The Knee – An update July 30, 2022

This has been a busy week and I found all kinds of interesting things. So, let’s get to it.

On Monday, I had an MRI on my balky left knee. It was kind of neat and you forget how noisy the damn thing is if you haven’t had one in a while.

On Wednesday I got the MRI results. 

FINDINGS:

  • Menisci: The lateral meniscus is intact. In the medial meniscus, posterior horn there is a horizontal slightly increased signal likely representing a horizontal tear (11-20).  
  • Ligaments: ACL, PCL, and LCL complex are intact. The lateral collateral ligament is intact. There is periligamentous fluid signal surrounding the MCL, which is otherwise intact.  
  • Tendons: Quadriceps mechanism and popliteus tendon are intact.  
  • Bone: No acute fracture or dislocation. Mild bone marrow edema within the femoral medial condyle and the medial tibial plateau.  
  • Cartilage: Patellofemoral: Thinning of the lateral trochlear facet with a small fissure in the median ridge (8-11) Medial tibiofemoral: Preserved Lateral tibiofemoral: Preserved 
  • Miscellaneous: Fluid signal posterior to the PCL (10-14), which may represent an extension of joint fluid versus a ganglion cyst. A small joint effusion is noted. A small Baker’s cyst is noted.  

CONCLUSION: 

  • 1. Grade 1 MCL sprain. 
  • 2. Possible horizontal tear of the posterior horn of the medial meniscus.  

At the end of the conversation, the staff asked if I wanted an Ortho consult. Since the pain levels haven’t really reduced all that much since May, I requested the consult. I figure that if after 10 weeks the level of discomfort is still such that I can’t do many of my ADLs or even walk a mile without it starting to bother, an Ortho consult is necessary.

It has been 10 weeks since the initial injury, and I still have a grade 1 MCL sprain, besides the torn meniscus. This makes me wonder how much healing has occurred in the MCL and meniscus over that time. I know as you get older the healing process takes longer, but damn, this is still bothering more than it should be. So obviously, it hasn’t healed enough, but if after 10 weeks I still have these injuries what were they when they happened?

Not that it really matters or changes what will happen going forward all that much.

Thursday afternoon, I had my physical therapy appointment, and we went over how I am doing and the lack of progress with the knee, while the shoulder and hamstrings were doing fine. It seems that this long lay-off is exactly what the hamstrings needed to heal. 

We discussed that the MRI conclusions probably meant that the Ortho would want to go in to do some sutures in the meniscus (arthroscopic surgery). Since the discomfort levels were still there, now that we know there is an MCL sprain, I should start wearing a light compression brace to give it support. 

Wearing the compression brace has made a difference and the discomfort level in the knee has reduced since I started wearing it. The PT told me to not wear it all the time, just when I am doing something.

All this really means is that I am back in the hurry up and wait mode for the Ortho clinic to contact me to set up an appointment. I attempted to speed up the process and was promptly shot down by them telling me there is a process to get an Ortho appointment. Oh well, I tried.

Since it is a non-emergency case and I have survived this long without seeing them, I am confident that I won’t see the Ortho until the end of August or sometime in September. Then scheduling surgery if it is necessary will be a couple more months after that. Just the way the process works. I went through the same thing with my right knee in 2011, so it is nothing earth-shattering or unexpected.

I ain’t gonna die or anything from waiting longer to get to see the ortho about the knee, but it sure is putting a crimp in my running and the rest of my lifestyle this year.

That is where things are in regards to my left knee.

It still is not letting me do things that I want to do (running, hiking, long walks, squatting down, and all those other things you take for granted when the knee feels fine). I am probably 2-3 months away from any kind of resolution (either way) to things. Like the PT said as I left, “if you want to get back to running and your active lifestyle, the only way you will get back to it completely, will be to have them go in and repair the meniscus. So, that is what I figuring on happening at some point this year.

Time will tell, but I sure do want to get back to running and all the other things that I can’t do or if I do, I pay for dearly the next day. All I can do is keep doing what I can, deal with the discomfort and keep smiling. So that is what I am doing.

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