Knee Possible Meniscus Detachment??

by R T
(CBY, MB, Canada)

I was playing hockey goal and went across in the butterfly. I am a 35 year old female. I heard a popping in my knee and some pain. After this I was unable to straighten my knee fully. When my leg reached about 15 degrees from straight my body would send a pain flash and force my leg back. When relaxing to go to sleep I would get jolts of pain once my knee completely relaxed.

If I kept the inside part of my knee tight things went better based on pain. This continued for weeks. Upon removal of shoes or pants from the leg, if I turned my leg the wrong way it felt like the knee was parting on the inside. I went to the doctor two days after it was injured and was sent to Physio. After three weeks of physio and still unable to straighten my leg I was sent back to the doctor.

I received a referral for an MRI and appointment to an Orthopedic Surgeon. (Note My knee never had exterior swelling and physio used heat to relieve pain and increase range of motion)

About 7 weeks post injury I had my MRI results read. The anterior and posterior cruciate ligaments and the lateral collateral ligament are normal. At the medial collateral ligament there is edema surrounding the proximal aspect of the ligament consistent with a Grade I sprain. The ligament remains continuous. There is a small amount of edema at its femoral insertion. The quadriceps and patellar tendons are intact. I suspect there has been trauma to the superior capsular attachment of the body of the medial meniscus. There is some internal increased signal within the body of the meniscus but this does not show definite extension to the meniscal surface. The lateral meniscus is normal. The articular cartilage is normal in thickness. No joint effusion or loose body is present. No other bone bruising is present. IMPRESSION Grade I mediaal collateral ligament sprain with associated bone bruising at the femoral insertion and probable injury to the superior meniscal capsular attachment.

At about 5 weeks the PT pushed my knee straight. I have full range of motion. When seeing the Orthopedic Surgeon for the first time at about 8 weeks, I was sent for a BREG OA FUSION knee brace to wear and return in 4 weeks. At second visit to the surgeon (~ 13 weeks) I was told I might have a detached meniscus and sent to a second surgeon for his opinion. At ~ 19 weeks I saw the second O. Surgeon who told me he thinks I need to stop wearing the knee brace except when absolutely necessary and felt I just feel the bone bruise.

I still am wearing the knee brace almost every day when I am active, as my life and job are somewhat physically demanding. I have a pinching feeling still at the top inside of my knee at times (same location hurt the most initially). The brace helps to remove the uncomfortable feeling in my knee. I find it beneficial to use when sleeping if my knee is not feeling good because it doesn’t allow it to fully straighten and twist when the knee is relaxed.

I plan on starting hockey again in the next month or two and wondered what your thoughts are? How do I tell if my meniscus is detached and what will happen if I play and it is? Do you have any recommendations?