OT-Meniscus tear

[Rob Marshall]

Anyone have any tips for dealing with a Meniscus tear on left knee. KT tape or different braces? I have an MRI next week but my Dr is pretty confident that it's torn. Says I can keep playing and put off surgery if necessary until after the golf season. Turning 60 sucks...

[Mark Mammel]

I'm a retired MD- not an ortho, but having had 2 meniscus tears and a knee replacement, the most recent research suggests that surgery vs rest/rehab are similar at 6 weeks, and surgery is more likely to lead to knee replacement over time. Each case is different of course, so I'd go with what your Dr recommends. However, if "clean-out" surgery is recommended I would suggest a second opinion.  My wife tore the meniscus in her left knee 6 weeks before a trip to St Andrews. No surgery, good healing, no problem.

[Ian Mackenzie]

Have addressed this in the past 15 years. I am 59 today.


I tore my meniscus playing hockey about 18 years ago.
Always kinda hurt, but i persevered.


After an annual check up, my GP referred me to an ortho guy for an exam.
One quick MRI later and the dude had me scheduled for the procedure....BOOM.


But, wait....


So, my wife was on the board of the Rehabilitation Institute of Chicago (now the Ability Lab) for 10 years.
She dragged me to a Xmas lunch where I sat next to Dr. Joel Press - one of the foremost rehab/ortho guys in the world apparently.


Of course i brought up my pending surgery.
He asked me 3 easy questions and told me not to do it.


- increases chances of osteo-arthritis later in life
- cash-cow for ortho guys and they cant always be trusted
- no guarantee that it will "work" as before.


Instead, he encouraged me to strengthen ALL the surrounding muscles via regular excercise.
Calves, ankles, hips, thigh, glutes, etc.


I used to cringe when I had to crouch to read a putt.


No more and, by the way, the other side benefits to golf are fantastic.

[Rob Marshall]

Good stuff, guys thank you. This was very helpful.


Ian,
What were the 3 easy questions he asked you?

[Greg Hohman]

Rob, no surgery here, the pain was not constant and dissipated while I weighed surgery. I can’t remember how long ago this happened (62 now), but am sure quite a few years have passed. I feel a very slight “something” occasionally.

[Jim Lipstate]

The knee has cartilage, a firm gristle capping the femur and tibial components, but also two crescent shaped additional cartilages - the medial and lateral menisci providing extra “cushion” for the knee joint. Unfortunately, cartilage has minimal reparative qualities. Meniscal tears don’t repair themselves, per se. Surgery, however, is a quality of life decision especially for non-elite athletes. Sometime tears can cause the knee to lock recurrently and those patients need surgery. Think of slashing at a tire with a box cutter so that every time the tire rotates a flap of tire flops around. You can’t really “repair” a torn meniscus with surgery but torn flaps of cartilage can be resected making the knee more functional. Earlier onset osteoarthritis is common post surgery.


Less severe meniscal tears frequently respond well to exercise measures strengthening supportive muscles for the knee. I certainly would try that first. If the knee is locking or has significant swelling and pain then surgical options remain available. Consider it an elective procedure not a ruptured appendix.


Hope this explanation helps. I am a practicing rheumatologist and encounter these problems frequently in my patients.

[Rob Marshall]

Thanks for all the reply’s guys. Very helpful.

[Jay Mickle]

I guess that I was lucky. When I was 55 I had surgery to remove some torn bits of my meniscus. When I asked the doctor when I could return to work (I shoe horses), his response was three days or 30 days depending on whether or not I was a government employee. In fact I had the tack a shoe back on a horse two days post surgery. Was back working full-time three days after that. I started playing soccer again after two weeks, the knee was not fully flexible but so long as I didn’t end up in a major squat position I figured I was OK.
It was a couple of years after that when doctors started suggested that perhaps rest would be equally effective. I don’t know I thought I had been resting it prior to the surgery. Good luck.

[Rob Marshall]

Had the MRI which confirmed the tear and met with the DR yesterday. He recommended surgery when it gets to the point I can't tolerate it. I'm going to try exercise and strengthen the leg and see how that goes before any surgery. Currently it's not anything I can't live with. Thanks for the advice.

[Dan Moore]

Rob,


I tore my meniscus in Jan 2017 while working out. Initial treatment for 2017 golf season was a steroid shot, exercise etc. It definitely bothered me while playing and made walking more difficult. A second shot really helped for a couple more months then pain and impairment returned. I had surgery in Dec 2017 and was playing and walking again in 6 weeks. It took about 6-9 months to get to 100% and I have not had an issue with the knee since the surgery. 100% pain free for several years now. Maybe if I had rested it completely for 2-03 months I wouldn't have needed surgery but I'm glad I had the surgery. My doc described the tear like a hangnail that keeps getting inflamed every time it gets caught on something and can never completely heal on its own.

[Jim Sherma]

I've torn it twice in my left and once in my right. Partial and not full tears. Healed ok but with flare ups based on usage. I've been wearing the simple wraps that sit under the knee caps and keep the meniscus in it's slot through pressure.


https://www.futuro-usa.com/3M/en_US/futuro-us/products/~/FUTURO-Knee-Strap/?N=4318+3294508215+3294529207&rt=rud

I find that it I wear these on both knees while playing or doing any long walks on cement I don't have flare ups and I have avoided any surgery. When I do get a flare up I use Voltaren (Diclofenac Sodium Gel) for a week or so and it helps get the bad knee back to being right.

[Craig Sweet]

Tore mine on the right knee but opted out of surgery. I wore a store bought brace to finish out the snowboard season. Golfed with it torn for a full summer and it was painful from time to time. I wore the brace while riding that winter and the following summer golfed with no pain. No problems since.

[Ben Attwood]

Strengthening the surrounding muscles reduces the pressure on the joint during the stride.


Two other things can help in this way, which may or may not apply. Weight loss and using a trolley rather than carrying.

[Tommy Williamsen]

As someone that has had many different knee surgeries (two ACLs and one meniscus) and problems every situation is different. Strengthening muscles is essential regardless of the problem, but beware of how you do the exercises. Some do more harm that good. Get good advice from y99ur dr and therapist.

[Michael Wharton-Palmer]

Had the MRI which confirmed the tear and met with the DR yesterday. He recommended surgery when it gets to the point I can't tolerate it. I'm going to try exercise and strengthen the leg and see how that goes before any surgery. Currently it's not anything I can't live with. Thanks for the advice.

After 4 such repairs, two on each knee, the post surgery was great whilst it lasted.
My right knee is at about 90 % ten years post the second surgery and the right knee at about 70%.
Now occasional discomfort but only on walking and carrying.


I highly recommend the tear surgery, post rehab it was so much better
Cannot run anymore but gym sessions are hardly limited, squats okay and like you Dr said knee replacement when it becomes necessary