Meniscus :
Minisectomy: Worse than living with tear? - - Posted by Joanne8902 (Joanne8902), 15 February 2004
I saw this post on another knee board and thought I'd bring it here. I really sums up the way I feel about things:
I would love to hear a response to this posting. Is arthroscopic surgery to trim a meniscus ever effective? Or is it a medical fad which, like "blood-letting," will go out of style. Show me the statistics that this surgery is effective. Where are the medical journal articles? What guides the development of medical standards for the treatment of knees?
Posted by jathib (jathib), 15 February 2004
Let's face it, if you tear your meniscus you are in for ongoing problems for life regardless of what you do. There is no silver lining. I walked on a tear for 17 years and dealt with locking and having to yank on my knee to get it to unlock. I did this until I couldn't unlock it anymore. By the time I had the torn pieces removed I already had arthritis. Over the next few years I kept tearing what was left of my meniscus until now it's gone. Removing the torn parts made my knee much more comfortable to live with over the years but I believe my fate was sealed the day it tore. I'm facing a knee replacement now, or at least a partial replacement but I have managed to live my life with a buggered meniscus for 30 years. I haven't been pain free but I've kept my knee strong and that has prolonged its life.
You can live with a torn meniscus but you won't be any better off than you would if you had the torn parts removed in my experience. And you may well be more uncomfortable with it in there.
Posted by heather8 (heather8), 18 February 2004
Not to belabor the negative, but I think this is important to discuss - or at least be real about.
When I went in for a partial menisectomy, I was offered promises of full recovery, and the ability to return to performing dance within months. When I asked about continuing problems or long-term effects, the doctors said that I shouldn't have any.
3 years later, I have had a ton of problems. I was not able to return to performing dance within months. I have been incapacitated by difficulties an average of 4 out of 12 months per year. If I hadn't already evolved my professional dance career into teaching and directing, it would have ended my career.
I went to the doctor today for the first time in a while. He said that there was nothing they could really do to help me and that my knee "just isn't normal anymore" and that there are a lot of movements (that are just part of my physical vocabulary as a dancer and 11-year yoga practitioner) that I shouldn't be doing. What a contrast from the initial promises!!
I am thankful for some truth, but it makes me think that the initial promises about this surgery are total b.s. I don't know if there are any good alternatives out there - if not, I hope that they are developed in the future.
Posted by Tsunami (Tsunami), 18 February 2004
I think the real consideration is how much is the tear bothering you. If you can live with the tear and continue doing the things you love whether is be hiking or swimming you may as well live with the tear as surgery causes other problems. The problem is when your meniscus gets caught in the joint. I tore my lateral meniscus in both knees. The right one slowly got better to the point where I could walk again. My left was so bad that I could not even extend it past 50 degrees. There is no doubt that I would have a better quality of life by having that meniscus removed. Since the meniscus can be torn in so many different ways it is had to say whether it is a practical procedure or a medical fad.
Posted by powbob (powbob), 19 February 2004
yeah, i had my first meniscus trim less than 2 years ago, (surgery). 1 year later, re-tear, and more trimming. 6 months later, re-tear and another surgery. 2 months later, re-tear and now i am facing my next descision. i did a lot of bicycle therapy and gave myself every chance to ensure a good stable knee, but it kept tearing. as i look back, some of those tears might have been caused by the slightest little thing, and i just don't understand why it is so easy to re-tear. once they go in your knee, that space will never be occupied by as much tissue as it is supposed to. therefore, your femur has more space to move around, and thus i think re-tears can happen REALLY EASY. if you are really active like me, it is just a matter of time.
right now i am waiting for a brace, as my medial meniscus is now almost gone, and the femur is becoming very familiar with the tibia. the brace is supposed to keep the bones apart. if i were you, i'd look into that right away. once you have the tear, and the surgery, the knee will never be the same, and the brace could help. i'm wondering why it wasn't recommended for me earlier. i dont feel that it will help me at this point, but i am willing to try anything. i have a bad tear right now, so if the brace doesn't help a whole lot, then i will need surgery of some sort. my knee feels so unstable to me right now, that i don't feel another trim is going to do much for me. i am looking into the "unispacer" as an alternative right now, and it was also recommended by my doctor who is a big fancy doctor here in jackson hole. other alternatives include cadaver replacement, or collagen or synthetic inserts.
i am 37 years old, and i have played very hard in my life and am dedicated to nothing but that, so i know what it means to give up things you have ingrained into your lifestyle. you gotta stop running..... and anything else that is weight bearing.
i have to find a new career that keeps me off my feet because my condition is so bad, and am currently trying to get vocational re-training services from disability.
Posted by cm (cm), 23 February 2004
My experience:
Last march I tore my meniscus, my knee locked and even after it was manipulated so I could move the knee, I couldn't walk without pain, and any activity beyond walking was absolutely impossible.
Had the partial menisectomy done and I've been back to mountain biking and dirt biking in the summer and skiing (alpine and telemark) 4 days a week since November at the same level I was at prior to the injury and I experience nothing but minor twinges of pain on occasion, and take no painkillers.
Considering that without the surgery I'd be barely walking and after it I'm comfortable and at full activity, I'd certainly recommend the surgery if you need it. I do realize that in the long term I can expect arthritis and such, but tearing up my knee by walking on a torn meniscus that was locking up would in no way have helped the situation. The doctor went in with the intent to repair the meniscus, but showed me the pictures where the tear had become frayed well beyond repair. The surgery restored my quality of life 100%.
Updated Thu Apr 29 2010
