofemoral joint; mild medial compartment narrowing; minimal joint effusion. Thank you for your efforts!
We can not change the natural outcome or arthritis, nor can we cure arthritis. What we hope to do by performing with the chondroplasty is to delay progression of arthritis significantly so that the time before you develop profound arthritis is much longer. The way that you can grow fibrocartilage best is to create as much new synovial fluid with new nutrition as possible and present it to the surface of the scar tissue that is growing from the operation that you have.
In order for new synovial fluid to manufactured there has to be an exit of the old synovial fluid. Synovial fluid leaves the knee throughout the mechanical motion of the knee moving. Using a stationary bicycle and riding it slowly at 15 minute intervals for at least 2 hours daily is one way to "squish out" the old knee fluid and allow the new knee fluid to present itself to the scar tissue. Joint motion following injury is extremely important in the healing and rehabilitation of the injured extremity. One reason that this is so important is that the joints must move in order to remain healthy and have good nutrition to the end of the cartilage. Good nutrition to the end of the fibrous tissue is also important and new synovial fluid must be remanufactured. This is why you must ride a stationary bike for 2 hours daily at 15 or 20-minute intervals.
I hope my answer is helpful to you.If you would like to give credit for my answer, please press the GREEN ACCEPT BUTTON. Feedback and Bonus would be highly regarded.With Regards,Dr. Bora.
Thanks for the informative reply. So apparently it is standard procedure in a case like mine to perform a chondroplasty rather than try phsycial therapy? And to do so without my consent? Although you cite its preventative effect, it appears that the chondroplasty is the reason that the recovery is taking so long. Without further medical knowledge, I don't know if it had a detreimental effect on the current status of my knee.
Are the post op changes in the second MRI normal, or indicative of a worsening of the condition due to the surgery?
What is your view of the clicking when I extend my knee? This is often cited as a reason for surgery; yet, I never had this prior to the surgery. Is this a normal outcome of a meniscopy?
I heard recommendations for continued bike therapy, but not to the extent mentioned in your response. Is it too late at this point (16 months from surgery) to still fully benefit from this program of cycling?
Thank you for time on complex question. If you have additiona questions questions I should ask my doctor, let me know, and I will accept this answer and ask a new quetion following my upcoming visit. Thank you!
Hello. I would like to help you find an answer.
The other expert opted out. What would you like to know further?
Yes, thanks. The question is quite complex, and if the physician does not have knowledge of orthopedics it could be difficult to answer. (Prior doctor just cut and pasted answer regarding riding a bike two hours a day in 15-minute intervals for recovery; I have never been told to do therapy this extensive.) Further, the same web site where the preceding doctor obtained his information
also states that the patient should stay non-weight bearing on crutches for a period of at least 4 weeks. I was on crutches for about three days, and started physical therapy 10 days after the surgery; it must have take at least three weeks before I could straighten my leg; yet, the medical assistants at the doctors office said most patients are pretty much back to normal after three weeks (again, the chondroplasty; I never asked for that!)
It's been 17 months since the surgery, and I still have a dull pain when walk. Knee just doesn't feel the same, but maybe that's normal after the surgery I had? What concerns me is the follow-up MRI which states in a few places postoperative changes that were not present prior to surgery, and the clicking when I extend my leg that was not present before surgery. And all that for just a nondistinct complex tear (albeit for a few weeks I was limping).
The lengthy recovery time was attributed to the chondroplasty, which from understanding is basically a preventative procedure to stall arthritis. Yet, I was having little problem the last couple weeks prior to surgery, and wonder if the surgeon was too aggressive in performing a chondroplasty for Grade I/II chondromalacia (in hospital report surgeon stated Grade II)? My thought process is that what good is a preventative procedure if it caused the knee problems I have now? I bet me left knee has similar chondromalica; yet, it is not giving me any problems. So I've been told I can start running again, but little hesitant. Surgeon said if still giving me problems in the spring to come back, and he will reevaluate for another MRI.
Do you think me knee is as good as its going to get, but either through time, or, as the prior doctor mentioned, riding an exercise bike for a couple hours a day, I can fill in the gaps with fibrocartilage and improve?
So I'm kind of ranting here, but if you could look back over my info and try to address my concerns and give advice for future care (e.g., running/non-running; tennis; basketball - I would hate to give these up due to a indistinct small complex tear of the meniscus!; physical therapy again; another MRI; get a second opinion from another orthopedic surgeon).
No; I just had physical therapy for approximately three months following surgery. I've been riding a stationary recumbent bike for about thirty minutes a day three times a week, and taking Glucosmine/Condrotin supplements daily.
Specifically, what is not normal: the pain, the clicking when extending my leg, or the MRI showing post op changes that were not present before surgery, or all of the above?
Do you believe the chondroplasty was warranted, and should I have been informed ahead of time of the procedure?
I will look into making an appointment.