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Old 12-17-10, 10:22 AM   #1
DnvrFox
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Torn Meniscus - current treatment approaches

Well, I am just recovering from my fusion, and - yep - the wife was going up the steps into the library yesterday, she heard this ungodly sound coming from her right knee - and was immediately in pain.

It is very similar to the torn meniscus she had on her left knee several years ago. We see the doc in a couple of hours - in the interim I bought her a walker last night. She is getting around slowly today - some less pain.

My question -

A few years back we were reading that one of the now acceptable options for a torn meniscus is to do nothing - that, in fact, it may be better than arthroscopy. Her last arthroscopy did not go well, with some complications.

So, I am asking if anyone here has experienced a torn meniscus, and if so, what treatment options were offered, and what were taken?

Any input appreciated.
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Old 12-17-10, 10:30 AM   #2
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I tore my meniscus in my right knee about 3 years ago. I went to the team orthopedic surgeon for the White Sox and Chicago Bulls (he was voted a world series ring by the players so it's not marketing BS). He said let's wait on surgery as I wanted to go skiing in about a month. He said it would be unlikely that I would make it dramatically worse even by skiing, and if it didn't bother me, I could avoid surgery. This is what I did and I still haven't had it scoped.

I can ride, golf, swim, ski, etc. with no/minimal problems. I can't run or play tennis though due to the pounding. It hasn't been worth it yet so I haven't done it.

Get a good ortho - there are a wide range of skills - and surgery (cash) hungry doctors out there.
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Old 12-17-10, 11:55 AM   #3
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I can give you two stories, leaving you exactly where you started...
I was diagnosed with a torn meniscus in the right knee six or eight years ago. I'd had intermittent knee pain since high school (close to 40 years at that point), but it frequently went away and wouldn't bother me for months at a time, even when I was running 50-70 miles a week, so I never had it looked at.
The doc who diagnosed the tear suggested rest, with a gradual return to exercise as I could manage it. I did that successfully and usually can ride or hike as I please (I don't run anymore). It still flares up occasionally, but rarely if I keep my weight down and stay active (inactivity and weight gain cause problems, and I do have a tendency to slack off and let my weight vary between about 220 and 240). In my case, doing nothing has worked well enough to keep me happy for several years.
OTOH, my wife (120 lbs.) is a runner and occasional cyclist, and she had to have her meniscus repaired after several months of increasing pain. Surgery went fine; recovery took longer than she'd expected, and she's able to do most of what she could before in greater comfort. Cycling doesn't bother her at all, but she's pretty much hung up her running shoes. Still, she's 60 and might have had to do that anyway. I was a runner for 20 years, and I enjoyed it, but if I had it to do over, I think I'd spend more time on the bike and less pounding the pavement.
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Old 12-17-10, 12:47 PM   #4
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One of my doctors told me over 20 years ago that they'd be cutting on my knees within 5 years. I managed to hold it off for almost 20 years with icepacks and ibuprofen before finally having to give in and have it done. I'll second ColorChange's suggestion; my surgeon does a lot of work for the Cincinnati Reds and several of the local college teams. Two years ago I had the right knee done, last year I had the left knee done. Both of the meniscuses in each knee were torn; in addition to trimming and smoothing those out, he also "scraped out the arthritis" while he was in there (I've forgotten the technical term for it, but that's how he described it). In both cases, I felt good enough to walk without crutches the next day, and only used the pain medication the days of the surgeries. In fact, the only times I used the crutches after either surgery was to go into and out of the physical therapy office; they yell at you if you show up without them! The doctor does matter a lot, apparently - the father of one of my daughter's soccer teammates got one meniscus repaired by a different doctor the same day I had my right knee done; the following Saturday, I was standing and walking aound helping to coach the team while he was sitting on the other sideline taking pain medication and still complaining about how much it hurt. I'd say try to find out who does the Rockies or the Broncos and go to them; professional athletes' livelihoods depend on their knees working properly, so they'll be going to the best doctor they can find.
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Old 12-17-10, 02:34 PM   #5
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Thanks for all the great responses.

Update:

A few years ago she also had a torn meniscus on the same right knee. After MRI, she was scheduled for an arthroscopy. However, the knee got better and she canceled the surgery.

We saw the PA for the doc today. X-Rays showed the knee in pretty good condition, bone=-wsie with some worn cartilage on one side. He examined her and feels it is a torn meniscus, but has ordered an MRI for further diagnosis. In the meantime, she is feeling better, and is not using the walker.

So, we will wait a bit as the MRI will be next week sometime - let's see what happens, Maybe she will again get better without the Arthroscopy.
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Old 12-17-10, 08:24 PM   #6
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I had arthroscopy on my left knee some 20 years ago -- lost most of the meniscus. Last summer I experienced pain in the other knee and after a few weeks went to the knee doc. Xrays were not definitive, but the nature of my symptoms suggested a torn meniscus. The doc suggested that it is not uncommon for folks my age (66) to have an undiagnosed tear and then something aggravates it. He suggested a cortisone shot as a starting point in treatment. Since then I have cycled about 1500 miles pain free. While there are certain things that are painful, cycling is not. This, like shoulders and other joint issues, is very individual, but the treatment progression with my doc is: try cortisone, if not successful, see if an MRI is revealing; if so or not, then surgery to determine what repair is needed. So far i am very happy to be avoiding the surgery on my knee...
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Old 12-17-10, 10:59 PM   #7
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Had an MRI about 3 years ago for my knee pain and swelling, sure enough a slight tear in the meniscus. doc said she could scope it and since it was in March I told her I wanted to hold off till I found out if it was going to give me fits as I started riding more and hiking as the summer went on. Rest and ice and a knee brace as I needed it. I haven't had the surgery yet but if my weight goes up so does my knee pain so I have to try to keep the weight down which necessitates more riding. Its a win win for my weight and my knee.
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Old 12-17-10, 11:30 PM   #8
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I have nothing to offer on the subject, except good wishes that Nora's knee will feel good again soon.
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Old 12-18-10, 12:18 AM   #9
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My wife had arhrocopic surgery in September for a torn meniscus. She was back on her bike the next day. It was on a trainer , but she put in some time every day until the DR released her in about two weeks after the surgery. It is the second time in about 10 years that it has torn. Se is pretty hard on that knee because it does not have an ACL. With the aid of a bionic brace and tremendous thigh muscle from cyling; she skis, climbs and hikes without problems
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Old 12-18-10, 02:17 PM   #10
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My experiences: I've always been active off and on for about 30 years (swim, bike, run, weights, etc.). When I first started, I was ignorant of proper shoes and training and I just ran ran ran...my knees suffered for it. Subsequently, I'd have constant pain in my left knee but ignored it. I'd just ease up on the running when it flared up, eventually quitting running altogether for months, then take it up again. I'd repeat this cycle many times over the years. My swimming and riding never was a problem though. Even lifting weights (squats, deadlifts, leg extensions, etc.) was fine.

But then I took up snowboarding about 5 years ago, and the subsequent knee pain and swelling led me to an orthopedic surgeon and an MRI. Found out that 1/3 of my left meniscus is all "torn up and shredded", as my doctor described it and the cartilage around my left knee was a lot thinner than a normal person's. He said I have two options: (1) get it scoped with risk of arthritis in the future, or (2) wait-and-see, avoiding running if possible. I decided to wait-and-see. Started running again a year ago, but only 1x a week (no more 5k or 10k races since), and only do it on the treadmill where the impact is much less than on pavement or concrete sidewalk. But my cycling hours have shot up, with no pain in the knee. I have also continued doing squats and deadlifts. It's possible the scope procedure is in my future, but for now, I have avoided the knife so far.
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Old 12-30-10, 05:50 PM   #11
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We had a consult with a different Ortho today - highly recommended - and have scheduled a right knee replacement for Nora on January 24th.
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Old 12-30-10, 06:05 PM   #12
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That is a huge change from "she is feeling better, and is not using the walker". Good luck to her.
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Old 12-30-10, 07:01 PM   #13
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Quote:
Originally Posted by DnvrFox View Post
A few years back we were reading that one of the now acceptable options for a torn meniscus is to do nothing ...[snip]...So, I am asking if anyone here has experienced a torn meniscus, and if so, what treatment options were offered, and what were taken?
A year-and-a-half ago my orthopede gave me four options:
1) arthroscopic surgery
2) a localized injection of a steroid/lydocaine cocktail
3) massive daily doses of NSAIDs combined with physical therapy
4) HTFU (i.e., do nothing)

After ~10 weeks of #3, my knee was feeling pretty good. 6 weeks after that it started to twinge a bit; I asked the doc what my options were now, and she basically repeated #1 through 4.

This time I opted for #4.

It's been almost a year since then, and things have gotten almost painful enough that I'm gonna start looking seriously at #2 now. But "do nothing" was definitely not just an offhand comment; she's seen it work successfully on quite a few knee patients. Obviously I just forgot to ask her how long it worked successfully!
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Old 12-30-10, 07:32 PM   #14
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This knee's meniscus tore in 2008, and at that time we opted to "do nothing." This time the tear is so bad that arthroscopy will not help, nor is "do nothing" an option because her knee is unstable and it hurts after most any exercise. As exercise is a critical aspect of our lives, we need to get her where she can do it.

The replacement is inevitable. The sooner we have it done, the sooner she can resume her active lifestyle.
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Old 12-31-10, 06:48 AM   #15
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I'm sure you've taken Nora to an excellent surgeon to come to this decision. It sure is a good thing that you put so much effort into your own recovery Dnvr, as your wife is going to be relying on your strength during her TKR recovery.

I wish you both well. Happy New Year!
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Old 12-31-10, 07:44 AM   #16
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I have nothing to offer on the subject, except good wishes that Nora's knee will feel good again soon.
+1 Give Nora a hug from me.....
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Old 12-31-10, 08:22 PM   #17
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We wish Nora well on the upcoming surgery.
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Old 01-02-11, 04:33 PM   #18
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I've had two tears, one in my twenties (left knee), one in my fifties (right knee). Treated both with physical therapy. I figure when I'm older I'll go for the total knee replacement if necessary...
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Old 01-04-11, 07:12 PM   #19
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Getting an MRI on friday for a probable torn meniscus, wish me luck!
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