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Suggest Treatment For Grade 3 Meniscus Tear With Pain And Locking
Question: Hi
I have just come back from having an MRI for a suspected meniscal tear. I am a 54 year old female and an alpaca breeder so I need to bend and kneel and lift and walk on uneven ground. I have a history of tendon problems and have had surgery in both shoulders for this, which has been very successful. I have been having problems with my right knee for around 8 months now. It is difficult to describe but I will give it a go .... when kneeling, pushing out of kneeling or sometimes twisting the knee or lifting from a squatting position ... I get sharp on the outside of me knee and behind, but also the knee seems to lock and this is extreemly painful. I have to try and relax and straighten my knee slowly, this results in quite a sizeable crunch/click noise and feeling, but then my knee will straighten and the pain goes away. I have had few problems between these episodes. Also, for the last 3 or 4 months I have been able to rest as it is not birthing season (little need for me to get down on the ground or lift babies) Recently, though, my episodes of what feels like dislocation of something, have been happening more often. 2 weeks ago I squatted down to pick up a young alpaca (25kgs) as he seemed to have a problem. My knee seized and I was unable to continue with what I was doing. This was the worst episode yet and my knee remained quite painful. It was difficult to go up and downstairs etc. I went to emergency after it happened again whilst I tried to move one of our dogs off my feet, by lifting my flexed leg. They diagnosed a torn meniscus and I have been in a leg brace ever since. I have been taking NSAI's , Codeine and Paracetamol for the pain, which I have to say, is not severe, but of course I have been resting.
My MRI results are that I have 2 x interior grade 2's and 1 x external grade 2. Also Moderate Patella Chrondropathy and, as I already knew, some osteoarthritis.
I am seeing an orthopedic surgeon on Friday (2 days time) and I need help with understanding what he can do for me. My problem is that I live in France and language always is a problem in these situations !! But the French health care system looks after it's farmers very well and I go to private facilities, so hopefully I will have more options. My main worry is that in May through to November I at my busiest as it's birthing season and this is my job.
I hope you can help me.
I have just come back from having an MRI for a suspected meniscal tear. I am a 54 year old female and an alpaca breeder so I need to bend and kneel and lift and walk on uneven ground. I have a history of tendon problems and have had surgery in both shoulders for this, which has been very successful. I have been having problems with my right knee for around 8 months now. It is difficult to describe but I will give it a go .... when kneeling, pushing out of kneeling or sometimes twisting the knee or lifting from a squatting position ... I get sharp on the outside of me knee and behind, but also the knee seems to lock and this is extreemly painful. I have to try and relax and straighten my knee slowly, this results in quite a sizeable crunch/click noise and feeling, but then my knee will straighten and the pain goes away. I have had few problems between these episodes. Also, for the last 3 or 4 months I have been able to rest as it is not birthing season (little need for me to get down on the ground or lift babies) Recently, though, my episodes of what feels like dislocation of something, have been happening more often. 2 weeks ago I squatted down to pick up a young alpaca (25kgs) as he seemed to have a problem. My knee seized and I was unable to continue with what I was doing. This was the worst episode yet and my knee remained quite painful. It was difficult to go up and downstairs etc. I went to emergency after it happened again whilst I tried to move one of our dogs off my feet, by lifting my flexed leg. They diagnosed a torn meniscus and I have been in a leg brace ever since. I have been taking NSAI's , Codeine and Paracetamol for the pain, which I have to say, is not severe, but of course I have been resting.
My MRI results are that I have 2 x interior grade 2's and 1 x external grade 2. Also Moderate Patella Chrondropathy and, as I already knew, some osteoarthritis.
I am seeing an orthopedic surgeon on Friday (2 days time) and I need help with understanding what he can do for me. My problem is that I live in France and language always is a problem in these situations !! But the French health care system looks after it's farmers very well and I go to private facilities, so hopefully I will have more options. My main worry is that in May through to November I at my busiest as it's birthing season and this is my job.
I hope you can help me.
Brief Answer:
You need to get a minor day care surgery
Detailed Answer:
Hello,
I have studied your case. You are having grade 3 meniscus tear with pain and locking. You need to go through a minor surgical procedure called Arthroscopic Menisectomy. In this procedure torn meniscus fragment is removed through a very small surgery. It needs a very small incision, does not require any stitch.
You will not need any bed rest and can work from very next day. Your doctor may advise you against squatting, sitting cross leg and using stairs for some time.
It is not very costly procedure and you will be discharged same day or next day.
If you do not want surgery than you can take mild pain killer, hot fomentation, volitran ointment and Calcium supplementation. Though locking episodes may continue to occur.
So my opinion is that you should get this surgery done.
I hope this answer will be helpful for you. Let me know if there is any other followup questions.
You need to get a minor day care surgery
Detailed Answer:
Hello,
I have studied your case. You are having grade 3 meniscus tear with pain and locking. You need to go through a minor surgical procedure called Arthroscopic Menisectomy. In this procedure torn meniscus fragment is removed through a very small surgery. It needs a very small incision, does not require any stitch.
You will not need any bed rest and can work from very next day. Your doctor may advise you against squatting, sitting cross leg and using stairs for some time.
It is not very costly procedure and you will be discharged same day or next day.
If you do not want surgery than you can take mild pain killer, hot fomentation, volitran ointment and Calcium supplementation. Though locking episodes may continue to occur.
So my opinion is that you should get this surgery done.
I hope this answer will be helpful for you. Let me know if there is any other followup questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
Locking suggest it is grade 3 tear
Detailed Answer:
Hello,
I am saying it grade three on the basis of your symptoms. When you are having locking it suggest that it is grade three tear. MRI is not very specific about grading. But locking only occurs when a torn fragment get entrapped between bones. And this is suggestive of a high grade tear.
For patella at the time of menisectomy your doctor can debride loose cartilage pieces and can make it smoother. It is called chondroplasty. This will give you some pain relief. You also need to make some life style modification like avoid squatting, stairs climbing.
Some doctors may inject visco supplementation in your knee. It is oily solution to make your knee movements friction less.
Let me know if you have any other query.
Thanks
Locking suggest it is grade 3 tear
Detailed Answer:
Hello,
I am saying it grade three on the basis of your symptoms. When you are having locking it suggest that it is grade three tear. MRI is not very specific about grading. But locking only occurs when a torn fragment get entrapped between bones. And this is suggestive of a high grade tear.
For patella at the time of menisectomy your doctor can debride loose cartilage pieces and can make it smoother. It is called chondroplasty. This will give you some pain relief. You also need to make some life style modification like avoid squatting, stairs climbing.
Some doctors may inject visco supplementation in your knee. It is oily solution to make your knee movements friction less.
Let me know if you have any other query.
Thanks
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Dr. Dr. Naveen Kumar Sharma
Orthopaedic Surgeon, Joint Replacement
Practicing since :2002
Answered : 4486 Questions
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