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Author Topic: Back in the club! >10 years post meniscus repair and my knee is shot  (Read 1842 times)

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Offline AndrewC

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Well, with the best will in the world I hoped not to be back frequenting these boards.... because it would mean bad things if I did.
I post as an update on my meniscus surgery and because I am miserable after my latest consultant appointment.  :o

Brief history, I tore my lateral meniscus some 13 years ago iirc and it was a large bucket handle tear to the posterior horn. Due to the NHS screwing me over i had to endure 3 weeks of agony after being sent home by a nurse who said 'its just bruised' , when I couldnt even straighten my leg. The pain, as many on here will know, was other worldly!

Anyway, finally got to see a consultant and he kindly got me surgery within 10 days and sutured the meniscus as it was in the red zone , then I did huge amounts of physio and got on with life. It was over 10 weeks before I could walk without crutches, partly I believe due to how long I had to endure with my knee bent (>3 weeks). After 2 years and lots of gym and efforts I was in good shape and back into things. It never felt 100%, and I always had some swelling at the back of the knee, but I was told 'thats just how it is'.

So the years went on and for the last 4 or 5 years I have had jabs of pain here and there and permanent discomfort at the back of the knee (bursitis), like my hamstring is piano wire scraping around the back of my knee and inner knee.
MRI 3 years ago, inconclusive, thinning to articular cartilage compartment, no major issues found, surgeon (private appt) said he may or may not be able to fix something. most likely not.

So as it was a lot of money I waited, things got a bit worse, MRI mk2 and NHS referral to a private consultant. I have meniscal extrusion (total) of the medial meniscus. Surgeon says it is degenerative, (same guy did the repair). No sh*t sherlock, probably due to the original injury as my other knees fine and no history in family.

 I'm 42 and wondering what options I may have. He basically said 'cant do anything, sorry.' Not even advice on how to try and preserve it. He said bone surfaces are currently ok..

19 minute appointment and I was pretty much ejected. Middle age sucks ;(

Am I entitled to a second opinion? should I go back to the GP?  The consultant really didn't seem to give a damn.

I realise there may be nothing that can be done, and I may have to live with worsening pain and symptoms. Just curious if any one else has had this?
thanks !
Big bucket handle tear to lateral meniscus from sporting injury. Arthroscopy and meniscal repair carried out June 2004. sloooowwww recovery!!

2018 - torn medial meniscus in RH knee, partial extrusion. ongoing issues,

Offline vickster

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Re: Back in the club! >10 years post meniscus repair and my knee is shot
« Reply #1 on: June 21, 2018, 09:12:23 AM »
You say your knee is shot. Precisely how? Arthritis? Full thickness defects? Which compartment(s)? You say you’ve had injections. Steroid? Hyaluronic acid? Do you have any meniscus left? Not sure what you mean by total extrusion? You mention your lateral meniscus was replaced but then the medial further down
Your post.

If the arthritis is confined to one compartment, have you looked at unloaded braces or there could be (an admittedly major) surgical option such as osteotomy or partial replacement. If all compartments are worn then it may be a waiting game for tkr (I’m 45 and in a similar situation albeit with the added joy of arthritis in my foot on the same side  :()

Do you do Physio? Have you tried hydrotherapy? Non impact stuff like Cycling and swimming to keep the knee moving.

Where in the U.K. are you? Ask your GP about a second NHS opinion. Or you could do lots of research and see a super specialist privately all depending on what the exact issue is (one with an NHS practice too in case you need surgery or it could get very costly)

Good luck. Arthritis in your 40s is difficult to say the least
« Last Edit: June 21, 2018, 09:15:38 AM by Vickster »
Came off bike onto concrete 9/9/09
LK scopes 8/2/10 & 16/12/10
RK scope 5/2/15 (menisectomy, Hoffa’s fat pad trim)
LK scope 10.1.19 medial meniscectomy, trochlea MFX
LK scope 19.4.21 MFX to both condyles & trochlea, patella cartilage shaved, viscoseal, depo-medrone

Offline AndrewC

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Re: Back in the club! >10 years post meniscus repair and my knee is shot
« Reply #2 on: June 21, 2018, 09:28:23 AM »
Hi Vickster.
Thanks for the reply. To be honest, the appointment was so rushed, the consultant didn't really tell me what stage arthritis I had. My MRI of about 4 years ago showed thinning of the articular cartilage in the lateral compartment, but made no mention of a missing medial meniscus.

This most recent MRI (different consultant, not private, NHS click and book, very very rushed **his colleague barged in mid appt to give him a golf club and chuckle about their next game....** )

latest MRI said (after translation by consultant) he said the medial meniscus is fully extruded, or the meniscus is hanging out side the knee joint. Effectively no medial meniscus because it has seperated from the root and collagen has softened up in my leg and allowed it to displace outside of the knee joint. The Lateral Meniscus which was originally repaired is still intact and ok, which is something.

This extruded meniscus is allegedly because of degenerative changes in the knee, probably brought around from the initial injury in my opinion as my other knee is fine. It has never felt right since the first surgery to repair the meniscus.

So the issue is with my medial compartment apparently. No full thickness defects, he said 'early signs' of damage but nothing they could do anything about.

Which is not good as I am in pain pretty much every day with the knee. I was offered no physio, injections or help otherwise. I was not impressed to be honest. Basically I was told 'I could do an arthroscopy and remove whats left of the medial meniscus but it could make things worse, and there is no option of a repair.'

Then I was basically told feel free to request to see him if it gets worse?!!! via the NHS's arduous system this is not of much comfort to me. Of course it's going to get worse, that's why Im here, because it is getting worse!!

Quote
f the arthritis is confined to one compartment, have you looked at unloaded braces or there could be (an admittedly major) surgical option such as osteotomy or partial replacement. If all compartments are worn then it may be a waiting game for tkr (I’m 45 and in a similar situation albeit with the added joy of arthritis in my foot on the same side  :()

Oh dear, I am sorry to hear that, thats rough having to deal with that and a long painful wait.

I already modified my activities some years ago with no running etc, cycling makes the back of the knee flare up, but swimming is by far the best thing for it and gives me so comfort afterwards, so maybe I will have to become a fanatical swimmer.

I realise the NHS is massively overworked... but am disappointed to feel so abandoned by a system I paid into all my life.

Quote
Where in the U.K. are you? Ask your GP about a second NHS opinion. Or you could do lots of research and see a super specialist privately all depending on what the exact issue is (one with an NHS practice too in case you need surgery or it could get very costly)

Good luck. Arthritis in your 40s is difficult to say the least

I am based in Sheffield. I originally saw Mr Derek Bickerstaff 4 years ago and he was very good, but could not guarantee a fix, as it was private appt I couldnt afford to pay it on the offchance. I am not sure now if he will also say he cannot do anything. He only does private and so may be my only chance unless anyone knows of a specialist place dealing in this type of thing?

Thanks so much for your input, its good to talk as they say!!


You say your knee is shot. Precisely how? Arthritis? Full thickness defects? Which compartment(s)? You say you’ve had injections. Steroid? Hyaluronic acid? Do you have any meniscus left? Not sure what you mean by total extrusion? You mention your lateral meniscus was replaced but then the medial further down
Your post.

If the arthritis is confined to one compartment, have you looked at unloaded braces or there could be (an admittedly major) surgical option such as osteotomy or partial replacement. If all compartments are worn then it may be a waiting game for tkr (I’m 45 and in a similar situation albeit with the added joy of arthritis in my foot on the same side  :()

Do you do Physio? Have you tried hydrotherapy? Non impact stuff like Cycling and swimming to keep the knee moving.

Where in the U.K. are you? Ask your GP about a second NHS opinion. Or you could do lots of research and see a super specialist privately all depending on what the exact issue is (one with an NHS practice too in case you need surgery or it could get very costly)

Good luck. Arthritis in your 40s is difficult to say the least
« Last Edit: June 21, 2018, 09:30:48 AM by AndrewC »
Big bucket handle tear to lateral meniscus from sporting injury. Arthroscopy and meniscal repair carried out June 2004. sloooowwww recovery!!

2018 - torn medial meniscus in RH knee, partial extrusion. ongoing issues,

Offline AndrewC

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Re: Back in the club! >10 years post meniscus repair and my knee is shot
« Reply #3 on: June 21, 2018, 09:32:40 AM »
and I am not expecting a miracle, but even some advice on management and coping with it was expected from my consultant appointment and I got nothing. Certainly no offer of any steroid injections of medication.

He just said leave it a while and it will probably settle down???
Really, after over 5 years of getting worse? what a load of rubbish!
Big bucket handle tear to lateral meniscus from sporting injury. Arthroscopy and meniscal repair carried out June 2004. sloooowwww recovery!!

2018 - torn medial meniscus in RH knee, partial extrusion. ongoing issues,

Offline vickster

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Re: Back in the club! >10 years post meniscus repair and my knee is shot
« Reply #4 on: June 21, 2018, 09:55:30 AM »
Steroids are good to avoid if possible as they can actually damage healthy articular cartilage, but should at least temporarily dampen inflammation. Is your knee swollen and possibly hot? Plenty of surgeons are unwilling to give them otherwise. Equally pain medication isn't their bag execept perhaps immediately post op.

Have you tried medication to manage, discuss with GP. Anti-inflammatories usually the start point (assuming you don't have any stomach issues), and paracetamol regularly. Then you move along the journey to the stronger stuff if needed. As odd as it seems some CBT might help with the psychological side of chronic pain. 

Maybe look into private sports physio (maybe £40-50 a session) although most exercises for the knee are pretty simple. You've probably done them all before anyhow :) you might find getting some orthotics in your shoes help a bit, get the physio to assess your gait. Using a foam roller or stretches can also be helpful as tight muscles will exacerbate knee issues. Maybe too after swimming when the muscles are warm or after a bath

The pain the back of the knee could be a bakers cyst often associated with meniscus tears. Degeneration of the meniscus starts from around age 30, so could just be part of aging rather than the result of the initial problem (which was the other side). Your other knee could well have some degeneration too but it's not symptomatic as is often the case.

You could try the arthroscopy but a total menisectomy is going to lead to pretty rapid degeneration, possibly a misaligned knee in time but it might give you a few years of relief if that is indeed the cause of the pain and not the arthritis. Degenerate meniscus can't be repaired (mine was degenerate when I first injured it in 2009, had lateral menisectomy. My medial is too, both are now tatty but as I have pretty much full ROM I'm leaving well alone despite constant discomfort managed with medication).

I'm fortunate in that I have private healthcare although it costs me a bucket load as I've claimed a lot over the years (and continue to for now as I see a rheumatologist for the inflammatory joint disease). Other than the rheum, all the specialists I've seen to have an NHS practice, but I'm self employed so the convenience of choosing appointment times is crucial.

Unfortunately, with arthritis it will get worse with time, nature of the degenerative disease beast and there isn't much to do until it becomes severe enough for replacement or if misaligned and an osteotomy might be helpful if an unloader brace doesn't help.

Have you had an x Ray to assess the joint space and alignment (forget MRI for this)?

Came off bike onto concrete 9/9/09
LK scopes 8/2/10 & 16/12/10
RK scope 5/2/15 (menisectomy, Hoffa’s fat pad trim)
LK scope 10.1.19 medial meniscectomy, trochlea MFX
LK scope 19.4.21 MFX to both condyles & trochlea, patella cartilage shaved, viscoseal, depo-medrone

Offline AndrewC

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Re: Back in the club! >10 years post meniscus repair and my knee is shot
« Reply #5 on: June 21, 2018, 09:59:12 PM »
Steroids are good to avoid if possible as they can actually damage healthy articular cartilage, but should at least temporarily dampen inflammation. Is your knee swollen and possibly hot? Plenty of surgeons are unwilling to give them otherwise. Equally pain medication isn't their bag execept perhaps immediately post op.

Have you tried medication to manage, discuss with GP. Anti-inflammatories usually the start point (assuming you don't have any stomach issues), and paracetamol regularly. Then you move along the journey to the stronger stuff if needed. As odd as it seems some CBT might help with the psychological side of chronic pain. 

Maybe look into private sports physio (maybe £40-50 a session) although most exercises for the knee are pretty simple. You've probably done them all before anyhow :) you might find getting some orthotics in your shoes help a bit, get the physio to assess your gait. Using a foam roller or stretches can also be helpful as tight muscles will exacerbate knee issues. Maybe too after swimming when the muscles are warm or after a bath

The pain the back of the knee could be a bakers cyst often associated with meniscus tears. Degeneration of the meniscus starts from around age 30, so could just be part of aging rather than the result of the initial problem (which was the other side). Your other knee could well have some degeneration too but it's not symptomatic as is often the case.

You could try the arthroscopy but a total menisectomy is going to lead to pretty rapid degeneration, possibly a misaligned knee in time but it might give you a few years of relief if that is indeed the cause of the pain and not the arthritis. Degenerate meniscus can't be repaired (mine was degenerate when I first injured it in 2009, had lateral menisectomy. My medial is too, both are now tatty but as I have pretty much full ROM I'm leaving well alone despite constant discomfort managed with medication).

I'm fortunate in that I have private healthcare although it costs me a bucket load as I've claimed a lot over the years (and continue to for now as I see a rheumatologist for the inflammatory joint disease). Other than the rheum, all the specialists I've seen to have an NHS practice, but I'm self employed so the convenience of choosing appointment times is crucial.

Unfortunately, with arthritis it will get worse with time, nature of the degenerative disease beast and there isn't much to do until it becomes severe enough for replacement or if misaligned and an osteotomy might be helpful if an unloader brace doesn't help.

Have you had an x Ray to assess the joint space and alignment (forget MRI for this)?

thanks for the reply.
Yes I have strong nsaids which I have started taking, I have used these in the past with some success.

echo that on the physio, I have had many sessions on the knee in the past, will have to start doing some exercises and trying to strengthen the quads more.

Regards the arthroscopy, effectively it seems I have that at present, just the meniscus is still trapped inside my leg on the medial outside!!

Unfortunately the NHS isnt as forthcoming with treatment as private healthcare, no I havent had an Xray or even been offered one. Effectively I feel I have been left to rot with zero treatment plans made.

I think a second opinion is strongly on the cards to be honest, as I sit here and my knee hurts all day and night, I can only assume it is getting worse.  thanks again

Big bucket handle tear to lateral meniscus from sporting injury. Arthroscopy and meniscal repair carried out June 2004. sloooowwww recovery!!

2018 - torn medial meniscus in RH knee, partial extrusion. ongoing issues,

Offline vickster

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Re: Back in the club! >10 years post meniscus repair and my knee is shot
« Reply #6 on: June 21, 2018, 10:51:22 PM »
Your GP should refer you for an X-ray. Just go have a frank discussion, you'll need a referral for a second opinion anyhow

You could check out the specialist list on here for a suitable surgeon who maybe has an interest in treating arthritis in the younger patient, although if going the NHS route, you can only choose a hospital not a specific clinician I believe

Your Mr Bickerstaff is there for Sheffield, and he had offered you the arthroscopy to remove the meniscus and been honest about potential outcomes, so I'm not sure what else you might find from a second opinion. There probably aren't any miracles to be had unfortunately. Pain management might be your best route, use the naproxen or celecoxib or whatever you have in conjunction with physio and swimming plus patience   :)

http://www.kneeguru.co.uk/KNEEnotes/specialists

Unfortunately, once a knee is injured and operated on, it's unlikely to ever be the same again

You could always self pay for private care, most hospitals offer payment plans if it's an option
« Last Edit: June 21, 2018, 10:57:47 PM by Vickster »
Came off bike onto concrete 9/9/09
LK scopes 8/2/10 & 16/12/10
RK scope 5/2/15 (menisectomy, Hoffa’s fat pad trim)
LK scope 10.1.19 medial meniscectomy, trochlea MFX
LK scope 19.4.21 MFX to both condyles & trochlea, patella cartilage shaved, viscoseal, depo-medrone

Offline AndrewC

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Re: Back in the club! >10 years post meniscus repair and my knee is shot
« Reply #7 on: June 22, 2018, 06:58:01 PM »
Your GP should refer you for an X-ray. Just go have a frank discussion, you'll need a referral for a second opinion anyhow

You could check out the specialist list on here for a suitable surgeon who maybe has an interest in treating arthritis in the younger patient, although if going the NHS route, you can only choose a hospital not a specific clinician I believe

Your Mr Bickerstaff is there for Sheffield, and he had offered you the arthroscopy to remove the meniscus and been honest about potential outcomes, so I'm not sure what else you might find from a second opinion. There probably aren't any miracles to be had unfortunately. Pain management might be your best route, use the naproxen or celecoxib or whatever you have in conjunction with physio and swimming plus patience   :)

http://www.kneeguru.co.uk/KNEEnotes/specialists

Unfortunately, once a knee is injured and operated on, it's unlikely to ever be the same again

You could always self pay for private care, most hospitals offer payment plans if it's an option

Thanks

Quote
Your GP should refer you for an X-ray. Just go have a frank discussion, you'll need a referral for a second opinion anyhow
Will do this, thanks

Quote
You could check out the specialist list on here for a suitable surgeon who maybe has an interest in treating arthritis in the younger patient, although if going the NHS route, you can only choose a hospital not a specific clinician I believe

That's just it, I dont have arthritis according to the surgeon. He said my articular cartilage is in ok condition currently on the medial side (and the lateral is ok as it has the meniscus) . His inference was that its ok now, but is going to go downhill.

And the pain is from the meniscus degradation.

Quote
Your Mr Bickerstaff is there for Sheffield, and he had offered you the arthroscopy to remove the meniscus and been honest about potential outcomes, so I'm not sure what else you might find from a second opinion.
No, I had an MRI that I paid for about 4 years ago that didn't show anything as bad as this. He said he could go in, and may find something but he may not. Were he to go in now, he would definitely find something, whether he could make things better is the question.

I think I may have to pay for a second opinion, I am currently looking into the options. Pretty gutted to be honest, it doesn't look great.

I don't think a private plan will take on a pre existing injury? but will double check it! thanks
Big bucket handle tear to lateral meniscus from sporting injury. Arthroscopy and meniscal repair carried out June 2004. sloooowwww recovery!!

2018 - torn medial meniscus in RH knee, partial extrusion. ongoing issues,

Offline vickster

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Re: Back in the club! >10 years post meniscus repair and my knee is shot
« Reply #8 on: June 22, 2018, 07:05:18 PM »
Ref private for pre existing not normally for 5 years or something unless you can get onto a corporate plan through work with no restrictions (these are v rare tho). You’ve had a consultation and treatment previously so it’ll be seen as pre existing unfortunately

Meniscus degradation and arthritis usually go hand in hand as I understand it, one causes the other. I’m not sure a second opinion will offer a lot, treatment of degenerate joint disease, even mild is hard beyond meds and physio.

So your last imaging was 4 years ago? Was that when the medial meniscus extrusion was spotted. I’m rather confused by your timeline, what was done when? When did you see the surgeon?

If my historical MRIs are anything to go by, wear and tear can get a lot worse in that time :(

There’s good info on meniscus and arthritis in the learning portfolio

« Last Edit: June 22, 2018, 07:09:26 PM by Vickster »
Came off bike onto concrete 9/9/09
LK scopes 8/2/10 & 16/12/10
RK scope 5/2/15 (menisectomy, Hoffa’s fat pad trim)
LK scope 10.1.19 medial meniscectomy, trochlea MFX
LK scope 19.4.21 MFX to both condyles & trochlea, patella cartilage shaved, viscoseal, depo-medrone

Offline AndrewC

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Re: Back in the club! >10 years post meniscus repair and my knee is shot
« Reply #9 on: June 23, 2018, 11:59:47 PM »

So your last imaging was 4 years ago? Was that when the medial meniscus extrusion was spotted. I’m rather confused by your timeline, what was done when? When did you see the surgeon?

If my historical MRIs are anything to go by, wear and tear can get a lot worse in that time :(

There’s good info on meniscus and arthritis in the learning portfolio

I tore the lateral mensicus badly 14 years ago, and was fortunate that it was sutured and repaired rather than removed. Over the years it was great for a good amount of years but over the past maybe 7 years it has got worse. I used to do a lot of squash and running even after the surgery and it was 95% all the time. It was a gradual realisation that I needed to get it looked at again so 4 years ago I saw Mr Bickerstaff, paid for an MRi and went to him for a follow up consultation. The MRI showed thinning of the articular cartilage in the lateral compartment but made no mention of anything on the medial side. Over the past few years it got worse with pain walking at times. So I made the decision to seek treatment regardless of what it had to be.

Then I discover from the latest consultant I saw, who seemed totally disinterested to be honest, that there was nothing he could do, off to play golf now bye type pf attitude...!
The latest MRI, from the limited explanation he gave, showed the medial meniscus is extruded completely (possible root tear) and I was told the articular cartilage surfaces were 'ok'.

I have been looking into mensicus transplant specialists on the offchance this is possible, and am going to be seeking a second and third opinion if required. It may come to nothing and not be possible, but I am not one to lay down and give up.
« Last Edit: June 24, 2018, 12:01:28 AM by AndrewC »
Big bucket handle tear to lateral meniscus from sporting injury. Arthroscopy and meniscal repair carried out June 2004. sloooowwww recovery!!

2018 - torn medial meniscus in RH knee, partial extrusion. ongoing issues,

Offline vickster

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Re: Back in the club! >10 years post meniscus repair and my knee is shot
« Reply #10 on: June 24, 2018, 09:32:02 AM »
Tim Spalding is a recognised meniscus transplant specialist in the Midlands. However, I strongly doubt the procedure would be available on the NHS (although he does have an NHS practice). Only a very few of the surgeries are done annually in the UK (private cost would be £10k+ I expect). There's one poster on here who went through the procedure and had a lateral meniscus cadaver transplant through his insurance in the last year or so. He's in his 30s I think

My understanding is that a transplant is only viable if there's no diffuse arthrtic change, hence most patients will be younger with otherwise pristine knees. Ok may not be good enough.

There's a list of meniscus surgeons in the learning portfolio, there are - handful in the U.K., some in private practice only (e.g. Ian MecDermott who's well recognised). One in Sheffield, I've never heard of him being mentioned on here

http://www.kneeguru.co.uk/KNEEnotes/primers/whos-who-knee-surgery/whos-who-meniscal-transplantation

http://www.sheffieldorthopaedics.com/home/our_surgeons/profile/?sid=68&surgeon=Jez_Brown
« Last Edit: June 24, 2018, 10:15:18 AM by Vickster »
Came off bike onto concrete 9/9/09
LK scopes 8/2/10 & 16/12/10
RK scope 5/2/15 (menisectomy, Hoffa’s fat pad trim)
LK scope 10.1.19 medial meniscectomy, trochlea MFX
LK scope 19.4.21 MFX to both condyles & trochlea, patella cartilage shaved, viscoseal, depo-medrone

Offline AndrewC

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Re: Back in the club! >10 years post meniscus repair and my knee is shot
« Reply #11 on: June 24, 2018, 10:35:21 AM »
Tim Spalding is a recognised meniscus transplant specialist in the Midlands. However, I strongly doubt the procedure would be available on the NHS (although he does have an NHS practice). Only a very few of the surgeries are done annually in the UK (private cost would be £10k+ I expect). There's one poster on here who went through the procedure and had a lateral meniscus cadaver transplant through his insurance in the last year or so. He's in his 30s I think

My understanding is that a transplant is on,y viable if there's no diffuse arthrtic change, hence most patients will be younger with otherwise pristine knees.

There's a list of meniscus surgeons in the learning portfolio, there are - handful in the U.K., some in private practice only (e.g. Ian MecDermott who's well recognised). One in Sheffield, I've never heard of him being mentioned on here

http://www.kneeguru.co.uk/KNEEnotes/primers/whos-who-knee-surgery/whos-who-meniscal-transplantation

http://www.sheffieldorthopaedics.com/home/our_surgeons/profile/?sid=68&surgeon=Jez_Brown

Thanks Vickster. I have been doing a lot of research into the transplant option, maybe my knee is not suitable for it, but at the Stone clinic in the USA they have taken on much worse knees in older patients (sub 55yr olds) and had good results.
But, I couldn't afford the US option!, with time off work and the massive costs of having to rehab over there for weeks etc.
I have a shortlist of potential specialists who do transplants in the UK and Tim is on it so I will firstly collect all my medical notes and information (if they will give it to me) and then have it sent off to the shortlist of surgeons.  Ian McDermot is also on that list so many thanks for that info too.

From my reading on meniscal transplant suitability I would fit the criteria for a suitably skilled and confident surgeon, chrondral defects have to be minor (unless you are in the USA where they are more advanced in this procedure) and joint alignment has to be straight or an osteotomy is also carried out with the surgery.

As to costs, Yes, it seems to be about £9-£12000 plus, and with complications like a retear and revision it may well double. In fact a lot of surgeons do a second arthroscopy 12 weeks in to check the state of the transplant and add more sutures and so on if needed, and trim any flaky bits. The recovery time on the surgery seems to be very big which is a great concern but theres not a lot I could do about that.

You are correct, the NHS will not pay for the surgery, private would be my only option. I would have to first find out if it is viable before working out how to get the money!! but if it could buy my knee another 10 or 15 years then it would be better than any possessions I could own instead.

The Sheffield listed one is a colleague of the chap I saw already and I am not convinced that would be the best route for me to take, however I will see what the GP suggests and go from there. I was told the consultant I saw most recently was 'very conservative' which could be good or bad. for someone in my position, things getting worse and no help offered, I wish I had gone for the more aggressive option, which existed when I booked the appointment!  Would be great to hear from anyone else who has had a meniscus transplant!

I so wish I had bupa or another private healthcare plan.!


« Last Edit: June 24, 2018, 10:42:01 AM by AndrewC »
Big bucket handle tear to lateral meniscus from sporting injury. Arthroscopy and meniscal repair carried out June 2004. sloooowwww recovery!!

2018 - torn medial meniscus in RH knee, partial extrusion. ongoing issues,

Offline vickster

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Re: Back in the club! >10 years post meniscus repair and my knee is shot
« Reply #12 on: June 24, 2018, 11:23:01 AM »
Not all private HC plans would cover what is still considered an experimental option, they pretty much follow NICE/NHS guidelines. I had an almighty battle back in 2010 when I thought MACI might be an option (unfortunately due to kissing defects, big on femur, and on oppoosite tibia and slight valugus, the surgeon wouldn't do it due to the 2 year rehab and in his estimation, 20% success without an osteotomy (which I simply couldn't stomach the thought of after reading about what it would entail). I've managed with physio, medication and hyaluronic acid injections (private) since. I'll need a replacement within the next 10 years probably.

In terms of funding private treatment, lots of private hospitals offer payment plans.

Look for posts by lateralmeniscusguy for a recent U.K. Transplant Experience (albeit lateral)
Came off bike onto concrete 9/9/09
LK scopes 8/2/10 & 16/12/10
RK scope 5/2/15 (menisectomy, Hoffa’s fat pad trim)
LK scope 10.1.19 medial meniscectomy, trochlea MFX
LK scope 19.4.21 MFX to both condyles & trochlea, patella cartilage shaved, viscoseal, depo-medrone

Offline LateralMeniscusIssuesGuy

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Re: Back in the club! >10 years post meniscus repair and my knee is shot
« Reply #13 on: June 26, 2018, 08:18:02 AM »
Hi Andrew,

As discussed, Tim Spalding did my recent lateral meniscus transplant.  He would be my surgeon of choice for any knee surgery he feels confident doing.  He is very honest, and I have complete faith in him.  I went through 6 surgeons before going with him i.e.

Jonathan Webb (UK) - initial partial meniscus removal
Tim Briggs (UK) - investigative arthroscopy
Rene Verdonk (EU) - paid phone colsultation with MRIs and Xrays
Dr Stone (US) - free assessment with scans
Ian McDermott (UK) - email assessment
Prof. Snow (UK) - paid consultation with scans
Tim Spalding (UK) - MY MAN FOR SURE

So far, 1 year in, everything is going to plan, not ahead of schedule or behind (well perhaps a little behind with my hesitancy to get into running).

I don't want to give you false hope, but is it definitely the case that they won't do MTs on the NHS?  I had a feeling Prof. Snow had a patient who had it, and perhaps Tim too.

It's not a cake walk, but there are success stories that give me inspiration.
JT


Partial Lateral Meniscectomy (2/3 removed), pristine articular cartilage...2013
Return to impact sport, continual responsive swelling ever since
Mild pain onset..2016
Arthroscopy reveals grade 2/3 articular cartilage damage lateral compartment behind kneecap
What now? Allograft / brace / nothing?

Offline AndrewC

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Re: Back in the club! >10 years post meniscus repair and my knee is shot
« Reply #14 on: June 27, 2018, 01:22:41 PM »
Not all private HC plans would cover what is still considered an experimental option, they pretty much follow NICE/NHS guidelines. I had an almighty battle back in 2010 when I thought MACI might be an option (unfortunately due to kissing defects, big on femur, and on oppoosite tibia and slight valugus, the surgeon wouldn't do it due to the 2 year rehab and in his estimation, 20% success without an osteotomy (which I simply couldn't stomach the thought of after reading about what it would entail). I've managed with physio, medication and hyaluronic acid injections (private) since. I'll need a replacement within the next 10 years probably.

In terms of funding private treatment, lots of private hospitals offer payment plans.

Look for posts by lateralmeniscusguy for a recent U.K. Transplant Experience (albeit lateral)

thanks for the info.!!
Big bucket handle tear to lateral meniscus from sporting injury. Arthroscopy and meniscal repair carried out June 2004. sloooowwww recovery!!

2018 - torn medial meniscus in RH knee, partial extrusion. ongoing issues,















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