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Author Topic: 15 year old gymnast, possible meniscal tear  (Read 3074 times)

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Offline cbono4

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15 year old gymnast, possible meniscal tear
« on: January 28, 2009, 02:54:15 PM »
Please anyone who has any advice, I would appreciate.  My 15 year old daughter, competitive gymnast, hurt her knee over 1 year ago on a typical plant and twist injury.   It never swelled, and after 1 week she felt fine, except it hurt to bend all the way.  Other than that no pain.   Dr. recently recommended an MRI....He says there is a good size tear and it needs to be repaired.   2nd and 3rd opinion say that, since she feels fine (no pain at all) other than the full squat, they wouldn't do surgery.  They also say that the MRI is a "close call" and it may not be a tear at all.   They recommend go back to gymnastics, and follow up in 6 months.   I do not know what to do, because doctor #1 scared me with talk of early arthritis.   I do not know who to believe.

Offline JaneDown

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Re: 15 year old gymnast, possible meniscal tear
« Reply #1 on: January 28, 2009, 03:28:54 PM »
I would advise strongly that if it isn't bothering her then leave it well alone. Surgery or even just an arthroscopy to see what's going on in there could well leave her in long-term worse pain and actually although the Doc#1 said that a meniscal tear can possibly lead to earlier arthritis, this is not always the case AND it's fairly well documented that having knee surgery can hasten your journey to arthritis anyway! If there is a meniscal tear and surgery results in the torn piece being taken out, the reduced amount of cartillage spacing the bones apart and cushioning them changes all the forces through the knee joint and can definitely lead to quicker arthritis. In a way, with a meniscal tear you are potentially damned if you do and damned if you don't becaue either the tear or the surgery could increase chances of getting arthritis (but equally either may not do any damage at all!).
I am personally very anti having surgery unless the reason you are having surgery is that your quality of life is so diminished that there is no choice. It sounds like that's definitely not the case with your daughter. She's so young too to be messing about having surgery that may damage her knee further. My story is not typical but nonetheless happened (and seems to happen fairly regularly on this site!), my meniscal trimming arthroscopy ended up with my knees (both!) being damaged by the surgery, the OS actually caused a brand new tear while he was in there on my medial meniscus which was perfect before he went in there!!
She's only 15 and wants to be active, her knee gives her no pain, if it were one of my kids it wouldn't even be up for discussion....no surgery!!!
Hope you make whatever decision turns out to be for the best
JANE
Knee pain since 2002
2006 MRI shows lateral meniscal tears
Oct 2008 Bilateral partial lateral meniscectomies (long recovery!!)
Jan 2009 MRI shows surgery caused damage to medial meniscus!!!
June 2013 knee injury, agony!!!
August 2013 - left knee medial partial meniscectomy

Offline cbono4

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Re: 15 year old gymnast, possible meniscal tear
« Reply #2 on: January 28, 2009, 04:34:51 PM »
Jane,  thanks so much for your reply and for sharing your story.   I hope you have some reprieve in your pain.    I certainly am leaning toward not doing any surgery...the docs say to follow up in 6 months, but of course call if there is any significant pain or swelling. 

Doctor #1 claims he can "fix" the tear to prevent problems in the future.  He gives himself something like a 50% chance of fixing it...even though it is NOT a recent injury (at least 14 months ago it happened).  There would be a 4-6 month rehab and then, if it doesn't work, he would need to go back in and take out the stitches and trim the meniscus where it was torn......(this dr. feels so strongly, he has called me at home several times, and even called doc #2 to argue his point..)

doctor #1 also claims that if you just leave it, it can "catch" at some point, causing a much worse tear and she could lose the meniscus entirely.   Doc 2 and 3 say that is pretty dramatic, however, the thought of it keeps popping up in my head.

thanks for your thoughts again, and good luck with your knees.    Carolyn





Offline JaneDown

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Re: 15 year old gymnast, possible meniscal tear
« Reply #3 on: January 28, 2009, 10:13:03 PM »
Hi
I'm glad you're leaning toward not going for surgery.If the doc is saying he has only a 50% chance of fixing it by doing surgery I'd be running in the opposite direction. I believe that meniscal repair (where the tear is in a portion of the meniscus which has a sufficient blood supply to heal) is disappointingly risky and has a low success rate (50% presumably!!). Doc#1 frankly sounds desperate to do the surgery!! I doubt it's out of genunine concern for your daughter! I hate to sound cynical but he seems overly keen to persuade you to do it...maybe he needs the money!
The doc who's told you to review it in 6 months sounds very sensible and very reassuringly conservative. I hope in 6 months time your daughter's knee feels even better and that you feel confident that she should steer well clear of surgery. A friend of mine who had an ice-skating accident was told that it would take his knee 3 years to properly settle down and feel normal again. At the time that sounded like a life-time, but strangely enough 3 years later he realised that for the first time in ages his knee felt perfectly ok again.
Knees are pretty complex, and whilst I'm not pretending a cartillage tear will mend itself, the human body is remarkable at healing itself and adjusting. Her knee will feel better and better, I'm sure. Good luck
jane
Knee pain since 2002
2006 MRI shows lateral meniscal tears
Oct 2008 Bilateral partial lateral meniscectomies (long recovery!!)
Jan 2009 MRI shows surgery caused damage to medial meniscus!!!
June 2013 knee injury, agony!!!
August 2013 - left knee medial partial meniscectomy

Offline JaneDown

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Re: 15 year old gymnast, possible meniscal tear
« Reply #4 on: January 28, 2009, 10:21:56 PM »
I forgot to mention that when your other doctors mentioned the MRI was a "close call" that can be so, so true! I'm sure you already know this, but an MRI is not  a photograph, it can only show up "signals" where there may be problems, and the radiologist has to interpret these as they feel is most likely. But they are often wrong, a "signal" which may show up as a lighter or darker than expected area may be interpreted as a tear but may in reality just be a small area of effusion or bruising etc. So she could go through an arthroscopy only to show there's nothing fundamentally wrong that wouldn't have just healed itself given time.
Anyway, I'll stop jumping in to your thread now! Hope all goes well whatever you decide.
jane
Knee pain since 2002
2006 MRI shows lateral meniscal tears
Oct 2008 Bilateral partial lateral meniscectomies (long recovery!!)
Jan 2009 MRI shows surgery caused damage to medial meniscus!!!
June 2013 knee injury, agony!!!
August 2013 - left knee medial partial meniscectomy