Will My Meniscus Tear Heal Without Surgery Doc?
by Steve A. Mora, MD
Board Certified Orthopedic Surgeon Specializing in Shoulder, Knee Elbow Surgery, Orange, Ca
Meniscus and articular cartilage injuries are the most common injuries we see in orthopedics. Here are some of the most common questions I get asked in my office.
How much time should I give my knee to heal on its own before having surgery?
Depends on the trend. Are you getting better and better each month? If yes keep waiting. Are you getting worse? Operate if non op measure have been done. Do you need to be ready for next season? If yes, don’t wait so long to decide. Do you have a vacation from work coming up in a couple of weeks? If yes ask your surgeon if its too soon or if it’s reasonable to do surgery.
Am I making it worse by being active or playing sports with my tear? If you are not experiencing significant catching or pain you are probably not making it worse. However I cannot say this with 100% certainty. The more pain there is the more likely the loose pieces are catching or rubbing on other surfaces. In rare cases a meniscus tear can become displaced with strenuous activity. If you are experiencing catching, giving way, or moderate/sever swelling, shut it down. Sometimes a minimally painful bucket handle tear can be suddenly displaced causing the knee to lock.
If I have surgery what is the likelihood I will have an excellent result? Will I be normal after the surgery? I will tell you now that you probably will not be 100% or normal. However after most simple knee arthroscopic surgeries for meniscus tears, most patients (85%-95%) will have a excellent result that allows them to function at their desired level with minimal to no complaints. The patients who experience difficulty with recovery are those with a large meniscus tear and/or arthritis. After the meniscus tear is fixed the arthritis continues to be a problem even in those patients who were “fine before the tear”.
Is the possibility of a complication high? Or is it very unlikely/rare?
Most surgeries for meniscus or chondral lesions are not risky. Nonetheless if you do suffer a rare complication such as a deep infection, it may lead to further surgery or delayed recovery.
Am I better off coping with the pain, living with the pain, changing my sport, or not having surgery? This is a personal decision you will ultimately have to make on your own. However the information your surgeon gives you will help you make the right decision for you. For example, if a chondral defect has undergone one surgery but requires more surgery, the surgeon might tell you the chance of an great result is lower. In this situation you should ask yourself if you are willing to go through another surgery, do rehabilitation/PT (again), take time off work (again), deal with crutches, and struggle with the emotional stress all over again. Some patients will say it is not worth it especially if they can do most activities. If your knee is severely locking or catching its probably a good idea to have surgery. It you have a small tear and minimal to moderate pain it might be okay to wait and see if it becomes less painless with some therapy, injection, bracing and activity modification.
Even if I have surgery, is it likely that I will be able to play my game or go back to work at pre-injury level? The goal for most surgeons is to get you back to the level of function which you desire. That function could be related to athletic or work activities. Some chondral injuries or meniscus tears are so severe that even with the best surgery the final level of performance is still not the same. For the most part many patients are able to return to high level sports or activities, especially with a small to medium size meniscus tear. Chondral lesions are a differently animal and not as predictable. The general rule for chondral injuries is that the smaller the defect the more likely things will turn out well.
I hope this information was helpful. If you are not sure what to do, you should see a Orthopaedic Surgeon preferably fellowship trained in Sportsmedicine. Good luck with your knee.
Steve A. Mora, MD
Board Certified Orthopedic Surgeon Specializing in Knee Surgery, Orange, Ca
Appointments can be made my calling 714.639.3750
You can visit my webpage for more information www.MyOrthoDoc.com
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