I have had pain in my right knee for a while. At the beginning, it hurts when I walk too much, and it will be better after rest; later, it develops to the pain when I walk a few steps, and it takes a night to recover. The pain was not severe, but it was uncomfortable all the time. So I stopped running, stopped playing ball, and took the elevator up and down the stairs, but nothing worked.
The pain came back after the summer and I knew I had to go to the hospital. The uneasiness in my heart was confirmed, and the MRI showed a discoid meniscus with a tear, requiring surgery .
Preoperative magnetic resonance examination丨Photo courtesy of the author
As a senior sports girl, I have a natural fear of having joint surgery. Thinking of saying goodbye to the sports field, I couldn’t help crying. After crying, I told my boyfriend very seriously that if I need a wheelchair when I get old, I must buy the most expensive and stylish electric wheelchair. I also have a dream of driving a wheelchair by myself.
After a long time of mental construction, on August 9 this year, I finally lay down on the operating table.
“Your situation is rare, you can use it as a teaching case.”
At first, the atmosphere in the operating room was very relaxed, and the doctors and nurses were chatting about what to have for dinner. When the scene inside the joint appeared on the screen, gradually no one spoke. I was beating drums in my heart, only to hear the doctor say: “Oh, the tear is so long… I can’t find the place where the tear is…”
The doctor stared at the display screen for a long time, and another probe pierced in from another angle: ” Oh, I found it. Look, her disc-shaped meniscus is squeezed here. ” The doctor asked one of his assistants He took a picture of the display screen, and then he said to me: “Your situation is rare, and it can be used as a teaching case.”
Hearing this, I couldn’t help feeling proud: “Sure enough, a powerful person can be a case for any illness, the proud son of heaven!”
“What’s the condition of your discoid meniscus? Look, this side is torn, and then the part that fell off slipped out of the bone seam and squeezed to this side. ” The doctor used the metal head in the camera Pulling the torn edge to show me, I looked at the furry edge on the screen and thought to myself: “Good guy, this joint looks like an underwater world, isn’t this just a seaweed bush!”
The doctor saw that I was young and didn’t want to cut it off directly. His solution sounded very simple: the meniscus that had run away from home was pulled back from the bone seam, sutured, and then trimmed into the shape of a normal meniscus . It’s a blessing to have salvaged this scruffy meniscus.
But fortunately, fortunately, this surgical plan is really easier said than done. I didn’t feel any pain after the anesthetic was administered, but I could clearly feel the doctor pushing the device in with all his strength, and I could feel something drilling and drilling in the crack of the bone, and I even heard the sound of “click, click” from the bones. . A long time has passed, and the doctors around my legs are still busy.
A long time is not a problem, the terrible thing is that I gradually feel my toes! Oh my God! If the operation is not finished, the anesthesia has worn off… Fortunately, a doctor pressed a mask on my mouth and nose: “Go to sleep for a while.” It seems that they are giving me medicine! I was nervous before the operation and the bed next to me was snoring all day long. I didn’t sleep well all night, and soon I fell into a deep sleep and had colorful dreams.
I was jolted awake by someone, and in a daze, I heard the chief surgeon jokingly say: “I’ve worked so hard for you here, but you slept soundly, wake up, wake up!” I was pushed out of the operation When I was in the office, it was getting dark, and my boyfriend said nervously, the operation usually only takes about half an hour, and I did it for two and a half hours .
The night after the operation丨Photo courtesy of the author
The most refreshing thing in the world is peeing, the most painful thing in the world is bending your legs
After returning to the ward, my mind was still groggy, but I hadn’t eaten for a long time, and I was so hungry that I couldn’t sleep.
That night, my knee was tightly wrapped, it didn’t hurt but it was a little swollen, which was bearable. What was unbearable was my bladder, which filled up little by little, and my inner struggle intensified, how to go to the toilet! In the middle of the night, the nurse came to see me and asked if I had urinated. I touched my swollen belly and said “no” in embarrassment. It was this greeting that strengthened my determination to pee. How can a living person suffocate to death with urine, it’s time!
After ringing the bell, the nurse aunt appeared on the stage holding the urinal. She deftly took off my panties, lifted my ass, and tucked the urinal under my ass.
“Okay, kid, go pee.” I… the concubine can’t do it!
It may be that the anesthesia has not completely worn off after the operation, and the muscles are out of control, or it may be the first time to lie on the bed and pee, or it may be that someone is watching and cheering me on. pee out.
After deliberating for a long time to no avail, I looked at my aunt awkwardly: “Why don’t you go out first, and I’ll let you know when I’m done.” “Okay, Auntie is waiting outside the door, take your time, and tell me when you’re done peeing.”
On a night alone, no one disturbed, the snoring sound from the bed next door came regularly. At this moment, when I feel my lower body quietly, I feel the indescribable Zen. I closed my eyes and gently pressed my lower abdomen with my hands, imagining that I was sitting on the toilet at this time.
A hot stream rolled down, and I felt the warmth of my ass being wet. My bladder loosened a little bit, and I was enveloped in unprecedented joy, and I let out a long and hopeless breath.
The next morning, the doctor came to see me in the ward. When he came in nibbling an apple, I was patiently counting the drops of medicine in the hanging bottle. I just wanted to open my mouth to ask someone to shake the bed, but the doctor stopped me: “Get up yourself!” It turned out that I could sit up by myself on the second day after the operation! I tried to move, but I actually sat up. The doctor took his mobile phone, flipped through the photos of my operation, and turned it sideways to show me.
“Hey, your operation is not easy! Let me tell you again, look here…” The doctor said happily, his words were full of complacency and joy, “I’ve been looking for a long time, but why can’t I find it? I said I shouldn’t, but I didn’t give up. I still want to try to protect you. You are too young. You have had three stitches on your meniscus. You should rest well and move around a little. ”
Next, my right leg, which I hadn’t dared to move all night, was lifted up. The doctor shook happily, held my calf and bent it a few times, and said with ease: ” This way, this way, hey, It’s all right! ” He didn’t seem to notice my series of “pain pain pain pain pain pain” and gasping face.
The doctor is used to this kind of scene, and the cloud is calm, but for every patient, it is a frightening experience.
Mechanical soaring, completely flat
After staying in the hospital for two or three days and being honored with the thick gauze wrapped around my legs, I finally returned home after a week away and touched my cat again. According to the doctor’s instructions, I need to wear a brace and rest in bed for a month, keeping the affected limb straight and unable to touch the ground.
I didn’t notice until three days later when I changed the dressing that there were five small wounds on my knee, each of which was seriously sutured. Other arthroscopes usually have two or three mouths, but mine piled up together, which is really exciting.
Alcohol wiped the wound, and there was a little sting. At first, my boyfriend leaned against my leg and didn’t dare to do it. In the end, he could only wipe it slowly. The knee was swollen high, fatter than the left leg. But fortunately, there is no pain in the joints, which makes people feel relieved.
Nine days after surgery丨Photo courtesy of the author
Two weeks after surgery丨Photo courtesy of the author
The stitches were removed three weeks after the operation丨Photo courtesy of the author
A month later, the wound where the stitches had been removed had basically healed, and I came to the hospital for a follow-up examination on crutches. The familiar doctor was still smiling. After learning that I had been lying down for a month, he praised me: ” We like obedient patients like you the most. “
The brace was removed, and I can try to walk again. It feels like life is returning to normal little by little. I remember that it was extremely hot at the time of the operation, and there was a cool breeze blowing in the blink of an eye, which is really amazing.
In this month, I also checked a lot of information, but I am still confused. My meniscus is obviously torn, but recalling the past life experience, my knee has never been very painful or swollen. Can the crack open little by little without knowing it?
Forget it, don’t want to. I still look at my feet and think about how to get out of this step!
Six weeks after surgery, I began to exercise slowly丨Photo courtesy of the author
doctor review
Wan Fang | Attending Physician of Sports Medicine and Arthroscopic Surgery, Huashan Hospital Affiliated to Fudan University
What is a discoid meniscus?
Why is the meniscus called the meniscus? As the name suggests, since its normal shape is a half-moon, crescent to be precise. However, some people have congenital mutations in their menisci, and they are born with a full moon shape called a discoid meniscus.
A discoid meniscus is thicker than a normal meniscus and is oval or disc-shaped. Depending on the shape, discoid menisci are divided into fully discoid (large disc) and incomplete disc (small disc). Discoid menisci are common on the outer meniscus of the knee and are rare on the inner side, sometimes in both knees. The Asian population has a higher incidence of discoid menisci.
Whether it is a discoid meniscus or not, it is very clear to check the magnetic resonance . The magnetic resonance can clearly see whether the meniscus is discoid, whether there is tear, etc.
Magnetic resonance imaging: discoid meniscus丨Photo courtesy of doctor
Why are discoid menisci more prone to injury?
A small percentage of people with a discoid meniscus may live their lives without any problems, pain or discomfort, or treatment. But most people with discoid meniscus will tear the meniscus at various stages of life, and it is more common in adolescence. Therefore, for teenagers with sudden knee joint locking, pain, and flexion and extension disorders, it is first necessary to rule out a discoid meniscus tear.
Three situations: 1. Completely discoid; 2. Incompletely discoid; 3. Combined plate femoral ligament laxity丨www.orthobullets.com
The bigger the meniscus is, the better it is. Because the disc-shaped meniscus is thick and large, it is easier to get stuck in the knee joint after tearing, which will cause difficulty in flexion and extension of the knee, snapping, locking and pain. Due to the lack of blood supply to the meniscus, it is very difficult to heal itself once it is torn. Imagine that your knees can’t be straightened or bent all the time, and there is always something rubbing inside, and your life will definitely be greatly affected.
Discoid meniscus tear: a: arthroscopic appearance; b: top view image丨Reference 1
There is also a special situation called laxity of the plate femoral ligament. The discoid meniscus is congenitally lacking a fixed structure and is so mobile that it is easily twisted and torn. This is most likely the case for the author, so it took several stitches to stabilize.
It is worth noting that in patients with a discoid meniscus , symptoms can occur even in the absence of trauma, because the intensity of everyday life is sufficient to cause a discoid meniscus tear.
How is a discoid meniscus tear treated?
For the treatment of discoid meniscus: asymptomatic, no treatment, follow-up observation, avoid sprain; once symptoms occur, arthroscopic surgery can only be performed in time .
During the operation, the meniscus will be trimmed to a normal crescent shape as much as possible, and the excess meniscus tissue will be removed together. For the tear, the meniscus should be sutured actively to fix the unstable meniscus and avoid various problems caused by the loss of the meniscus in the future caused by excessive resection.
Discoid meniscus surgery: A: Trimming the meniscus tissue to a normal half-moon shape; B: Suturing the tear part丨Reference 2
The postoperative rehabilitation plan depends on the intraoperative operation.
Only forming without stitching : Generally, you can go to the ground with crutches on the second day after surgery, change from double crutches to single crutches in one week, and complete the removal of crutches in two weeks. Brisk walking, running, and cycling can all be started gradually. Competitive sports can be completed after rehabilitation Participate later.
If sutures are done : Generally, you can go to the ground with crutches on the second day after the operation, the double crutches will change to single crutches in three weeks, and the crutches will be removed in four weeks. Fast walking, running, and cycling will gradually start after 2 months. Competitive sports need to be recovered after recovery. Participate after completion, usually 3-6 months later.
If there is no operation after the injury, the tear will gradually increase, the meniscus and cartilage will wear out, and finally the meniscus can only be completely or subtotally cut. Without one meniscus, the service life of the compartment on one side of the knee joint will be greatly shortened, so timely treatment is required.
references
1. Shimozaki K, Nakase J, Takata Y, Asai K, Toyooka K, Kitaoka K, Tsuchiya H. The characteristic findings of an inverted-type discoid lateral meniscus tear: a hidden tear pattern. BMC Musculoskelet Disord. 2019 May 17;20 (1):223. doi: 10.1186/s12891-019-2618-9. PMID: 31096968; PMCID: PMC6524316.
2. Ahn J, Lee SH. Editorial Commentary: Saucerization Is Superior to Total Meniscectomy in Patients With Symptomatic Discoid Lateral Meniscus. Arthroscopy. 2021 Feb;37(2):655-656. doi: 10.1016/j.arthro.2020.11.022 . PMID: 33546802.
The sharing of personal experience does not constitute a diagnosis and treatment recommendation, and cannot replace the doctor’s individualized judgment on a specific patient. If you need to see a doctor, please go to a regular hospital.
Author: a qualified cat
Editors: Yuan Ye, Li Xiaoqiu
Cover image: retrieveadvice.com
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