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Treated for meniscal tear of posterior horn. Getting pain while walking. How to avoid this?

Answered by
Dr. Saurabh Gupta

Orthopaedic Surgeon, Joint Replacement

Practicing since :2004

Answered : 5930 Questions

Posted on Sat, 9 Feb 2013 in Bones, Muscles and Joints
Question: hi ,
i am 37 years old male weighing 135 pounds , was diagnosed medial meniscal tear of posterior horn of right knee 4 years ago .
i was advised physiotherapy .
it did not improve much and i still had pain on walking long distances .
From the last 2-3 years i am having the snapping of medial hamstring tendons at the knee .And there is also too much popping of patella but no pain in patella .
On walking long distance i get pain at the HEEL .

my question is :
1.Can i avoid partial meniscectomy . is there any other latest treatment available for meniscal tear.
2. will partial meniscetomy will lead to early arthritis .
3. what is causing the hamstring snapping and pain at the heel .
4. what are the treatment options for hamstring snapping .
thanks and regards ,
Answered by Dr. Saurabh Gupta 2 hours later
Thanks for posting your query.

I have gone through your query in detail. The answers to your queries are as follows -

1.Your menisci injury is four years old and in this condition partial menisectomy is the only surgical treatment.

2.Yes, without repair of menisci injury, there are chances that you can get the arthritis early. You should be able to do much better by treating this injury.The meniscus acts as a shock absorber, removing part of it would lead to more stress on the articular cartilage and bones. While there is no way to predict if you will develop later arthritis or how quickly.

3.Pain in the Achilles and heel region is a common clinical presentation particularly in individuals involved in repetitive weight bearing activity such as excessive walking, jumping or running sports.

4.Treatment options for medial hamstring snapping are as follows:-
Unfortunately, this is such a rare condition that a definitive treatment course has not been determined. In some patients, it has been found that simply releasing the gracilis and semitendinosus tendons at their attachment along the pes anserine bursa, followed by scar tissue release of the tendons proximally, is very successful at relieving the snapping symptoms. In others, a surgical excision of the snapping hamstring tendon(s) with an open hamstring harvester has also been performed.

One can leave it alone if there is no pain, redness, inflammation associated with it.So surgical treatment is considered only if the associated symptoms occur.
So I suggest consult this with your orthopaedic surgeon.

I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.

Wishing you good health...
Dr Saurabh Gupta.
Orthopaedic Surgeon
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Saurabh Gupta 2 days later
hi ,
thanks for detailed explanation . i have some follow up questions :

1. One of the orthopedic surgeon said that trimming medial meniscus will stop snapping of hamstring tendon . is it true ?

2. How complicated is the tendon releasing surgery . And will this surgery make the hamstring weak significantly .

3. Will exercise and physiotherapy improve the pain symptoms in achillies tendon , heel and calf muscles .

thanks and best regards.
Answered by Dr. Saurabh Gupta 5 hours later
Thanks for posting your query again.

1. Snapping of hamstring tendon might occur due to torn medial meniscus. So it is quite possible that you may get benifieted by trimming medial meniscus.

2. Even in the best of circumstances of tendon releasing surgery, recurrent snapping can occasionally occur because it is becoming increasingly recognized that the hamstring tendons can regenerate.Thus, the results of a surgical release, or harvesting, of the medial hamstring tendons does always not prove to be as successful as the treatment of lateral snapping hamstrings.

3.Yes with good physiotherapy and exercise, you can get improvement in pain symptoms of achillies tendon, heel and calf muscles.

I hope this answers your query.
If you have any questions I will be happy to answer.
Please close the query if you have no other questions.

Wishing you speedy recovery...

Warm regards.
Dr Saurabh Gupta.
Orthopaedic Surgeon.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

The User accepted the expert's answer

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