Meniscus tear...any advice for me?

[CindyBlue]

This is what the MRI report showed for my left knee today...

"Tear of the central posterior horn and posterior root attachment of the medial meniscus"

I haven't had time to consult with my doctor on this yet - the MRI was this morning and the results just came in about an hour ago. Nice to get them so fast!

I looked it up on multiple sites online, and still can't figure out if surgery is warranted.

Anyone had this? Any opinions and/or advice for me?

 

[MuirWannabe]

Just do your best to find a trustworthy orthopedic doc. My opinion is many of them default to surgery repair for meniscus. May be needed, but may not. The repair consists of just removing a portion of your cartilage in that area. You can’t get that back. And some of them ‘over cut’ and remove too much. Surgery not always required.

All I can say is find someone you trust. However you can do that. Best wishes.

 

[Dan32]

Agree with the above. Surgery can’t be undone. I’ve had good luck twice with doing exercises found on YouTube. Google meniscus tear

 

[Aerides]

If it hurts, get surgery. If it doesn't, meh. It's not going to heal on its own most likely unless you are very young. If it hurts and you're not ready for surgery, inquire about a cortizone shot. They don't work for everyone, and might take a week to work. But if/when they do, you'll get a couple of pain free months to decide when and where to have the procedure.

It's a very simple surgery, you should walk out unassisted, if you are otherwise healthy and mobile. No cane, no crutches. Two teeny little incisions. My only "down" time was I didn't drive for a couple of days as it was my right leg. Started short walks a few days later, and my Ortho let me resume running at about 6 weeks, and worked in strength training as well.

 

[Out of Steam]

Just do your best to find a trustworthy orthopedic doc. My opinion is many of them default to surgery repair for meniscus. May be needed, but may not. The repair consists of just removing a portion of your cartilage in that area. You can’t get that back. And some of them ‘over cut’ and remove too much. Surgery not always required.

All I can say is find someone you trust. However you can do that. Best wishes.

I had a meniscus tear while moving furniture about 20 years ago. My then-GP sent me for an MRI, he thought it wasn't too serious and would heal up with conservative treatment.

When I asked about going to an orthopedist, his comment was that if I went to an orthopedist, I'd have surgery. Since I was about 40 years old and 50 pounds too heavy, healing wasn't fast. I did some physical therapy, and was OK after about 3 months.

I never had surgery and have hiked about 1400 miles of the Appalachian Trail since then. No problems beyond an occasional twinge that worsens when I wear shoes that are too worn.

 

[chassis]

I had a meniscus tear while moving furniture about 20 years ago. My then-GP sent me for an MRI, he thought it wasn't too serious and would heal up with conservative treatment.

When I asked about going to an orthopedist, his comment was that if I went to an orthopedist, I'd have surgery. Since I was about 40 years old and 50 pounds too heavy, healing wasn't fast. I did some physical therapy, and was OK after about 3 months.

I never had surgery and have hiked about 1400 miles of the Appalachian Trail since then. No problems beyond an occasional twinge that worsens when I wear shoes that are too worn.

@Out of Steam great advice. It confirms what a surgeon friend told me, "If you go to a surgeon, he's going to cut you." That's a direct quote.

 

[RunningBum]

Meniscus repair is usually simple surgery, and easy to recover from. Most times they remove the torn part so it no longer catches and makes it painful for you, or maybe even locks the knee up. If there is enough blood flow, they will repair with some kind of adhesive. That's what happened with me.

If you don't have a lot of pain and you knee doesn't lock up, you don't need surgery, but most people wonder why they didn't do it sooner after having it done.

I think there actually is some kind of artificial knee padding if you lose too much of the meniscus, but I don't know any details.

To find a good orthopedist, try to find out who treats the athletes at a local university, or ask at a local running shoe store or ski shop.

 

[bolt]

Research D3.

Supplement your lifestyle w/D-3, & research Michael Hollick, an MD.& earlier a medical professor teaching @ BU, MA.

Draw your own conclusions.
Yoga is your friend. Not hospitalzations & operations.

This person used to run 8-10miles daily. For decades, over the last 50+yrs.
D3 has helped him enormously, avoiding all medical misinformation!

I hope my time & OP assists you.
Good luck & Best wishes.....

 

[Aerides]

@Out of Steam great advice. It confirms what a surgeon friend told me, "If you go to a surgeon, he's going to cut you." That's a direct quote.

Not my experience. My doc was very "if I were you, I'd wait and see" on my knee. So I did, gave it about 8 months, then I asked to proceed once the 2nd cortisone shot wore off so I could get back to normal.

On my shoulder, despite it getting worse over time, despite my injury running out of options, he told me "You do NOT want shoulder surgery, I've had it, it sucks, let's try other stuff." He was was genuinely thrilled for me when PT finally worked.

Get a doc that talks like that, there are plenty, just interview them like you would someone you were hiring...because that's exactly what you are doing.

To find a good orthopedist, try to find out who treats the athletes at a local university, or ask at a local running shoe store or ski shop.

Yes to this - find one with Sports Medicine on their resume. Mine has previously worked as a college football team's doctor.

 

[RunningBum]

Not my experience either. I had a torn ACL, MCL, and meniscus after a ski injury. First surgeon I went to said I didn't need it, because I was 50, not a 20 something former college athlete. This despite me telling him I had run 24 marathons or longer and wanted to continue to run like that and ski for as long as possible.

Second surgeon actually listened to me and explained why I should have it if I wanted to continue being active and not need knee replacement at 60.

So I had the surgery by doc #2. And in the 10 years since, I've run another 35 marathons or longer, including 2 100 milers. And skied 50 days or more every winter. And I'm not done with either.

 

[harllee]

A few years ago ( at age 66) I tore my meniscus dancing. It was terribly painful and I could not walk. After a few weeks of pain and inability to walk I had surgery. It was day surgery, went home in a couple of hours. Back walking in a few days, no physical therapy required, back dancing in a month. If you are in a lot of pain I would have the surgery.

 

[skyking1]

My advice, do as the doctor suggests. Some things you get better on your own, others there is on path to healing without surgery.
I had a bucket handle tear and the handle separated, and got in the works of my knee.
It was the same effect as sticking a rock in your door jamb by the hinge, and trying to close it.
My knee would not go straight no matter how hard the PT person tried. I quickly got a second opinion and surgery.
It was 1980 one of the earlier arthroscopic procedures. 3 days on crutches then get moving.
I would think 40 years and they have it all more perfected. Don't fear a surgery if it is warranted, but get a second opinion if that makes you happier.

 

[Montecfo]

I had a medial meniscus tear from skiing. The medial meniscus, as I recall, can heal as it has a blood supply.

I wore a brace on it for a long time. Surgeon decided surgery was not indicated since knee had mostly healed. I eventually stopped wearing the brace as I did not need it.

I did everything on it, basketball, skiing, the works for a couple of decades. It is still good compared to my other joints .

Would wait on surgery and get a good brace.

 

[googily]

I had a torn meniscus back in 1988, when I was 21. We tried therapy, but ended up having surgery to repair. Even though I was overweight and not very athletic, I healed pretty quickly.

Alas, back then they just chopped out anything that looked remotely shredded, so I lost about 1/3rd of the meniscus, and the ortho also shaved back some of the bone. But there was no padding to insert or any of the other tricks they now have, and, combined with a borderline dysplastic hip on the other side (which often screws with the other knee) I am now bone on bone, and haven't had full range of motion available in that knee for years (and since it never really hurt, I never investigated any of the injections or other options that now aren't available to me). A replacement is definitely in my future--but the hip is probably going to have to be replaced as well, and so I'm trying to avoid both as long as possible. (Widow, no kids, so these surgeries will be a supreme hassle.)

 

[CindyBlue]

Wow, thank you so much for all of your thoughtful responses!

Some background: I've always been very active. I grew up in the country on a small ranch with lots of animals to take care of and trees to climb and forts to build and tackle football in the cow pasture (messy, but fun!). One of my majors in college was physical education (though my eventual career took a different path.) I spent my youth and middle age doing marathons and endurance events (horses) and my knees have taken a beating. But they never ever hurt.

We live on a small ranch. With my hubby, I do a lot of physical work such as hand mowing gardening and chain sawing logs and splitting wood (albeit now with an electric splitter - what a blessing that is compared to the splitting maul (grin!)) Hubby and I do a lot of walking, play disc golf and recently (about 6 months ago) took up pickleball.

Other than the occasional twisted ankle and scraped up body part, and the occasional back pain (an old horse injury!) my body has always been strong and healthy. I've never had anything like this knee issue that could potentially derail my entire very active life. The pain seems to have come on relatively gradually - I don't remember any one single moment of injury.

Right now, I'm overweight for the first time in my life. I have never really thought about it because I have always been able to do anything physical I wanted to do (up to this knee injury.) When I look at pictures of my mom through the years, our body weight/shape is almost an exact parallel - thin throughout most of our lives, then gradually gaining weight starting in our 60s. She passed at 63, as did almost all of my female relatives, so I have nothing to go on after about that age (I'm past that age and happy about it!)

I've never had to lose weight, but it's sure time to think about it. While I'm not grossly overweight, I know that any extra weight is adding tremendous pressure to my knees.

I don't do any of the cooking - my hubby does it all. He loves to cook. Up until recently, I would eat anything he cooks because I didn't have to cook it and because it's is delicious! It's so hard to have to tell him that I won't eat what he's cooking because I need to lose weight...but I've finally started to tell him this. Now we are eating cereal for breakfast most days and starting to eat a light lunch. I know this will help with my need for weight loss eventually. I need to change my habits and my perspective on eating.

But now not being able to exercise as I used to because of the knee is not helping the need for weight loss. I need to investigate how to exercise in a way that doesn't keep injuring that knee. Come to think of it, I have no idea if continuing to do the work I'm doing on the property and continuing to exercise as I was doing will just cause pain (which I can deal with) or continue to injure the knee further (which is not something I want to do.)

Based on how the pain came on over time - the last couple of months - the knee injury seems to be degenerative rather than acute. I don't care if I wait it out for a few months or have surgery - like most people, I just want it fixed (smile!) I wish there was a magic mirror to see into the future and tell me exactly what course of action to take!

My hubby was diagnosed with Parkinson's a short while back, and I know I need to be in good shape for the years to come in order to take care of him when he needs me - that is my biggest concern. I need that knee to work well, and for a long time.

So...wait and see? Or surgery? Arrgghh! I am on hold right now waiting for an appointment with the ortho (Kaiser.) Meanwhile, I'm researching all I can and getting advice from everyone, especialy all you good folks. I want to go forward with this with as much information as I can.

I really appreciate everyone's opinion and advice!

 

[RunningBum]

So...wait and see? Or surgery? Arrgghh! I am on hold right now waiting for an appointment with the ortho (Kaiser.) Meanwhile, I'm researching all I can and getting advice from everyone, especialy all you good folks. I want to go forward with this with as much information as I can.

I'd see what the ortho says. Yes, there are some surgeons who will automatically recommend surgery because that's what they do, but not all. They will be better than asking strangers on the internet. You can ask questions like "What if I don't have surgery?" and "Can I just rehab it?" to make them justify surgery. Get a second opinion if you aren't comfortable with the answer, or the doctor in general.

I wouldn't fear the surgery if it comes to that though.

 

[harllee]

When I had my meniscus tear surgery at age 66 the doctor first did an x ray of my knee to see if I had any arthritis. If the knee had been bone on bone the knee doctor said that he would not have recommended the meniscus surgery--he would have recommended knee replacement instead. Fortunately the X-ray did not show any arthritis, I still had good spacing and cartilage in my knee. So the next step was an MRI which showed the meniscus tear. At that point the knee doc said I was a good candidate for the meniscus surgery and he almost guaranteed the surgery would fix my pain and get my back to dancing shortly and he was correct.

 

[CindyBlue]

When I had my meniscus tear surgery at age 66 the doctor first did an x ray of my knee to see if I had any arthritis. If the knee had been bone on bone the knee doctor said that he would not have recommended the meniscus surgery--he would have recommended knee replacement instead. Fortunately the X-ray did not show any arthritis, I still had good spacing and cartilage in my knee. So the next step was an MRI which showed the meniscus tear. At that point the knee doc said I was a good candidate for the meniscus surgery and he almost guaranteed the surgery would fix my pain and get my back to dancing shortly and he was correct.

This seems to be my situation, also. When I saw the doctor after the X-ray, he said I showed very little if any arthritis and also had good spacing in my knee. Thank you for this information - I will use it when I ask questions at the next appointment!

 

[CindyBlue]

I'd see what the ortho says. Yes, there are some surgeons who will automatically recommend surgery because that's what they do, but not all. They will be better than asking strangers on the internet. You can ask questions like "What if I don't have surgery?" and "Can I just rehab it?" to make them justify surgery. Get a second opinion if you aren't comfortable with the answer, or the doctor in general.

I wouldn't fear the surgery if it comes to that though.

Thank you!
I am asking questions here because I "know" and trust you people to give me your honest opinions, and those opinions will help me with my research. I have done a whole lot of online research since the MRI report came in, and every piece of information will help me when I go in to see the ortho docs!

 

[chassis]

Not my experience. My doc was very "if I were you, I'd wait and see" on my knee. So I did, gave it about 8 months, then I asked to proceed once the 2nd cortisone shot wore off so I could get back to normal.

On my shoulder, despite it getting worse over time, despite my injury running out of options, he told me "You do NOT want shoulder surgery, I've had it, it sucks, let's try other stuff." He was was genuinely thrilled for me when PT finally worked.

Get a doc that talks like that, there are plenty, just interview them like you would someone you were hiring...because that's exactly what you are doing.


Yes to this - find one with Sports Medicine on their resume. Mine has previously worked as a college football team's doctor.

@Aerides which specialty does the doc practice that you refer to?

 

[Aerides]

@Aerides which specialty does the doc practice that you refer to?

Orthopedic surgery, arthroscopic and fracture, mainly knees and shoulders are his thing, irrc.

 

[harllee]

I went to an orthopedic doctor who specialized in knees--that was all he did.

 

[JT90505]

Any reason not to try Physical Therapy and if it does not provide a level of relief you can live with then have surgery?

 

[harllee]

Before I had my meniscus surgery I tried a few PT sessions--no help. The PT person told me there was not much PT could do for a meniscus tear.

 

[Aerides]

Any reason not to try Physical Therapy and if it does not provide a level of relief you can live with then have surgery?

Depends! The ortho doc can tell more from the MRI. The placement of the tear and the general condition of the overall knee and patient are all factors. There is no one-size-fits-all here.

Of all the surgeries out there though, this is super low on the scale of what's done, and the impact, recovery, scar, etc. Having had one done I'd do the other in a heartbeat if I ended up tearing that one too.

One other benefit from my repair: My doc got a lot of pics from inside my knee during the scope, and was able to let me know my future - showed me in detail where there is cartilage missing, and that there is some arthritis, etc. I'm a candidate for a future partial knee replacement...But! He also guided me to increase strength training in my legs to put that off as long as possible.