Torn Miniscus

In February at MI Icefest, I was approaching a climb with crampons on, Stepped over a tree, and twisted my knee.  Felt a pop, and instant pain.  I continued, climbed all day, and just had some soreness the next day.  No bruising, no instability, or other signs of major damage, so thought it was just a minor sprain.  Fast forward, and i've had some issues with pain in that knee, especially ascending stairs, or uphill.  Now I've got a clicking in that knee, and shooting pain in certain positions.  The symptoms point towards a torn miniscus.  

My question is: if I need to have it surgically repaired, how is the recovery?  Would I be able to ice climb again this winter if I have it repaired within the next month? I don't want to miss out on another great season of ice, especially now that my son is absolutely hooked.  

If it is the meniscus, at your age it's much more likely they will simply cut out the torn part rather than attempt a repair - the plus side of that is that you will be able to get back to regular activity much faster that way. Do the PT and you'll definitely be climbing ice this winter.

I had a bucket tear from bouldering and had it repaired at age 51 and was on crutches for 6 weeks. Doc told me it would be 1 year before I felt 100% and he was spot on. I was able to start climbing after 10 weeks or so but couldn't bend my knee very much at first. Took me a long time to get over the last mental hurdle that it wasn't going to tear again.

I'm glad I got it fixed though because if they start cutting pieces out, it really will only end with a knee replacement down the road.

A few years ago I tore my meniscus with an awkward crampon position as well. Mine was a repair. Recovery was 4 weeks of couch which was hard, then slowly I started getting back into my exercise and routine at light duty.  Three years later and no lingering effects, if I didn't remember it happening I wouldn't be aware based on physical limitations. Had surgery at 30 yrs old, 4 days after my tear.

 Now im back to climbing just as mediocre as I ever was

 Also, I spent the following season exclusively on top rope, but also I don't really have a desire (ability) to lead hard ice, so it wasn't much of a change.

Adam Stonewrote:

 The symptoms point towards a torn miniscus.  

Are you saying you have seen an orthopedic surgeon and gotten an MRI? Are you saying a family practice MD has done an examination and listened to your symptoms and said you probably have a torn meniscus? Are you saying you have read stuff on the Internet and self-diagnosed?

My question is: if I need to have it surgically repaired, how is the recovery?  

The three answers so far may not be explicit enough for you to understand that there is a difference between a repair and a meniscectomy - what people sometimes describe as a trim.

A repair is a more complex procedure and typically is followed by at least a month of non-load bearing followed by a longer recovery.  A meniscectomy typically has you load bearing as soon as possible, typically as soon as 2 days after surgery. There are a couple of very good threads on MP about repairs, and many others on trims.

An MRI can sometimes distinguish and predict the need for one or the other but not always.  Based on my symptoms and MRI, my orthopedic surgeon warned me that a repair was likely warranted, but during surgery decided a clean up was sufficient.  I was back to limited climbing in 4 weeks.  

"I'm glad I got it fixed though because if they start cutting pieces out, it really will only end with a knee replacement down the road."

I'm not sure what this opinion is based on.  I've had meniscectomies on both knees know, one 25 years ago and one 4 years ago.  Both my knees are fully functional and baring a new injury I don't anticipate needing a knee replacement in this lifetime.  That is the experience of millions of other people too.

phylp phylpwrote:

I'm not sure what this opinion is based on.  I've had meniscectomies on both knees know, one 25 years ago and one 4 years ago.  Both my knees are fully functional and baring a new injury I don't anticipate needing a knee replacement in this lifetime.  That is the experience of millions of other people too.

Just what my doctor told me. Glad you aren't heading there...

Knee Replacement after Menisectomy

Joe Mwrote:

Knee Replacement after Menisectomy

Maybe I’m reading this wrong, in which case my apologies, but from the study: “TKR occurred in 9.62% and 7.64% in AM and non-AM groups” Sample size was ~35000 people and there was a 2% difference in the incidence of TKR in an already small, minority population (>10%) of those studied.  

That seems a bit of a stretch to conclude from that that if you undergo menisectomy, you’re likely to have TKR later, no?  Statistically likelier, sure, but isn’t it important to delve into the specifics behind that statement?

Joe Mwrote:

Knee Replacement after Menisectomy

This study is specifically based on patients aged 50-79 with osteoarthritis. It compared OA patients who had a surgery to OA sufferers who choose not to have a surgery, and then looked at the incidence of TKR later on. The key here is - these are people with arthritis, who are probably suffering from chronic knee pain. But who knows why the cohort who choose the surgery rather than avoiding it, choose it.  Maybe their pain level was in general higher than the non-surgery group? Pain is one of the main factors that lead people to choose to go the surgery route.  So maybe even after the surgery, their perception of their pain is higher, and that is what leads downstream to more of them again seeking relief via surgical intervention, relative to the group that never sought surgery before.

OA, and RA for that matter, are contributing factors to degenerative changes in the knee, including increases in meniscus damage and meniscus tears.

This has little bearing on people, younger, without arthritis, who have surgery following a muscle imbalance-related, or acute injury-related meniscus tear.  

If your doc gave you this feedback it's possible that he/she knows from your x-rays that you have extensive arthritis and are on the road to TKR already. So in your case, the advice may have statistical significance.  But many people who have meniscus surgery do it because of an injury.  their knee is largely non-functional and they can barely walk.  For huge numbers of these people, a simple trim removes the flap that is catching and locking up the knee and cause excruciating pain - and then that's the end of it. 

Had one done and one not. I am 60+.

With PT had the same outcome for both. Took over a year to get strength back. Have to work out every day to avoid problems. No off the couch anymore.

Hi Adam- I had surgery for a meniscal root repair Oct 2024 at 49 years old. This is the worst type of meniscus injury and has a conservative healing period, 6 weeks non weight bearing, my leg was so thin following. I was told by the surgeon mesiscotomy is no longer standard of care and in my situation (chronically inflamed knee due to root tear) would have likely resulted in TKR within 2-10 years. I was skiing by late January and have continued steady progress upward (no issues sport climbing, bouldering is terrifying!, able to now do 8-10mile mtn hikes/runs, etc...). Greatest challenge has been regaining strength in my quad, 10 months out from surgery I'm ~80% of my good leg. If you go the surgery route, and have significant non weight bearing time, I'd suggest PT as well as a personal trainer (I did this and thought it may be overkill, it wasn't) consistent single leg weightlifting (quad, hammy, glute) as well as BFR on the quad at home. 

Mike

I tore my meniscus last year and an MRI confirmed the diagnosis (multiple tears).  I opted not to go for surgery (typically a meniscectomy) after a lot of research.  Some types of severe meniscus tears do require surgery, but my understanding is that the studies are now showing that in most cases the knee heals better using just PT and time (and will not increase the likelihood of arthritis later as does a meniscectomy).  Check out El Paso Manual Physical Therapy on YouTube among other channels