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When is enough pain enough?

post #1 of 6
Thread Starter 

I tore my meniscus two years ago while skiing  after taking a jump and landing flat. It's a flap tear in the front left side of my left knee, just to the left of the patella. I went to the doctor afterwards and he gave me a list of pt knee strengthening excercises. I did the excercises twice a day for almost a year, and while it helped, the torn flap never healed, leaving my knee with a click, and soreness after a hard day in the bumps. Latley it has been taking me longer to recover after skiing a day than usual, up to three days to get the knee flexibility and stability back. Its starting to hinder my skiing, which is bothering me quite a bit.

 

My question is when should I stop screwing with it and get surgery?

Can it cause any additional damage? Or is it just going to cause pain and no real damage to the knee?

I have medical insurance, and I plan to do it before I'm off my parents insurance plan (three years left).

post #2 of 6

I would get that fixed, especially since you are still young (or so I gather from your post).

 

I had a similar injury to my left knee (landing flat in a mountain bike crash from a bridge) and it has been bothering me since it happened in July, 2011. But I managed to do many XC races with the injury and I can ski just fine. Most important there is constant improvement and less and less pain. Hopefully it will repair by itself eventually. I am 50 years old.

post #3 of 6

The flap was never going to heal-the exercises were just to stabilize the knee with the idea you wouldn't injure it again. Orthopods are trained to deal with the 95% of people who don't put undue stress on their knees. If it is still bothering you, I'd get that loose edge trimmed as soon as feasible. It'll take 3 weeks to recover

post #4 of 6
Quote:
Originally Posted by snowyphil65 View Post

Can it cause any additional damage? Or is it just going to cause pain and no real damage to the knee?


Are these two questions about the surgery? If so, they are questions for your doctor because the answer depends on how bad the tear is and where it is located. The meniscus is a hunk of fibrocartilage in the joint capsule, meaning it gets its nutrients through diffusion- there is no direct blood supply.

 

Since nutrients are not directly delivered to it, the outer edge of the meniscus gets more of what it needs. (Think of putting ball-shaped sponge in water- the last thing that gets wet is center or the core.) By the time the fluid reaches the center, the outer layers will have taken all the nutrients they need, leaving little for the cells in the middle. Thus tears or surgical repairs involving the middle are less likely to heal.

 

Your Ortho guy has two options when he gets in there- either repair the tear or remove/shave off the part that is 'torn off'. Depending on how bad the tear is, that could be part or all of the meniscus (although seeing you're still skiing, this is probably unlikely but again, a question for him). 

 

If the questions are regarding putting off surgery- the risks of further damage to the knee is pretty much the same as if you had surgery. Either way- fixing it or not fixing it- you're at risk for osteoarthritis because you have damaged the 'cushion' of the joint. So if you're going to get arthritis in the knee anyways later on, why live in pain until then?

 

For me it was an easy decision- and the surgery was a breeze. It's usually done arthroscopically in a day surgery center and they tell you to stay on crutches for a few days. Usually in 2-3 weeks you're back to 100% with the help of knee exercises. The only scars you're left with are 2-3 little 'mosquito bites'.

 

Of course surgery always has risks, so it's important to consider them and talk to your doctor. But if you're living in pain and are going to get it fixed anyhow, why wait? 

post #5 of 6
Thread Starter 

Thanks guys, 3 weeks is nothing compared to the year I spent rebuilding my acl, maybe in mid april between ski and mountain bike season, preferably in the fall. I will see how more excercises help it out, i have been skiing alot less this year already since im a mechanic and not a liftie, but it would still be nice to be back to 100%. Anyone know if it can cause more injury to the knee?

post #6 of 6

Quote:

Originally Posted by sillie View Post
 

If the questions are regarding putting off surgery- the risks of further damage to the knee is pretty much the same as if you had surgery. Either way- fixing it or not fixing it- you're at risk for osteoarthritis because you have damaged the 'cushion' of the joint.


I guess you could technically tear it more, making a possible repair impossible.. That loose flap hanging around in the joint could cause the knee to give way causing other injuries but seeing it's been two years it seems unlikely that could happen unless your further injured it. 

 

Like I said, osteoarthritis is the only further damage that will occur to the knee (and this may take a while to catch up to you). It is not something that really needs to be fixed ever. But if it's been two years and it's still bothering you, it doesn't sound like it will ever heal on it's own.

 

Whether or not to have surgery (if it is recommend by your doctor) really depends on the pain you're experiencing and the effect it is having on your quality of life.

 

 

 

  

 

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