Torn meniscus repair/surgery, anyone?

In My Humble Opinion
1

Fell August 8. Felt a pop, but delayed going to the doc hoping it was a sprain. Still in pain, I finally went Monday to have it looked at. They X-rayed, and i may be mistaken here, but do soft tissue injuries show up on X-ray?

So he says its a torn meniscus, and there there’s really nothing they can do. He gave me some exercises and says if it keeps hurting they’ll go in and (his words) “shave it down.”

So although I’d been avoiding the gym since the injury, I’ve gone back each day this week. And it hurts like HELL. It seems most of anything I do, including his exercises, just make it hurt.

2 people have told me they can in and “clean it up” and the pain will go away. This from their personal experience.

So 3 mos. with pain (getting out of the car is rough, it’s the left leg)–why would he say exercise it? Why not just fix it now?

Do I need a second opinion or just go back and demand it be fixed?

2

When I tore mine, the doctor could tell right away by a combination of looking at the x-ray and performing joint manipulation tests. He verified it conclusively with a follow-up MRI. Repairing a tear only works for small tears of a specific type within a specific area of the cartilage. Otherwise, the fix is to partially remove portions of the meniscus to “shave it down” as you say. Tension is placed on the meniscus, so leaving a tear in place risks causing a larger tear in the future. Think of a piece of paper that you are trying to pull apart at each end. If the paper is whole, you can’t pull it apart. If there is a rip in the center, it will easily pull completely in half. But, if you cut around that rip and remove a large section of that area, you can’t easily pull the paper apart anymore. Is that making sense, visually? This is the concept behind your proposed meniscus surgery.

3

I’ve never heard of this specifically for torn meniscus however I was prescribed exercises for strengthening my shoulder muscles (or which ever group of muscles) to help with stabilizing a damaged something in my shoulder that was causing me pain years ago. So for the last 15 years I’ve been doing these exercises for 10 minutes a day and pain free (can ya tell I ain’t a medical type? (-: ) so I wonder if that was idea for you. Otherwise my experience with a torn miscues was a past gf, she ended up having the surgery

4

My husband tore his meniscus and after much fussing and whining, he finally had the torn area removed. The surgeon told him that eventually, he’d need a new knee (no surprise, as both of his parents have had theirs replaced) but in the meantime, he’s been pain-free. Frankly, I’m somewhat aggravated that he waited as long as he did to get it fixed. Yeah, surgery sucks, but sometimes you have to tolerate the sucky to get on with life.

5

I’ve done a lot of damage to my knee, and need a new one. I’m also only 45 years old, so essentially I’m living with the old knee for several more years.

Currently, I do exercises to build up the muscles so the joint has to do less work.

I did have a knee arthroscopy, and the doctor cleaned out some stuff and shaved stuff down. It helped stop the popping and “giving out”. I was on crutches for a day or so, then switched to “furniture surfing” (bracing myself on furniture as I went thru the house). Then it was fine after a long weekend. It took care of the pain for several months.

Since the pain returned, I’ve been getting cortisone injections quarterly or so (though a few times, I’ve gone six months). They help a lot, and the amount of cortisone is low. And it’s not like it’ll ruin the joint, because I’ve already done that myself.

Good luck!

6

So what should I do with a doc that seems loath to do the surgery and says exercise it? Honest to christ, I did the recumbent bike for 30 minute (they recommended the bike) and it’s worse than ever today.

7

When I tore my meniscus a while back, I ran across this on the internet:
There is a Scandinavian study where doctors performed an arthroscopy on 150 or so people with torn knee meniscus, and a sham arthroscopy on an equal number of people with a torn meniscus. A year after the operation, they interviewed the participants and found that 93% of those who indeed had the operation felt that the operation helped them. Of those who had the sham operation, 96% felt the operation helped them!

8

About 10 years ago, I tore the meniscus in my right knee. An MRI showed it to be a buckethandle tear in the vascular region of the meniscus, which meant it could heal. My doc said that the pain would go away even if we did nothing, but he strongly recommended surgery to avoid complications in the long run. Sure enough, by the morning of my surgery, there was no pain and I walked as if nothing had happened. I had the surgery and don’t regret it for a moment.

I think you should get a second opinion. Clearly, what your doctor is recommending is not working, so it’s worth seeing if there are other options. Arthroscopic surgeries are pretty easy, as far as surgeries go. If you are just removing the torn tissue (not trying to repair it), you will be able to bear weight pretty much immediately, which makes recovery much easier.

9

A co-worker of mine had his done years ago, he was back to work (on his feet all day) probably a week or two later. My uncle had his done and I recall seeing him walking very soon after. If it makes a difference, my co-worker was probably 18 when he had it done. Being young probably helps with the recovery time.
As for the X-Ray…sometimes the doc can tell based on the way he manipulates the joint what it probably is, but does the X-ray to rule out a fracture. Mostly since they’re considerably cheaper than an MRI.
You can start with PT, if it’s anything like my labrum tear (cartilage between the ball and socket in your shoulder) , the idea is to build up the muscle in that area so the cartilage doesn’t have to support it AND make sure you’re not compensating in some way that’s going to end up doing more damage. For example, if it’s making you walk with a limp, you’re going to end up with your other knee hurting, or your ankle or back bothering you. A physical therapist will help you build up the muscle in the surrounding area so you can still walk properly.

If you have your mind set on surgery, you’re going to need to see an orthopedist, so you might as well make an appointment. They’re probably going to want an MRI, but if it’s a knee guy (and you may want to ask your primary for a referral to a knee guy), he/she may very well be able to diagnose something this routine without an expensive test.

Do keep in mind, though, orthos tend to be cutters. Even though you may want surgery, that is the direction you’re going to be pushed towards, they’re not, in general, going to try to talk you out of it.

When I saw my ortho for my shoulder, he gave me a shot of cortisone (already knowing I had a tear based on the MRI) and said ‘if this doesn’t help, we’ll have to go in and fix you’, and said it like it was as routine as going to check the mail.

I do regret putting the surgery off for so long. While my shoulder is still tight a year later (but that’s another story), the pain from the actual tear was gone within a few weeks/months. It was well worth it.

Also, again, if it’s similar to a torn labrum (labRUM, not the other thing, I don’t have one of those), when I asked my doc what would happen if I ignored it, he said it could end up arthritic. Not something I wanted in my early 30’s.

TL;DR, go see an orthopedic surgeon.

10

Conservative treatment of many knee injuries would suggest symptomatic treatment (ice, anti-inflammatories) and careful physical therapy - so it seems reasonable they’d try that before going in surgically. Sometimes the level of pain is not directly related to the severity of injury, I gather - so it makes sense.

That said: I’ve got knee issues. I spent over a year doing PT for them in the 1990s, and a few months doing PT for them in 2010. Both times, it made the symptoms much worse. So in my case, I’d probably refuse PT as it’s proven to be useless. Of course my knees are different; while the menisci aren’t in the best of shape, there’s little to no tearing - and the main surgical option for me would be replacement!

11

They found mine with a MRI. With therapy mine quite hurting. When I put off surgery the doctor’s comment was “we are not discussing if you are going to have surgery but when.” That was 5 years ago. I do therapy exercises and most of the time my knee does not bother me much. I am putting off surgery because in a few more years I will need a new knee and I only want to go through surgery once.

But every knee and every tear is different. But you could consider getting a second opinion.

12

My husband had surgery in both knees. The first was open-knee surgery after he’d been on crutches for weeks, and took forever to heal. The second was arthroscopic, shortly after the knee stopped working, and he was hobbling that evening, and back to normal within a week.

They held up for years, but now they are acting up again. :frowning: (he’s in his 50s).

13

I tore mine a couple of years ago, and did a couple of rounds of PT, which helped, but ultimately had it 'scoped. It took about six months to fully recover, but it is now in great shape. Actually, that’s not quite correct; it is now no worse than the other one (arthritis). But I can hike and ski and so forth.

14

Well, after a week at the gym I could barely walk Saturday. One of the trainers, seeing me with the printouts of exercises, asked what I was rehabbing. I said nothing, it hurts, these exercises are supposed to make it stop hurting. He said that was insane, you don’t work a sore joint until you know what the problem is.

So I called and complained. First woman I spoke with mentioned my “tolerance” level which set me off. I said I’d had this pain since August, and that she had to certainly agree that living the rest of my life on NSAIDS was not a sustainable therapy. Then I asked to speak with someone else about getting my Xrays sent to me. I went thru the whole story again, and when I mentioned the gym, she said “WHO sent you back to the gym?” Well, you guys. She wasn’t too pleased with the response, and I mentioned that neither the doc nor the PA had even so much as touched my knee or leg and I wasn’t happy at all with their service, she agreed that I needed an MRI.

So that’s where we are.

15

The meniscal tear itself won’t show up on an X-ray. However, the internal derangement in the joint in conjunction with manipulation can allow the doctor to diagnose the tear. I’m not sure what you mean by “neither the doc nor the PA touched your knee or leg.” If you mean there was no physical exam, I wouldn’t go back to that doctor. Was it an orthopaedic surgeon? Hie thee to a knee specialist right away.

Whether or not it can be “cleaned up” depends on the type and thickness of the tear. Generally, surgery would be indicated unless the joint is asymptomatic.

I’m a lawyer who deals with a lot of knee injuries, not a doctor, so take this with many grains of salt. My dad is an orthopaedic surgeon and I stayed at a Holiday Inn last night, though.

16

Yup, he’s a knee specialist and highly rated if you can believe the internet. Oh, and the Xray guy in the separate imaging office sung his praises. But right, no one touched or attempted to manipulate the joint at all. They looked at the Xray and told me they thought it was a meniscus tear. And it’s certainly not asymptomatic.

Since I’ve already ponied up for an Xray, and will be for the MRI, if this guy doesn’t make me a lot happier on a second visit, I am out of there on the hunt for an actual doctor. /sarcasm\