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Dr. Andrew Rynne

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Having knee pain. MRI showed meniscus between knee cartilage. Should I go for surgery?

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Dr. Michelle Gibson James

General & Family Physician

Practicing since :2001

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Posted on Wed, 6 Feb 2013 in Bones, Muscles and Joints
Question: Around 3 months back, for an urgent office work , i was sitting all day in-front of my computer and since then i started having pain in left knee. Now, When i straighten my knee , it makes some sound as if two bones strike and sometimes it becomes very stiff and heavy. Last weekend , on a doctor's advice, i went for a knee MRI and here are the observations i got,
1) Horizontal tear within posterior horn and body of medial meniscus. Tear is
seen extending into outer surface.
2) Horizontal tear within posterior horn and body of lateral meniscus. Tear is
seen extending into outer surface.
3) Minimal joint effusion with small Baker's cyst.

Doctor explained me saying meniscus between knee cartilage has got torn-ed out and it needs a surgery to either repair the loose meniscus or remove it. Also he mentioned, i can wait for few months to see whether pain increases or decreases but he has asked me not to do any thing which puts pressure on knee

My questions are:-
1) How serious is this injury ? I mean how many people get affected by this and what impacts it has? Should i be worried about it more?
2) What are the options available apart from surgery?
3) What are the side affects of surgery? Will my normal life be back or it will be back with precautions?
4) I have heard about some magnetic resonance therapy for revival of bones and cartilage? Can they help me?
5) Any other thing that i am missing?
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Answered by Dr. Michelle Gibson James 3 hours later
Hi, thanks for using healthcare magic

The menisci influence the transmission of force in the knee, the amount of contact force and the distribution of the load placed on the knee.
Most of the blood supply to the menisci is on the outside,this is important in terms of healing because blood is needed for any area of the body to heal well. For this reason, injuries to the outside or near the outside of the menisci are more likely to heal well.
Your injuries involve both the body (the inside), extending to the outside of the menisci.

(1) menisical injuries are more common in men, they are often sports related. They are associated with pain and deviation of the person's gait (way in which a person walks).As a result of the discomfort, it can mean that time is needed away from work and activity.
Delaying surgery can, in some persons, result in worsening of the tear and discomfort associated with it.

Treatment is affected by the extent and duration of the injury.It involves rehabilitation with a physiotherapist and surgery. The surgery is done through a small hole placed around the knee,it is not usually a large open wound.
Once the surgeons have made the small incision they insert a camera, during the procedure they can see the tears better on the screen and decide whether to repair, remove or leave the meniscus alone.
If you op not to have surgery then your doctor may suggest removal of the fluid (the effusion that was mentioned in the MRI) which may improve the symptoms temporarily, along with pain medication and rehab.

After surgery (repair or removal)- there may be initial pain and swelling which is treated with medication, ice packs.
After a few days exercises are introduced.There are a number of different exercises that the physiotherapist will ask you to do. Full weight bearing is held off a little longer if repair is done.

At present magnetic resonance therapy is experimental and there are not alot of studies as yet proving its effectivenes.

Hope this helps, feel free to ask any other questions
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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