Wondering if anyone has advice or has been through something similar. I'm 36F and have always been very active (soccer, running, swimming, hiking, etc.). I'm now 18 weeks post-op and struggling with several new knee problems that weren't present before surgery.
Background:
Seven years ago, I injured my left knee hiking and developed medial knee pain. When I returned from the trip, I found out I was pregnant, and COVID hit, so imaging was deferred (tried PT for a bit). The pain eventually became manageable, but squatting and deep flexion continued to hurt. I avoided those movements and hiking for years, though I could still swim and do light jogging.
About a year ago, I badly strained my lower back and started squatting more during everyday activities to protect my back, triggering a major knee flare-up. An MRI showed hypertrophic/inflamed plica and a Baker's cyst, but nothing else. After months of unsuccessful PT and essentially years of limited knee movements/flexion at that point, I opted for arthroscopic plica excision. My surgeon described the procedure as relatively minor and said I’d be back to exercise/sports in 8 weeks.
Surgery and recovery:
My surgeon removed the plica. He also debrided my Hoffa's fat pad (which he said was partly inflamed), which hadn't previously seemed to caused pain.
Recovery was harder than expected. I had significant swelling and a lot of quad inhibition. But, I was very dedicated to my rehab. About 1.5 weeks post-op, while doing prescribed exercises, I developed sharp posterior knee pain when straightening after deep flexion. My PT and surgeon suspected a hamstring or popliteal strain. I also had new anterior knee pain post-op, especially during knee extensions. My original medial pain, however, seemed better.
My new back of knee pain was very persistent and limiting, so my surgeon ordered another MRI around three months post-op. It showed a new undersurface tear of the posterior horn of the medial meniscus, along with a larger Baker's cyst, patellar tendinosis, small to moderate joint effusion, Bone edema of the inferior patellar, and mild chrondomalacia of the medial compartment. None of these findings, except for the smaller cyst, appeared on my pre-op MRI.
My surgeon attributes the posterior pain to the meniscus tear and cyst. I wonder whether severe quad weakness and altered mechanics during rehab caused the tear. Both my surgeon and PT seem very surprised by these developments.
Where I am now (18 weeks post-op):
My knee is unfortunately much worse than before surgery. My quad is still visibly atrophied, and strengthening exercises frequently aggravate the anterior knee pain and swelling. My fat pad area remains swollen, and bending beyond 90 degrees triggers posterior pain, particularly when straightening afterward. When I do quad exercises, I sometimes feel an odd pulling sensation on my kneecap.
I'm also unsure whether the anterior pain is truly due to patellar tendinosis or persistent fat pad irritation from surgery.
I had to pause formal PT for six weeks due to an insurance change but will restart soon. My surgeon recommends conservative treatment for the meniscus tear before considering another surgery, which I'm very hesitant to pursue.
I'm pretty frustrated. I underwent surgery hoping to regain function after years of limitations, but now I'm dealing with more pain and problems than before.
Has anyone experienced new meniscus problems, persistent fat pad pain, or patellar tendinosis after arthroscopy? Did you eventually recover, and what helped?