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Knee surgery

 
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LDSMITH
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PostPosted: Tue Mar 24, 2009 1:04 pm GMT +0000    Post subject: Knee surgery Reply with quote

Hey Doc,

I had knee surgery Jan. 6 for a torn meniscus. The orthopedic surgeon said the surgery was successful but he had to remove the torn part of the meniscus and that I do not have very much meniscus left where he had to remove to torn section. The surgery went fine and the ortho said I should be able to function normally.

I have taken it easy since then trying not to stress the knee too much. I did the strengthening exercises he prescribed and am now back full duty. I returned to the ortho eight weeks after the surgery and he said I could ride my bike, swim, and exercise as normal but should probably not run or perform certain weight lifting(leg) exercises.

My concern is that I am still having some discomfort. I can ride my bike on the road without pain(I am not pushing a big gear). My knee starts to feel tight later, after riding, and will feel tight(I am guessing inflamation) for a couple days which causes me to limp slightly. I also feel a dull aching for several days afterwards. I cannot pinpoint an exact location for the ache.

The ortho said to come back after eight more weeks and if I am still having discomfort/pain that he will give me a cortisone shot. My questions are: Am I pushing my recovery too fast(I was advised I could return to normal activities)? How long should I give my knee to heal(almost three months now since surgery)? I am hoping I won't have pain/discomfort forever but would like your opinion. What do you think about the cortisone shot? Any thoughts would be appreciated.


Thank you,


Lenny D. Smith
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The Bike Doc
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Joined: 08 May 2003
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Location: Corpus Christi and Warda, Texas

PostPosted: Tue Mar 24, 2009 7:19 pm GMT +0000    Post subject: Reply with quote

Lenny:

Listen to your body. Ease off the intensity for a while and work your self back up more gradually. Give yourself 1-2 days of rest between bike rides. Do follow-up with your ortho doc if there is no improvement.
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Paul K. Nolan, MD
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LDSMITH
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PostPosted: Tue Mar 24, 2009 8:12 pm GMT +0000    Post subject: Knee Surgery Reply with quote

Doc,

Thanks for the recommendations. As always, you are the best.


Lenny
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LDSMITH
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PostPosted: Thu May 21, 2009 8:55 pm GMT +0000    Post subject: Questions? Reply with quote

Doc Nolan,

This is a follow-up question/questions from my earlier post. I went back to ortho May 6 for follow-up. He recommended cortisone injection which he advised would reduce swelling and speed up the healing process. I had the injection and the knee feels good from the meniscus surgery but other problems persist. I seem to have a dull ache just below the knee cap and what sometimes feels like it is underneath the knee cap.

I can walk with little to no discomfort but cycling seems to gradually aggravate it. The ortho diagnosed it as patellar femoral pain syndrome and advised I could swim, use the elliptical trainer, and gave me a list of strengthening exercises, and advised I continue on the trainer.

I recently tried to swim but the kicking motion(flutter kick) of swimming really aggravates the pain and easy riding(trainer or spinning on road) also aggravates it(but not as much as swimming). The ortho also advised I not climb or descend stairs. I fell a slight agitation when I bend my knee to about a 35-45 degree angle with weight on the knee but the pain does not occur before or after that angle(if that makes sense).

I've been continuing my strengthening exercises religiously for two weeks as well as taking Advil as the ortho recommended(twice daily for 2-3 weeks). The ortho seems to think I will eventually return to my normal riding and racing sometime in the future but gave no time frame.

I am very frustrated as I seem to be caught in a never ending circle and cannot do any of the activities I usually participate in(basically any type of physical activity). I was hoping to return to racing in the Fall but that is looking doubtful as I basically cannot do any training.

Do you have any recommendations, thoughts, or insight that may help? I would appreciate it.


Thanks,

Lenny
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The Bike Doc
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Location: Corpus Christi and Warda, Texas

PostPosted: Sun May 24, 2009 8:07 pm GMT +0000    Post subject: Reply with quote

Lenny:

You symptoms sound like you are having some significant inflammation or damage to the cartilage under the knee cap. Have you had an MRI or arthroscopy of the joint to look at the cartilage? You may benenfit from an artificial synovial fluid injection to help lubricate the joint and decrease the irritation. Work closely with your orthopedic doctor and don't be afraid to ask for a second opinion if you are not seeing any significant improvement.

Thanks,
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LDSMITH
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PostPosted: Sun May 24, 2009 10:01 pm GMT +0000    Post subject: Reply with quote

Doc,

I have not had an MRI or arthroscopy since the initial MRI prior to the arthroscopy to repair my meniscus back in January. The ortho said I have some scarring on the underside of my knee cap but did not appear too concerned with it. I am scheduled to return for follow up sometime in mid-July. Should I request another MRI at that time or would you recommend I return sooner?

Thanks,

Lenny
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The Bike Doc
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Location: Corpus Christi and Warda, Texas

PostPosted: Mon May 25, 2009 8:25 pm GMT +0000    Post subject: Reply with quote

LDSMITH:

The scarring on the underside of the knee cap could be the culpret. Condromalacia is due to damage to the cartilage under the knee cap and causes pain with flexing the knee then extending it under load such as going up stair, deep squats, knee extension exercises with heavy loads or harming hard in a big gear. Visit with your Orthopedic doctor about your symptoms; there may be increased scarring developing under your knee cap and you may benefit from a repeat MRI to compare with the prior study and plan your interventions.

Thanks,
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LDSMITH
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PostPosted: Sun May 31, 2009 9:37 am GMT +0000    Post subject: Reply with quote

Doc Nolan,

Thank you for your help. I am due to return to the ortho in about 5 weeks. I am going to continue with the exercises and home rehab until I see the ortho again. If my symptoms have not improved by then I will certainly ask for another MRI and/or second opinion. Again, thank you.


Lenny
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