8 years after meniscus injury

Medical Q&A [Moderated]
1

Hello,
I have torn my meniscus at April 2017, when I was 25 years old (male). The MRI exam said it’s a complex lateral meniscus tear, involving the body and anterior horn.
The ortho said I need a surgery but I didn’t want to do it and tried rehabbing it without surgery, which went well. I could do a bodyweight full-squat after 14-16 days and started increasing load very slowly. I managed to do a full below-parallel squat of about 405lb about 8-10 months after the injury and pain disappeared completely after about 12-18 months (hard to recall).

Last year, at April 2024 at age 32 I had a low back pain so I switched from back squat to front squat which triggerred it awefully. I didn’t even think or remembered that injury, it was way past behind me.
Since than, up until now (14 months after the front squat) the knee is far from being 100%. I can back squat to almost below parrallel but I can’t bounce and when I go relatively deep it’s sensitive. A full flexion of the knee is very painful and trigger that area very badly, so I don’t fully flex the knee since than.
I want to add weights but at 225lb back squat it doesen’t feel like a good idea since I can’t bounce and I’m afraid of making it worse if I go below parrallel, and 225lb is not a good deal for me, I want to return to being relatively strong. When the weight is lighter, i.e 135lb, the knee feels more stable to do a deeper range of motion. 225lb is not heavy for me, but the knee doesen’t feel 100% which prevent me from a full range of motion in most reps.
The deadlift feels mostly ok, though at the last workout with 260lb the knee also felt not so good.
At the daily life the knee doesen’t bother me at all, except for when I need to bend down so I don’t fully flex that leg.
There is an improvement through these 14 months, but it’s very fragile and every small “mistake” of bending too much is taking me 8 weeks backwards, and to be honest, at the last 2-3 months there’s probably a stagnation.

My questions are:

  1. I heared that if there’s a meniscus tear which is not surgically repaired there can be a joint damage over time, does it seem like I’m doing such damage?

  2. How much time shall I give it before I start the path of seeking an ortho and maybe going to a surgery now? (if the ortho would advice so)

  3. Is it even possible to do a surgery for that 8 years after the injury?

  4. Is it possible this can be rehabbed without a surgery?

I would appreciate any advice, thank you so much!

2

KP123,

Thanks for the post and for joining the forum. Happy to have you.

Meniscus injuries can certainly be challenging to manage, though it sounds like you did a pretty good job initially.

Hard to say from here, but I would not attribute your current knee pain to your meniscus (or any anatomical structure) necessarily. Instead, seems like your training program may need some adjustment to help meet you where you’re at and get you back to where you want to be. That is something we can help with via consultation with our pain and rehab professionals. You can contact us at support@barbellmedicine.com for that.

Regarding your questions:

  1. No, besides likely due to reduced activity tolerance/participation.
  2. Hard to say if surgery is the right choice or not given this limited information. I can’t give you medical advice via the forum, but I’d be trying conservative management (e.g. exercise and lifestyle modification) first if it were me.
  3. Yes, it’s possible. Unlikely to help in most cases though.
  4. Yes, especially since this pain is unlikely to be related to your meniscus at this time.

-Jordan