Meniscectomy Vs Knee Replacement

[RetiredGypsy]

These are the two options I've been given. I was cursed with a meniscus that keeps tearing itself up, and multiple surgeries later it's just gotten worse.

The concern about the meniscectomy is developing arthritis worse than I already have and the concern about a partial or total knee replacement is I'm only 30.

So, if anyone has had either, I'd be grateful to hear how it's been for you. Especially over the long run.

 

[erkevin]

Had a meniscectomy in 1998 (?). Arthroscopic surgery and about a 5-6 week recovery to full activity. Went on to run several dozen marathons and half-marathons with no residual problems. I took it upon my self to replace my running shoes often to minimize wear and tear on the knee.

Now the achilles tendon rupture I suffered, that's a whole different story................

 

[folivier]

Had a total meniscectomy on right knee over 30 years ago. Had varying amounts of pain over the years. Actually has been better the last few years since I'm retired. However I don't run but do walk frequently.

 

[RetiredGypsy]

So a meniscectomy might not be so bad then. Good to know.

 

[Meadbh]

The concern about joint replacements is that they may wear out over time and need to be redone. Knee replacements don't yet have a lifetime of study. It's possible that you might need 2 or 3 replacements over your lifetime. At 30, it's very early to get on that cycle.

 

[nuke_diver]

These are the two options I've been given. I was cursed with a meniscus that keeps tearing itself up, and multiple surgeries later it's just gotten worse.

The concern about the meniscectomy is developing arthritis worse than I already have and the concern about a partial or total knee replacement is I'm only 30.

So, if anyone has had either, I'd be grateful to hear how it's been for you. Especially over the long run.

I'm pretty surprised you would be given those 2 options at 30. I knew a guy that was 50 and though he had reoccurring knee issues they were reluctant to do a knee replacement as a first or second option (though eventually they had to but he had a degenerate bone issue).

I've had 2 meniscus surgeries on my right knee and a full meniscus removal on my left (and an ACL tear). Once the surgeries were done there was (is) some discomfort but nothing I can't handle and I can do pretty much anything I want (except deep knee squats with heavy weights). I don't, however, run and 5 orthopedic surgeons have commented that it is a major factor in the fact that my knees are not as bad as they could be given 5 surgeries. You might examine what activities are causing your tears. I'm not a doctor but you may want to get a few opinions. Doing a KR is final and at 30 seems drastic for a torn meniscus.

 

[RetiredGypsy]

It's possible that you might need 2 or 3 replacements over your lifetime. At 30, it's very early to get on that cycle.

I had thought it was a full replacement when the parts wore out, but it seems like ideally (if you treat it how you're supposed to), it's a replacement of just the one piece that tends to wear out over time.

Flip side is, even if I have the meniscectomy, the Dr. said it'll only buy me maybe ten years until I need a knee replacement anyways. So I don't know if ultimately I have any fewer surgeries whichever happens.

 

[Nemo2]

Flip side is, even if I have the meniscectomy, the Dr. said it'll only buy me maybe ten years until I need a knee replacement anyways. So I don't know if ultimately I have any fewer surgeries whichever happens.

I've mentioned this on other knee related threads - had arthroscopy on both knees at age 56; surgeon at the time told me that, sooner or later, I'll require replacements for both knees - he added, "Make it later, if possible".

This was subsequently repeated a few years later by another surgeon, who endorsed the 'make it later' thought.

Still haven't had either knee replaced, and as long as I don't absolutely have to, I'll hold off......I'll be 74 1/3 on Saturday.

 

[Bamaman]

"Make it later, if possible".

This was subsequently repeated a few years later by another surgeon, who endorsed the 'make it later' thought.

Still haven't had either knee replaced, and as long as I don't absolutely have to, I'll hold off......I'll be 74 1/3 on Saturday.

When pain speaks, you need to listen. And when you're completely miserable, it's time at your age to have the surgery done.

 

[Nemo2]

When pain speaks, you need to listen. And when you're completely miserable, it's time at your age to have the surgery done.

I'm not at that stage yet, (but if the Dr. I'm seeing on Friday suggests that fusion, or somesuch, will alleviate my lower back arthritis issues I'd likely jump at it)......knees, right now, I can live with....still doing ~ 45 minutes a day on the elliptical and looking to increase....I guess there isn't a one-size-fits-all though.

 

[RunningBum]

I would think that some kind of artificial meniscus replacement would be on the horizon though I'm no expert at all. Otherwise it seems like if they take out some or all of the meniscus you are headed for a knee replacement at some point, though delaying it seems like a good thing. I was very lucky when I tore mine, it was where there was good blood flow so they repaired it rather than remove the torn piece.

 

[RetiredGypsy]

I'm pretty surprised you would be given those 2 options at 30. I knew a guy that was 50 and though he had reoccurring knee issues they were reluctant to do a knee replacement as a first or second option (though eventually they had to but he had a degenerate bone issue).

I've had 2 meniscus surgeries on my right knee and a full meniscus removal on my left (and an ACL tear). Once the surgeries were done there was (is) some discomfort but nothing I can't handle and I can do pretty much anything I want (except deep knee squats with heavy weights). I don't, however, run and 5 orthopedic surgeons have commented that it is a major factor in the fact that my knees are not as bad as they could be given 5 surgeries. You might examine what activities are causing your tears. I'm not a doctor but you may want to get a few opinions. Doing a KR is final and at 30 seems drastic for a torn meniscus.

Last time it tore walking across the house. The thing's just defective. The rest of the knee is a mess of osteoarthritis. Tried everything from hyaluronic injections to stem cells. My knee locks and pops so much you'd think it was destined for a career in hip hop. Creaks like a tall ship and hurts like hell.

I've had two opinions so far. One was for a partial KR. One was after finding an elevated rheumatoid factor suggesting a total KR or meniscectomy if I want one last chance to put off the replacement.

 

[Chuckanut]

I had cartilage removed from one Knee over 30 years ago. While it has limited some activities - no jogging or twisty sports for me - I have pretty much done most of what I wanted to do. I simply don't do anything that causes the knee sharp pain or leaves it sore for days on end. If I go on a hike, I take ibuprofen before departing and use poles to reduce the pressure on the knees.

An orthopedic surgeon told me that at my ripe old age I can probably get one knee replacement that will last me the rest of my life (20 to 30 years I hope). The joint technology has gotten a lot better and they can more precisely align the artificial joint to your bones, thus reducing stress on the both your bones and the joint.

However, at 30, that still might require another surgery in the future. I would think twice about a replacement at such a young age. Still, it's also a quality of life issue, and if you are going to suffer for another 20+ years of your relative youth, that's not great either.

One thing for sure, if you decide to delay the surgery you can always change your mind later, whether in a month or a few years. Once it is done, there is no going back.

 

[Skoach]

I would think that some kind of artificial meniscus replacement would be on the horizon though I'm no expert at all. Otherwise it seems like if they take out some or all of the meniscus you are headed for a knee replacement at some point, though delaying it seems like a good thing. I was very lucky when I tore mine, it was where there was good blood flow so they repaired it rather than remove the torn piece.

This has been done at Ohio State in clinical trials. My daughter has had three ACL surgeries with meniscus damage. This just happens to be her surgeon, so I keep a eye on it...

https://wexnermedical.osu.edu/media...lastic-meniscus-implant-in-fda-clinical-trial

 

[bclover]

So I'm currently in my 8th week post surgery from a TKR on my left knee. I am 56 years old.
My decision was based on a few things. 1) after spending all of 2016 in excruciating knee pain, I was sick of it. 2) I had already went through 2 arthroscopic surgeries, cortisone shots, Physical therapy and a series of HA gel shots. 3) I have osteoarthritis and it was not going to get better.

Lastly, I simply got tired of the pain. Now you are only 30 so I would definitely exhaust all other alternatives but....

so far I'm pretty happy with my knee replacement. the first 3 weeks were the toughest but I had immediate relief. first I don't have hip pain from lopsided walking on bad knees.

I'm off the all walking devices (walkers and canes) and my knee pain level is lower than pre surgery and getting better weekly.

 

[Taxman59]

Bclover, I am glad you are doing so well. I'm six weeks out, and am also doing well, but last night and today have been rough. My thigh almost feels like it did immediately after the surgery. I am assuming this is a case of two steps forward and one step backwards. The overall status is the surgery was worth it. At 30, I would do everything possible to postpone the surgery since it would need to be redone in about 10-20 years based on today's technology.

 

[nuke_diver]

Last time it tore walking across the house. The thing's just defective. The rest of the knee is a mess of osteoarthritis. Tried everything from hyaluronic injections to stem cells. My knee locks and pops so much you'd think it was destined for a career in hip hop. Creaks like a tall ship and hurts like hell.

I've had two opinions so far. One was for a partial KR. One was after finding an elevated rheumatoid factor suggesting a total KR or meniscectomy if I want one last chance to put off the replacement.

Well it sounds like your problem isn't the tears but what is causing them (that's more like what my friend had). Still at 30 as others are saying, you probably want to exhaust all options first, once you commit that's it and you might have to do it 2 or 3 more times because of your age.

 

[bclover]

Bclover, I am glad you are doing so well. I'm six weeks out, and am also doing well, but last night and today have been rough. My thigh almost feels like it did immediately after the surgery. I am assuming this is a case of two steps forward and one step backwards. The overall status is the surgery was worth it. At 30, I would do everything possible to postpone the surgery since it would need to be redone in about 10-20 years based on today's technology.

hey Taxman. definitely know the feeling. I still have nights where I running for the oxycodone.
I was actually hoping to get to 60 before surgery but my knees had other ideas.

wishing op the best, tough decision. i would hate for him to have to endure 20 years of pain also

 

[Chuckanut]

Below is a podcast by Peter Attia in which he interviews an orthopedic surgeon. As one who has a wonky knee I found it very interesting.

The good medical stuff starts about 1 hour into the podcast.

They have a descent discussion on how to exercise and differences between young folks and many of us 50+ folks. The #1 Rule of Exercise (Surprise!) - Avoid injury.

At 1 hour 30 minutes the surgeon comments on how a recent study was misreported in the media - the writer claimed that there is no difference between PT and surgery with meniscus tears. It turns out some of the PT folks crossed over and had surgery, but the reporter did not account for that when presenting the statistics. Opps!

Overall, a very enlightening discussion, IMO.

https://peterattiamd.com/ericchehab/

We discuss:

• Favorite bands, musicians, and concerts [3:30];
• Eric’s upbringing, biggest influences, college life, and teaching overseas [12:45];
• Eric’s training, fellowship with the New York Giants, and the risk vs. reward of playing football [39:15];
• The knee joint: common injuries, knee replacements, and proper exercise [1:00:00];
• Best exercise for orthopedic health and bone density [1:10:00];
• Most common injuries: knee, hip, shoulder, elbow, ankle, foot [1:20:45];
• Physical therapy vs. surgery, and the meniscus surgery controversy [1:28:30];
• PRP, stem cells, sham surgeries, and the placebo effect [1:41:00];
• Back injuries: when does surgery make sense? [1:54:15];
• How to find the right orthopedic surgeon for you [2:01:45];
• How to cope with complications and maintain quality of life through adaptation [2:09:15];
• Dr. Bukk Teef [2:26:45]; and
• More.

 

[Bamaman]

My wife had her knee replaced in June, and she's doing great. She spent a weekend in December walking all over Las Vegas, and she's on a cruise this week.

After the first 4-6 weeks, it's a breeze. Just make sure you get the best of the best orthopedic surgeon to do the surgery. They cost the same as an average surgeon. My wife's doctor does replacements on Tuesday and Thursdays--three to four a day. And he's an artist at doing knee surgeries.

 

[24601NoMore]

Having bad knees at the moment, this is pertinent / interesting to me..

Knee replacement is a really big deal. Have had several family members wind up crippled for life with knee replacement, despite using reputable and highly regarded surgeons. One of them (wife's cousin) takes opiods daily for the pain and has walked with a cane post knee replacement for over 10 years now.

I'm doing PT 3X/week currently for knee issues. Hoping that "fixes" things so that I can avoid whole knee replacement for many years..

 

[Dash man]

My FIL had a double knee replacement 12 years ago and is doing great. DW had her knees done a little over a year ago 3 months apart and is doing great too. Good surgeons make all the difference in the world.

 

[aja8888]

I'm going on 76 with both original knees.

Two summers ago, I tore both meniscus's in my right knee (don't ask how ). I had a highly regarded knee surgeon here repair the tears and clean up a bit of arthritis on the kneecap. I now walk at least 10,000 steps per day and feel great, but the repaired knee still hurts a bit now and then. I don't take any pain meds for it because the level of pain is easily tolerable. Maybe it will get less painful over time?

I think the keys to keeping your joints in good shape and avoiding replacements is weight control, don't get injured and plenty of exercise.

 

[Conundrum]

Age 52 and 4 knee surgeries down and 2 more on each knee left to go until total joint replacements on both knees. The 4 surgeries I would call maintenance. My meniscus keeps getting smaller and smaller as they remove some with each surgery.

After a number of conversations with my knee surgeon over the years the strategy for me is continue to manage the situation conservatively. Annual hyaluronic acid injections, infrequent use of prescription NSAIDS. Swimming laps has helped the most.

 

[gerntz]

I think there’s a difference between a lateral and medial injury and effects with medial being both the more common and worse impact.

That said, I’m 42 years past a lateral removal and hanging in there. No running since. Lots of walking. I do use a treadmill at times with its cushy surface. Had to give up ski trips a few years back as recovery from pain and stiffness became too much. Still hit the local hill for a half day few times a year.

At the time of removal, was told I would need a KR sooner or later. Three years ago I had it re-examed for the first time as it was acting up more severely than it ever had. Told I was 2-5 years out yet, but today it’s not as bad as then. Did learn I’m not a PKR candidate because of poor bone alignment - bow legged. So TKR is what it will be.