Torn meniscus - to repair or not to repair?

Posted by valandsheri @valandsheri, Feb 28 9:19pm

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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I can relate to your situation and the dilemma. Major factors are age and what type of surgery they will do..A repair or debridement (clean out). For younger patients they repair. They were planning to do debridement for me, since I’m over age 30.

The injury happened when I had a freak accident several years ago and injured both my knees, but the right one worse than the other. I didn’t get MRI on the left , but suspect it’s torn too.

I saw an orthopedic surgeon, who I knew was conservative right away, got MRI and surgery was recommended. While waiting for surgery, I started feeling less pain and ran into a friend who said she had same thing, but wasn’t having surgery. I then got a second opinion from another orthopedic surgeon who specializes in knee injuries. He viewed my MRI results and said delaying surgery was reasonable in light of my mri, that surgery was not a guarantee of relief and it would create arthritis down the road. Plus, there is some risks….So, I canceled the surgery, got PT to strengthen my hips and treat my ITBS that also developed. It was amazing. It got much better. I went on a fitness kick, lost weight, changed my diet, and now work out 6 days per week. I have some health issues from post covid syndrome, but am improving. I’m mindful of my knee, but it’s holding good. I feel I made the right decision for me.

It’s an individual thing really. If I was in pain or had locking, weakness, etc. I’d seriously consider surgery.

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@celia16

I can relate to your situation and the dilemma. Major factors are age and what type of surgery they will do..A repair or debridement (clean out). For younger patients they repair. They were planning to do debridement for me, since I’m over age 30.

The injury happened when I had a freak accident several years ago and injured both my knees, but the right one worse than the other. I didn’t get MRI on the left , but suspect it’s torn too.

I saw an orthopedic surgeon, who I knew was conservative right away, got MRI and surgery was recommended. While waiting for surgery, I started feeling less pain and ran into a friend who said she had same thing, but wasn’t having surgery. I then got a second opinion from another orthopedic surgeon who specializes in knee injuries. He viewed my MRI results and said delaying surgery was reasonable in light of my mri, that surgery was not a guarantee of relief and it would create arthritis down the road. Plus, there is some risks….So, I canceled the surgery, got PT to strengthen my hips and treat my ITBS that also developed. It was amazing. It got much better. I went on a fitness kick, lost weight, changed my diet, and now work out 6 days per week. I have some health issues from post covid syndrome, but am improving. I’m mindful of my knee, but it’s holding good. I feel I made the right decision for me.

It’s an individual thing really. If I was in pain or had locking, weakness, etc. I’d seriously consider surgery.

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Thank you! I really appreciate your reply!!

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I've had four arthroscopies on my knees for, among other things, torn menisci. I was in my late 40s. In my late 60s I had both knees replaced due to osteoarthritis and years of marathons. My knees feel great now and I'm in the gym every day. But no impact exercises - running, basketball, tennis, and on, which is fine. I do a lot of spin classes and love it.

My understanding is that small tears in the meniscus can eventually dissolve/resolve without arthroscopy. The best thing would be to see a good orthopedic Dr specializing in knees. He or she would know if surgery is required. Most MRIs are inconclusive.

It sounds like your knees are improving. Mine never did improve, and the torn meniscus would cause the knee to lock up from time to time. I also had a cyst behind my knee removed during one surgery.

Sounds like you may be able to avoid surgery. I'd talk to a good Dr - and that means a surgeon whose first recommendation isn't surgery, at least not without a lot of justification.

All the best!

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God Bless You! Knee pain can be miserable. In 2018, I turned my knee the wrong way and tore the mensicus! I also have arthritis in that knee. I had surgery to clean out the arthritis and for the torn mensicus repair. I did well and the knee healed, except for more arthritis with aging. I'm glad I had it done. I am a slow healer, so it did take me a little longer too heal, but, it was worth it! Praying for you and I wish you the best!

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@heyjoe415

I've had four arthroscopies on my knees for, among other things, torn menisci. I was in my late 40s. In my late 60s I had both knees replaced due to osteoarthritis and years of marathons. My knees feel great now and I'm in the gym every day. But no impact exercises - running, basketball, tennis, and on, which is fine. I do a lot of spin classes and love it.

My understanding is that small tears in the meniscus can eventually dissolve/resolve without arthroscopy. The best thing would be to see a good orthopedic Dr specializing in knees. He or she would know if surgery is required. Most MRIs are inconclusive.

It sounds like your knees are improving. Mine never did improve, and the torn meniscus would cause the knee to lock up from time to time. I also had a cyst behind my knee removed during one surgery.

Sounds like you may be able to avoid surgery. I'd talk to a good Dr - and that means a surgeon whose first recommendation isn't surgery, at least not without a lot of justification.

All the best!

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Thank you! I am now waiting for an appointment with a sports medicine doctor to gather more information. It sounds like there are a lot of various ways to treat this.

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@covidstinks2023

God Bless You! Knee pain can be miserable. In 2018, I turned my knee the wrong way and tore the mensicus! I also have arthritis in that knee. I had surgery to clean out the arthritis and for the torn mensicus repair. I did well and the knee healed, except for more arthritis with aging. I'm glad I had it done. I am a slow healer, so it did take me a little longer too heal, but, it was worth it! Praying for you and I wish you the best!

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Thank you somu h. You inspired me to contact my PA and ask for a surgical consultation. I'm waiting for it to be scheduled. Thank you for your kind words and prayers.

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@valandsheri

Thank you somu h. You inspired me to contact my PA and ask for a surgical consultation. I'm waiting for it to be scheduled. Thank you for your kind words and prayers.

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Honored. Keep me posted. I care. Blessings....

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@valandsheri

Thank you! I am now waiting for an appointment with a sports medicine doctor to gather more information. It sounds like there are a lot of various ways to treat this.

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There are a lot of ways to deal with knee pain. And first, it helps to know what you have and what the future looks like, with PT, with or without surgery, and on. A good Dr can spell out those options for you. If the Dr wants to jump right to surgery, get another opinion before committing.

In my case, and with advanced osteoarthritis is both knees at age 68, I needed replacements. But I ran over 20 marathons on the old knees, and only required the replacements 20 plus years since I last ran. Now I feel great with the new knees, but running is still over.

PT and working with a trainer have helped me immensely. Best wishes for you!

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I have a meniscus tear in one knee. My sports medicine dr recommended 3 PRP injections, spaced 3 months apart. I have had 2 so far with no improvement. I’m debating on having the 3rd because insurance does not cover this procedure. Has anyone had luck with this treatment?

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@cadunkin

I have a meniscus tear in one knee. My sports medicine dr recommended 3 PRP injections, spaced 3 months apart. I have had 2 so far with no improvement. I’m debating on having the 3rd because insurance does not cover this procedure. Has anyone had luck with this treatment?

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Hmmm, I thought PRP was recommended for osteoarthritis, but it is sometimes recommended for a meniscus tear. If it's a significant tear in your meniscus, arthroscopy might be faster.

How do you know it's torn, or how badly it's torn? Does your knee lock up occasionally? If yes you probably need a scope. Or try PRP one more time, or try another surgeon for a 2nd opinion. Be well.

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