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Author Topic: New to the forum -- questions & MRI results on horizontal tear with cyst -- long  (Read 942 times)

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Offline racyscooter

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Hi there.  Any thoughts would be greatly appreciated.

My background:

I'm 42. female.  I was housesitting and took 2 dogs for a jog a year ago. They saw a squirrel and took off and I stopped them in 3 steps. I was actually proud of that. No immediate pain, but when I got back to the house, my knee blew up and I couldn't bend down. Anagelsics and many many many ben gay patches saved the day.  I was able to manage with minimal problems.  Swelling went away, but the pain comes back when I exercise or going downstairs.  I finally got fed up when my knee started hurting while I was walking in a mall. I was like, "that is frickin' IT. This makes no sense whatsoever" and made an appointment. The pain is an occasional, but definite ache. The kind that ibuprofin and ice/hot pad is needed so that I can fall asleep. Kneeling is a definite no-no.  I can do it for a short-short-short time, but my knee hates me afterward. So I've given up kneeling. I've gradually eliminated exercise, thinking I was just aggravating the situation and needed to give my knee a chance to heal on its own.  Actually, I wasn't sure anything I was doing was helping. I'm also now overweight by a LOT, unfortunately. So I finally went to the doctor who sent me to an OS, who sent me for an MRI.   

Here's my MRI results:

Large horizontal tear of the lateral meniscus extending from the anterior to posterior horns. The tear exits the inferior articular surface. Immediately lateral to the tear is a septated meniscal cyst located between the lateral femoral condyle and the iliotibial band. The lateral collateral ligament complexes  are intact and normal. There is some lateral displacement of the lateral capsular ligament from the meniscal cyst. The medial meniscus is decreased in volume with central grad 1-11 signal and some inner surface irregularity.   There is a small inner surface tear at the mid portion of the meniscus.  The medial collateral ligament is normal.  The anterior and posterior cruciate ligaments and extensor tendon mechanism are normal.  There is no knee effusion and there is no popliteal cyst. There is mild lateral compartment osteoarthritic disease particularly about the weight-bearing portion of the lateral femoral condyle with small osteophyte and subchondral cyst formation.  The remainder of the bone marrow signal is normal.


1) Extensive horizontal tear of the lateral meniscus with associated meniscal cyst formation as described above.
2) Small degenerative medial meniscal  tear.

I spoke with the OS.  He gave me 3 options.

OPTION 1) do nothing (no surgery), but he suggested that the cyst could cause future problems.
OPTION 2) remove the cyst and the tear.
OPTION 3) remove the cyst and repair (suture) the tear (this may not be possible, depending on how much blood flow is available in that area).

Because of the cyst, I gather that the do nothing isn't really an option.

OPTION 2) will almost guarantee arthritis in 5 years. But i can be on my feet in 1-2 weeks.
OPTION 3) 6 weeks on crutches.  6 weeks rehab. Back to normal in 3 months.

Can you give me any idea how bad my tear and cyst is?  Do people simply go for the option 3 because other options will eventually worsen?  Do people actually go for the do nothing option?  Does the cyst make surgery a given?

I'm an active person. I'm not a runner, but I like working out. I especially like hiking -- the 6 mile kind, an easy way to knock off 900 calories. I also love dancing, but I'm overweight now because I've been babying my knee for a long time -- giving up the long walks and dancing.  I haven't replaced it with much else. I tried swimming, but my knee still bothers me (but not always).  I tried the elliptical at my gym and I don't experience any pain, but I fear I may be overdoing it by doing it for an hour. I gave that up too. I haven't done anything except ordinary walking. No major pain, but going downstairs triggers a bad ache.  I've been babying my knee to the point that I hop up and keep my knee forward, when I go downstairs, so I don't have to bend my knee back while my other foot lands on the step below.

So do you have any extra advice or info on what I'm about to face? I particularly want to know if the brace would be completely straight or bent.  I'm having trouble imagining the changes I need to make to do six weeks on crutches. How do you put shorts, etc on? 

I live alone and I ride a scooter, hence the username.  I can give up the scooter for a month for the sake of getting my knee to the point where I can exercise again. That's my main goal. I love hiking and long 6 mile walks.   I don't like the idea of doing a band-aid cure only to have arthritis looming in my future.    Is Option 3 the only route for my situation or am I wrong?

I'm also contacting other friends (including a male nurse) for their knowledge and similar experience.


Offline Nettan

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One thing for sure is that you have been forced to give up a lot of things that you like. Only that should be a good reason for doing surgery.
I would really go for option 3 though that takes longer time. You want to come back to a active life, so why hesitate ?
Get dressed is not a problem if you sit on a bed and get dressed.
Wether you will have a brace or Immobilizer is up to your surgeon. Why not call back and ask more questions ?
Good luck wether you choose.
Surgery 6 times left knee torn meniscus, RSDS,chondromalacia, nervdamage cause constant nervpain,chronic inflamm.
Spinaldamage wheeler 100%.
Right knee damaged aug-06, use brace surgery 4/9-07.LCL tear.