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Author Topic: Non surgical treatment for bucket handle tear  (Read 4874 times)

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Offline tpase

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Non surgical treatment for bucket handle tear
« on: December 29, 2012, 03:45:57 AM »
Hi!
This will be a third time for me, if I go ahead with surgery on my right knee. I twisted it bad about 4 weeks ago, and an MRI reports a bucket handle tear in the posterior horn of the medial meniscus with an anterior flip into the joint.
I have been unable to straighten my leg, have been exclusively on crutches, and can barely bear weight on a bent leg position (feels good to use that leg again, but it gets inflamed everytime I limp too much on it).
OS recommends meniscectomy. I don't want osteoarthiritis in < 10years. Besides, I am a little surgeried-out. OS was so incredibly arrogant and unhelpful at our only consultation, that I am also a little put off.

I am depressed in the way that only those that have experienced loss of motion like this can be.

a) I wanted to hear your thoughts on what options might be available to me. Non surgical alternative treatments. I have tried one session of Feldenkrais, but am doubly disappointed that it made no difference at all. What about prolotherapy? Other methods?

b) I wanted to know if it is normal to be still gimping 4 weeks after initial injury?

c) anybody walking around with a BHT who is doing alright after forgoing surgery?

Thanks in advance, all. And so sorry for all the knee troubles we share. :(

Offline Kaputt_Knee

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Re: Non surgical treatment for bucket handle tear
« Reply #1 on: December 29, 2012, 08:10:48 AM »
Sadly for a bucket-handle tear surgery is the only option. The meniscus is turned back over itself and is blocking the normal action of your knee. It can only be sorted out by going in and either repairing  it (unlikely) or trimming back the torn surface so that it is smooth again.

The fact that your surgeon and you did not exactly hit it off is an all too often situation. But if they have a good reputation and can sort out the problem what is the big deal? You are not wanting to be best buddies are you? If you know nothing of their experience or reputation, then do you have the option to find a more sympathetic one?

Good luck

Sue ;)
1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline tpase

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Re: Non surgical treatment for bucket handle tear
« Reply #2 on: December 30, 2012, 12:06:22 AM »
thanks for the response sue.

Argh! I am so bummed. Was hoping to hear of at least one or two instances, where a displaced meniscus flipped back in on its own.

Wrt the obnoxious orthosurgeon, true, sue - his expertise may not be correlated with his unfounded arrogance, but my fear is that someone like that is more likely to slice and dice with more abandon than a conservative surgeon who perhaps respects the body and it's parts more.

i am a little uncomfortable with a few aspects of surgery - i do believe that there is a strong correlation between surgery and repeat injuries due to the overall weakening of the joint given the interventions. two, i am uncomfortable with the meniscectomy. whenever mod sci has claimed that a body part is vestigeal or useless, it has come back to bite us in the bum. we know so little of so much, that i would rather always take the conservative approach when it comes to my body. it does have to last me a while.

it has been 4 weeks of no weight bearing on the injured knee. it is still inflammed (not taking any meds). wondering if i should wait for another few weeks to see if the swelling goes down, or schedule surgery right away.



Offline Vickster

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Re: Non surgical treatment for bucket handle tear
« Reply #3 on: December 30, 2012, 12:33:45 AM »
The meniscus section is informative  http://www.kneeguru.co.uk/KNEEnotes/node/2259

I had a meniscus tear, small on MRI (not bucket handle), tried the conservative, physiotherapy approach for 4-5 months on the recommendation of a very caring and communicative surgeeon - knee was painful, locked, swollen, grindy...then it started to buckle and that was the impetus for the operation.  It had got rather worse than had appeared on the MRI and had to be trimmed (while my surgeeon had hoped to repair) - that grinding had actually ground part of the meniscus away, the tissue was degenerative (I was 37).  I have no regrets about surgery - too much pain, instability to carry on...the results were clear very quickly.  There may be future consequences but I would rather be painfree and able to function in the here and now than worry about 10, 20, 30 years down the line

My knee is still troublesome, but not anything related to the meniiscus - the surgery was nearly 3 years ago (I am now 40)

If you don't like the surgeon, as Sue says, get a second opinion.  What country are you in - realise this is not always easy and can end up being costly - there is a list of knee surgeons in the info hub too

Good luck :)
« Last Edit: December 30, 2012, 12:36:34 AM by Vickster »
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline tpase

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Re: Non surgical treatment for bucket handle tear
« Reply #4 on: January 01, 2013, 07:54:43 AM »
I am in southern California. I plan on looking up and meeting with orthosurgeons in my city, and scheduling the surgery. What was your recvery time from surgery to pain free movement.

Offline Kaputt_Knee

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Re: Non surgical treatment for bucket handle tear
« Reply #5 on: January 01, 2013, 09:06:39 AM »
It varies from person to person and from operation to operation. I've had meniscus trims that took ages to recover from and others that were relatively quick recoveries. The best was my last trim, where they tidied up ragged surfaces everywhere in day surgery and I was skiing 3 weeks later, although I was restricted from teaching skiing until 6 weeks after the operation.

It all depends on what your surgeon does and how your body reacts to the actual surgery on that particular occasion. Talk to your surgeon when you finally find one you like and feel secure with, make sure that they are aware of your post surgery sporting goals. Actually this is one of the criteria I use when talking to potential surgeons. If they do not agree and cannot give me valid reasons for dismissing my goals other than my age, then I look for another one. Happily my current surgeon is happy that I am still active despite my knee history.
1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee