From eight-minute miles to eight-minute city blocks :-/
March 19, 2017 7:16 AM   Subscribe

Seeking experiences with osteochondral defect (hole in cartilage, basically) surgery for the knee. Was the recovery rough? Did you make a full one? NYC on crutches? Dealing mentally with activity limitations? Other tips for this or knee surgery generally?

History: About a year ago during a minor meniscectomy my surgeon found a "pothole" in my knee. I was told that this might or might not cause me problems, and that to avoid surgery in the long-term I should consider giving up running. When I tried to run again a couple months later, I started having bad hip pain on that side. I declined surgery at the time because it sounded so arduous (open knee surgery, weeks on crutches, lots of PT), and it wasn't a good time. Gradually I began to have pain during other types of exercise, and the pain spread to my lower back on that side. Now I'm increasingly having pain in my day-to-day activities. I really don't exercise at all anymore other than walking. I sometimes have pain in the knee, but the hip and back actually hurt more.

I haven't gotten a new evaluation or MRI yet, and I'm planning to seek out a couple more opinions, but it looks like it's time to do this.

About me: Mid-thirties female, average weight, general good health.

- Did you make a full recovery? What I really want to know is whether I'll run again, but I know that's a matter for me and my doctor. I feel like my knee never really recovered from that minor meniscectomy (it's often stiff, despite going to all the PT they told me to - which I didn't really feel did much), so I'm wary of this big operation that's going to solve all my problems.
- How hard is recovery? I was told six weeks on crutches. Again, I know the specifics are for me and my doc, but my experience with surgery has been that recovery is more difficult than the surgeon says.
- Did PT actually help with recovery? My experience with it has always been that it doesn't do much. (The PT always seems like they're calling it in, frankly.)
- How the hell do I get around NYC on crutches? I've been considering leaving the city to stay with relatives. On the one hand, anything and everything can be delivered and cabs everywhere, but on the other, I feel like I won't be able to go anywhere or do anything since it's such a walking-centric city.
- How do I cope mentally? I'm a really active person. I know a few months is not the end of the world, but it's a huge part of my life. I want to avoid the post-surgery frustration and depression I've had with other big medical issues.
- I wouldn't mind a couple more second opinions if anyone has doctor recommendations.

posted by unannihilated to Health & Fitness (3 answers total) 2 users marked this as a favorite
I didn't have this surgery but I had a pretty major reconstruction of my knee as a teen. I was on crutches about 5 weeks but I think I pushed it and it shouldve been six.
Absolutely do your full course of physical therapy! Beyond that I had success doing gentle yoga to realign and strengthen the muscles. I actually credit yoga to my recovery. I still run today but I have to be very mindful about proper form and I cannot go too hard. Biking is better as long as my bike is set up properly.
I won't lie. Recovery was excruciatingly boring for me! I just tried to sleep as much as possible most days. And smoked a lot of pot. Haha. It would've helped to have a creative project on the go that lent a sense of momentum and purpose. I bet there are seated yoga videos you could do to help the body recovery before you can stand again!
You'll want a sort of hip bag or something you can wear to help carry I.e. A snack from the kitchen while you hobble on the crutches.
Good luck. It's not fun....but you'll get through.
posted by elke_wood at 8:18 AM on March 19

I have a bunch of potholes and rough cartiledge under my knee cap from a car accident and that does not sound anything like the pain from them. Mine are generally non painful but if I do something that causes pressure on that spot it's a very "stabbed in the back of the kneecap angrily" feeling, followed by a predictable bout of stabby pain walking up stairs for a day, swelling up and then settling down over a couple days. It only hurts where the defect is. Mostly though it doesn't bother me and it looks terrible, I've seen the photos.

You sound like you have what I had post menisectomy which was major IT band issues. I dunno if its the change in angle or scar tissue from surgery or the weird angle they crank your knee and hip to what but it's super common post menisectomy to have IT band issues and/ or femoral nerve issues. An osteopath fixed mine by manually "un zipping" the offending IT band which was super painful but worked like a charm after a couple years of failed PT. I have had zero issues with it since. A rolfer would do similar work.

Anyways, my experience and that of a lot of other people I know is that you can ameliorate a lot of cartiledge defects by yes not running as much, fixing the IT band so your kneecap isn't locked down and building space in the joint by having good muscle strength (try biking, swimming isn't good etc) and nutrition then ease back into running. That's my good knee now!

If it ever does get significantly terrible I'm going to try stem cells first off. Friend just had it done and she's over 70 and she's zipping around on that knee now. Kind of amazing.
posted by fshgrl at 11:31 AM on March 19

I had both knees completely replaced a year after "cleaning out the junk" in one (leaving me basically bone-on-bone). And I'm a guy and 52. So my experience is not directly applicable, but here goes.

If your PT is "phoning it in" get another PT. Raise hell about it. This is your life, and you are paying a ton for PT so it ought to be helping.

Being in pain before the surgery means you're going to be less fit afterwards. You've also almost certainly got some range-of-motion and strength issues, and it's going to take a while with a good PT to get those resolved and get you back into shape.

Push yourself during recovery. You need to get moving and get your ROM back and get walking. Transition from crutches to a cane as soon as you can. Also ask for a second opinion. If there are alternatives (there are two different kinds of knee replacement, for example), look into them. Your stiff knee after the previous surgery happens, but PT is how you fix that, and that means some pain while doing the PT and being religious about ibuprofen and ice to bring down the swelling after the exercises. Make sure to tell your PT that the goal is to get running again, and make sure that's in your case notes.

But PT sessions aren't everything. You will need to do exercises outside of PT. The more you do, the better your recovery. I had PT twice a week, but had to exercise two or three times daily, adding up to a couple hours every day (about a half hour of exercise followed by a half-hour with ice on my knees post-exercise, morning and evening, every day for months). Recovery will be a part-time job for you.

For me, the biggest thing was the exercise bike. It was winter in MN and I spent a lot of sessions on the bike, which gets the knees moving. Any other exercises I do are prefaced by a session on the bike to loosen up first. But I generally pushed myself. I was doing stairs five days after surgery (the doctor and PT figured weeks) and didn't look back. Full recovery will take a while. Six months to a year for me, but I'll be back doing everything I did before surgery about five months after. And I'm hoping that by the six-month mark, I'll be doing it with less pain.

Good luck!
posted by DaveP at 4:35 AM on March 20

« Older How do I say "stay away" in dog-speak?   |   Can you recommend games for my three kids? Newer »

You are not logged in, either login or create an account to post comments