Meniscus arthroscopy or not!

[Mark300zx]

Ok so told by the NHS physio a couple of years ago I have a tear in my meniscus, and they are reluctant to operate. Done the exercises and waited for it to calm down but in reality it continually feels like it is jammed up with cotton wool and swells occasionally. I am tempted to push for an op but have been informed it reduces the lifespan of the knee joint, but in reality I am trying to balance that against having a knee that won't give me the confidence or ability to use as I want.

I am not looking for medical guidance, I suppose venting is the definition

Edited by Mark300zx on Sunday 11th February 23:11

[Wacky Racer]

I had this op around eight years ago, told I would be on crutches for a week or so, but I was back at work two days later.

I can't even see the tiny mark where they went in.

Sometimes have some very mild knee pain, but nothing to worry about after I've taken a couple of paracetamol.

I accept I was lucky though....I'd say go for it.

I'm 64 btw.

[Mojooo]

Go for it, no brainer.

[The_Doc]

Mark300zx said:

Ok so told by the NHS physio a couple of years ago I have a tear in my meniscus, and they are reluctant to operate. Done the exercises and waited for it to calm down but in reality it continually feels like it is jammed up with cotton wool and swells occasionally. I am tempted to push for an op but have been informed it reduces the lifespan of the knee joint, but in reality I am trying to balance that against having a knee that won't give me the confidence or ability to use as I want.

I am not looking for medical guidance, I suppose venting is the definition

Edited by Mark300zx on Sunday 11th February 23:11

What has your knee surgeon told you? , because only he/she has a decent idea of what's needed or implied.

Meniscii become redundant through the decades.

Edited by The_Doc on Monday 12th February 08:15

[Mark300zx]

Thanks for the replies, never saw a surgeon, it was a NHS physio that told me the above information, he said I had mild arthritis ( I am 52) and a tear in my medial meniscus. He advised me to not to go for surgery as this would accelerate general deterioration in the joint and an exercise programme would be more effective in the long term, but at certain point my knee would lock up and I would need surgery in the future.

[Mojooo]

I partially tore my ACL, my surgeon told me not to have surgery (I was early 20s an wanted to play sport). In the end I rehabbed but then fully tore it and caused more damage

In hindsight I do wonder if he was pushing me away from surgery for reasons other than medical need (i.e hospital too busy).

After the ACL surgery I still had problems and another surgeon went in and found torn meniscus preventing proper joint movement - this was sorted and the recovery from this surgery was very quick - i.e back to normal within a week (if not a few days).

My view on it is that if it is making a big detriment to your life to go for it.

[juggsy]

I originally tore my meniscus rushing up a loft ladder to attend an overflowing header tank. Ended up having physio which after a couple of months was fine for 5 years. Then one day I was walking up the stairs and it went again.

Knee consultant suggested I should have the arthroscopy, however when having it done turned out the lateral meniscus was torn too, which apparently didn’t show on the original MRI. This meant the procedure lasted longer and more had to be cleaned up. His words after the surgery were ‘it was a mess in there’. I also had a non-functioning ACL (which wasn’t attended to with the surgery as this is a much bigger job).

6months later and I get pain in the original tear site and the knee is weak, I’m hoping it will settle over time. Just make sure your constant checks both sides of the knee beforehand!

[The_Doc]

Mark300zx said:

Thanks for the replies, never saw a surgeon, it was a NHS physio that told me the above information, he said I had mild arthritis ( I am 52) and a tear in my medial meniscus. He advised me to not to go for surgery as this would accelerate general deterioration in the joint and an exercise programme would be more effective in the long term, but at certain point my knee would lock up and I would need surgery in the future.

this isn't really accurate.

trimming of degenerate symptomatic meniscal tears is not going to accelerate wear and tear of the joint. There is no evidence, and it has no logic. The meniscus ceases to bear/share load when it is torn, so taking out the non functioning bit cannot do any harm. Physio is useful, but if it fails then the next step is to see a specialist.

Mechanical symptoms are the be all and end all of arthroscopy in the aging joint. If you operate on pain rather than mechanical symptoms then you can expect no improvement.

[The_Doc]

juggsy said:

I originally tore my meniscus rushing up a loft ladder to attend an overflowing header tank. Ended up having physio which after a couple of months was fine for 5 years. Then one day I was walking up the stairs and it went again.

Knee consultant suggested I should have the arthroscopy, however when having it done turned out the lateral meniscus was torn too, which apparently didn’t show on the original MRI. This meant the procedure lasted longer and more had to be cleaned up. His words after the surgery were ‘it was a mess in there’. I also had a non-functioning ACL (which wasn’t attended to with the surgery as this is a much bigger job).

6months later and I get pain in the original tear site and the knee is weak, I’m hoping it will settle over time. Just make sure your constant checks both sides of the knee beforehand!

Just make sure your surgeon is good/experienced at it

[juggsy]

The_Doc said:

Just make sure your surgeon is good/experienced at it

Hopefully he was, he’s already done the procedure!

[Mark300zx]

The_Doc said:

this isn't really accurate.

trimming of degenerate symptomatic meniscal tears is not going to accelerate wear and tear of the joint. There is no evidence, and it has no logic. The meniscus ceases to bear/share load when it is torn, so taking out the non functioning bit cannot do any harm. Physio is useful, but if it fails then the next step is to see a specialist.

Mechanical symptoms are the be all and end all of arthroscopy in the aging joint. If you operate on pain rather than mechanical symptoms then you can expect no improvement.

Thanks for your guidance the way the physio explained it was that they have to remove good tissue when they trim the torn meniscus, I presume you disagree with this?

[The_Doc]

Mark300zx said:

The_Doc said:

this isn't really accurate.

trimming of degenerate symptomatic meniscal tears is not going to accelerate wear and tear of the joint. There is no evidence, and it has no logic. The meniscus ceases to bear/share load when it is torn, so taking out the non functioning bit cannot do any harm. Physio is useful, but if it fails then the next step is to see a specialist.

Mechanical symptoms are the be all and end all of arthroscopy in the aging joint. If you operate on pain rather than mechanical symptoms then you can expect no improvement.

Thanks for your guidance the way the physio explained it was that they have to remove good tissue when they trim the torn meniscus, I presume you disagree with this?

I disagree with this

[Mark300zx]

Thanks for your advice, just one last question, is it possible to have this done under local anaesthetic?

[millen]

I haven't looked in any detail but this can be a helpful forum for all manner of knee pain/surgery/rehab issues and experiences http://www.kneeguru.co.uk/KNEEtalk/index.php

[The_Doc]

Mark300zx said:

Thanks for your advice, just one last question, is it possible to have this done under local anaesthetic?

not properly and not often (indeed never realistically)

Spinal anaesthesia or General

[grumpy52]

I have had 4 arthroscopies .
3 done by an RAF surgeon in Wegberg Hospital in Germany, 1 done by NHS in this country.
Mine were caused by sports mishaps .
The correct excercise after surgery certainly helps .
Doing more damage while playing cricket against your surgeon may be classed as self inflicted, according to the surgeon!.
The last one 12 years after the initial injury give me a horrible infection in the knee and a diagnosis of osteoarthritis.

[Ruskie]

I had a miniscus repair about 4 years ago. It’s fine but my knee aches with prolonged sport.