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Meniscus Surgery-Pain and swelling 4 mths post op.

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I had a Meniscus repair done in Jan and Bakers Cyst removed. Dr stated I have minor arthrities in both knees. I continue to have extensive pain in knee and swelling in both feet as well as knee I had surgery on. Knee is 2 inches larger than other! Cortisone shot was amazing for 3 weeks, then I was standing and felt my bad knee sort of twist and pop and the pain started to come back again and has continued to get worse for the past 4 weeks. Dr., assured me all ok and finished round of Synvisc shots which do not appear to be helping at all. Everytime i see Dr. he assures me all is well, but I am in terrrible pain and can hardly walk- legs both feel like they weigh a ton, feet are so swollen I can hardly wear most shoes and I have a narrow foot. I am 49 and in great health otherwise, but i feel crippled and exhasted all the time. I want to see if I have another tear but would have to go thru the entire mri again. Dr. has not even suggested this- just smiles and assures me all is well. I feel like my life is over and i will never be able to do normal things again. Is this normal to have such pain and swelling ? Is there anything that could have caused this during surgery or perhaps some type of infection? Has this happened to anyone else? I just feel my Dr. is so busy he just is trying to appease me and so each time i go, I think well now I will be ok but the synvisc shots were excruciating and have not helped at all. Very discouraged and would welcome advise!
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First Helper meniscus_tear
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replied April 25th, 2011
Especially eHealthy
JMT123,

The swelling in both feet may not be coming from your knee surgery. It could be understandable if it was only in the operated leg. Bilateral swelling of the feet can be a sign of untreated high blood pressure or heart disease. You should have this symptom checked out by your family doctor.

With your knee, did you really have a repair (which is not too common, and usually done in young persons) or a partial meniscal resection (much more common). The meniscus does not have a good blood supply, as only the peripheral rim has any vascular supply. If you did indeed have a repair, it would have been done for a very peripheral tear. The usual post-op rehab would have been range of motion in a hinged knee brace with NO weight bearing for at least 4 to 6 weeks. If you had a resection, weight bearing would have been allowed as soon as possible.

Anyways, with the pop and swelling you had a few weeks ago, if you had a repair, you could have torn the repair apart. If it was a resection, it was probably just some scar tissue. In either case, an MRI at this time would not be able to tell if there was a problem, because of the post-op surgical changes. Even with gadolinium, if is essentially impossible to tell the difference between a healing repair, scar tissue, a new tear, or just surgical changes. The recommended time to wait to do a new MRI is about one year from surgery. Surgeons will sometimes do one earlier, but it may just muddy the picture.

Unfortunately, you do have some arthritic changes in your knees. Sometimes, even with some "house cleaning" by taking care of a torn meniscus, the patient continues to have discomfort and swelling. NSAIDs, or very occasional steriods, can help. Other methods such as ice or heat, elevation at night, mild compression, neoprene knee sleeve, all can be of some help. In the end, you may come to a total knee replacement, but they can also have their own set of problems.

If you believe that your surgeon is not taking care of you properly, seek a second opinion. A new set of eyes, a new exam, may reveal something that can be done. Just go into the situation with realistic expectations. And, have the bilateral feet swelling checked out by your family doctor, it's better to be safe. Good luck.
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replied April 26th, 2011
My apologies it was resection I believe- he cleaned up the area and I was allowed to bear weight. feet swelling- I did go to family doc who just gave me some pills to get rid of fluid but this did not seem to help.Also had an EKG done recently which was fine. Should i seek a heart specialist or are there easier tests my family doc can do to look into hear issues.I cannot thank you enough- just about it tears last night due to the pain and swelling. Iced it and took some anti imflam medication and it is better today. Just long term, I want to be able to live again. It is like one day you are fine and the next you are crippled. I just cant come to terms with it. I would think the swelling would have gone down by now-as it is i am not much better than before surgery! Again, my thanks- you are so kind to take the time to reply!
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replied April 26th, 2011
Especially eHealthy
JTM123,

The usual medicine that patients are started off on, for the distal edema, is a diruetic (waterpill). The most common is HCTZ (hydrochlorothiazide). But, it sometimes has to be increased in dosage or changed to a different one. Yes, I would see your doctor again or someone else, as edema in both lower extremities is not a good sign. Something you can do to help get that fluid back into your core is the use of support stockings. These provide continuous concentric compression, pushing that fluid out of the tissues. Sometimes, people who are on medicine still have to use stockings. You can pick up a pair at any pharmacy.

You are doing everything right for your knee. It does help to do ROM everyday and maintain muscle fitness. Everyone is different. I have seen people with horrible looking x-rays, that have very minimal pain. While others have significant pain, but their x-rays really don't look all that bad. So, determining exactly what the pain generators are in joints (the spine included), is still not all that good. Surgeons can take care of the obvious stuff, but sometimes, it just doesn't help. In those cases, the patient and doctor have to try to figure out what can be done to maximize what the patient does have. Remember, there are people out there with crippling rheumatoid arthritis that work everyday. They have figured out what needs to be done. You will have to do the best with what you have.

However, one thing that people often forget, is that it take a long time for patients to get over orthopedic surgery. It's not like some other surgeries, that when the skin incision heals, everything is good to go. In many cases, it can take as much as 12 to 18 months before the joint reaches it final status. So, you still have a ways to go in terms of the possibility of your joint getting better.

So, I would speak with your physician and explain that the medicine has not taken the edema away. Do you need to change medicine/dose? Long term swelling from edema can also cause problems locally with stasis ulcers and skin changes (becoming "tawny" and leather like).

Hopefully the knee will get better gradually. But, like I said also, if you feel your surgeon is not taking care of you properly, always get a second opinion. A new exam might turn up something that was overlooked by your previous surgeon. Just be wary of any surgeon saying he/she can take care of all of your problems with a simple little surgery (as you have found out, that is usually not the case).

Good luck.
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replied January 3rd, 2012
Meniscus tears
Meniscus tears are very frustrating. The meniscus is a very complex tissue and has poor vascularity for healing. Hundreds of thousands of people injure their meniscus every year and its frustrating that we don't have better medical treatments for this injury. Stem cell treatments look promising but needs more research and does not seem to be ready for the masses for many years:-(
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Users who thank meniscus_tear for this post: n2chat  n2chat 

replied January 4th, 2012
Post-Op Meniscus Surgery Knee Pain
Dear JTM123,

I had the same knee pain and swelling starting about 10 weeks post-op. My doc did the same, put me on Synvisc (which did not help) and assured me all was well. I found a new doc and have had 3 aspirations and two cortisone injections. I am better but now this doc says no more of this treatment for 3 months. I may be looking for a new doc. I understand the dangers of cortisone and such but I like being out of pain. I purchased an expensive brace ($600) from him which I wear sometimes but the one thing that I think has reduced the pain and helped the most is a $100 inversion table I recently purchased. Hanging on it seems to open up my knee joint, perhaps hydrating the meniscus. I think it may also be allowing fluids to migrate south to my upper body. Not sure but I do know it has provided some relief. I got the idea looking at the manipulative exercises on thekneepainguru.com. Hope this helps.

Steve Flacy
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replied April 11th, 2012
Torn meniscus and pain
I also have been going through hell, mine started with my spasticity which gave me hammer toes ended up with a plate and screws in my left foot, never walked pain free since last winter. There for I fell tore the meniscus. At first was told xray was fine. But swelling never away or the pain. Had the surgery, and the pain and swollen knee joint and leg is worse tan before the repair. Over a year in pain there are days I wished God would just take me. No none seems to understand. I fell again on Sunday landed on my knee, not the first time. Now on prednisone not healthy I have osteoporosis, then going to have shots with an ultrasound, and the bone on the bottom of my foot shaved down the bone that runs down on the sole from the great toe which has been cut up so much it's gross twice the size it should be,all toes half cut off, baby toe gone. Still have spasticity in my foot. Since I have the plate can't have Botox in my foot! Sick of the hospital and so far at least 7 surgeries on my foot now my knee sick of the pain, how no one believes you can still be in pain so long!
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replied January 29th, 2014
I am so sorry for what you went through. I see this is an old post, so hope things are better for you now.
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