meniscus tear - no MRI!

Hey yall,
i have a meniscus tear on my left knee. Having a PM prohibits the use of a MRI, so we did an X-ray and I'll see those on Monday. Doctor wants to scope my knee because of my pain and other symptoms point to a moderate tear. When I rest, it feels much better. When I wear a knew brace and compression sock, it feels better. So, I'm thinking maybe I don't need to do the scope.

What do you think?

12 Comments

meniscus pain

by natandhop - 2014-09-26 09:09:51

AngrySparrow1 thank you for your quick reply. My doctor poked around my knew and pushed on the meniscus which moved and for about 2 minutes it felt good, until I stood up and tried to walk! It hurt for the rest of the day and into the next. Today I was in a training all day and sat. So today it has not hurt.

You are so right about that weed need to keep moving and this knee pain is not making that easy!

I have a shot of pain anytime I move to the right either just by pointing my toe or actually taking a step but when I rest it feels better. I'm in a quandary!

Torn Meniscus

by donr - 2014-09-27 01:09:45

They may never heal, depending on the type of tear.. Cartilage does not repair itself very well. If you have a confirmed tear, accept it & let him go in & do whatever he can do to repair the damage by trimming off the rough stuff. Unfortunately, it takes an MRI to diagnose reasonably well the type tear you have BEFORE going inside to examine it.

Go to http://orthoinfo.aaos.org/topic.cfm?topic=a00358 to read about the potential for repair/regeneration.

OR: go to: http://www.hopkinsortho.org/knee_arthroscopy.html for another good discussion of torn meniscus repair/recovery.

You are just prolonging the agony w/ wishful thinking.

Have you had any swelling? Any fluid collected in the knee joint? Those are bad signs.

BTW: unless they injected contrast material during the X-Ray, nothing will show - & even with contrast, the results may be equivocal.

BTDT. At least a 4 time loser.

Donr

Donr - you are the best!

by natandhop - 2014-09-27 08:09:09

Thank you Don, you always give me the right information that I need! Yes I have swelling and fluid on the knee joint. I see my doctor on Monday and will share with you what will happen next.

I wish you well,
Natalie

Surgery

by ohiolaura - 2014-09-27 09:09:08

I had a tear in mine,before I received my PM,as stated earlier, a tear will not heal itself.The surgery is cake,meaning a scope and trimming off the torn part that is flipping around and irritating you from the inside.
After you will be stiff and sore,but it goes away pretty quick,and you will be all the better for it.My surgery was 3 years ago,and my knee is great,my Ortho told me he knew I had a tear,I disagreed,so he did an MRI,and well, he was right,it was torn.
Guess that's why he makes the big bucks!
When I got my PM, they gave me a MRI compatable one,cause of my age,and maybe incase I need to disagree with another Ortho in the future and have a MRI done,for fun!
They know their stuff,I say just do the scope and it will be fixed then.Good luck!
Laura

You have fluid...

by donr - 2014-09-27 09:09:21

...it is NOT a simple situation. Especially if they have to drain the joint. When the fluid becomes great enough in volume, it contributes more pain than the cartilage damage, itself. (Want to know how I know?)

I assume that at this point, the surgeon you have seen has placed a thumb over some spot on your knee, grabbed the ankle & moved the lower leg around to see if he could make you scream. If he did & you did, you have some sort of torn meniscus. I was introduced to that exam back in 1956 when I was a mere 19 yr old lad - I still remember it!

Sometimes draining the joint followed by a cortizone injection through the same needle will work wonders - for a while. It does NOT make the cartilage repair itself.

I can also attest to the equivocal nature of knee X-ray w/ contrast material injected. (As recent as 1975) If an orthopod suggests this procedure, let me know & I'll give you an opinion on what that's like.

All in all, if you are going to insist on continuing to run, get it repaired - now. Like bad news, it does not get better w/ time. The invention of the modern arthroscope has made knee surgery a piece of cake. Back when I was ruining knees, the surgery was performed by a man who did his residency under King Henry VIII's headsman w/ his ax. It meant a solid week in bed, followed by many weeks on crutches & painful rehab. I've seen our #1 Son have a knee job w/ 'scope walking around the next day, dragging his crutches with him. He had already been on a stationary bike & walked w/o pain.

If you become disenamored w/ your surgeon, let me know, I'll refer you to one of the best in Atlanta. He just repaired my foot & specializes in feet, knees & shoulders. Has been team surgeon for the Falcons & Thrashers. As a college football player, he's been on the other end of a scalpel, so has a lot of empathy for his patients.

Don

MRI

by joelcr3 - 2014-09-27 12:09:35

Im new to PM. got one 4 days ago. I saw online that min can use an MRI. I dont need any but asked my cardiologist who said it cant be used . I called the manufacturer. They said internationally its ok for MRI but the FDA didnt appove it. So he thinks it would be ok to have it but the warantee would be voided. pet scans etc woud be fine,

How did the ...

by donr - 2014-09-28 11:09:05

...weekend go? Knee swell up any more?

Hope it has settled down somewhat for you.

let us know what happens tomorrow at the surgeon's place.

Have a bowl of cornflakes tomorrow - Kelloggs, of course - after all I wish the best to you tomorrow.

Donr

Yes to the scoping!

by natandhop - 2014-09-30 06:09:13

I will have the surgery. I thought I could have it done at my doctor's out patient facility. But they won't take me because if the pacemaker. I'll have to do it a hospital. My surgeon works out of Northside.

Is it a problem that my cardiologist is in Gwinnett? If anything goes wrong with my PM, wouldn't the staff at Northside be able to help me?

The PM has thrown my knee surgeon. I had to get clearance from my cardiologist. Luckily I had a clear EKG back in March. Hopefully all will come together.

Natalie

Scope at northside

by donr - 2014-09-30 07:09:57

Natalie: I wrote a long comment this AM & it never made it - here goes a second try!

1) Don't sweat the Northside for the scope job. It's a large hosp w/ a Cardio dept. Your Ortho is not set up in his/her outpatient suite for emergency Cardio support, should you need it. It is not at all unusual for an Ortho to make this choice. I just (10 Sept) had a foot surg by an Ortho who owns his own OP suite - he chose to do it at St Joes - literally across the street from Northside - because I have a PM & he wanted back up Cardio support - just in case - Not at all a bad call. It's for your safety, as well as to CYA the surgeon.

2) No Ortho is really qualified to handle a cardio arrhythmia emergency on the table. That's why they hire anesthesiologists to sit at the head of the table to monitor life's vital signs & keep you alive. Even they will be prepared to call a Cardio should things go south on you during the procedure. I've been done both ways - a local for removing an offending screw in a foot & general for doing the repair of a foot. With the local, they hooked me up to an auto BP machine & checked me periodically. With the general, they hook you up to a monitor & someone separate sits & "Watches " every beat.

3) Let's talk anesthesia - how do you feel about having a spinal block for this? Relieves stress on the C-V system, since the only thing really out of it is the lower extremities - hips to toenails. They usually give you enough Propofol to put you in La-La -Land because of the length of the procedure, but you are not far enough under to be required to be intubated - as my Ortho put it - you are breathing on your own, they are not breathing for you.

I've had foot surgery twice using a spinal block. Nearly painless as far as the two injections were concerned - first a very small needle w/ lidocaine to numb the site then another small needle to inject the meds into the spine. I was amazed at how innocuous the event was.

Woke up quickly & was clear-headed & NOT nauseous. Chatted w/ the nurse attending me while I came completely to my senses.

4) Take a complete copy of your PM settings w/ you to hand to the anesthesiologist - this is a strange Hosp to you. There is no guarantee that they will have a lot of data on your PM & its settings - this way you assure that you are covered. OK - so they look at you a bit strange. You are taking responsibility for your own situation. At least they will have them should anything untoward occur.

5) Ask your Ortho if he/she plans on any electrocautery (Called a "Bovie") during the procedure. Ask him to place the "Ground Return" for the device below the knee if possible. OR - at least on the same thigh or buttocks to preclude stray electric current entering the trunk of the body & potentially affecting the PM. When I mentioned this to my ortho three weeks ago, he commented that it made good sense - he'd just never thought of it himself.

6) It's not a problem that your cardio is in another town 40 miles away - any cardiac PM specialist can take care of an emergency IF he/she knows about it in advance. Northside has a big Cardio section w/ plenty of talent.

I had a pair of surgeries at St Joe's - literally across the street from Northside (Collectively all the med institutions right there are called "Pill Hill") while my Cardio is located in Cumming, about 35-40 miles north of there.

You might ask your Cardio if he knows any of the cardios on the staff at Northside & ask him to talk to them prior to the big event. You might just be surprised!

BTW: it is common to require a cardiac clearance for anyone w/ a PM - as well as for a lot of people who don't host them. Your Ortho is not a bit unusual in this instance.

When is the big day?

Don

10-1-14 9 am

by natandhop - 2014-09-30 09:09:21

My surgery is scheduled for 9 am Wednesday morning! I'd been playing phone tag and at 3:15 heard the message. I'll be at the hospital in Cumming which is so much better for me and my parents. I'm all cleared and ready for the event.

I'll let you know how it goes in a day or so. Thank you again for all of your wisdom!

I wish you well, Natalie

Love Northside in Cumming!

by natandhop - 2014-10-01 06:10:19

Everyone was kind and helpful and efficient. My doctor found I had also deeply twisted the ligament and I have arthritis. He said I will likely have more discomfort and/or pain. But I'm still happy we did it.

I awoke in recovery with no recollection of the event. Wow, anesthesia puts you right out! Glad that is mostly out of my system now. And no problems with my PM. She kept on working.

I do hurt but will soon have the nice cold ice pack and the next round of pain meds.

I wish y'all well, Natalie

Northside Cumming is....

by donr - 2014-10-01 12:10:32

...a good hosp. I've had a surgery there. They have a new cardiac section there, w/ good support. They have people qualified to download & analyze PM/s there. According to my belly surgeon, no one gets out of the recovery room w/o having their PM checked to ensure that it is set & functioning correctly.

MOF, I'll be there in one of their med office Bldgs at 1100 for an appt.

Cumming is a relatively new hosp in terms of its development, adding capability as the yrs have past. They have an outstanding ICU that is essentially all new, staffed w/ an excellent pulmonary care section. They've added OB/GYN & cardiac capability in the past few yrs, so you will be in good hands.

We have not been disappointed by any of the care we have rec'd there.,

Don

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