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Author Topic: medial meniscus - oblique tear  (Read 351 times)

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Offline Balaclava

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medial meniscus - oblique tear
« on: July 27, 2020, 02:22:26 PM »
I am in the UK.  I am 73 years old.  1.9m and 74kg.  I strongly suspect the damage to my knee was caused by swinging a golf club at the ball 4 days a week.

I paid for an MRI scan. The report says:
There is an oblique tear of the posterior horn of the medial meniscus and there is a
partial tear of the posterior root attachment. There is a macerated degenerative tear of the body and posterior horn of the lateral meniscus.
There is chondral thinning in both tibiofemoral compartments which is maximally grade 4 in the mid lateral femoral condyle over a length of 15 millimetres.
There is irregular chondral erosion on the medial patellar facet with relatively preserved lateral patellofemoral cartilage. The cruciate and collateral ligaments are intact. There is popliteus tendonosis and there is a moderate joint effusion with synovial thickening and a bakers cyst.

History:  Prior to 11th July I had no known problems with my left knee.  On 12 July (morning after playing golf the day before) and for that week I had a nagging aching pain deep inside the back of my left knee and I was limping.  I rested the leg all that week.  On 18th July I tested the knee by simulating a golf swing to see how the swing moved the knee and I tested the knee with small side the side twists and something gave.  Immediately I went from minor discomfort to intense pain.   I couldn't bear any weight on my left leg (knee).  That day just sitting in a chair looking at my knee was painful.  I was unable to bend my knee up to 90*. The next day I was able to walk on crutches but still could not bear weight on the leg (knee).  Each subsequent day got better and by Thursday I could bear weight on the leg and I could walk on one crutch.  By this weekend (after 7 days) I can walk easily on one crutch including up and down stairs using both legs and I can walk a few steps in the house without a crutch.  I am still not able to bend my knee past 90*.  I am hoping (with little expectation) to get an NHS appointment with knee specialist.

Questions:
1.  I have formed the view from various reading that meniscus tears do not repair but in the past 9 days I have gone from totally lame to quite mobile.  Have I experienced a miracle?

2.  I want to be more mobile, to walk further but I am frightened of set-backs - how frightened should I be?

3.  I suspect that I will be waiting 3 months for an appointment with an NHS knee consultant.  The cost of private consultation/treatment would make a serious dent in our finances. I need information that would help me make that decision e.g. can it wait without compounding the damage? 

Thanks in advance

Offline The KNEEguru

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Re: medial meniscus - oblique tear
« Reply #1 on: July 27, 2020, 02:39:56 PM »
You seem to have multiple degenerative issues in the knee. Degenerative tears at age 73 are quite common and the issue is rather than they lead gradually to osteoarthritis of the knee, rather than being a crippling problem in their own right. It may be the partial tear of the meniscus root that caused the pain.

Peripheral tears in younger people often heal, but really after only 4 days your 'resolution' is not due to 'healing', but may be rather that the resting of the knee has settled any inflammation related to the root tear, or maybe the Baker's cyst has settled because some swelling has gone down.

I imagine that most surgeons would suggest that you keep off sport, keep the leg elevated when at rest, just do gentle exercise with support, perhaps use a compression bandage - and give it a couple of weeks to see how things go.
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Offline Balaclava

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Re: medial meniscus - oblique tear
« Reply #2 on: July 27, 2020, 03:00:57 PM »
Thanks for the helpful reply which is very much appreciated.

I've done a lot of reading and obviously some of the stuff I have read could have been rubbish but one thing said something along the lines of  . . . s symptom of this is difficulty straightening the leg (knee).   I have difficulty bending the knee.  What puts the area of injury under pressure straightening or bending the knee?

Offline Balaclava

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Re: medial meniscus - oblique tear
« Reply #3 on: July 27, 2020, 04:41:49 PM »
It's me again  . . . .  as this all started with discomfort deep inside the rear of my knee and when it 'went' the pain was located there and now when I walk for too long I feel like I can feel a lump in the back of my knee - could the cause of my pain be the Baker's cyst?  (from what I have read I have formed the view that the Baker's cyst is located deep in the centre at the back of the knee)?

Offline Balaclava

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Re: medial meniscus - oblique tear
« Reply #4 on: August 03, 2020, 03:44:57 PM »
I'm back . . . .
The MRI scan shows a number of areas of damage and degeneration in my knee. I need to know which of those caused the sudden catastrophic failure of my knee.  And I need to know why that happened and what I need to do to ensure it doesn't happen again.  I'd like to get those answers without spending the children's inheritance; I'm 'pestering' my GP trying to get something out of the NHS.  I feel like anyone who knows a little about knees would be able to answer those question from some significant features in the story of my knee.  They are:
1.  From catastrophic failure and total inability to bear any weight on the leg, after two weeks I can walk to the shops and back with just minor discomfort.
2.  The minor discomfort is a feeling like a golf ball on the hollow at the back of my knee.
3.  No problems straightening my knee but intense pain trying to bend it past 90*.

Diagnose me?


Offline Balaclava

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Re: medial meniscus - oblique tear
« Reply #5 on: August 03, 2020, 03:47:14 PM »
If all else fails and I have to sell the family jewels to get some answers - how much will an on-line consultation cost me?

Offline Vickster

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Re: medial meniscus - oblique tear
« Reply #6 on: August 03, 2020, 05:18:55 PM »
I think I said in another post that at least around London a private initial consult is usually around £200. Consultants are now starting to see patients face to face and online depending on preference.
This Liverpool based surgeon in the kneeguru specialist database has a practice at Spire. Profile says £180 for initial consult

https://www.spirehealthcare.com/consultant-profiles/mr-john-davidson-c3353000/

Seems to be the standard fee for knee surgeons at that hospital, here’s the knee specialists there (hopefully)

https://www.spirehealthcare.com/consultants/profiles/?filterByLetter=&filterByLocation=18218&filterByTreatment=0&filterBySpecialty=0&filterTreatmentSpeciality=Knee%20arthroscopy%20surgery&filterConsultantType=consultant
« Last Edit: August 03, 2020, 07:25:50 PM 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