Two winters ago I was skiing, off the trail, on top of crusty snow. Part way down I broke through the crust into about 3 feet of powder and twisted my right knee. This injury caused a slight limp that disappeared after a few days. However after a hard workout (a day skiing) this limp would return. When summer came I backed off on my usual activities and after about 6 weeks all the symptoms disappeared (limp, joint pain). I started last years ski season with no problem. However on Thanksgiving weekend a Snowboarder crashed into my right side reinjuring the knee.

Again this past summer I backed off and took it easy. The symptoms disappeared and I thought I was all set. But when cool weather returned and I increased the difficulty of my activities the problem reappeared. It was not going to heal on its own this time. Since it has been causing me to hold back while skiing I decided that it was necessary to find and repair the cause.

Doctor time. X-ray negative, MRI negative. So we went in for a look suspecting a torn Medial Meniscus. We found a Patella (kneecap) that was in poor shape, a Plica that was oversized and fragments of cartilage floating around. The Patella was ground/scraped smooth, the Plica was removed and the fragments sucked out.

The Plica was probably the cause of the problem. This particular Plica (medial) does not exist in 70% of the population. Injuring it can cause it to interfere with joint movement, this apparently caused inflamation after hard activity along with the slight limp or desire to limp. Time will tell.

TIME LINE TO RECOVERY:
09/28/99- Surgery. (crutches)
10/07/99- Bandage removed.
10/08/99- Physical Therapy evaluation. Limping and swolen. Given stretching exercises.
10/12/99- Learned to walk (treadmill). 10 minutes on bike. 70 degrees of movement.
10/14/99- Learned to do stairs. 10 minutes treadmill, bike. 104 degrees of movement.
10/18/99- 10 minutes treadmill, bike, machine. 124 degrees of movement.
10/21/99- 10 minutes treadmill, bike, machine. 130 degrees of movement.
10/23/99- Moderate hiking is up to 5 miles. Cellar stairs 20 minutes.
10/26/99- Working on the last few degrees of movement extended and bent.
10/28/99- Hiking is up to 7 miles.
11/04/99- Did a 9 mile hike. Biking is up to 8 miles. Full movement has returned.
11/11/99- Working on increasing strength. No limp after a hard workout.
11/17/99- First ski days of the season. Groomed cruisers were my limit. 3 hours per day.
12/11/99- Slowly pushing the hours per day skiing. Knee is in good shape. I stop for the
                 day when the knee begins to get tired.
12/28/99- Was able to ski for five full days. Knee is almost back to normal. There is a
                 little pain after a full day so I ice it down. Kneeling on it is still painful.
                 If the snow surface is hard or ice the knee still gets tired quicker.
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Patella (kneecaps articular cartilage) before.	Patella after smoothing.
Plica before.	Plica removed.
Normal Medial Meniscus. (femur and the tibia, meniscus inbetween)	Normal ACL.