Mine removed itself (wore out) and I ended up with a knee replacement, but I went six years between the time that my surgeon noticed the meniscus was pretty much toast during an arthroscope, to the time that I could barely even ride my bike and I knew it was time to get the knee replacement. I can still bike and swim no problem. In fact, both of those plus weights are highly recommended.

I would think if it were totally gone, eventually that bone on bone is going to cause a lot of pain in everything, even just sitting around. Can you get a second opinion?

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clm
Nashville, TN
https://twitter.com/ironclm | http://ironclm.typepad.com

I saw another ortho. He agreed it was torn and was honest. He said he didn't want to get involved. Wasn't sure if he would make it worse or better. I appreciated his honesty. Another doc said come see me in another 6 weeks if it was still catching, but felt uneasy about him. Just not sure how I can get it stronger if I can't do the basic PT stuff. I want to avoid surgery all together, but seems like I might not have a choice if I can't walk. I just think that was a DB move when he said he would just take it out when he doesn't even know what it looks like. I'm on to another doc next week...

My dad had his completely removed I believe in around '82-83 time frame (his late 20s). It's what they did back then in his line of work if you injured your meniscus.

Took until about early 2000s for it to really start bothering him, and it wasn't consistent, with a cortizone shot usually clearing up the worst symptoms for a while. He did just get a new knee last year though, and the past 4-5 have been pretty brutal.

That is called a knee replacement

I've had 5 meniscus surgeries for basically 3 separate injury instances. Based on my experience, if they do it right you should walk out of the surgery feeling like your knee is healed and working properly right away (though obviously with some trauma from the surgery). Two of my three injuries (first and third) were like that - in both cases I was starting to get back active within a week.

For the other injury (second), which was pretty bad, I unknowingly went to a not very good ortho. He operated once and I could tell right away he hadn't fixed it. After a couple months he went back in and operated again. It was better, but still not good - I still got swelling when I ran, etc. I then moved to a new city and went to a new surgeon who turned out to be really really excellent. He looked at my scans and immediately said "we've failed you" - meaning the medical profession (specifically my previous Dr) had failed me. He said it didn't look to him like the guy had done anything at all (in two surgeries!). He went in a third time and I walked out of the surgery knowing immediately that it was fixed. The knee has been great ever since (well until I tore the ACL in that knee and had another surgery, but it's back to being great now!) That one was almost 20 years ago so good long term result as well. Yes he had to remove some significant portion of the meniscus. No he did not have to remove all of it.

So based on my experience it's obvious to me that your first surgery was a failure and you need another one. I would highly suggest asking around and finding a great surgeon. The good ones know they are good and will have no fears of going in and fixing your knee, whatever state it is in. Find someone who does 5 of these per week, the guy who does your local pro sports teams (NFL/NHL/NBA etc). Get it fixed and you'll never look back.

Thanks that is what I think. This doctor has told me too many different stories and doesn’t listen to me at all. He’s fired! The sad part about it is I let this go on for too long and should have looked for another opinion awhile back

Hope it all works out.

There is life after running but it takes some effort to have enthusiasm about it. I'm pretty happy with all my "menisci" being a former shadow of themselves so life goes on. However I could take a minute off my T1 transitions if I could hobble a little faster up the beach to the parking lot.

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"They know f_ck-all over at Slowtwitch"
- Lionel Sanders

I had a ping-pong size cyst on the external side meniscus that had to be removed at 14 yrs old, that's in 81'. At the time, surgery was not as advanced as now. It left me with a 3.5'' "zipper" on the right side of the knee. In my teenager years, my sports were mostly downhill skiing in the winter, and soccer in the summer...I remeber going back to the orthopedist to "help" ( read force) the articulation to bend again. It was so painful I couldn't bend the knee for many months. I had many, many years with instability in my right knee. The doc told me to start cycling to develop more muscle around the knee area. I never ran really ran besides the skiing's pre season training routines.
Every time I'm returning back to intense workouts, my right knee hurts. I'm not sure, but my theory is that when I gat back to intense work, the tendons "pull" on the articulations, since I have extra room on the external side of the right knee, the alignment is modified. I learned through the years to work a lot on my right AT band, with the foam roller, and the pain finally goes away. I don't have less strenght on my right size though.
I started running only a few years ago. And I always quit because of some pains. NOw I can run 10-15 km's fine, at 52 :-) . I use very stable, overpronator shoes. Hope this helps.

Louis :-)

I have had 4 in my right knee, all mainly due to a partially torn acl
Which allowed instability and thrashed the meniscus each time playing soccer.

Eventually when the acl was finally totally torn and fixed
Did my meniscus problems sort themselves out.

Once you get a good doc you should be sorted out, it's not rocket science anymore.

Meniscus surgeries should only be performed now in the most extreme circumstances. I hope your physician is only recommending a partial menisectomy as full removals shouldn’t be done anymore. Even partials, research shows, are the same as PT one year out. We know that the meniscus tears and fractures as part of life and is frequently not a problem. Don’t rush into any surgery and give it time to scar down with some good PT.

AndrewL, is that the common remedy now - rather than surgery? I followed this because I coach soccer, and I constantly have kids coming to be and saying that they have been diagnosed with tears in the meniscus. And they are getting a variety of suggestions. The main thing I want to have for them is good knees, or at least as good as they can be, 10 or 20 years from now.
On this same point, does putting real effort into building up strength around the knee take any pressure off of the meniscus? I had a son go through PCL surgery, so love the idea of some other ways to rectify these issues for the kids.

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C4 Sports
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I had a medial menisectomy (ortho told me 75%, OR record says 90%) in 1996 at age 25. Took about eight years off from running to "preserve my knee". In 2004 a buddy talked me in to running a 5K on a whim. Afterwards I had no pain and decided to try running again.

I've run well over 1,000 miles per year since 2006 and will pretty easily make it over 2,000 this year with no knee pain. I have altered my running style to a midfoot (chi, pose, natural.....) landing and I believe that this takes significant load off the knee joint. Of course it puts more strain on your ankles and feet, so there's that.

My N=1 says that you can run after subtotal menisectomy.

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Jason
None of the secrets of success will work unless you do.

That’s amazing. I would be w anything however the I could like with biking and hiking

No experience with full removal, but this advice is CRUCIAL! I've been to 2 docs for 3 surgeries; 1 botched, 2 a great success. The successful ones were all done by a doc who works with the local pro sports teams and colleges.

At the minimum I would say get another opinion from someone with that kind of experience.

Where are you located? Maybe someone will know of such a doc.

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Strava

The one thing my original ortho told me, and I have had repeated by others since: don't get fat!

Carrying the extra weight around puts pressure on the knee every step that you take. I work in health care. We very rarely do knee replacements on skinny marathon runners; they are almost all done in 100kg + folks.

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Jason
None of the secrets of success will work unless you do.

Agreed .. I’m not over weight and very cautious about that

Kids really shouldn’t be getting surgery. Their bodies are still growing and changing and medical professionals shouldn’t be messing with thatThe meniscus tears and it frequently doesn’t even hurt. There’s many reasons one can have knee pain. My stance is let the kids play, if the pain is too much get them to a PT and rest them from practice.

For credibility's sake, are a doctor? I ask because I've had 3 menicus heard over that past 8 years with the first one when I was 20 (so a bit older than a kid), but I would think if the pain is bad and constant, shouldn't it be considered? I know my 2 surgeries that worked had recovery times of 2 weeks.

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Strava

I’m a PT. I’m not making recommendations. Just describing what’s out there in the literature and how I personally interact with patients.

Pain from meniscus tears is typically not constant (every minute of every day). It is usually intermittent when a mechanical load of some sort or angle supposedly creates that pain. Some mechanical loads are helpful and some aren’t.

The meniscus is mostly aneural and avascular. Kids can have vascularized menisci and therefore good healing potential. The interesting thing is as we get older vascularity decreases and therefore healing potential. These tears tends to scar down however. But as cartilage is mostly aneural anyway, it can’t generate pain. If one cannot conclusively identify a pain generating structure and the reason, then how can you have good surgical results? MRIs show anatomical differences from an ideally typical individual, but imaging cannot identify pain simply because there is a tear or arthritic changes.

I had my first partial menisectomy at age 12; several after that, culminating in a total menisectomy at age 33. I also had full thickness grade 4 OA. All lateral compartment. I had an osteotomy at age 33.

Lateral is tricky in that it is unusual and most folks won't do partials on lateral knees (for good reason), so if your damage is on that side, options are limited as you lose more and more chunks.

Where and how much they clip depends on the year location. And it could be with therapy you don't even NEED a clip and can exist with the tear/failed repair. Any time a full menisectomy is on the table, of get a couple of opinions. If it's unstable, sure...clip it. But you shouldn't need a total.

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