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Author Topic: How do you know how much meniscus a surgeon has left you?  (Read 1108 times)

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Offline Tahugo

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How do you know how much meniscus a surgeon has left you?
« on: May 03, 2006, 06:06:56 PM »
I had a partial mntmy and debridement.  As its the NHS, I had not seen the surgeon who would be doing the op until right before the surgery-- (although they had notes from another OS and a fuzzy xray).  I brought MRI film with me to show them.  I tried to impress upon the OS that even though I am 54, I am extremely fit and a performer who is very active.  Nothing else is wrong with me and I am physically strong.  Therefore, the less meniscus he took away the better. He said they don't differentiate between knees (though ofcourse if I was in my 20's they would sew not trim).  The OS was in his 20's and I wondered if he might classify me as old and near retirement age, not needing a prime knee any longer  -- so this was my motivation to get him to see "the whole patient" not just the knee.  I won't be retiring for another 25 years if even then.

I had a triangular tear of the posterior horn which he repaired and he cleaned up an osteophyte which may have appeared due to an accident early December when I was performing (I came down on a metal floor plate right on my knee)

Do I have to resort to another expensive MRI to find out how much meniscus I have left?  I said to him afterwards -- "Did you leave me enough meniscus?"  But he didn't really respond to that (I was drugged up anyway)  Does the percentage left determine specific rehab I could be doing? Even exercises for the next years ahead?  What if he took away too much -- anything I can do to counter it?

I am curious that some people on the site say things like I had 20% taken away, etc -- why didn't they put that on my report?  The percentage of how much was taken away.

Please answer. 

Grateful

Tahug

Offline blackbeltgirl

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Re: How do you know how much meniscus a surgeon has left you?
« Reply #1 on: May 03, 2006, 07:00:38 PM »
A lot of doctors don't tell their patient this detail unless asked.  And even then, if they didn't write it down they can't give you more than a best guess from memory.  They are most likely to take notes if it's extreme in either direction, i.e. it was a very small tear, only 10 or 20%, or if it was large, 70-80%.  An MRI won't tell you how much meniscus is left, so don't spend your money to find out.

As to repair vs. removal of the tear - it depends on the location of the tear and the type of tear, not the age of the patient.  Only a small % of mesnicus tears are actually repairable, most are removed.  I've had 2 partial meniscectomies - one when I was 17, the 2nd when I was 30. 

In terms of long-term care - any damage to the menisci can lead to damage to the articular cartilage over time.  They serve the role of shock absorber, so losing this can result in increased wear and tear.  The best way to help yourself is to keep your knee strong.  Basically, your rehab is never done.   Even when you are released from formal physio, you want to keep your knees strong.  Some people are able to do that through sport-specific training.  Some people continue doing basic physio exercises at home.  Some people join a gym and lift weights.  But strong muscles are the best thing you can do to maintain your knee health for the next however many years.

It sounds like you're very uncomfortable with the doctors you've seen, and the limited communication.   I know several other UK kneegeeks have found ways to switch doctors to find someone they liked and trusted.  Maybe you can ask them who they've seen, and how  you can switch.  Trust in your doctor and physio is important, and it sounds like you have none.

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
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Offline henri

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Re: How do you know how much meniscus a surgeon has left you?
« Reply #2 on: May 03, 2006, 07:10:26 PM »
The age doesent make any different ,when it comes to taking away some part of meniscus.The part,which they took away ,depends on the injury you had.I suppose it was small tear,so probably the part taken was like 20 % or so.I also had a meniscus tear,which MRI didnt show at the time i had it.Thought i had one nasty fall without my acl and after the MRI and then i got knee hurting,so that could explain,why MRI didnt show that.But the doctor showed me,on the paper,how big part he took out, it was like 25 % i suppose.You should ask your doctor,i suppose they should take notes about their operations,dont they?
unhappy triad

Offline heather k from wales

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Re: How do you know how much meniscus a surgeon has left you?
« Reply #3 on: May 03, 2006, 08:29:52 PM »
Im in the UK, I have had 7 knee operations and none of the notes state a % removed or even an amount such as a 'the majority, a large amount etc...'.  I had a spinal for the last two operations mainly because I wanted to know what was going on and what state my knee really was in.  The OS was brilliant at explaining what he was doing throughout the operations.
He told me on the 1st opertation he did on me (my 6th) that I had had over 90% removed prior that operation.  The next time he removed a bit more, so I have had about 95% removed, leaving about 5% :o

You will really need to try and ask the OS who did the operation and hopefully he will either remember how much or he may have taken scope photos.

Good luck,

Heather ;)
91 Mangled Right knee on trials motorbike
94 Meniscus Repair
95 ACL/LCLrec,notchplasty,bone graft
01 90% Menisectomy
02 Scope
03 ACLrec,LAD
OA,osteophytes
04 Ch'plasty, ACLdeb,Suprapatella mbr ex, haematoma
04 Scope
March 06 Scaphoid op/bone graft
Nov 07 Thyroid Cancer ops x 2, radiation

Offline UK Girl !

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Re: How do you know how much meniscus a surgeon has left you?
« Reply #4 on: May 03, 2006, 08:35:01 PM »
Hi
I was really lucky??!! - my surgeon gave me back all my meniscus in a little pot! so I know there was 100% removed!
1978 - ruptured acl and all cartalidge removed.
several debridements over years
TKR 10TH JULY 2006 http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=28257.0  Aug 07 patellar maltracking - more physio! Still pain - but so much better !
BIOMET AGC  TKR  (with 10 yr warranty !)

Offline Tahugo

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Re: How do you know how much meniscus a surgeon has left you?
« Reply #5 on: May 03, 2006, 08:54:57 PM »
Thanks for the replies -- I found them really helpful!  Great to hear from others.

Tahugo

Offline smiley196

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Re: How do you know how much meniscus a surgeon has left you?
« Reply #6 on: May 03, 2006, 09:06:38 PM »
Along with the others, I wouldnt get an MRI on it. You could always contact your OS and ask how much he took out. I have about 25% left in my left knee, and I only know that because my doc told me.
Kritsa
*16 years old*
Left Knee:
Torn:PCL, ACL, MCL
SEVERAL dislocations
Grade 3 Chondromalacia
Medial & Lateral Meniscus tears
Plica Syndrome
Sept 14th 2005-(LK)ACL recon, TTT, menisectomy,plica removal

May 26th/06-Torn ACL(RK)

June 14th/06-(LK)ACL graft recon, screw removal, menisectomy