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Meniscus Surgery & Motocross

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Having my 2nd medial meniscus surgery on my right knee next Thursday. Both injuries are bucket handle tears, caused by quickly opening and twisting my leg at the same time, and riding was not involved. The first surgery stitched the meniscus back together, which lasted about 6 years. This time, depending on what the surgeon sees when he gets the camera in there, will likely remove the partially attached 'strips' of meniscus since they are not worth stitching back to what remains in the correct spot. The likelihood of them ripping apart at those seams are pretty high. He said in about 10 years it may be possible to have an elective surgery to replace my meniscus with a synthetic material which would basically be a full cure. Hopefully I don't tear it again before then, but it's possible of course. 

Moving forward I will have less than the normal amount of meniscus. I need to be generally careful when my knee is bent at or less than 90°, and definitely need watch out for twisting it when bent like that. 

When I mentioned riding, the surgeon specifically said he has dealt with motocross riders who have gotten injured this way by getting their leg caught in the dirt when putting it out for a turn. The leg bends back quickly and usually twists. Exactly how to injure the meniscus. Apparently knee braces would not really help for this, since they mostly help with hyper extension and can't really help stop the twisting below the knee. This news really sucks since I just started rebuilding a 125 to learn MX with. 

I ride supermoto and trails mainly, and with learning MX, all three styles involve putting my foot out, and risking this injury. Knee down is possible with supermoto at least, but I don't like it. While it is 'safe' to ride in the sense that it will not damage what's left of my meniscus, having this kind of mistake can tear it again.

Has anyone dealt with these injuries? It doesn't look like there's anyway around it, other then to ride as safely as possible. Knee braces are not the solution, but I was going to invest in these even before I got injured this time. Let me know if you have any experiences with knee problems, thanks.

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2 hours ago, HansLanda said:

 Let me know if you have any experiences with knee problems, thanks.

Lol, probably get more than half the forum members on this.....

I've had My meniscus partially ground off (or whatever they do to remove the wrecked bits) quite a few years back, and no real issues with damaging the knee further. I am fairly solidly built though.

I'd say after the surgery find yourself a good sports trainer and work on strengthening the area the best you can.

edit; BTW I don't wear a brace.

Edited by DEATH_INC.

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Tough call to make, as braces will not prevent this injury & bucket handle tears are more serious than those on the edges of the meniscus.

You did not mention your age, but if you lose too much of the meniscus & end up "bone-on-bone" you are on your way to a total knee replacement.

You may have to choose between your love of dirt riding & being able to walk pain-free.

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12 minutes ago, nytrainer said:

Tough call to make, as braces will not prevent this injury & bucket handle tears are more serious than those on the edges of the meniscus.

You did not mention your age, but if you lose too much of the meniscus & end up "bone-on-bone" you are on your way to a total knee replacement.

You may have to choose between your love of dirt riding & being able to walk pain-free.

I'm 25. Surgeon made it seem like he would remove the torn parts, and leave me with a smaller amount of medial meniscus. I'm going to have to be very careful in the dirt until those artificial implants are available here. Europe seems to already have a good plastic implant.

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Removing the damaged tissue leave you with a smaller articular surface on which the femur rests.

I would not hold my breath waiting for the implants. They have been talked about for years & there are many people hoping for them, myself included.

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Surgery went well today. The surgeon found the meniscus to be worth repairing and he stitched me back up! My meeting with him in 10 days will give me more details, and pictures. I will take my physical therapy very seriously and hopefully it heals better this time. We also discussed leg braces briefly before the surgery and said it could help when riding if it prevents my knee from bending past 90°. Although putting my feet on the pegs is already an angle more acute than 90°.

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Saw my surgeon today. I will be in a brace and on crutches until Jan 10, then will begin weaning off both, eventually starting PT. He said it has plenty of stitches securing the cartilage together, but we need wait and see if they will actually fuse together. 

Here are some pictures:

 

1 minute ago, HansLanda said:

Saw my surgeon today. He took a lot of pictures of the inside of my knee. Here are the good ones.

The back of my kneecap had some rough cartilage. Unrelated to the meniscus damage.

5a2edfa8d1233_2017-12-1111_38_11.jpg.2e6eb05953f7726045d64d3fb9dc51f0.jpg

 

So he smoothed it out for me.

5a2edfaaa1bb0_2017-12-1111_38_17.jpg.b3cc08ee9368457791fe8a7e7e3b64ef.jpg

 

Camera positioned in the middle of the knee, looking toward the inside. The meniscus has folded over onto itself. We should be seeing the flat top of the meniscus, but we see the outer edge.

5a2edfac1e64a_2017-12-1111_38_34.jpg.b4c47176470a794c5eac2eb82d12f54b.jpg

 

Part of the tear on the medial side.

5a2edfada80d8_2017-12-1111_38_55.jpg.4abc17cf216a9f30680e2c9ca5ad463d.jpg

 

He put all the cartilage back where it should be to see if it fits. It does, but has this thin squiggly extra bit.

5a2edfaf48668_2017-12-1111_39_03.jpg.246199ab3d6d2260e1fd617937e1762f.jpg

 

So he cut the extra stuff away.

5a2edfb228c13_2017-12-1111_39_35.jpg.50592dd783ae647c7a67ac1315b8297a.jpg

 

Starting to stitch it back up.

5a2edfb3f2c77_2017-12-1111_39_54.jpg.893cd30747bb1e6ae65064c0b408466e.jpg

 

Got more stitches than ever before.5a2edfb560361_2017-12-1111_40_30.jpg.65bec82b946ccc60f8480eb95761ab68.jpg

5a2edfb6d68ad_2017-12-1111_40_47.jpg.d31f08cbcefb8ddfc216be514d5465da.jpg

 

Poking some holes in my bone to encourage some stem cells to help fuse the cartilage together5a2edfb86b3d1_2017-12-1111_41_04.jpg.010e21e031e4a92e12836000444b5113.jpg

 

The holes are those several dark pockets on the left.

5a2edfba2bf92_2017-12-1111_41_24.jpg.c87baccc08791ce21a99d282c18f4843.jpg

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I just read that MDs are optimistic about the stem cell infusions for meniscus repair. Controlled weight-bearing during rehab will stimulate the repair. Good luck!

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42 minutes ago, nytrainer said:

I just read that MDs are optimistic about the stem cell infusions for meniscus repair. Controlled weight-bearing during rehab will stimulate the repair. Good luck!

Stem cells just shot into your knee, or natural ones from my bone? The surgeon said just shooting cells into your leg doesn't mean they will turn into what you want. They could form an organ or ball of hair, haha.

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35 minutes ago, HansLanda said:

Stem cells just shot into your knee, or natural ones from my bone? The surgeon said just shooting cells into your leg doesn't mean they will turn into what you want. They could form an organ or ball of hair, haha.

Not sure, but I imagine they would be inserted directly into the cartilage to foster regrowth of that tissue. I will have to look it up.

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I've been walking around without crutches for a while now, and had my first PT visit last Saturday. She said I'm behind schedule on bending, and I should have been able to hit about 90°, and have a more pliable patella at that time. I was maxing out around 60°, and that was after she helped me get there. She said it was the 'knee sack' which had gotten stiff when the joint was locked for 6 weeks. At least it's not a negative effect from surgery, it just needs to stretch out. 

So I got some workout for increasing my bending, and rebuilding my lost leg and glute muscles.

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My YZ125 is about ready for some MX. I'm seeing a new ortho on Monday due to new health insurance. Hoping to get a prescription for some nice knee braces that my insurance will pay for. I think the Asterisk medical ones look good. They have straps for limiting rotation below the knee. And they're carbon fiber. :)

Definitely have neglected doing my on therapy since I changed jobs and couldn't see my physical therapist anymore. The bending and strength is not where it should be.

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