The outside one-third of the meniscus contains a rich blood supply. Many experts debate the idea of jogging after the surgeries due to fear of degenerative changes. It is a very valuable initiative to share your time and expertise to explain the pros and cons of meniscus surgery. In fact, my practice is full of patients who are on their second meniscectomy and have been told they now need a knee replacement. All content provided in this blog, website, or any linked materials, including text, graphics, images, patient profiles, outcomes, and information, are not intended and should not be considered or used as a substitute for medical advice, diagnosis, or treatment. Arthroscopic meniscus repair is an outpatient surgical procedure to repair torn knee cartilage. Learn About the #1 Stem Cell & Platelet Procedures for Treating Knee Meniscus Tears - Regenexx. As per the research, the knee is more susceptible to arthritis after meniscus surgery. If the meniscus is torn in a knee with only mild arthritis, symptoms often improve with surgery. Many return to normal activities within six to eight weeks. They think the cause of their pain is the meniscus tear itself, and many have the expectation that surgical repair is what they need. After surgery, I’m just hoping I’ll be able to comfortably run 3-4 times a week for the next 4 years. Some of it may be simple to explain. A meniscus injury can be diagnosed by an X-ray and it can help the doctor rule out other causes of knee pain, such as a fracture or arthritis. Many people experience knee popping or other cracking sounds as a result of their meniscus surgery. And epidural steroid injections are problematic due to their long-term negative impact on bone density. Persistent Knee Pain after Arthroscopy. Knee arthritis can also be a common cause for aging athletes to abandon the sports and activities they love. Another reason for knee pain 1 year after meniscus surgery is new-onset arthritis. The purpose of the new study was to investigate how meniscectomy affected the knee structure long term. Is there a chance that I wont need one at all? Due to a large number of questions I have received over the years asking about products for health, injuries, performance, and other areas of sports, exercise, work and life, I have created an Amazon Influencer page. If you need more information about your particular injury and options to treat it and recover quickly and safely, talk to me one-on-one! We know that increased damage to the knee, after surgery, is likely if certain risk factors are present. Knee after Meniscus Surgery. To review these include: BMI over 30, age over 40, arthritis prior to the surgery, lateral meniscus tear, female gender, degenerative tear of the meniscus, and more than 1/3 of the meniscus removed during surgery. If you tear one and need surgery, that surgery most likely involves trimming out the torn portion of meniscus. The torn meniscus is repaired by a variety of minimally invasive techniques and requires postoperative protection to allow healing. The meniscus is the shock absorber in the knee. by Steve A. Mora, MD Orange County Knee Specialist. A few other interesting findings included knee arthritis in the medial compartment of the knee in males that was just under 9% prior to surgery and climbed to nearly 59% during the study period (females went from 26% to 73%). Treatments for you have persisting knee joints that torn meniscus long term effects of torn meniscus tears should see a trimmed meniscus surgery of a meniscus tears without them to the prolotherapy. Get fresh updates and insights from Regenexx delivered straight to your inbox. How long recovery takes depends on the type of meniscus surgery and the severity of the injury, but expect two weeks down time, at minimum. This is done arthroscopically (keyhole surgery using small incisions), so there is minimal damage to other structures of the knee. Knowing the meniscus is there to protect the cartilage, it’s easy to understand why slicing out pieces of it could leave the cartilage vulnerable and potentially lead to arthritis. The investigators reviewed records from 4,796 participants in the ongoing Osteoarthritis Initiative study. After a rehabilitation from a successful total knee replacement, a patient can expect to have at least as much motion as prior to surgery, without pain. Understand your meniscus tear and your treatment options even if you have no medical knowledge and have looked everywhere for answers with no luck! Physical therapy is useful to regain full function of the knee, which occurs on average 4-5 months after surgery. In addition, we have to take into account the location of the tear with regard to its blood supply. And almost everyone believes that loss of meniscal tissue — a loss of “padding” — leads to knee osteoarthritis. Unfortunately there isn’t a yes or no, black or white, answer. Is there anything I can do to prevent arthritis? Please note that as an Amazon Associate I earn from qualifying purchases. The only way to stop the cycle of pain is to begin looking at the knee pain as it relates to the rest of the body. You gotta love medicine. My first partial meniscectomy occurred almost 30 years ago, after a tennis injury. If PT doesn’t help and it appears to be more meniscus, if it were my knee, I would have the surgery. If you have surgery to repair your meniscus, it may take more like 3 months.The Best Exercises After Meniscus Surgery. Meniscus surgery is the surgical reconstruction or removal of a torn meniscus from your knee. WEDNESDAY, Dec. 3, 2014 (HealthDay News) -- A common type of knee surgery may increase the chances of arthritis, a new study suggests. The next meniscus tear happened many years later, in my 30s, after a seemingly innocent move. They may include injury to skin nerves, infections, and knee stiffness. The meniscus serves a role of shock absorber between the bones of the knee. The patient may or may not have had X-rays which show signs of arthritis, sometimes advanced arthritis. Am I guaranteed to get osteoarthritis and need a knee replacement when I’m older? X Knees are the target of many common sports injuries. First, let’s review knee meniscus surgery. Synthetic and torn meniscus is the long term outcomes are the two after injury: where none of torn meniscus long term effects, leaving a critical early arthritis. I had a partial meniscectomy done on my left knee due to a work-related injury. Tips For Choosing the Perfect Orthopedic Surgeon For You. In theory, if a patient tears the meniscus and requires surgery that involves trimming out the torn part (a partial meniscectomy), then more of the stress transfers to the knee’s bone and cartilage. Knee Pain AFTER ACL & Meniscus Surgery is extremely challenging IF you're ONLY looking at how to force the knee into a range of motion it doesn't want to go in. 1:1g. The surgeon decides to repair the meniscus or trim part of it out based on the location and orientation of the tear and not personal or patient preference. Nearly 63% of knee meniscus surgery patients developed knee arthritis in the meniscectomy knee within 8 years, on average, following surgery. Meniscus repair is low-risk. meniscal tear, meniscectomy, meniscus, osteoarthritis, pain, radiography, symptoms, treatment Osteoarthritis (OA) is a major health burden among the middle aged and elderly. Loss of the main meniscal functions, load distribution and THE SITE IS NOT RESPONSIBLE FOR ANY ACTIONS OR INACTION ON A USER’S PART BASED ON THE INFORMATION THAT IS PRESENTED ON THE SITE. The torn meniscus is repaired by a variety of minimally invasive techniques and requires postoperative protection to allow healing. Learning How Best to Inject the CCJ Ligaments: Our CCJ Instability Trial Begins…, Other Degenerative Conditions & Overuse Injuries, Other Knee Ligaments / Tendons & Overuse Injuries, Thumb Arthritis (Basal Joint, CMC, Gamer’s Thumb, Texting Thumb), Ulnar collateral ligament wear (common in baseball pitchers). Is arthritis inevitable? If you have surgery to remove part of the meniscus, it may take 3 to 6 weeks before you get back to normal activities. A meniscus tear is a common knee injury. People could add swimming, biking, upper body weight lifting, and other non-repetitive impact activities a few days each week. I am a 58 years old Canadian male who had partial meniscectomy 15 years ago on my right knee after a hockey injury. Three bones come together to form your knee joint—the femur (thighbone), tibia (shinbone), and patella (kneecap). Through the stories of a dozen athletes whose injuries and recovery advanced the field (including Joan Benoit, Michael Jordan, Brandi Chastain, and Tommy John), Dr. Geier explains how sports medicine makes sports safer for the pros, amateurs, student-athletes, and weekend warriors alike. That is a key reason I rarely shut people down from sports or exercise. The researchers looked at structural changes on knee MRIs over an 18-month period after surgery. An expert panel produced these recommendations based on a linked systematic review triggered by a randomised trial published in The BMJ in June 2016, which found that, among patients with a degenerative medial meniscus tear, knee arthroscopy was no better than exercise therapy. Finally, in patients who had degenerative meniscus tears (tears due to wear and tear), 10% had medial knee arthritis prior to surgery while just under 67% had knee arthritis after. by Steve A. Mora, MD Orange County Knee Specialist. Why would this happen? Some of it may not be simple to explain. Dr. Roemer and colleagues studied magnetic resonance imaging (MRI) exams of 355 knees that developed OA during a 5-year period, and compared those to a control group matched for age, gender, About 1 million knee arthroscopies are performed each year in the United States, at a cost of more than $3 billion. This morning I’d like to review some research that places another nail in the proverbial coffin of knee meniscus surgery. You can't walk right after surgery. Most injuries of the elbow’s tendons and ligaments, as well as arthritis, can be treated non-surgically with regenerative procedures. “Arthritis and meniscus tear are very common,” said West Penn Hospital orthopedic surgery director Michael Seel. stiff knee after meniscus surgeryhow to stiff knee after meniscus surgery for Pain the 1 last update 2021/04/23 ManagementPain Management. A physical therapy regimen that is started immediately after surgery can better prevent and address persistent strength deficits and activity limitations following an arthroscopic partial medial meniscectomy. The procedure repairs tears in the meniscus, … Thus, it is important to develop early and effective interventions to prevent posttraumatic arthritis after ACL surgery for … This is something I frequently see in my office especially for second opinions. Arthroscopic surgery 'ineffective' for knee catching, locking. The goal of the study was to determine whether or not surgery was necessary when compared to a group of patients who only had Degenerative meniscus tears are simply a sign of the development of arthritis. However, there is no guarantee that this degeneration will definitely occur. Regenexx is a world-wide network of specially trained physicians providing the world's most advanced, research-driven, regenerative-medicine treatments in North America, Europe, the Middle East, Asia and Australia. For one, there are many different types of meniscus tears – large or small, simple or complex, acute or chronic, associated with arthritis or not, and more. With less protection against repetitive stress, it makes sense that degenerative changes could develop over time. Methods: Eighty-one patients with an arthroscopic meniscus shape-preserving surgery after isolated traumatic medial meniscal tear (repair: n = 42; meniscectomy: n = 39) were examined clinically (Lysholm score, Tegner score) and radiologically (Fairbank score, compared with the uninjured knee); the follow-up was divided into midterm (3.4 years; n = 35) and long term (8.8 years; n = 46). THE SITE MAY OFFER HEALTH, FITNESS, NUTRITIONAL AND OTHER SUCH INFORMATION, BUT SUCH INFORMATION IS DESIGNED FOR EDUCATIONAL AND INFORMATIONAL PURPOSES ONLY. After all, the complete removal of the meniscus leads to an increase in the load on the articular cartilage and the further development of arthrosis. Good grief—it hurt! While this can be uncomfortable and irritating, knee popping is fairly common and normal. Copyright 2021 Dr. David Geier Enterprises, LLC, Dr. David Geier’s Amazon Influencer store. We have some research already that shows that meniscectomy isn’t good for your knee cartilage. A 2017 study found that about 75 percent of people who underwent ACL reconstructive surgery had arthritis findings on x-rays of their knee within 10-15 years of the time of surgery. Doctors and Patients Say ‘No’ to Arthroscopy for Arthritis. A torn meniscus is a common knee injury which often leads people towards surgery. I'm a parent, so I know that having a sick kid is no fun. The patients who were missing their menisci were 14 times more likely to have "advanced" degenerative arthritis of the knee than those who still had their meniscus intact. The meniscus is a cushion of tissue that protects the cartilage in the knee joint. Despite that, it’s still the most common knee procedure in the United States. As a matter of fact (in cases where both osteoarthritis and meniscus tears are present), sometimes your pain can get worse because of something that we call a stress fracture or a stress reaction. Spine surgery should be a last resort for anyone, due to the cascade of negative effects it can have on the areas surrounding the surgery. But there's a good chance that it's not necessary and that it won't "fix" your problem. and has been featured in major media publications over 1,200 times throughout his career. Reed A C Siemieniuk 1, 2, Ian A Harris 3, 4, Thomas Agoritsas 1, 5, ... Over-optimistic patient expectations of recovery and leisure activities after arthroscopic meniscus surgery. Arthroscopy is primarily used to remove loose debris and/or repair or remove part of a damaged meniscus – the C-shaped cartilage pad between the thighbone and shinbone. A meniscus injury can be diagnosed by an X-ray and it can help the doctor rule out other causes of knee pain, such as a fracture or arthritis. Meniscus tears are often treated with arthroscopic surgery. Complications are rare. With severe arthritis, the meniscus is inevitably damaged. Yes, some patients with a history of partial meniscectomy could one day require knee replacement. Surgery often doesn't address pain from arthritis. How soon you can walk after meniscus surgery depends on whether the surgery was open or arthroscopic, whether it was a partial or total removal of the meniscus, or whether the meniscus was repaired. Arthritis after a meniscus tear With less protection against repetitive stress, it makes sense that degenerative changes could develop over time. Dr. Eric Samuelson, an orthopedic sports medicine specialist, describes how meniscus tears, one of the most common knee injuries, occur and the usual approach to treatment and recovery. Get a Regenexx® Second Opinion and avoid unnecessary surgery. Your orthopedic surgeon treats your tear can depend upon the tear you have got its size and its location. Regenerative procedures can be used to treat a wide range of knee injuries and conditions. Many Shoulder and Rotator Cuff injuries are good candidates for regenerative treatments. Great question! Physical therapy is definitely recommended after meniscus surgery. If you have a knee meniscus tear, you may benefit from a physical therapy exercise program to rehabilitate your knee. *DISCLAIMER: Like all medical procedures, Regenexx® Procedures have a success and failure rate. Bone on Bone Arthritis, Cortisone Shots, and Meniscus Tears are all common challenges tolerated by chronic knee pain sufferers. Not only that, but the surgical patients were much more likely to be complaining of knee pain and decreased function. If there is no blood supply it may have a hard time healing or “scarring” back together. Eventually, a surgeon might be able to tailor the procedure to a patient’s specific needs and address the areas that are at risk of developing osteoarthritis. After this operation, the meniscus continues to provide shock absorption – reducing the likelihood of knee arthritis in the future. Arthroscopy is primarily used to remove loose debris and/or repair or remove part of a damaged meniscus – the C-shaped cartilage pad between the thighbone and shinbone. As an example, we’ve known for years now that knee meniscus surgery doesn’t work. Some physicians will recommend non-weight bearing activities for a long time and others may want you to start trying weight-bearing activities sooner in your recovery. Surgery Is Not a Good Option for Knee Arthritis. meniscus surgery likely increases the onset of arthritis. This does not come as a big shock to me. #### What you need to know What is the role of arthroscopic surgery in degenerative knee disease? Compare this to the opposite knee that was not operated on: 28% developed arthritis in that same time period. Fig. Avoid meniscus surgery! The researchers looked at structural changes on knee MRIs over an 18-month period after surgery. Between the femoral and tibial components of the knee, there are two wedge-shaped pieces of cartilage—each one is called a meniscus. The surgical solution for arthritis is a Partial meniscectomy, the most common orthopedic surgical intervention, is recognized as a strong risk factor for knee OA. About 1 million knee arthroscopies are performed each year in the United States, at a cost of more than $3 billion. It’s time for surgeons to retire this procedure! A final point worth mentioning lies in the fact that the patient has little control over the outcome. For example, check out this study that demonstrated that meniscus surgery likely increases the onset of arthritis. The meniscus is a piece of cartilage in the knee, often injured in sports. If you have questions or comments about this blog post, please email us at [email protected]. Sometimes surgery is an alternative, but not most of the time. With this type of surgery, a surgeon makes three or four small incisions around the knee then inserts a camera to see inside the joint and uses small instruments to make repairs. Even if arthritis does occur, I think the value of exercise to overall health might outweigh that risk. In any case, patients are usually advised to stay off their feet and the use of crutches may be advised for at least several days. Arthroscopic surgery for degenerative knee arthritis and meniscal tears: a clinical practice guideline. This is a frightening finding, considering many ACL tears are treated in the teens and twenties of young athletes. The study consisted of 57 patients, each having received an arthroscopic partial meniscectomy (for traumatic or degenerative meniscus tears) within a period of 5 to 12 years (8 years average) prior. Early…, Does getting a neck injury in a car crash, even if it heals, cause long-term…, Regenexx has always had an active research program with our goal being to try and…, One of the hardest things to watch in the stem cell wild west has been…. This is something I frequently see in my office especially for second opinions. Compare this to the opposite knee that was not operated on: 28% developed arthritis in that same time period. Knee after Meniscus Surgery. So you’ve had knee arthroscopy but your knee still hurts. Exercising during pregnancy might provide long-term health benefits to their children, South Carolina residents among the least concerned about COVID-19, Eating tree nuts as snacks might help keep weight off. A meniscectomy, which accounts for over 95% of meniscus surgeries, involves excising, or removing, pieces of the meniscus. Many other tears that aren't associated with locking or a block to knee m… To properly visualize the meniscus and adjacent cartilage, an MRI scan may be indicated for some patients. Despite the fact that orthopedic surgeons keep performing meniscus surgery and insurance keeps covering it, there are an abundance of problems plaguing the procedure, and it’s likely we’ll see this surgery relegated to the medical history books in the not-too-distant future. A recent article in the New England Journal of Medicine has attracted a lot of attention and it should. For obese patients, 18% had medial knee arthritis prior to meniscus surgery while a whopping 100% had it in the years following. I have people coming in who do have a lot of arthritis in the knee and said, “Can we do an arthroscopy?” And there are some doctors out there who will do an arthroscopy, but it’s not a successful surgery for arthritis. Using the MRI scans, our experts can create a computer model to predict how the mechanics of the joint will change in a virtual surgery simulation. In older patients, the tear is often not repairable. However, removing a torn meniscus will not help knee pain due to arthritis and may make it worse. Now, in new guidelines, an international panel of experts has strongly recommended against the surgery for nearly everyone with “degenerative knee disease.”. Nearly 63% of knee meniscus surgery patients developed knee arthritis in the meniscectomy knee within 8 years, on average, following surgery. ... 63% developed arthritis after partial meniscectomy. Do to the nature of the joint, it’s not quite as easy to injure as a knee, but it can take a beating and pain often develops over time. How long do you have to wear a knee brace after meniscus surgery? Meniscus surgery it’s not a good surgery for people with significant arthritis. Then and only then can you start to experience and evolution in the relief of your knee pain. In simple terms, arthritis is the result of the gradual wearing out of the joint cartilage and the subsequent inflammation triggered by this process. Although this knee has always been more fragile or weak during training, il remains pain free. In theory, if a patient tears the meniscus and requires surgery that involves trimming out the torn part (a partial meniscectomy), then more of the stress transfers to the knee’s bone and cartilage. Knee pain after meniscus surgery It rests between the upper and lower leg bones where they meet to form the knee joint. With this type of surgery, a surgeon makes three or four small incisions around the knee then inserts a camera to see inside the joint and uses small instruments to make repairs. Knee Pain AFTER ACL & Meniscus Surgery is extremely challenging IF you're ONLY looking at how to force the knee into a range of motion it doesn't want to go in. We also have some research to show that it likely causes or at least facilitates the development of knee arthritis. Tears associated with arthritis often improve over time with treatment of the arthritis, so surgery usually isn't indicated. Recommended Products and Resources Take steps to recover from knee surgery quickly and safely! Meniscus Surgery is one of the most common knee surgeries in orthopedics today. Sometimes surgery is an … The article focused on a group of patients with meniscus tears and osteoarthritis. In fact it could make it worse. I have people coming in who do have a lot of arthritis in the knee and said, “Can we do an arthroscopy?” And there are some doctors out there who will do an arthroscopy, but it’s not a successful surgery for arthritis. Objective: To compare consultation rate for knee osteoarthritis (OA) after meniscus repair, arthroscopic partial meniscectomy (APM), and in general population, respectively. NOTE: This blog post provides general information to help the reader better understand regenerative medicine, musculoskeletal health, and related subjects.
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