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Latest Update on My Knee Recovery

Posted Aug 31 2010 1:29pm

Right Knee Meniscal Tear
Day #91 post-prolotherapy
Friday, August 27, 2010

I had hoped that my visit with Dr. Fullerton today would be my last.

Not so.

Turns out that although a good portion of the meniscus tear has healed, there's a part on the back side, where it connects to the femur, that's a little loose. Under ultrasound, you can see it shift when he tugs and twists my knee.

This may explain why it's sometimes painful to bend my knee past a certain point or to perform a deep squat. The meniscus is being tugged from the angle of pressure.

"So, what's next?" I ask.

"Well, we could get an MRI. Get a clearer picture of what's going on," said Dr. Fullerton.

MRIs. Really? Seriously? I really don't like MRIs.

"And so would a clearer picture change the course of action? Seems like I'm really not a candidate for surgery."

"Good point. No, it wouldn't change the options. We could do another round of prolo or use PRP and since we haven't hit that area of your tissue with prolo, that might be the thing to do first."

"I'm good with prolo. I would rather try that, see what happens and since I've had a good result thus far, I suspect I will in that area of the knee too. And if it doesn't work, I could then go to PRP," I said.

"Sounds good to me," said Dr. Fullerton as he shook my hand and then left the room.

There are few things I can't do right now. Run is one of them but that's mostly because I haven't tried it. At least full body weight. I've done some intervals in my Kangoos. No problems.

Well, I did try one round of running this past weekend while visiting my mother in Daytona Beach. The call of the beach was just too much. Early morning. Sunny. Warm but not too warm. A nice breeze. Desolate. Perfect. I jogged 30 second intervals for 20 minutes and felt great. Knee held up well.

Now, if you had a chat with my right Achilles tendon, it might say, "Whatchu' talkin' bout?" Yeah, the Achilles was sore and I stopped. It's almost recovered now so no serious issue that I can tell but the run was worth the fall out. I can still do all of my training drills and my daily activity is unimpaired. But for now, running will wait.

Some people wondered why I wouldn't just get the surgery - a partial menisectomy. It's quick. Relatively few post-op complications. And you go on with your life.

There are three.

First, I think we, as a society, take surgical procedures for granted. Like driving to the grocery store to buy a gallon a milk. No big deal. But every time you're in surgery, there's always significant risk. Risk of infection, stroke, and bunch of other stuff that's on all that paper work you sign off on before you have surgery.We think it can never happen to us but it does happen. So, if you have less invasive options and can pursue those, do. Sometimes you can't. Tear is to large, unstable. Or, your lifestyle and other demands just won't allow for the timeline.

Second, whenever you can preserve your meniscus, whether by repair or otherwise (prolo or PRP) you should do it. In a recent study of patients who had partial menisectomy, 60% had detectable changes of osteoarthritis of the knee compared to 20% of the repair procedure. 1 I had a partial menisectomy in my left knee in '94 and I have to work a lot harder at keeping that leg fit than my right leg - until recently that is.

Turns out, your mensicus is a very important component of optimal knee function. Keep it if you can.

And, third, I like to try new and different things. I wanted to know what the prolotherapy experience was like, how it worked, did it work, how would I respond. Thus far, I'm happy with my progress. It's not an easy or quick road, (and did I mention that it hurts?) but I think when it's done, I'll have a much more solid knee.

So, my next prolo appointment is in the third week of September.  Until then, I train.

Stay tuned.

1. Stein, T., A. P. Mehling, et al. "Long-term outcome after arthroscopic meniscal repair versus arthroscopic partial meniscectomy for traumatic meniscal tears." Am J Sports Med 38(8): 1542-8.

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