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Author Topic: To shave or repair  (Read 763 times)

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Offline Lee willox

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To shave or repair
« on: November 07, 2013, 09:31:30 PM »
My son is 15 and has been advised his Cartlidge tear should be repaired and not shaved. However there is a 20% failure rate and the recovery is 3 months, longer should a shave need to be preformed after the failure.
My question is is this a one off young surgeons approach or is this now the way forward. We are privately insured, the choice is ours. My son is a avid sportsman and thinks the benefits of the repair option will become null due to advances in surgery and replacement knees in later life , when he may be feeling the negative affects of a shave.
Thanks for you time
Lee

Online Vickster

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Re: To shave or repair
« Reply #1 on: November 07, 2013, 09:44:52 PM »
A repair is always better than menisectomy especially at a young age (which I assume is what you are referring to).  He has his whole life ahead of him, but only two knees.  Surely it's better to have a little down time and do everything to safeguard the health of his joints if at all possible.  3 months isn't exactly long in the context of a lifetime.  He'll likely need 3 months to recover from any knee surgery.  80% odds of success is a very high figure, and certainly worth taking to preserve the body's natural tissue and biomechanics

Replacements are far from perfect and when needing revision which is more likely when done at a young age, less so.  And they are major operations which involve removing bone etc

If you are concerned, use the private healthcare to get a second opinion from an experienced knee surgeon with a sports focus :)  Personally, I'd follow the advice of a highly trained expert rather than taking a risk based on possible future advances - articular cartilage repair is still pretty hit and miss for many and should be considered a last resort.  Prevention is certainly better than cure in this scenario :)

You might find these interesting  http://www.kneeguru.co.uk/KNEEnotes/primers/meniscus-primer

http://www.kneeguru.co.uk/KNEEnotes/specialist-commentaries/dr-mr-ian-mcdermott/2008/update-state-art-surgery-menisci


« Last Edit: November 07, 2013, 09:53:01 PM by Vickster »
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Offline Kaputt_Knee

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Re: To shave or repair
« Reply #2 on: November 07, 2013, 09:49:14 PM »
While a shave results in a faster return, a repair preserves the meniscus. Even a shave may not get all the damaged tissue first time around. Keeping as much of the meniscus intact as long as possible seems the better idea to be honest, but why not get a second opinion? If you say where you are based there are plenty of people here who may well be able to recommend another surgeon.

I had a meniscus trim (one of many over the years) back in September 2006 and was back in theatre in October 2006 for a second trim. There are no guarantees that any surgery will be perfect, but convincing a 15 year old that they have to go carefully and spend a number of weeks non-weight bearing on the effected leg might be difficult  :-\

Given the choice I'd always go for a repair to be honest. Sadly that is no longer an option for me but I'm still not yet at the stage where I need  new knee!

Good luck with the final choice!  ;)
1989 big trauma R. knee - sorted
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Offline JTB

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Re: To shave or repair
« Reply #3 on: November 07, 2013, 10:25:57 PM »
Cartilage, unlike a beard, once shaved, does not grow back. My point is, I think it is good general policy to preserve as much cartilage as you can. Young folks are lucky, inasmuch as they have that option.

On the other hand, getting most any active person to adhere to a conservative rehab plan is problematic. A healthy fear of bad outcomes can be a good thing. Reading posts here might help promote that.

"Improvements in replacement knees?" Seems like a possible oxymoron.
Bike racer electing sport-med scope Jan 2011 for patella catch: shave patella, MFC and trochlea (with sneaky lateral release) Grade 3 findings. @ 1 year, CRPS, pain inhibition, muscle atrophy, osteopenia, sudden bilateral chondromalacia. in free-fall 2 1/2 years.
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