Meniscus tear, again. Surgery?
Hi Rip,
Last year I have torn the meniscus squatting, and this time I have torn it by falling.
I went to an obstacle race of 5km without any running training, but with lots of strength and swimming, so I was in a very good shape, generally (bad decision - I know).
Anyway, I fell from one of the obstacles, that was obviously an accident, I fell really bad twisting my knee. It was really high, was sliding from about 6.5 meters.
I happen to coach an orthoped which is considered the best in my country in the knee joint, he is very well known (I coach him in swimming), so I have consulted with him and got an MRI really quickly. It was done exactly 2 weeks after the injury, while it usually take here at least 8 weeks, if you manage to get it at all. At the MRI they have seen the tear from last year, at the medial meniscus, and said it is stable.
On the current tear, which is in the lateral meniscus, they said: "complex lateral meniscus tear, involving the anterior horn and the body".
No specifics about red / white zone, or the size of the tear, or which exactly kind of tears the complex tear involve. No ACL / PCL damage.
Absolutely no pain at the medial side of the knee, it heald up "100%" since last year. Pain only at the lateral side of the knee.
The orthoped said I need a surgery, arthroscopic, and that it's likely to worsen the situation if I will keep training on it without surgery, which may force me to a surgery later, on a bigger tear.
The symptoms last year were not as bad as now. About 2 weeks after the injury I could compete in underwater hockey. Pain consisted for about 2 more months but I could squat carefully even heavy weights. It heald up really good.
This time, now, I'm 3.5 weeks after the accident, and today I squatted 50kg, with a nagging pain, and any rotation still hurt quite bad. At the day of the injury I could not step on the leg.
The symptoms today are way lower than the day of the injury and it gets better with time. I keep adding 5kg to the squat every session, 3 times a week, but I don't press over 70kg at the moment out of fear for the knee.
It took about 3-4 days, but now I have a full range of motion regarding flexion and extension as long as there is not loading on the knee. Extreme extension hurt, but I can lock the knee. If it's pushed to hyper extension the injury hurt (also the bones, obviously). Lateral rotation of the shin ("knees caving out") hurt, especially when the knee is flexed.
My legs were quite strong when the injury happend, I was resetting the squat due to a back injury (probably annular tear) but I was squatting 155kg the day before the race, on the way back to 195kg for fives.
I'm a stronger than average, competitive athlete, 25 years old, 87kg / 191lb BW, 1.72m / 5'8", so the healing of the meniscus shall be better than average, I guess. I hope.
My questions are:
1. Considering the MRI results, is there any way to predict how well this tear will heal up on it's own?
2. The surgery will probably be a menisctomy, but if it will be possible he will stitch the tear and not take that part out of the knee. His surgery skills are one of the best in the world, so if it will be done it will be done by him, and it will be done the best way it can be done in 2017. At the moment I'm not into the surgery. What needs to happen so I will definately need it in your opinion? Do you think I shall do it now?
My plan is to keep squatting light and swimming easy with pushing the wall really carefully, and see how it feels in the upcoming month. If you have any other recommendation I will be very happy to know.
Thank you very much in advance, really appreciate your help! :-)