Menisci Tear? Help with terminology please

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Last Oct my very large german shepherd knocked me off my feet injuring my knee, a trip to A&E diagnosed soft tissue damge, recommeded RICE and self referral to NHS Physio if no improvement after 7 days, so did this and waited a further 3 weeks for appt, so Mid Nov went along and physio couldnt be carried out as still extremelypainful and swollen, physio referred me to Orthopaedics which I attended on Christmas eve, she referred me back to physio for acupuncture and an MRI (which I'm having March 8th) the report came from Ortho that there were positive results for McMurrays, Clarkes and patella compresion tests, this means nothing to me, the acupuncture hasn't helped and even on my fourth visit my knee was so swollen that he couldnt get the needles in one part so its been reommended I don't carry on. So I'm now 4 months down the line and no where near getting any better, walking up and especially downstairs is very painful, driving hurts as its my left knee and the bending and straightening for the clutch aggravates it as does getting up from a seated position. I'm only 45 and feel like an old crock, my GP won't prescribe me anything stronger than 15/500 co codamol, does anyone know what the terminology used in the report actually means so I have some idea what i'm up against.

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13 Replies

  • Posted

    Sounds as though you have cartilage tears.  It would depend on your consultant ortho ad to what needs to be done, usually repairing and wash out after arthroscopy.  I outfit be going to chiropractor, acupuncturist until you see an orthopod if I was you, I presume you have to see one?   If not you need a re-referral.  
  • Posted

    McMurray is a clinical test for a torn cartilage(meniscus). This is where the NHS falls down in caring for injuries. In my view the MRI should be as urgent as an Xray would be when looking for a broken bone, but the NHS does not seem to have the capacity. 

    If the MRI demonstrates a torn meniscus then you will need keyhole surgery to trim the torn area and remove any fragments of useless cartilage. They cannot be repaired in your age group. Then you will need intense physio to get you back to normal. 


    • Posted

      Of course they can be repaired in his age group. It depends on the type/location of tear however.
    • Posted

      I agree.  I was going to say the same thing.   I had a repair when I was in my fifties!
    • Posted

      You are right that location type and age are all factors that the surgeon considers when dealing with a torn cartilage. My point is that degenerative tears can rarely, if ever be repaired and they are the ones most likely after age 35. Only 7% of tears in the US are repaired! The rest are left alone (physio) or trimmed. Cannot find any figures for the UK. Here is aquote from the Mayo clinic below..

      i tried to cut and paste some stuff from the Wheeless on line text book but have not been able but it is there for free if you want technical detail. Other treatments that are named in web site are not routinely available because they are so much more expensive or experimental and NICE has not supported some of them.

      Mayo clinic.


      If your knee remains painful, stiff or locked, your doctor may recommend surgery. It's sometimes possible to repair a torn meniscus, especially in children and young adults. If the tear can't be repaired, the meniscus may be surgically trimmed. Surgery may be done through tiny incisions using an arthroscope. After surgery, you will need to do exercises to optimize knee strength and stability.

      so those two of you who have had repairs are in a small fortunately minority. 

    • Posted

      .....meant to say ..small fortunate minority. I also wonder if some surgeons say they have 'repaired the damage' when what they really mean is trimmed the ragged bits or tidied it up. Maybe I am being too cynical. 
    • Posted

      The OP stated his symptoms occured after a fall. This would not be degenerative. A person's age has nothing to do with whether or not a meniscus can be repaired. The odds, due to age, of how a meniscus is torn is irrelavant. We don't even know if the OP tore his meniscus. He can go see 10 different doctor's and get 10 different opinions on his knee. He could have pain in the knee joint being cause by almost a half dozen different things, including muscular at this point with how long this has gone on.

      "so those two of you who have had repairs are in a small fortunately minority" Not sure who you are talking. I only see one person state this.


    • Posted

      I don't think I was in the "minority" having a repair at that age.  The tar in my cartilage was due to a fall I had.  I see you are quoting from the Mayo clinic. I actually had my op done in a private hospital and the surgery was done by a top surgeon.   What a surgeon intends to do in any case is entirely up to him so I don't see that quoting from the Mayo clinic has any relevance.
    • Posted

      Your own experience is very valid and you are fortunate to have such a skilled surgeon. I tore both my cartilages within 18 months of each other, and neither was repairable at age 40 (I was an amateur footballer). My son was 22 when he tore his landing awkwardly heading a football and his was not repairable. My friend tore his skiing last year along with his ACL - neither was repaired and he has made a good recover aged 58. And I refer you to yet another source of information:

      BOSTAA (British Orthopaedic Sports Trauma and Arthroscopy Association) 

      "Only about 10 - 20% of meniscal tears are actually repairable. However, these tend to be in younger patients, in whom the consequences of loss of a meniscus are that much greater."

      That is a minority!


    • Posted

      Can I just ask what probably  happens if it can't be repaired, if it is of course a tear as the orthopod and physio suspect, all i know is that it is still extremely painful and quite swollen.
    • Posted

      There are four options that I can think of.

      1. Conservative management with physio. Some tears simply stop giving symptoms and are not in the way of function so everything settles down.

      2. Repair -fixing the torn bit back in to place. The text book I mentioned online Wheeless, gives a list of the technical issues about when a repair job is likely to work. some zones/areas of the cartilage have very poor blood supply and do not mend oven if surgery is done.

      3. Trimming off the ragged/ torn fragments that are in the way of function. Mine was stuck in a partly bent position(locked) until I had arthroscopy. They trim sit back to a stable smooth surface. they try not to remove more than 20% of the surface otherwise the chance of early arthritis  goes up.

      4. Very rarely done these days is to remove the whole meniscus. That is the worse outcome!

      I was back to work in 2 weeks and back to football in 6, with a lot of hard  work with the physiotherapist. Mine was all NHS. 17 years later I have no knee problems. My son had no post op physio  and still runs 10 K regularly.

      someone else might have some other ideas as well. 

  • Posted

    Thank you for your advice, I have an appt for MRI on March 8th and to see Orthopod on 24th March, work are getting really impatient with me, the acupuncture  had no effect after 4 sessions so he advised me to go back to GP for pain relief.

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