In 2000 I had a torn meniscus repaired on one of my knees. After a good-paced (for me anyway) early spring ride 6 weeks ago, the knee was hurting like a sum*****. An MRI confirmed that I tore it again; an x-ray shows well developed arthritis in the knee as well. The doctor gives me 3 options: let it be and hope the tear scars over; take a shot of cortisone and hope that the inflammation goes down and allows me to get back to life (maybe regularly taking OTC anti-inflammatory medication); have another arthroscopic surgery on it, which she says might not be the cure-all like the first time around.

My insurance coverage stinks so I am leaning towards the cortisone option as the best value for the investment. The cloudy outlook as to what I might expect is discouraging though and I was wondering if anyone else has faced a similar quandary. Thanks.

AFAIK current outcomes research is that letting it alone and/or cortisone is the best option. I had a repair done years ago and my knee has been OK ever since, so I haven't had your problem. I suppose it might depend on the exact type of tear. Outcomes research is a scattergun.

cortisone is never a good option. Don't head down the path of (that kind of) steroids.

I'd get a second opinion, and either take time off to heal or get surgery. Once your start getting steroid injections, you'll be going back quite a bit.

Just as a general rule: Go with the least invasive (but reasonable) approach first. If rest doesn't get you back to where you want to be, take it up a level to the shots. If they don't work, you can always go with surgery -- and by that time you may have insurance that will cover it. But you can never undo what the surgeon has done. If it doesn't work well, you mostly have to learn to live with it.

I think one major exception to that rule is: if you will do more damage if you DON'T have the surgery. But it sounds like the surgeon does not think that that is an issue.

And, second opinions are usually good -- especially when a complex decision must be made...

cortisone and take up swimming for a year