Torn Meniscus....Anyone?

Hatchie Dawg said:

Couple of things, there are at least two different procedures being described here. Meniscal repairs and menisectomies " meniscus tear removed". They are completely different. As someone siad about 2/3s of the meniscus is largely avascular and therefore has limited healing properties. If a meniscal repair is an option the tear has to be in the more vascular outer 1/3 and then greater post surgical limitations have to be placed on the patient ie non-weightbearing for 4-6 weeks or longer and ROM limitations. Recovery from a repair is a longer process but you have a better chance of saving articular cartilage (covers bones at joints) in the long run because the force absorbing and spreading function of an intact meniscus will hopefully be more fully preserved. A partial menisectomy is removal of the tear. Typically no weightbearing restrictions after this procedure and can rehab very quickly, even a matter of weeks if the rest of the knee is in good shape and there is not much inflammation, swelling, or muscle atrophy. However in the long run the partial menisectomy can lead to early onset of osteoarthritis ( the wear and tear kind) which can lead to knee replacement. If the knee is locking, stays inflamed and swollen, and just doesn't get better you may have to consider surgery. However there is more and more data coming out that we are scoping too many knees and performing too many partial menisectomies when long term results are similar between people with tears that have surgery and those that don't.

As disclosure I am a PT so you can take this with a grain of salt but I would first find a reputable orthopedic physical therapist and try a few weeks of PT before I did much else. I have a R medial meniscus tear myself that I manage through exercise.

These are generalities but evidenced based.

HD

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Hatchie Dawg said:

Couple of things, there are at least two different procedures being described here. Meniscal repairs and menisectomies " meniscus tear removed". They are completely different. As someone siad about 2/3s of the meniscus is largely avascular and therefore has limited healing properties. If a meniscal repair is an option the tear has to be in the more vascular outer 1/3 and then greater post surgical limitations have to be placed on the patient ie non-weightbearing for 4-6 weeks or longer and ROM limitations. Recovery from a repair is a longer process but you have a better chance of saving articular cartilage (covers bones at joints) in the long run because the force absorbing and spreading function of an intact meniscus will hopefully be more fully preserved. A partial menisectomy is removal of the tear. Typically no weightbearing restrictions after this procedure and can rehab very quickly, even a matter of weeks if the rest of the knee is in good shape and there is not much inflammation, swelling, or muscle atrophy. However in the long run the partial menisectomy can lead to early onset of osteoarthritis ( the wear and tear kind) which can lead to knee replacement. If the knee is locking, stays inflamed and swollen, and just doesn't get better you may have to consider surgery. However there is more and more data coming out that we are scoping too many knees and performing too many partial menisectomies when long term results are similar between people with tears that have surgery and those that don't.

As disclosure I am a PT so you can take this with a grain of salt but I would first find a reputable orthopedic physical therapist and try a few weeks of PT before I did much else. I have a R medial meniscus tear myself that I manage through exercise.

These are generalities but evidenced based.

HD

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TimeOnTarget said:

Thank to all the responses.

Mild MCL tear and medial meniscus tear. He said the MCL will heal on its own over time. Meniscus will need surgery according to him. Have a 2nd opinion coming up on the 25th. I always get 2nd opinions. sometimes 3rd.

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JohnCushman said:

My ortho doc at the VA gave me what's called a medial unloader brace. It has a hinge where the knee bends on that supports the inside of your knee and takes most of the weight off of it. That and a cane has been a godsend while I wait for my knee surgery later this year after hunting season. Using trekking poles while you hunt would be a good suggestion. I only use the brace when I'm going to be doing a lot of walking or causing stress to my knee. I take it hunting because after a couple of days my pain gets brutal and the brace takes the burden off of it and lets my knee basically rest for a day or two while I still hunt.

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Inkedmedic8404 said:

I had the same exact injury when I was 21 and in the military on deployment. I was running three weeks after surgery and had zero problems with it until this October (16 years) where I fell on it during a hunt. Been to two Ortho's, Two MRI's and a DPT, Injections, Pain meds. Not one of them could figure out what was wrong with me. Luckily I started a lifting program against recommendation from the Doc and my knee has been getting better by leaps and bounds. I can actually hike a pack with weight and squat again. I would highly recommend staying off the Pain killers and only take them as needed. Prolonged use can actually make your pain worse over time. (Something to do with the opioid receptors becoming sensitive to pain) I was taking them only when the pain was unbearable and needed to sleep. Tramadol is a pain killer but is not opioid based. The only warning I have with it is do not take too much! I feel stupid when I took too much and started to stutter. It has also been linked to seizures in some patients. The last good piece of advice I can give you is to start physical therapy as soon as you can if you get surgery. You have to get that knee back up and moving. I wouldn't get surgery until season is over and you have time to recover. Get yourself a good knee brace and some trekking poles. As for a brace, look into the Donjoy line. I am sure Hatchie Dawg can give you a good suggestion. Drop some cash on it though if your insurance doesn't cover it. You will need support above and below the knee.

Good luck!

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Addicting said:

FYI it's feeling great right now because you have nerve blockers in there. That last for about 8 hours or so, then you start feeling things. Make sure you stay up on you pain meds every 6 hours or so for the first few days. If you forget you will get a decent amount of pain uncomforte to remind you. It's best to just stay on schedule. Good luck on your recovery.

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