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Knee arthroscopy - any advice on recovery welcome

 Poster: A snowHead
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I'm scheduled for a knee arthroscopy later this month and am wondering what my chances of skiing in early 2017 are, about 3 months after the procedure. The operation is to try to repair damaged cartilage and remove any loose fragments. Also to deal with a small Baker's cyst and prevent fluid leaking in future.
I realise every case differs and I'll get advice from the consultant, physiotherapist, etc. I'd welcome any real life experience of this, things to do, what to avoid and recovery tips from snowHeads please.
I'm 60 year old male, average weight, generally fit and active, which I hope may help.
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I had my meniscus cartilage in the October and skied in December. The holiday was pre-booked and I didn't want to miss out completely... Due to cost we couldn't have afforded it to be later if we cancelled.

I was in pain, I had to cut days short and one day gave up completely. However it was still better than not going at all that season.

I was quite a bit younger... Don't know how much difference that reply makes?
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Perhaps it depends what you have done, but I had an arthroscopy to tidy up (NOT repair) cartilage and was fully recovered very quickly. I'm a fair bit older than you but I did do all the right exercises.

But I think recovering after a repairs take quite a lot longer and the right rehab is more important. Jonathan Bell, SH's "resident" knee expert might be a long soon to help.
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First up I'm not an expert, but have been through the process recently. The concern I have is when you write "repair" as a repair is something that takes months to get over, the healing process is slow and the repair will be very fragile for some time - I believe your leg would be immobilised for some weeks after surgery and would probably rule out skiing until late season.
On the other hand if the surgery is to cut out torn sections and have a general clean out then you should be ok, but much may depend on age II have no idea about the baker cyst).
I had a surgery in at the end of May '16 to remove a chunk of torn cartilage. After 6 weeks I ran a 10km, which I regretted, I thought I had done more damage, however after a week of pills and ice it settled down and I decided to take the rehab a bit more seriously.
So my advice would be to take your time and don't over do it. After a month or so my knee felt fairly normal and I should have worked on it gradually and by 3 months I'm sure it would have been close to 100%. If you have good leg muscles before the surgery it will help.
Good luck and keep us posted.
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@intermediate, specific advise when it comes to recovery, is get yourself some physio exercises to be doing leading upto op, do try and maintain as much muscle while waiting for it. Once you have had the op do the physio exercises every couple of hours during the day if you can. Initially it will be ones like foot pumps and tensioning your leg as straight as you can etc. I find this not only improves recovery time but helps reduce discomfort.
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@NickyJ, thanks and the early return you had to skiing is encouraging. Sounds like you went through the pain barrier to do that and I hope you've made a full recovery now.
Thanks also for advice on exercise. I've been specifically strengthening muscles around the knee, as well as general cardio/resistance work. I've also managed to get my weight down to the lowest it has been for over 35 years, as that helps reduce strain on knees I'm told.
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@pam w, thanks and your fast and full recovery is encouraging. I think the surgeon will decide exactly what repair or tidy up work he can do once he can see inside the knee. He has an idea from an MRI scan but I get the impression that's not detailed enough to be sure exactly what can be done.
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intermediate wrote:
@pam w, thanks and your fast and full recovery is encouraging. I think the surgeon will decide exactly what repair or tidy up work he can do once he can see inside the knee. He has an idea from an MRI scan but I get the impression that's not detailed enough to be sure exactly what can be done.


Yes, this is what the surgeon told me when I had a meniscus trim a month ago.
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Hi, I had an arthroscopy 2 weeks ago to trim cartilage one side and remove some pieces the other side of knee, I am also due to go skiing 31 Dec, am already back at my local CrossFit gym and scaling everything accordingly, concentrating on seated squats and anything that will strengthen the knee and all of the major muscle groups around the knee....have no pain and hopefully will get full mobility in the knee back over next few weeks and then fully fit for end of December
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@intermediate,
Is it a partial menisectomy? Age 55 I had one 3 years ago. 6 weeks later I had my first ever week on an off piste course in Chamonix.

Key for me was doing exactly as I was told for rehab. 6 weeks of diligent exercise. I presume you are fit and strong to start with. Also, no reason not to do plenty of pre-hab before.
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@Charliee, thanks, useful to learn about your experience. Won't know extent of repair vs cartilage removal and clean-out until op is done I guess. Happy to take your advice and not do a 10km run six weeks after op. If I can ski a 10km piste 3 months after I'll be delighted. Very Happy
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@Holly101, @HammondR, thanks for your responses. Indicates how much of this knee surgery is going on. Your positive progress and quick return to skiing all sound good.
I'm not sure whether I'm having a partial menisectomy...exact procedure depends what surgeon finds once looking inside knee. I'm doing plenty of pre-hab and will do everything I can to recover fully. I suppose the trick is being patient and getting balance of exercise and rest right.

@Kelskii, thanks and I hope you're doing well after your treatment last month. Do you plan or hope to ski in the coming season?
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Had both knees done together quite a lot of torn cartlidge removed from both .Went to the snow dome one month afterwards skied 6 weeks last winter! Did the tour mont blanc this summer .It is essential to do physio and keep knees moving so they lubricate and you do not get reduced movement.
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@brock, thanks, another fast and full recovery, sounds great. Having both knees done together seems unusual. Doctors in UK told me they only operated on one at a time. I will definitely take physio advice and keep moving as soon and as much as possible.
BTW, I really enjoyed my first day visit to Les Contamines last March (from Megeve base) and hope to return next season. Very Happy
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@intermediate, yes, skiing at New Year and the knee feels pretty good now and isn't clicking like it was prior to the operation. I fell skiing and injured the knee two years ago and have skied with the injury but the knee would swell after a few days. The surgeon said that the meniscus tear was very minor but there had been a bit of bone-to-bone contact so he added a bit of 'Microfracture' to the procedure. I haven't tried running yet but can walk around and cycle without any problems.
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@Kelskii, thanks and good to hear recovery going well.
Had my op yesterday. It turned out to be 'medial & lateral menisectomy + chondroplasty'.
Doing physio recommended exercises every half hour, as instructed.
Thanks again to all for sharing information and advice. Very Happy
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@intermediate, best of luck, and stick with the exercises they make the world of difference.

Once you progress to thinks like leg lifts etc, make sure you do them on both legs. Remember going to the physio who got to raise bad leg... Then good leg to compare, which had a little wobble Embarassed
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Jonathan Bell worked on my knee in September and I skied at the end of March.

My advice is:

1) Follow the rehab program;
2) resist the urge to overdo it;
3) Ice, Ice,Ice,Ice;
4) Take it easy when you do hit the slopes - if you go for a week book in rest days - give your knee a break
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@FrediKanoute, thanks. Did you have a similar op?
1 week since mine. Working hard on rehab. Knee bending, leg lifting OK. Walking short distances carefully. Stairs now OK.
Still painful and occasionally feels a bit 'loose' and clicks loudly. Early days!
Received letter giving details of what surgeon found and did. Bit technical for me to fully understand, even with online research.
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Yes, mine was a general clean and tidy up. I decided that in my 40's taking up tennis again was a great idea and ended up with a knee that was problematic. Having had it scanned it turns out that it was a mess, including an undiagnosed 25 year old ACL injury. Basically the arthroscopy was to clean and tidy up the meniscus and make the knee more stable and less prone to inflammation.

I found that you recover surprisingly quick, but there can be a tendency to over do things. So whilst you feel as though getting back on your bike is great, I would wait for the physio/surgeon to give you the all clear. My rehab included lots and lots of squats. Lots of single leg lift and bent leg lifts with light weights. I through away the crutch after a few days and only took it with me as a just in case. I had no problem skiing the following March - so 6 months post Op.

12 months on and the knee is fine it occasionally locks (mainly on stairs), but I have worked out that is more a result of lack of stretching on my part - lots of Quad, those ones down the side of quad and hamstring stretches all help considerably. What I did find is that the knee felt inflamed for a lot longer than I expected (even after I had gone skiing) and really only settled down about 3 months ago, so regular icing helps.
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Hi. I had a left knee arthroscopy exactly 7 days ago (to the hour). I had no cartilage or ligament damage but needed to trim the plica and Hoffa pad which had inflamed and were impinging on my knee hinge.

Interesting and encouraging to read some of the comments above. I'm 41 and reasonably fit.

Pre-surgery I've been working with physio to strengthen the muscles above the knee and I believe this is a key component to a swift recovery. Physio told me 6-8 weeks for a full recovery but also commented that some surgeons will promise a 2-3 week recovery time.

What has surprised me is where the post op pain is. Other than the entry wounds which feel a bit fragile as if they might tear, the knee feels clean and tidy. But my quad muscles are screaming. They are taut, strained and and constantly sore.

I have learned (post op) why this is. I'll not say why, for the benefit of those who are yet to go under the knife, but there's a lot of trauma and associated bruising /damage to the soft tissue of the thighs and calves.

I'll check in again in a week to give a better update once the bruising settles and the physio develops beyond the very basic.
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I had a knee arthroscopy "trim" and didn't have a problem with quad muscles. So I wouldn't want people to think it was inevitable. My rehab exercises including "leg lifts", very gentle at first, just tensing the muscles, and I started immediately.
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Indeed. Physio today thought my knee was better than expected but quads are a bit mangled. After soft tissue massage, a load of bruising has been brought to the surface. Been assigned a few straightforward exercises to clear the muscles and reinstate full movement range.
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@aljay, good luck and look forward to your update.
Agree about bruising, more and longer lasting than I expected. Still using ice regularly. My hamstring very tight, no problem with quads. Doing regular hamstring stretches.

Been back in gym, including light resistance exercises on leg press and leg lifts. Gentle resistance on cross trainer. Knee sore afterwards but that passes in 24 hours. Avoiding twisting, turning and any sideways pressure, which feels like it would be very risky. Test trip to snowdome still feels long way off.

Physio yesterday seemed happy with range of movement, leg strength and general progress after just over 3 weeks.
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Exercising the quads so they dont get flabby is a significant part of ensuring a good rehab. Using the muscles with straight leg to pull the knee cap back and forward is good for this. Some ultrasound treatment by a physio is also helpful. The most important thing is to get the advice of your medic who will know exactly what he has done and will advise how quickly you could hope to get fully fit and what you need to do so. As with anything quite a lot of your recovery and how quick it is will depend on how much you put into it and how well you follow the instructions given to you by your doc and physio.
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Had follow up with consultant today, 6 weeks after arthroscopy. He showed me images of damage inside knee. Main problem is that medial meniscus cartilage is completely worn away and both exposed bone surfaces significantly worn. Level 4 osteoarthritis damage. Smoothing the bone surfaces has been attempted, I think he said using 'vaporisation' technique.
I'll keep doing exercises recommended, look for a knee brace to suit and hope I get lucky, to be able to ski again some time this season. Very Happy
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Good luck. My uncle in the states had some stuff inserted into his knee to replace the worn away cartilage. I haven't heard of anybody being offered this in this country, I assume you weren't offered this?

My Dad was recommended to take glucosamine and chondroitin supplements to help and due to the state of my knees I have also been taking it. Certainly my knees are "pretty good" considering, but obviously I can't simultaneously take the supplement and not take it so don't know for sure if it is really helping. However I was asked to stop taking it a week prior to my shoulder surgery, 4 days after stopping my bad knee flared up. That COULD have been coincidence of course.
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You got to avoid stress fractures from even the smallest of shocks.
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My wife is having a full knee replacement soon and the Consultant has recommended a cryo-cuff. Basically a cross between an elastic bandage and a pack of frozen peas.
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@NickyJ, no I wasn't offered stuff to insert where cartilage used to be. Did it work well for your uncle in USA? Will look into benefits of those supplements, thanks.
@nosnowballz, mmmm, stress fractures - maybe more likely when cartilage gone? Impossible to avoid 'shocks' how I ski. Flat light skiing especially challenging for knees, hips etc.
@Matt1959, thanks, physio didn't mention cryo-cuffs - I'm still using frozen peas. Good luck to your wife with op.
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@intermediate, re a knee brace I would recommend a Ski Mojo - expensive but effective.
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@RUGBY PETER, a mojo is not a knee brace adn does not do the same job, although I agree it is very good for reducing strain on the knees
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bump.

as stated above, I had a knee arthroscopy on 1 Nov. due to go to St Anton first week in April, so building up the quads around the knee, and my hips, for that.

surgeon had initially told me 6 -8 weeks recovery. I saw him after 6 weeks and he said "operation successful, you've pretty much recovered. Now you can start to rehab and rebuild". I had understood 6-8 weeks was for a full recovery, but it turns out this was just to recover from the trauma of the operation.

so, i'm now 14 weeks post op. I've been 6 weeks of physio stretching, static biking and yoga for strength. have just started running again, on a couch to 5k programme to get the knees used to impact again. (have also managed to play a bit of golf).

feeling optimistic for Austria in April, but will be taking advice about applying some knee-strapping/bracing to help with confidence - and will be sticking to the blue runs. my initial injury was hyper-extension so above all, wish to guard against a recurrent event.
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I had a partial menisectomy on my medial meniscus and a debreidment on my later meniscus 17 days ago. Knee feels great. Swelling gone, normal range of motion, equal strength with no muscle loss on my quads at all. I did a very active recovery, no crutches at all, was weightbearing out of the O/R. Did 4-5 days of RICE, since then have been doing stretches and squats and leg lifts. Physio says I am OK to ski!!!!!!!!!!!!!!!!!!!!!!!!!!! I'm delighted she says that, but I'm probably going to wait a week or so as i think my propreception isn't right yet.
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@coddlesangers,

Id be very careful skiing in less than six weeks after and arthroscopy.
It may well be that it feels good for day to day but it will be highly likely to swell if you ski. that will put you at risk of articular cartilage damage and further injury.

Jonathan Bell
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As OP for this thread, I'm 18 weeks post op. Worked hard on rehab, keeping to physio recommendations. Knee still feels too unstable and frequently painful to ski yet. Light lateral pressure causing problem where medial meniscus used to be. Will keep working at it and still clinging to hope of skiing this season. Recovery taking longer than I hoped but being able to walk longer term more important than skiing short term.
Great to see positive progress for other snowHeads Very Happy
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Jonathan Bell wrote:
@coddlesangers,

Id be very careful skiing in less than six weeks after and arthroscopy.
It may well be that it feels good for day to day but it will be highly likely to swell if you ski. that will put you at risk of articular cartilage damage and further injury.

Jonathan Bell


Thanks Jonathan,

Saw your post while on my my way back from a great mornings skiing in Flims Shocked . I've had 2 mornings in total, 25 days post op today. No swelling or reaction at all, I guess I've been lucky! Caution to others, not all recoveries are like mine, I'm genuinely stunned at the success of the op.
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coddlesangers wrote:
Jonathan Bell wrote:
@coddlesangers,

Id be very careful skiing in less than six weeks after and arthroscopy.
It may well be that it feels good for day to day but it will be highly likely to swell if you ski. that will put you at risk of articular cartilage damage and further injury.

Jonathan Bell


Thanks Jonathan,

Saw your post while on my my way back from a great mornings skiing in Flims Shocked . I've had 2 mornings in total, 25 days post op today. No swelling or reaction at all, I guess I've been lucky! Caution to others, not all recoveries are like mine, I'm genuinely stunned at the success of the op.


Be guided by whether it swells then.
It s ok to ice the knee to keep swelling at bay.

Jonathan Bell
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6 months since arthroscopy. I've continued to work consistently on rehab, keeping mobile, ice treatment, etc. Knee condition still variable. Walking on uneven ground, or for anything other than short distances, painful. Cancelled a ski trip in mid March. Good news is that I risked going to Tignes in early April. Managed 3.5 days challenging skiing, using just basic 'compression' supports and resting in between. Sore and unstable since then but settling down after a couple of weeks. Boost to confidence and thinking positively about next season. Steroid injection suggested but need to research pros and cons. Very Happy
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