knee surgery and cycling

the great cornholio

I have a torn meniscus (medial, left knee). The knee has been bothering me off and on for a few years, and has got worse this year - probably triggered by a backpacking/hillwalking trip in February. An MRI scan has found the meniscal tear, and evidence of a burst Bakers cyst. My guess is that the meniscal tear happened a few years back, but recent irritation has caused this cyst, which has led to increased pain. It doesn't bother me when I cycle (about 100 miles a week of club runs, occasional races and sportives, plus commuting on a fixed wheel), but it does in most other activities (including just moving about).

I have been offered arthoscopic surgery, and am trying to decide whether to opt for this. I guess there will be others on this forum who have been through similar experiences, and I am interested in any advice or useful information.

In particular:

How long is the surgery likely to keep me off the bike?

Are there any downsides of the surgery (apart for the the obvious downsides of any surgery)?

Apart from the pain, is there any downside to leaving it alone? I guess it might settle down now that the cysts has burst and if I can avoid activities that aggravate it, but I also worry that the tear might get worse with time.

Thanks for any help

gkerr4

ha - weird - me too!
http://www.bikeradar.com/forums/viewtop ... highlight=
left knee, MRI scan showed meniscal tear and small cyst too !


I have an appointment on the 10th of July to get my 'fixed'.

re. leaving it alone - I had a good chat with the surgeon himself - he felt that leaving it alone wasn't a good option as it would get worse, flap about and the tear would enlarge leading to arthritic problems later in life (which we may get anyway)

the op itself is around 40 minutes - general anaesthetic, discharged same day (private clinic) - i asked about crutches he said "we'll give you some but in honesty you won' really need them" - " i should expect to take a week of work but within about two - three weeks you will be back to normal, give or take.."

I explained that I was a bit nervous having never broke a bone or been on hospital really (i'm 34) and the surgeon said "don't worry - honestly - to you this will be a non-event - within no time you will be back to normal and wondering what you were worried about"

I know other people who have had it done too and they say that after the swelling goes down it will feel great.

up to you - but I am scheduled in for the 10th of July at 10:30 - i'll let the board know how it goes...

Beeblebrox

What other fix is there except from the surgery?
I should think about 6 months before gentle exercise would be okay. But ask the experts!

A friend of mine had a similar injury - from playing rugby - and was told not play for an entire year. Obviously a very different sport from cycling!


Edit - Hmmm, perhaps my friend had something worse after re-reading your post. Either way he had to go for surgery.

gkerr4

a friend of mine who is a PE teacher was back taking classes within 3 weeks of the same OP - i'm hoping to be back on the turbo trainer before the end of july

Bemmiebiker

Bbrox - I suspect your mate may have had a cruciate tear or rupture, which requires more serious surgery.

I've got a complete rupture of my left anterior cruciate. I did the injury initially when i was living in Uganda, without a lot of access to MRI scanners and other diagnostic tools we have here, so I just spent a while on crutches and slowly got back to normal. Since then I've aggravated it from time to time by still trying to do things like playing football (the casue of the orginal injury) and skiing. But during he whole time cycling has never been a problem, and when I finally got a proper diagnosis the physio and surgeon both thought the only reason i'd been able to function fairly normally with this injury was becasue i'd been cycling around 100 miles a week for most of the intervening 5 or 6 years.

But it seems the last wrench when skiing has pushed it a little too far (although cycling is still no problem) so I'm now booked in for surgery and expecting an appointment in October to have a bit of my hamstring cut out and used to replace the ligament.

I've been told I should be back on the bike in 8-10 weeks if things go well, and cycling is the best thing to strenghten the knee - has anyone else had any experince of this kind of operation?

the great cornholio

Thanks gkerr4, that's really useful.

I think I will go for the surgery, but try to arrnage this for the early winter, as I am working up to some races this summer and the Bealach-na-Ba in Sept. The knee is good on the bike (so far, at least), so it will be ideal if I can fit surgery and recovery into the off season. There is about a 12 week wait in any case.

Good luck with your own surgery - it sounds like you have more trouble than me, as I have not experienced locking etc. It will be great to hear how it goes.

nkirussell

The reason you seem to be ok when cycling but not any other activities is that you are not putting any rotational stress or much in the way of compression forces through your knee.
The menisci are horseshoes of soft cartilage that sit on top of the tibia and help with the stability of the knee and act a shock absorbers. When cycling you are not moving you knee in such away that its stability is stressed nor are you putting any real compressional force through you knee.

Unless you are willing to stop doing the things that make it hurt then the only real option is surgery, and it is only likely to get worse without surgery. cartilge is avascular (has no blood supply) so it does not heal itself.

The operation itself can be done under a general anasthetic or with you awake under a spinal anasthetic. a small inscision about 1cm in size is made on either side of your knee and you knee joint is washed out and all the torn/loose bits of cartilage are trimmed of. The surgery is usually performed as a day case

You are encouraged to get your knee moving early after surgey. The exact time you would be advised refrian from cycling will be up to the surgeon who does the operation, but i would suspect you could get back to it in 3-4 weeks.

After all look at Tiger, he has just won the US open a month or so after having his arthroscopy!

Neil

P.S. I am a General Surgeon not an orthopeadic surgeon, so if any orthopods read this then feel free to correct me

gkerr4

Neil - thanks for the response comforting for me as I am just about to have it done.

and nice to see there are some senior medical professionals on the board too!

bornagaincycler

Tigers Knee is a mess & by the sound of it, it's caused by not having the correct surgery at the correct time. I'm an ex ACL reconstruction & shredded cartilage patient. Playing proper golf on an ACL deficient knee is impossible.

As for Cycling, I could Cycle on the flat OK, but found it impossible to get up a hill due to the stress involved. Since the op, I've used Cycling as a major part of the rehab & I've discovered a sport which I enjoy & one that I can continue to enjoy into my 70's. I had a nightmare getting my knee problems sorted out a couple of years ago & have huge sympathy with anyone out there suffering with similar problems. Good luck & Cycling is definately the kindest sport for knees.

Also I would say following a knee reconstruction, my surgeon gave me strict instructions on how to ride a bike. He advised me to always keep the knee bend to a minimum & keep the cycling motion as closed chain as possible, never allow the knee to obscure your toes while Cycling.

nkirussell

I did not realise Tigers injury was an ACL tear as well as cartilage. Having an ACL tear is a copletely different ball game to cartilage tear. The Anterior cruciate ligament (ACL) is heavily involved in the stability of the knee, mainly in stopping the tibia sliding forward and will be understrain when cycling especially when the knee is bent as that is when it is under most tension.
ACL repairs require trikier surgery and much longer rehab than a meniscal trim/repair.

keef66

I had identical tears in the medial menisci in both knees (football, rugby, running up & down mountains etc) and had them tidied up by keyhole surgery about 15 years ago. Walking the day after surgery and cycling after a week but could prob have done it sooner.
Knees have functioned perfectly since the op, until 4 weeks ago. Innocent bit of walking about on the grass, went to turn round, and something went crunch in my right knee. Couple of weeks hobbling about and eating ibruprofen, referred to knee specialist. X-ray is clear, but the joint feels like it's full of Lego, so he suspects medial meniscal damage again, going in for surgery on Thursday. I'll be back on the bike as soon as I can.