non surgical recovery for "complex medial meniscus bucket handle tear"

[ripnriding]

Just over three weeks post injury. Training loops on offroad motorcycle to ready for an upcoming race and too much throttle on a wide sweeper in between single track sessions. About 60 km/hr and a couple dabs of the right foot before dumping the bike to avoid going into the woods and here we go........MRI done and findings as follows:

- Pivot shift pattern of injury involving the lateral femoral condyle and posterolateral aspect of the tiba. Full thickness tear of ACL
-Complex bucket handle tear of the medial meniscus (gulp)
-low grade tibial collateral ligament injury
-partial thickness tearing of the lateral collateral ligament
-small proximal fibula osteochondroma

Been able to tolerate light spinning on MTB with flats(removed clipless) and still have residual swelling. Waiting for consult to fracture clinic to meet with specialist regarding surgical consult to address the meniscus.

QUESTION....anyone else on here have the Complex bucket hand tear of the medial meniscus resolve WITHOUT surgery? My extension is still limited but is getting a bit better every day. I'm 48 years young

[vickster]

You'll also need to discuss the plan regarding the bony damage to the femur and tibia, as well as as the torn ACL in the first bullet, as neither of these have good healing properties. The ACL may need surgical reconstruction too if you plan on being active (they'd possibly address the meniscus at the same time). At 48, it's likely they'd need to remove rather than repair the meniscus as the tissue degenerates from the 30s onwards

In the content part of the site, you can find primers on the meniscus, ligaments and joint cartilage.

/KNEEnotes/knee-dictionary/meniscus
/KNEEnotes/knee-dictionary/cruciate-ligament
/KNEEnotes/knee-dictionary/articular-cartilage

Find a specialist knee surgeon with lots of experience fixing ACLs (most should do a fair few as long as they aren't just replacement specialists). There are meniscus specialists too, but not many (assume you're in the UK?) and most of the replacement options aren't going to be available unfortunately given your age due to lower success rates.

You'll also need to find a top notch physio if you can (probably privately)

Good luck

[ripnriding]

Am now at 29 days post injury and still need to wait until Sept 21st for my ortho consult. Here's the question...I am still blocked from full extension...leaning heavily on the fact that findings pointed towards the complex bucket handle tear in medial meniscus. Here's the question....

I have been an avid cyclist (more MTB than road) and over the past 6 years have shifted the passion towards offroad motorcycle enduro/xc racing and riding....I've been spinning at low resistance and for up to an hour 3-5 days a week now and wondering if I should be good to start with some light intervals....

Yes, my gut says wait until you meet with surgeon around the scope approach....I think I just answered my question LOL but...wondering if anyone has "scarred down" a bucket handle tear with consistent easy spinning over a decent course of time?

[vickster]

I believe it's also possible for the ACL stump to block the joint, the tissue left after the rupture. Has that been ruled out as a cause?

What do you mean by scarred down the meniscus? Mashed it up even more? You don't want to be damaging it further as you want as little removed as possible if menisectomy is needed to free up the joint (as menisectomy will in many cases lead To arthritis sooner or later).

Wait until you see the surgeon before embarking on exercise, unless it's been directed by a physio already?

[ripnriding]

I believe it's also possible for the ACL stump to block the joint, the tissue left after the rupture. Has that been ruled out as a cause?

What do you mean by scarred down the meniscus? Mashed it up even more? You don't want to be damaging it further as you want as little removed as possible if menisectomy is needed to free up the joint (as menisectomy will in many cases lead To arthritis sooner or later).

Wait until you see the surgeon before embarking on exercise, unless it's been directed by a physio already?

Agreed.......Just needed to hear it from another source. Making a visit to my AT this morning for further "WHOAH NELLIE" much needed advice

[ripnriding]

Just giving updates for anyone in a similar situation....

just got back from an appointment with my Athletic Therapist. Great advice and great soft tissue work to help release some triggers in glutes, ITB, hamstrings and gastrocs....yikes...was pretty deep but effective. Left there with the most extension I've had to date which confirms I need to work on the soft tissue work.

Some seasoned AT's at the clinic who also gave me good local advice on the preferred surgeon in town...consult with one of the ortho guys is Sept 21st but the recommendation is to have the surgery with "THE" guy who has the best outcomes/reputation so....will navigate tactfully through this one.

Insurance benefits were tapped out after last session but the gains from today will keep me saving my pennies to get a weekly session up to the surgical consult!!!!! Important to find a great therapist to help guide and answer the questions. Helps to have a background and experience as a Kinesiologist here as well Always a little different when the patient..

[ripnriding]

Further updates pending surgical consult Sept 21st:

Have tolerated light asphalt spinning with some rail trail gravel the past couple of weeks without set backs. Spinning smartly by keeping the cadence up there with modulations of resistence.

Just finished first MTB of a 10 k local loop and interesting....felt pretty damn good...This is NOT all doom and gloom right now....

Still lack end range extension which I'm attributing the "complex bucket handle tear" and avoid the plant and turn to left on the right foot as this will now CLUNK instead of JAB. Very curious to see how it goes the next three weeks leading up to consult.

[ripnriding]

Ortho consult just happened. He wants to scope and remove the physical body limiting end range and then see how I manage without ACL...could have been scheduled for surgery this friday but have a family trip planned......he said do the family trip and we schedule when I get back....going to see how I am with another week or two to see if end range continues to improve...my opinion is if I can avoid getting cut....do THAT!