should I have meniscus surgery

Posted , 7 users are following.

I am a healthy 51 year old male who has been having moderate medial knee pain for the last year or so. I had an MRI (report below) and my orthopedic doctor recommends arthroscopic surgery. However, my knee is strong (I do Bikram yoga 3x/week) and though I can't run well, walking is fine. But it does ache after sitting and fun stuff like tennis and basketball are out. In general I'm against surgery unless it's absolutely necessary. Just not sure what's best here. Any advice?

MRI Results:

1. Flap tear of medial meniscus, involving body and posterior horn 2. Grade 2 chondral degeneration of the lateral aspect of the the medial patellar facet extending to the patellar ridge of a 1/2 cm area medial to lateral. Grade 2 chondral degeneration of the medial aspect lateral patellar facet extending over a 4.5 mm area medial to lateral. 3. Mild proximal patellar tendinosis. 4. Medial popiliteal cyst measuring up to 4.4 cm in longitudinal extent. 5. Intact cruciate and collateral ligaments

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17 Replies

  • Posted

    Tear? You need a scope.  Don't even think about it...it will only get worse.  I had four (2 each side) before my TKR years later.

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  • Posted

    Hello

    I am interested as to why you are not keen on surgery? I am a 57 year old female and due to have an arthroscopy and Meniscus repair at the beginning of April. I get knee pain when doing certain activities and walking is impaired around distance but I've not thought twice about having the surgery if it can get me back to baseline which I haven't so far, doubted why it won't. I've spoke to a couple of physios who have both said it won't repair on its own and have recommended that I go ahead. Do you mind letting me know why you are not keen....unless I've read your post wrong. Thanks.

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  • Posted

    I know how u feel . I had the best surgeon 2007 to scope my knee for what u have alone with bakers cyst. Don't let them cut any away. My dr did said mine was too bad to save and now here I am bone on bone in terrible pain for years and can't straighten my leg. Had replacement set up for feb 20 but ran a fever and had to postpone.

    I feel my pain 2007 was nothing to what o felt 2008 post op. Granted I did have medial miniscus realtor 1987 when I was 18. Then something.wmet wrong is bad swelling was back in for scope and repairs 4 month later. 2 diff surgeons the one 2007 had best reviews yet both times I felt like they removed to much . As others said maybe I let it get too bad . I was young and loved to water ski. Now 47 and I swell all the time and have pain up and down stairs & awful night pain . My knee has never been right . Another friend had hers done wasn't happy either but we r both or were both active . I know iys good to have it done but looking back I feel is not be in this mess today if I'd have not let them cut my tears.

    Wish u luck . My ortho told me mri show more damage sometimes and so we did X-rays

    My X-rays are bad too. But he did say sometimes it makes your cartilage tears look worse than they are. I knew mine was bad since I've never been in this much pain . So yes now 10 years later getting new knee which of truth be told it's so rutted out I needed this years ago. I truly feel like if they can repair it fine but when they cut away flaps u r left with worse. Gel and cortisone won't help me anymore . Maybe. U can try that see if it helps. Some

    Tears can heal. I don't know the answers I just know what happened to me sux!! Wish u all the best! So sorry for your pain !

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  • Posted

    I've heard some people say it's relieved the pain but that in most cases, the pain comes back usually , after a year or two. You could try prolo therapy.

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  • Posted

    Im 52,active and waited on my 2nd knee arthroscopy initially. Then a piece of the flap broke off and floated causing the knee to intermittently lock. Bad safety at that point. Your bursa already seems swollen and indicative of trying to "smooth over" the irritation your knee is feeling. Sounds like you have a lot going on w your knee cap. (Patella)

    I had a great response from my right knee arthroscopy but a year later i ended up w a partial replacement. At least you have a doc who cares about your lifestyle and you have time to plan your recovery. Its not months but weeks,usually..

    No one can decide for you. Do some research, time off etc. Surgery is a big deal w risks and should always be entered into risks vs benefits in mind.

    Funny thing is, most of us go forward because were so sick n tired of the pain/inconvenience to our daily living. For me, the arthroscopy allowed me to backpack another 8 months b4 i had to quit and wait for the pkr.

    Good luck in your decision

    smile

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  • Posted

    Ps, the cartilage is independent of your muscles,ligaments. So u can have a strong knee but the "gliding" is affected. Cartridge n bursa are the oil for ur boned do to speak

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  • Posted

    Hi there,

    You must make up your own mind.

    What I am prepared to say is, I had arthroscopy on my LEFT knee for 2 tears in meniscus. During the procedure it was found I had arthritis in the knee joint. That was in 2007. In 2010 I had Orthopaedic appr, they x rayed both knees and found advanced osteo arthritis in both knees& the only treatment they could offer was TKR, both knees. However at 57 I was considered too young & to go away until I could no longer stand the pain. Which happened last year, so in Oct I had TKR in RIGHT knee. The arthroscopy knee is just about holding on now & am waiting to back on the (waiting) list. So to put it in terms of time, I had 9 extra years from the arthroscopy.

    I leave it to you to make your own conclusions.

    Good luck with whatever you decide to do.

    Marilyn

    XX

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    • Posted

      Hello All

      I am 57 years old, female, and in 5 weeks, due to have an arthroscopy and meniscectomy which I just assumed would solve my knee issues. I have already been told I have significant arthritis in my knee however, prior to tearing my miniscus, was able to walk miles and lead a fairly active life. Since the tear, my level of activity has reduced significantly due to pain and swelling. I was just assuming the reason for the pain and swelling I am experiencing was because of my tear, not the osteoarthritis. After reading these posts I'm quite concerned now. Should I go ahead? Reading your post Marilyn, you found the arthroscopy beneficial. Aaagggghhh I'm now in turmoil and have Googled and read fairly negative things, especially for older people like me. I can realize now why Truman is reluctant. 

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    • Posted

      Hi Deb,

      There is so much conflicting information out there, I'm not surprised you're confused!

      Maybe it would be best to speak to your ortho consultant & ask him/her what he/she would do if it were him/her. You want honest answers, answers that apply to you not the ideal patient!

      For me it was beneficial but may not be best for you!

      It's a minefield, & only you can decide what is best for you. You need to know the bottom line!

      I hope you can sort it out.

      Good luck,

      Marilyn

      XX

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    • Posted

      I had four arthroscopies, two each side.  All worked out fine.  As the arthritis became more of a problem, I went to SynVisc shots that worked GREAT for many years.  Moving to a warmer climate made the shots unnecessary. Of course, it all came down to the TKR in 2016.

      Since my first scope was in 2001, this has been a 15-year journey.  Yours could be the same or very different.  No one can know.  Start with the scope and get rid of your pain. Then take it day by day.  Everyone walks their own path...yours is yours...

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    • Posted

      Thanks Marilyn, I went for a walk y'day, a distance I could usually do easily. Today I am paying the price and realise if I want any hope of a decent quality of life, I've got to try the op. Thanks go replying.

      Deb

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    • Posted

      Had my first scope at 51...now I'm 69...had the TKR a year ago at 68, so that was a 17-year time span.  Bilateral scopes and SynVisc put off the inevitable for a long, long time.  If you need a TKR as the last resort, I'd plan it so that: a. the procedure is done late enough in life so that its 25-year lifespan would not require another one; but b. early enough so you can be strong enough to handle the brutal recovery and regain a good quality of life for years to come.

      It's a delicate balancing act considering the patient's age, current pain level, medical/surgical options available, etc.  The docs try to put it off as long as possible but not usually into the late 70's or 80's unless absolutely necessary.  The true elderly patients will usually never make it through a full recovery regime so their goals are typically way less than younger patients who need to drive and resume work.

      I still have the other knee to do and will not put it off for a very long time.  I want to fully recover from this one over the next year, rebuild ALL my strength and get it done while I'm still strong enough to endure the recovery as well as reap its benefits for many years.

      This is not easy, especially the planning, preparation, full understanding of the pain and recovery time/effort involved and more.  With all my other ops (27 in 17 years...mostly small crap), it was the most difficult one ever.  Artificial hip, back fusion, shoulder scopes, four scopes on the knees, gallbladder, double hernia, trigger fingers (7), carpal tunnel, stomach resection and so many more...NOTHING compared to the knee in terms of pain and recovery.  Always kicked rehab's a$$ because I would ALWAYS push the rehab timeline...hip completely done in 6 weeks (5 hours a day/six days a week)...totally opposite with the knee.  Push it and it swells so you have to back off.  Very frustrating.

      That's why you have to lose all your expectations and assumptions.  Instead, you need PTSD: Patience, Time, Strength and Determination.  Then you've got a shot...

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    • Posted

      Wow, thank you for that Chico. I really really don't want a TKR if I can get away with it but am realistic enough to know I might not be able to avoid it. I HATE getting old. So bloomin depressing. 

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    • Posted

      Hi Deb, yep when you struggle to do what was easy a year ago, then maybe for you the time has come for you to act.

      Yep getting older in NO fun! I always used to think I'll never be like that! Hey ho, time & life had other ideas.

      Keep in touch

      Take care

      Marilyn

      XX

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    • Posted

      Remember...TKR is last resort.  If the doc can do a scope, do it.  If he can do the SynVisc and you can get 6-12 months of relief, do it.  Again...age.  If you're 50, put it off until the doc says there are no other options.

      At 68, my doc told me he could so Synvisc or cortisone but the shots would only last a little while and that I'd be putting off the inevitable.  THAT'S when you know you have no other choice.  Talk to your doc...make a plan.  TKR might be 6 months or four years away.  You guys decide.

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