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Torn meniscus - to repair or not to repair?

Posted by valandsheri @valandsheri, Feb 28, 2024

Hello, this is my first rodeo in the knee department. Been through it with my husband - both meniscus repair and then, ultimately, a full knee replacement.

I injured my knee in a fall last summer and I have arrived now with two tears - this is, partially, what my MRI says: Chronic appearing horizontal tear of the posterior horn and body of the medial meniscus extending to the tibial articular surface with intermediate signal granulation tissue within the defect. Small 9mm parameniscal cyst along the anterior horn. Mild peripheral extrusion. Horizontal tear of the body of the lateral meniscus extending to the femoral articular surface. The report goes on....

I received a cortisone injection as a "quick fix" and will have a follow up consult with the PA in a few weeks. I was also offered a surgical consult which I did not take at that time.

So, of course, I've been reading Dr. Google and getting a lot of input from friends and family. The general consensus is that I have only masked the pain with the injection and it also doesn't help with healing the tears and can possibly slow healing. That I should get a surgical consult and see if the tears can be repaired.

I am happy that my knee is feeling better and I can get back to walking and my busy day, but I don't want to injure myself more under the comfort of the cortisone, but I am not opposed to surgery.

I would love more input from anyone that has experienced this. My main question is: can certain meniscal tears heal themselves without surgery?

Thanks so much!!

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Mentor
Sue, Volunteer Mentor | @sueinmn | 3 days ago
In reply to @richtar "I am 75 years old, work out twice a day, six days a week, very athletic,..." + (show)
@richtar

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!

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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')

REPLY
covidstinks2023 | @covidstinks2023 | 3 days ago
In reply to @sherrym25 "@richtar Hello, over the course of a long and physical career, I had three lateral meniscus..." + (show)
@sherrym25

@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

Jump to this post

richtar, I had a torn meniscus repair done back in 2017 and I did very well. I am a slow healer, so it took me 3 months to full recover. PT actually before the surgery made it worse. I was
glad to have had it done.

Praying for you. Blessings...

REPLY
pepanyc | @pepanyc | 8 hours ago

This is my first time commenting on this forum. About miniscus tears - I’ve experienced 2. I lived in Buenos Aires at the time and PCP recommended “do nothing”. The sinovial fluid replenishes within weeks! And so it did! I’ve never had another tear. Buena suerte!

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