ACL/meniscus surgery Aug 2010, now struggling

Hi all,

I'm new to the forum, but not new to knee injuries. I'll give a brief history of my situation first of all to hopefully help identify what's going on..

I first tore my ACL playing football in April 2009 , but I didn't know it. The hospital said it was a sprain and to rest for 6 weeks and then try playing again. I did and I managed two games of 5-a-side but towards the end of the second one my knee gave way again and I knew it was more serious. I eventually got diagnosed after visiting my GP, who referred me to a physio, who referred me to a surgeon, and I eventually had the operation in August 2010.

It was a while ago so the details are sketchy in my mind, but I think the meniscus damage was in the section near to the blood supply so I had a repair rather than removal. The ACL was repaired with a hamstring graft. My physio and rehab went generally well, I was in a bit of pain but I think I was initially naive and thinking it would be as good as new. After around 10 months I played football again and apart from the odd bit of pain, it was fine. I've since played around 80 games in the past couple of years since the recovery.

I have had a couple of 'episodes', where my knee has locked up and become incredibly painful to bear weight on. I'd say the pain is almost comparable to the pain immediately after tearing the ACL, so pretty serious. I'm not sure but I think it's after stretching in my sleep, but it's also happened when I sat in a position for a long time without moving my leg. These usually last a few hours to a day, and then it's as if nothing happened. I think I've had 3 or 4 of these incidents in the past two years, but I decided to ignore them as they go away quickly but obviously I was a little concerned about how it may develop in future.

More recently, maybe two weeks ago, I got a different pain on the inside of my knee (the other pain tends to be on the outside). It feels like it needs to click, but it isn't that. This pain isn't as bad as the other one by a long way, but it's niggly. I played football on it last week and after warming up it was fine and I enjoyed the game. However this week I felt pain during the match, probably for the first time in over a year. It wasn't so bad I had to stop but it was there and on my mind. Obviously I'm disappointed and not sure what to do next. It doesn't seem to be going away like the other pain did.

The knee doesn't feel unstable, I'm sure the ACL is fine. I'm not an expert, hence me asking advice, but it feels more like a meniscus related injury. To my knowledge, nothing has happened during a game or a run to cause another injury. It hasn't given way for example.

Any help or advice on where to go next would be much appreciated.

Thanks
Ash

I played again tonight as it's been feeling fine to walk on this weekk, but something is definitely wrong. If i try and turn quickly or kick the ball a certain way its uncomfortable and feels like popping on the inside of the knee.

I think its floating/damaged cartilage, would explain the clicking and intermittent nature of the pain. Where do i go though? Doctor or back to my surgeon? My surgery was done on NHS through a private (nuffield) hospital which might complicate things.

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I played again tonight as it's been feeling fine to walk on this weekk, but something is definitely wrong. If i try and turn quickly or kick the ball a certain way its uncomfortable and feels like popping on the inside of the knee.

I think its floating/damaged cartilage, would explain the clicking and intermittent nature of the pain. Where do i go though? Doctor or back to my surgeon? My surgery was done on NHS through a private (nuffield) hospital which might complicate things.

all in all, it does sound like a meniscal sort of injury. A meniscus can be pinched causing pain for days. Along with the patella and plica, it can cause a popping, particularly with a deep squat combined with rotation. Tests for MMT have been validated in the literature by pressing along the medial joint line. The test with high specificity for the outside is the Thessaley test.

Can't help much with the referral aspect as we do things differently across the water. Good luck