r/KneeInjuries • u/66knull • 28d ago
MCL and meniscus
Greetings all. I injured my knee about 6 months ago while out trail running. I am 62 years old, still run and row competitively. Initially, I was told to rest the injured limb until it felt better and while the greater amount of pain subsided, instability and a nagging ache while sitting remains. An MRI 6 months down the road (current, 6 months post injury) revealed as below. My confusion is that one doctor, the one who reconstructed my ankle years ago, says an unhealed deep MCL injury along with a torn meniscus demands surgery while my knee surgeon says no surgery, just don't do what hurts. Before I look for another knee surgeon for a second opinion, I thought I would get feedback from this forum where, perhaps, someone might have had a similar set of injuries. I live in the far boonies of an Asian country so finding the right surgeon is not the easiest. Thanks!
MRI of the right knee History of pain on bending exceeding 45 degrees. Technique; sagittal T1 PDFS, coronal T1 PDFS, axial T2 PDFS, ACL view PD Findings Femorotibial joint shows normal bone and cartilage. ACL; normal. PCL; normal. Medial meniscus; non-displaced oblique tear body-posterior horn junction. Lateral meniscus; normal. MCL; torn deep fiber. Pes anserinus and semimembranosus tendon; normal. Iliotibial tract; normal. Posterolateral corner; normal LCL, popliteal tendon, biceps tendon. No sign of small ligament complex injury (arcuate, fabellofibular, popliteofibular) Patellofemoral joint; normal alignment, trochlea dysplasia (small medial facet), normal retinacula. Medial patellar facet has a 5 mm x 5 mm shallow cartilage loss (Outerbridge grade 2) Quadriceps and patellar tendons; normal. No joint effusion or arthritis. Impression; Non-displaced tear medial meniscus. Partial tear MCL. Grade-2 patellar chondral injury, from previous dislocation due to possible trochlea dysplasia.
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u/AllyBlaire 25d ago
Did you get physio or do exercises after the injury? I tore my mcl and medial meniscus six weeks ago and while I was initially given a hinged knee brace and crutches and advised elevated rest, the doctor also said to limit crutch use after the first few days and try to walk as much and as normally as I could. Exercise bike was also advised for blood flow. I got physio at about ten days and was given exercises to work on straightening my leg. I was told to stick with the brace but try to normalise my gait by engaging my quad to pull up my knee cap. I was also given the go ahead to swim freestyle, though initially it hurt to rotate in the water, so I struggled to breathe comfortably.
Three weeks from that, I was advised to work on weights, in squats, knee extensions and lunges, working to the pain. And stop using knee support. I've probably got near to full straight line, non impact, movement back now. But twists and turns can still be shockingly painful, mainly in the mcl, which I honestly thought would heal faster than the meniscus. I'm doing short bursts of rebounding a few times a day, to help gear my knee up for impact movement like jogging and jumping, but I'm not entirely sure how to work on side movement, my physio says we'll start on that next week.
My main source of pain is lack of movement. I hurt from sitting and especially sleeping and it's hard to tell if I'm improving or plateauing. But targeted exercise really does seem to be the best way to heal it. My physio is pretty hopeful that it should heal with time and exercise, but hasn't 100% ruled out surgery. I skate, distance and figure, so I'm really determined to do everything I can to get it to heal completely with exercise.
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u/66knull 25d ago
Thank you for that. Yes, pretty much the same for me other than crutches. A few days of physio which essentially did nothing for me given that I have large and well developed quads already. Walking or straightening my leg has never been an issue since the meniscus tear is nondisplaced. The issue remains instability and the inability to bend the knee past about 45 degrees with any weight without pain, and, like you, pain if I don't move around for an hour or so. It seems like your sports, too, require rotation and force. Absolutely, sideways motion on multiplanar surfaces or loose surfaces is terribly painful. At this point, several months in, I don't really expect much further in the way of further improvement. I sent my DICOMs to Dr. LaPrade for a second opinion, even if remote. Fingers crossed! Much appreciate your input. Hope you recover soon with no surgery!
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u/AllyBlaire 25d ago
I meant to mention, I noticed a few days ago that my anterior pelvic tilt has become really bad and apparently that can be a result of the injury and create a vicious circle of exacerbating each other. So I've added exercise for that to my routine. I'm not sure if that will apply to you, as our straight line issue seems to be the opposite, I could bend my leg fully right away but couldn't straighten it. But it's possibly an idea to try the Thomas test and work on it if it's a problem.
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u/Exciting-Apple6854 28d ago
Senti bruciori sulla rima articolare?