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Arthroscopy 9 weeks ago - still swelling and pain - experiences ?

 Poster: A snowHead
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Arthroscopy 9 weeks ago to clean up medial meniscus tear
approx. 20% of my meniscus removed so my surgeon says
aged 42 - no particular injury but came on last autumn after 4 days walking in the alps and could not get under control even after resting for 10 weeks.

Unfortunately I'm still experiencing pain along the area where it was removed and knee still swollen
Surgeon keeps telling me to be patient and that no evidence of Arthritis

Have had several private physio sessions with pretty good strength.

did start riding my bike again etc but have totally stopped all exercise for the moment to see if I can decrease this pain and swelling

Anyone with history of Arthroscopy take a long time to settle down ? its all rather frustrating Confused
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@norris, are you getting pain all the time or during certain actions?

I was getting pain at that point post op for similar when squatting, which was due to a particular muscle pair not quite firing at the same time, and when the Physio taped my knee cap had no pain. Used a patella stabiliser knee support to create same effect for the upcoming skiing holiday I had at the time.
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@NickyJ, dull pain generally but more in certain spots along area of my medial meniscus when I put more pressure through my leg/knee -

I believe the meniscus has no pain receptors in it so I think its the bottom of my femur ?
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norris wrote:
@NickyJ, dull pain generally but more in certain spots along area of my medial meniscus when I put more pressure through my leg/knee -

I believe the meniscus has no pain receptors in it so I think its the bottom of my femur ?

I "think" I'm right in saying that the articular cartilage on your femur also has no pain receptors. Pain on pressure is usually because the articular cartilage on the femur has worn away and you have bone-on-bone pain. I have the same issue with my patellar. Have you had an MRI to confirm no arthritic damage?

IME the swelling is more of an issue than the pain. Pain should disperse over time but swelling is an indicator that something is not right within the joint. I had an arthroscopy with a small meniscal trim after 4 years of severe knee pain and was cleared to ski after 8 weeks. I had no swelling. However, something else gave out which caused a new set of problems so it was probably too early. Following year, it became a Baker's Cyst that burst and went down the inside of my calf muscle. Baker's cyst is basically extreme swelling due to another underlying problem. I would definitely be concerned about swelling 9 weeks post-op.

Long story short, I had PRP injections in my post Baker's Cyst damaged knee 18 months' ago and it now doesn't swell at all and I don't take anti-inflammatories anymore either. Two years ago I couldn't walk down stairs and now it's 90-95% pain free, even after hard skiing for two consecutive weeks. PRP is relatively new in the UK (I was treated by an American specialist) but assuming that an MRI says everything is "correct" in your knee, it would be my recommendation for how to settle it down.
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@Raceplate, my initial MRI showed no sign of arthritis apparently (just meniscus tear) and also pictures during the operation looked OK according to my surgeon.

You do sound right about the bone on bone thing though. What else could it be?

Saw the surgeon 10 days ago who suggested waiting longer and won't see him until late April (NHS)

Seeing physio in 10 days but currently things look bleak

Interesting regards the PRP. Presumably would not be offered on NHS, so would need to get this privately?
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@norris, get another MRI. Somethings not right. You’ve waited long enough. I had scar tissue causing discomfort after an ACL reconstruction which was only discovered by follow up MRI. A subsequent quick clean up sorted it within a week.
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Seems scar tissue could possibly be an issue. One of my arthroscopic portals is slightly raised on the skin. The medial one near where the pain is. I will ask the physio about deep tissue massage
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norris wrote:
Seems scar tissue could possibly be an issue. One of my arthroscopic portals is slightly raised on the skin. The medial one near where the pain is. I will ask the physio about deep tissue massage

I would not expect this to cause swelling. Minor pain, discomfort maybe but swelling, no. Any swelling in normal life rather than vigorous exercise is a bad thing IMO. Swelling following vigorous exercise is also bad but perhaps can be expected/mitigated for a time. If your knee is swelling, you have a problem. It may be an ongoing problem (due to misdiagnosis/poor treatment) or it may be an historical problem that just won't settle. If it's the latter, PRP would fix it, IMO.

For PRP, these are the cheapest I've seen in the UK http://www.blackberryclinic.co.uk/index.php?option=com_content&view=article&id=327:prp-platelet-rich-plasma&catid=27:injections
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@norris,
Back to your original question, when I had similar surgery (age 55, 4 years ago), though I had some discomfort but no swelling, I was able to strengthen the affected leg such that I had my first ever off piste week in Chamonix 5 weeks later.

Something doesn't sound right about your recovery.
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@HammondR, Yes this sort of recovery I was led to believe was the norm. It is in theory a small straight forward Op. The more you read about it though the more peoples reactions seem to be different.
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@norris,

If it was an isolated medial
Meniscus tear in an otherwise perfect knee then here are my thoughts :

Not everyone settles in 6 weeks especially if they overdo it.

Sometimes the inflammation that sits around the edge of the meniscus can take longer to settle- occasionally a steroid injection is helpful. Ultrasound scan it a good way to look for persistent inflammation.

Rarely, in a 42 yr old, the loss of the piece of meniscus really unsettled the knee lagging to bone bruising

At nine weeks I’d probably do and US scan with a view to steroid injection.

Repeat MRI at nine weeks is a bit premature

Jonathan Bell
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@Jonathan Bell,

Really appreciate the input.

Yes, I was fairly aggressive from week 4 - week 7 in gym work and on bike...so have curtailed this for the moment, and I think it is very very slowly settling.

I have physio on Monday, so following this will possibly push for Surgeon appointment and ask for Ultrasound and steroid injection.
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