Meniscus Injury

[Tumbleweed]

My son had a complete tear of his meniscus, which during surgey ( this last April) all they did was trim it as once they discovered it was torn in half (they can not stitch a complete tear, as there is no/limited blood flow to this part of the meniscus). Since then he has been jumping with minimal pain, with slight swelling. His Doctor now is sending us to another specialist to discuss "Meniscus Allograft Replacement Surgery", which is when they replace the damaged meniscus with a cadavor meniscus. This is apx. a 4-6 month recovery period.

My question is, has anyone had this surgery or have any opinion regarding it?

Thanks for your help in advance, FYI: He will be going into his Senior year and would have to miss fall/winter in-door season if he has the surgery, so we are weighing the options and trying to become as informed as possible.

[vaultmd]

Make sure the donor was really fast

[Tumbleweed]

If we get to choose, it would be someone who can jump real high, say 5.5m or so

[VaultPurple]

na the Meniscus is more for cushioning, id go with some lazy guy that sat around all day doing nothing. Dont want it warn out.

[tsorenson]

I am not familiar with the new procedure, but here is my experience with knee injuries and pole vaulting:

I had an ACL reconstruction, including removal of ~50% of my meniscus in the 10th grade. The injury was incurred playing basketball and football, and it cost me my entire track season in 10th grade, and I had to give up playing competitive basketball & football. I rehabed extremely hard and was able to come back ok for my junior and senior year vaulting, and college. It was about a year after surgery before I started vaulting again...the knee regained strength but I felt that I never got back to 100% of the "springs" I had before (I never was able to dunk a basketball again). I had to quit doing certain types of exercises (deep squats, some types of plyometrics, etc.) Pole vaulting has been ok on the knee, but I still have pain and occasional swelling, mostly in the patellar tendon, which they cut to create a new "ligament." Ice after activity is the best way to reduce pain, in my experience. Advil works, but will make you beat up the injury more than you should, perhaps, and can have long-term health consequences with frequent use.

My recommendation is to avoid surgery unless absolutely necessary, unless it is a minimally invasive procedure like arthroscopy. My knee has never been the same since my surgery, and I often wonder if it would have been better to just rehab and not go under the knife, especially since I lost a year of vaulting! The body has an amazing ability to heal itself, and unless your son's injury prevents him from vaulting, he may be better off to strengthen the supporting muscles (hamstrings and hip flexors) to alleviate pressure on the knee. Since it is his senior year, he may not be able to recover in time to meet his potential in the vault, so a good rehab program may be an alternative. If the knee becomes too painful to use, or if there is damage to ligaments, then surgery may be necessary.

The best bet may be to discuss this with a Physical Therapist or Athletic Trainer as a qualified second-opinion to your doctor, who is, I assume, an orthopedic surgeon. With all due respect to surgeons, in my experience, surgeons will usually advise surgery...

[Tumbleweed]

Thanks for the advise and insight, the surgery is arthoscopic. I found this on you tube today showing the surgery. http://www.youtube.com/watch?v=bPljTDws ... re=related

I think what they are trying to prevent is a liftime of arthritis. He has a good portion of his meniscus still in place, it just has a tear that wont heal. The surgery he had was basicaly a trim job, so it wouldnt catch. He had a bone scan this week that revealed either a bone healing or a bone that is showing trauma from the lack of cushion from the injured meniscus. The odd thing is it shows up both ways in the scan and x-rays, so they can't be 100% exact.

Here is some more insite that I found that gave us some valuable information: http://www.orthop.washington.edu/uw/tab ... fault.aspx

I just thought that with all the vaulters and Doctors who use this forum , there would be someone who known a vaulter or had the surgery themselves. So thanks again for your insite and I look forward in hearing other stories from vaulters.

[superpipe]

On a more positive note, I also had ACL reconstruction on my jumping knee 5 years ago ( Snowboard landing that I stuck actually ). ACL was blown to shreads, but I only had about 15% of my meniscus cut out. It took a solid year and alot of quad stretching to get full range of motion back in the knee. I should have done alot more quad stretching and quad flexing during rehab. It would have only been a maximum of 9 months if I did it 100%. Onto the positive. My knee is 98% perfect. The other 2% is that lingering scar tissue where I feel slight pain/tightness when I do deep squats where my hells touch my butt. I did have patella tendonitis in my jumping knee when I came back to vaulting a year later, but it was gone for good after that season. The key, lots of quad stretching! That stretches the patella tendon as well. My experience with the ACL reconstruction is that you must do lots of maximal quad stretching ( full range of movement with the knee ) to break down the scar tissue, which is the main cause of problems after the surgery. It takes years for the scar tissue to break down and really disappear, but the more full range of motion you put the knee through, the faster the scar tissue breaks down. Point is, my ACL reconstruction went well for all intense purposes. Difference? You obviously had a worse meniscus issue along with yours. Mine was small enough to not cause any real issues. As you pointed out, cartilage does not grow back because there is no blood flow into most cartilage.

I would question the meniscus "transplant" especially since vaulting is ridiculously intense on the jumping leg. It would probably be better for people that don't do much physical activity. I did a bunch of research myself on cartilage repair when I blew my ACL. They still have not figured out a way to "transplant" real or fake cartilage such that it will hold and be durable. That essentially is the cure for arthritis.

As was said before, I would only get a surgery like you're talking about if you can't physically do things you want to and this may be the only option.

Oh yeah, my jumping leg is now stronger now than it ever was. If you stay focused on proper rehab ( patience and commitment ), most surgeries will come out fine. It's my opinion that 99% of athletes rehab about 50% of what they were supposed to do ( doing the workouts multiple times a day and for 6 - 9 months continuously ). I wasn't that bad myself, but I wasn't great either. That's why mine took longer to heal.

I'm no doctor, but that was my first hand experience.

[Tumbleweed]

Superpipe, thanks for your insight. It is great to hear 1st hand stories on the good/bad sides of having surgery. It makes for a more informitive decision.

[txpolevaulter_k25]

Ow, I had the same surgery last year. My meniscus was torn in 3 direction somewhat like the mercedes symbol. The removed all of the cartilage, and cleaned the bone fragments out from working out on it for a year previous to the surgery. I had surgery a week before christmas and sat out until mid january and began PT. I did that until almost the end of February, my knee still hurt, but not near as bad as before the surgery. I did light weight leg workouts, and as much knee strengthening exercises as possible, and in april it felt like I had a brand new knee. No pain other than the occasional flaring up. The most important thing to do is keep positive. There were many times I didn't want to do PT or the boring sometime painful exercises but it was all worth it in the end. I wish the best of luck and if there is anything else let me know. BTW I am a college decathlete so my knees take a beating.

[VaultMarq26]

If he gets it done he will have to be religious with doing his Physical Therapy exercises. I'm a physical therapist, and patients that i have seen with a meniscal repair take a while to heal, but do well if they push hard with their exercises.....those that don't sometimes won't regain 100% normal range of motion and function.

[Tumbleweed]

Its getting to the point that puttting it off maybe the best thing since he feels no pain, limited swelling and does not restrict his activities. I mean wouldnt it be better to put it off until it is required, rather than preventative? Its hard to sell a complete loss of the in-door season and possibly even part of the spring season. This is his last year in High School and he wants to show college coaches what he can do rather than sit the season out and start over in 7-10 months! I want him to do whats best, but it is hard to predict the future and have 20-20 hind site!

[Tumbleweed]

Surgery option has been postponed. New surgeon wants to try a brace to put surgery off. He feels that since there is no pain, that a brace can adjust his postion of his knee to releave the outer side where there is no miniscus. So it's goingto be intersting to see how he handles jumping with a brace. Are there any vaulters who have expirienced jumping with a brace? insite? Advise?
Thanks and here is to a great in-door season!