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Author Topic: Torn Maniscus to Knee Replacement  (Read 1942 times)

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Offline Radarpy

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Torn Maniscus to Knee Replacement
« on: September 13, 2005, 02:42:40 AM »
Year and a half ago a doctor scoped my knee for a torn maniscus.   I went back about 4 times after and he said it was fine without laying a hand on my knee.  I decided to go to another doctor and he scoped it again telling me I am going to knee a replacement and that it is bone on bone.  Is it normal to go in for a torn maniscus and in a year and half another doctor tells you that you will need it replaced ?  Just wondering if the first doctor did something wrong or is it normal.

Thanks in advance for your help
Darrell

Offline Radarpy

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Re: Torn Maniscus to Knee Replacement
« Reply #1 on: September 13, 2005, 03:31:00 AM »
I forgot to mention in my first post that I am 42 years old and dread the future.

Thanks again
Darrell

Offline Audice

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Re: Torn Maniscus to Knee Replacement
« Reply #2 on: September 13, 2005, 09:28:14 AM »
Hi Darrell ~ Among other knee problems I, too, have a torn medial meniscus as well as abnormal signal within the lateral meniscus which could be a tear of just wear & tear from old age (67). My OS suggested that the meniscus could be dealt with if it became a real problem but he, as well as a second OS friend, seemed to think that unless it was more than I could deal with, it would be quite all right to leave things alone. So it's sort of a case of repair being on a back burner, to be done - if necessary.

To date I've had a couple of incidences where I thought surgery was going to become a reality but given sufficient ice & Advil, things seem to be quieting down. I'm an admitted coward & the last thing I want to undergo is surgery so I will avoid it at all cost. It's a comfortable feeling to know that there are some repairs that can be made but I'm not being pushed into having them done. Wishing you well... Ellie 
April, 2005 - ACL rupture, medial meniscus tear within posterior horn to articular surface, abnormal signal within lateral meniscus, partial tear MCL, bone contusions tibia/fibula, Baker's cyst.
No repairs.

Offline blackbeltgirl

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Re: Torn Maniscus to Knee Replacement
« Reply #3 on: September 13, 2005, 01:06:02 PM »
It is not uncommon for a torn meniscus to be the most visible problem when reading MRI films.  Many patients decide on surgery for a torn meniscus.  Then the OS gets inside the knee, sees damage to the articular cartilage, and performs microfracture (see the board for bone marrow stimulation, but it's basically a cartilage restoration procedure).  It sounds like your first OS did what he could for the meniscus, probably saw some damage to the articular cartilage, and chose to leave it alone.  You can find out for sure by requesting a copy of your medical records from his office, and your surgical records from the hospital.

There seems to be no direct relationship between the amount of damaged/missing cartilage and the amount of pain.  Some patients are in agony, and come to find a lesion (or pothole) in the cartilage the size of a tic tac.  Others are functional with only periodic pain, or certain activitieis causing pain, and the doctor gets inside to find a bald knee.  Consider yourself lucky that the first OS didn't go straight to a more major procedure, without knowing if the lack of cartilage was the source of your pain.  Read through your records.  Ask questions to find out if the entire joint is bone on bone, or if it's just one area.  If it's isolated, aka a lesion, there are a variety of techniques available before TKR.  All of them require a lengthy rehab and recovery period, if you enjoy another 20 years of life pain free before proceeding to a TKR, it may be worthwhile.  The procedures available to treat isolated cartilage lesions are microfracture, ACI, and OATS.  You can learn more about each one here on kneeguru.  But your first step is to try to find out if you've got lesions or if the entire joint is bone-on-bone.

Good luck.
ACI was supposed to be 2/21/06.  On 6/29/06 Insurance co said have another scope, and if it still looks good, they'll ok the ACI.
Microfracture Dec 7, 2004
   3cm x 6cm lesion, LFC; 3cm x 1cm lesion, trochlear groove; lateral tibial plateau lesion
2nd degree black belt, tae kwon do (had to stop)

Offline Radarpy

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Re: Torn Maniscus to Knee Replacement
« Reply #4 on: September 14, 2005, 12:25:04 AM »
Thanks for the advice,   Every part of my knee is fine except for one spot at around 10 o'clock.  In that spot the maniscus is very thin if any at all and it is bone on bone in that area.  I saw the pictures after scope procedure and the doctor pointed out the area were the bone is touching.  He told me to do everything I wanted to do and that when I was ready to come back and he would do a replacement.  He told me I was really to young but that quality of life was more important.  Just tired of limping and the stress its putting on my other knee and back.

Bottom line I thought a year and half ago it was suppose to be a simple procedure to repair a torn maniscus.   I was basing this from people around me that had one and from what the doctor told me.  Now year and half later I have had 2 scopes and being told I need a replacement.  Just kinda depressing when you are 42 and know you have to deal with this the rest of your life.  But I try to think on the positive side that there are a lot worse things in life than just a bum knee.

Thanks to everyone and their advice.

Darrell


Offline blackbeltgirl

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Re: Torn Maniscus to Knee Replacement
« Reply #5 on: September 14, 2005, 02:16:54 AM »
If it's just one spot, and your current OS hasn't offered anything but a knee replacement - FIND A NEW OS!!!!!

As I mentioned, there are 3 main procedures intended to regenerate or replace cartilage from isolated lesions.  AND they can be use on "kissing lesions" where the 2 lesions touch as you use the joint.  I don't know where you are, but if you check out the boards on each procedure, you can probably find some good referrals.  For ACI, you can visit carticel.com to learn about the procedure, and to find a FULLY CERTIFIED surgeon.  A lot of surgeons are only completing their basic training, but they only list surgeons who have completed a higher level of training on their website. 

I've had microfracture (and on huge lesions - not adviseable but it was the best option at that moment) and am condsidering ACI in the future.  Let me know if you have any questions.  I'd be happy to try to help.

Jess
ACI was supposed to be 2/21/06.  On 6/29/06 Insurance co said have another scope, and if it still looks good, they'll ok the ACI.
Microfracture Dec 7, 2004
   3cm x 6cm lesion, LFC; 3cm x 1cm lesion, trochlear groove; lateral tibial plateau lesion
2nd degree black belt, tae kwon do (had to stop)

Offline kath

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Re: Torn Maniscus to Knee Replacement
« Reply #6 on: September 14, 2005, 03:34:52 AM »
Radarpy...Jess is knowlegeable and gives very good advice.  She is totally correct in advising you to get another opinion...TKR is a drastic recommendation for someone with bone on bone in one spot.  There are less "final" procedures which can help you.

Good luck!

kath
Bi-lateral unicompartmental Nov 2004

Offline blackbeltgirl

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Re: Torn Maniscus to Knee Replacement
« Reply #7 on: September 14, 2005, 01:04:50 PM »
Darrell -

I just re-read your last post, and I'd bet you also have a non-surgical option.  I don't know which knee is causing you trouble, but if the damage is on the medial side of the knee (the inside of the knee) you may benefit from an unloader brace.  I've never used one, since my damage is all on the lateral side.  But a lot of people swear by them.  Basically, the brace redistributes your weight, so that the damaged area isn't carrying much of your weight, and the healthy part of the joint bears more of the weight.  Some people wear them all day every day.  Others use them for sports and other activities.  They can be expensive, but are often covered by insurance.  And I'd certainly prefer a  brace to major surgery.

Jess
ACI was supposed to be 2/21/06.  On 6/29/06 Insurance co said have another scope, and if it still looks good, they'll ok the ACI.
Microfracture Dec 7, 2004
   3cm x 6cm lesion, LFC; 3cm x 1cm lesion, trochlear groove; lateral tibial plateau lesion
2nd degree black belt, tae kwon do (had to stop)

Offline Patty0513

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Re: Torn Maniscus to Knee Replacement
« Reply #8 on: September 14, 2005, 02:46:55 PM »
Hi Darrell,
   Jess and Kath are right, get a 2nd or 3rd opinion.  Your OS should have discussed your other options with you and there are others available.  Don't get too down, you should be able to put off TKR for many, many years (I am speaking from experience).

Take care,
Patty

Offline SKOM

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Re: Torn Maniscus to Knee Replacement
« Reply #9 on: September 14, 2005, 03:38:57 PM »
Best of luck to you!
ACL/PCL Reconstruction (96)
Partial Medial Meniscectomy (03)
Post Lateral Corner reinforcement (too help with Laxity issues) (03)
Partial Lateral Meniscectomy (05)
ACL/PCL Revision (05) Hamstring, Achilles Allografts.

Leader of the "Lax" Knee Clan!

Offline Radarpy

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Re: Torn Maniscus to Knee Replacement
« Reply #10 on: September 15, 2005, 12:25:05 AM »
This is a great forum with some great advice.  Thanks for all that have replied.  The bone on bone spot is on the inside of my knee. The OS did mention a brace and said it would help my knee.  He said the downfall is taking the thing on and off and just getting use to the thing.  When I mentioned I may have to go overseas he said to come back and he would fit me for a brace and give me a shot of cortisone.  He did mention a partial replacement as well but said he would like to see what the rest of the knee did.  He said he didn't want to do a partial and then couple years later need a full replacement. 
From the wonderful advice each of you have given I think I need to get fitted for a brace and see how that performs
 .

Thanks again for all the advice
Darrell

Offline paxgeek

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Re: Torn Maniscus to Knee Replacement
« Reply #11 on: October 02, 2005, 02:58:34 AM »
blackbeltgirl,
    <I just re-read your last post, and I'd bet you also have a non-surgical option.  I don't know which knee is causing you trouble, but if the damage is on the medial side of the knee (the inside of the knee) you may benefit from an unloader brace.>

 Am I reading correctly, that unloaders help only if it's the medial meniscus removed? I had removal of 100% of the lateral meniscus. I'm giving PT time to build my muscles but if I start developing back pain, I need to know what nonsurgical options are available. Thanks, Leslie

Offline blackbeltgirl

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Re: Torn Maniscus to Knee Replacement
« Reply #12 on: October 02, 2005, 04:24:32 PM »
paxgeek -

I've never had an unloader brace, so I'm not 100% sure.  I do know that they are used more frequently when the damage is to the medial side of the knee.  But I recently saw mention of an unloader brace that can be set for damage to the lateral side of the knee.  I don't remember where, and I'm not sure if it will help if you have damage to both compartments.  But it can't hurt to ask the OS about a brace before deciding on surgery.

Good luck!
Jess
ACI was supposed to be 2/21/06.  On 6/29/06 Insurance co said have another scope, and if it still looks good, they'll ok the ACI.
Microfracture Dec 7, 2004
   3cm x 6cm lesion, LFC; 3cm x 1cm lesion, trochlear groove; lateral tibial plateau lesion
2nd degree black belt, tae kwon do (had to stop)















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