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Torn meniscus - to repair or not to repair?
Bones, Joints & Muscles | Last Active: 17 hours ago | Replies (66)Comment receiving replies
I am 75 years old, work out twice a day, six days a week, very athletic, play racquetball, etc.
I had a broken right ankle 20 years ago and recovered with a steel plate and several screws. Recovery was long, but it worked out just fine. Everything healed just fine and I was right back to everything I wanted to do.
I fell on my left knee four weeks and could barely walk.
I went for an MRI, which was very confusing to me at least.
The summary was: Medial compartment: There Is grade 3 signal within the posterior horn and adjacent body of the medial meniscus extending to the inferior meniscal surface associated with a truncated free margin of the body of the medial meniscus indicating a large complex medial meniscal tear, with torn meniscal cartilage displaced into the medial gutter Multiloculated medial para meniscal cysts are seen adjacent to the periphery of the meniscal body and posterior meniscal root. Segments chondral thinning and fissuring are seen within the medial compartment, with localized subchondral bony changes along the anterior medial tibial plateau.
Lateral compartment: intact lateral meniscus. Segment of high-grade chondral loss along the posterior latera/ tibial plateau. Localized chondral loss with subchondral bony changes along the far posterosuperior lateral femoral condyle.
Patellofemoral compartment: Extensive full-thickness patellar chondral loss throughout the lateral lacet and involving the patellar ridge. Diffuse high...grade chondral thinning and deep fissuring with foci of subchondral bony signal change within the femoral trochlea with full-thickness chondral loss along the superolateral femoral trochlea.
I tried PT for three weeks, and my knee has improved, but not where I would like it to be. I am probably 70 percent better now.
I have been reading everyone's comments on here, and I am totally confused as to the next course of action:
Not sure if PT is the best way to go, or
Start getting shots periodically, or
Just have an operation
Any input would be greatly appreciated!
Replies to "I am 75 years old, work out twice a day, six days a week, very athletic,..."
@richtar Hello, over the course of a long and physical career, I had three lateral meniscus tears in my right knee. Each time I had orthoscopic surgery and they fixed it.
I did Physical Therapy, etc. and the only thing that worked was for them to go in and clean up the tear. They cut off pieces that were interfering with the joint action. They also removed any floating pieces of meniscus that were causing issues.
I do not regret the surgeries and would do them again. I put my first surgery off for years and it would feel better for a short time and then the pain would return.
While there might be differences of opinion on how to treat your knee, with the tear that you have, I’m not aware of anything being able to fix that surgery.
Wishing you the best!! Sherry
I would consult with an orthopedist who focuses on "older knees" because what I read tells me you have damage from the fall as well as significant wear and tear (bony changes, chondral thinning, meniscal cysts) - probably from a combination of age and your strenuous workout routine.
What I am guessing you will hear is that they can clean it up, but the deterioration will continue. If I had to guess what the long-term recommendation would be, it would be to dial down the stress on your knees in your workouts, or a joint replacement.
For example, no other leg work on racquetball days, switch to doubles or pickleball...
Sad to say, our bodies do not heal as well in our 70's as they did 20 years ago and we need to begin to adjust. For example, after complex rotator cuff surgery last fall, my doc told me to "not even think" about hauling 40 lb bags of soil any more, or doing a lot of hammering with the repaired arm or I would be back for a full replacement. So we will hire out the heavy stuff so I can stay as active as possible. (We have already given away the extension ladders, due to intermittent vertigo, we know not to climb ladders taller that 4')
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Hmmm, that’s tough. Maybe talk to an orthopedic surgeon that specializes in joint preservation or replacement. I’d think they’d have good recommendations once they understand how active you are used to being, what your pain level and limitations are currently, and what you’d like to end up through all of this. Does your PT have a thought about how much more improvement you should expect?