12 Years Post-Meniscus Repair: Should I Strengthen My Leg or Get an MRI First?

Twelve years after meniscus repair surgery?

Hello Doctor: I had a meniscus repair surgery 12 years ago due to a car accident.
Since then, I have experienced several instances where my knee suddenly gave out, causing me to kneel down.
I immediately arranged follow-up visits in Taiwan, and there were also times when it felt like my bones were slipping out of place but then returned to normal.
Living in an outer island with limited medical resources, I could only seek treatment on the main island of Taiwan.
Now, 12 years have passed, and in the past few months, I have noticed that climbing stairs has become somewhat difficult, and my knee feels slightly swollen.
After visiting a local hospital, the doctor mentioned that I need to strengthen my leg muscles and noted that my bones are showing signs of mild osteoporosis.
I would like to ask whether you recommend that I focus on strengthening my leg muscles first before getting an MRI, or should I get the MRI first to see if surgery is necessary, and then work on strengthening my legs?

Zhou Zhou, 30~39 year old female. Ask Date: 2024/03/12

Dr. Chen Yongxue reply Orthopedics

It is recommended that you discuss with your current physician whether additional treatment interventions or rehabilitation maintenance are necessary.
Thank you.

Reply Date: 2024/03/12

More Info

After 12 years post-meniscus repair surgery, it is understandable that you are experiencing new symptoms such as difficulty walking up stairs and swelling in your knee. Given your history of knee instability and the recent assessment indicating some degree of osteoporosis, it is crucial to approach your situation with a comprehensive plan that considers both strengthening your leg and obtaining further imaging like an MRI.

Firstly, it is essential to understand that the knee joint is complex, and symptoms like swelling and instability can arise from various issues, including but not limited to the meniscus, ligaments, and surrounding musculature. The fact that you have experienced episodes of your knee giving way and a sensation of "bones slipping" suggests that there may be underlying instability or damage that needs to be evaluated.

Your local physician's recommendation to strengthen your leg is a common approach in managing knee issues, especially when there is a concern about muscle weakness contributing to instability. Strengthening the quadriceps and hamstrings can provide better support to the knee joint, potentially alleviating some of the symptoms you are experiencing. However, it is crucial to ensure that any strengthening exercises are appropriate for your current condition and do not exacerbate any underlying issues.

On the other hand, obtaining an MRI can provide valuable insights into the current state of your knee. An MRI can help identify any new tears in the meniscus, ligament injuries, or other structural changes that may have occurred since your last surgery. Given your symptoms of swelling and difficulty with certain movements, an MRI could help clarify whether there are any new injuries or degenerative changes that need to be addressed.

In terms of timing, it may be beneficial to discuss with your physician the possibility of getting an MRI before starting an intensive strengthening program. This way, you can have a clearer understanding of what is happening within your knee joint. If the MRI reveals significant issues that may require surgical intervention, it would be prudent to address those before committing to a strengthening regimen that could potentially aggravate the condition.

In summary, while strengthening your leg is important for overall knee health and stability, it is equally important to ensure that you are not exacerbating any underlying issues. Therefore, I would recommend discussing the option of getting an MRI with your physician as a priority. This imaging will provide a clearer picture of your knee's condition and guide your treatment plan moving forward. Once you have the MRI results, you can then make a more informed decision about whether to proceed with strengthening exercises, further treatment, or possibly surgery.

In conclusion, balancing both strengthening and diagnostic imaging is key to managing your knee health effectively. Open communication with your healthcare provider about your symptoms and concerns will help you navigate the best course of action for your situation.

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