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Old 05-24-2014, 03:29 AM   #1
Cleve Chia
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Knee Pain - Horizontal tear at lateral meniscus - Surgery?

I need advice if I would need to go for surgery for this knee issue.

6 weeks back, my left knee swell up after standing and walking during work, nothing uncommon.

Subsequently till now , even after knee swell has subsided, the main issue is I have is aching pain felt at the back of my knee during left terminal knee extension (weighted & unweighted) and full knee flexion.

Since then, I have seen physical therapists, did sport and ART massages, even dry needling as I thought it may be caused by tight muscles or trigger points.

4 weeks after first onset (last week), my knee swell up the next day after I did light weighted squats (trying out). But finally I bought a knee sleeve, which resolve the swelling after two days. Compression seems to help alot this instance. Since then, I have been wearing a knee sleeve.

Last few days, I have just seen an orthopaedic and did an MRI. Doc suggested keyhole surgery after the Findings on the MRI report (files as attached) states:

"There is horizontal tear present at the posterior horn of the lateral meniscus. This reaches the inferior surface of the meniscus."

The Impression in the report states:

"Suspected horizontal tear present at the posterior horn of the lateral meniscus reaching the inferior meniscal surface"

I am in my mid-30s and looking to CrossFit for at least another 20 years. No prior injury to knee before. Do my question is do I necessarily need surgery for this? Or it may just heal on its own? Anything I can do other than not squatting for now, to promote healing?

You can refer to the attached report, or enquire further here on the condition.

I understand there are mixed opinions for surgery, especially for my non-traumatic meniscus tear. Appreciate your kind helpful opinions on the above.
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Old 05-26-2014, 07:12 PM   #2
Sean Rockett
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Re: Knee Pain - Horizontal tear at lateral meniscus - Surgery?

So the answer is no you don't need it, but what is the alternative. If this tear has no blood supply then it will not heal. If you can live with the symptoms and modify what you do to avoid pain then some people will choose that option. I have seen both I have seen pain quiet down and people return to functioning well. I have also seen tears get bigger like hang nails that get pulled on and become bigger. If the pain is bad and you have already modified what you do and tried all the other stuff out there that you have tried, then surgery is reasonable.
Quote:
Originally Posted by Cleve Chia View Post
I need advice if I would need to go for surgery for this knee issue.

6 weeks back, my left knee swell up after standing and walking during work, nothing uncommon.

Subsequently till now , even after knee swell has subsided, the main issue is I have is aching pain felt at the back of my knee during left terminal knee extension (weighted & unweighted) and full knee flexion.

Since then, I have seen physical therapists, did sport and ART massages, even dry needling as I thought it may be caused by tight muscles or trigger points.

4 weeks after first onset (last week), my knee swell up the next day after I did light weighted squats (trying out). But finally I bought a knee sleeve, which resolve the swelling after two days. Compression seems to help alot this instance. Since then, I have been wearing a knee sleeve.

Last few days, I have just seen an orthopaedic and did an MRI. Doc suggested keyhole surgery after the Findings on the MRI report (files as attached) states:

"There is horizontal tear present at the posterior horn of the lateral meniscus. This reaches the inferior surface of the meniscus."

The Impression in the report states:

"Suspected horizontal tear present at the posterior horn of the lateral meniscus reaching the inferior meniscal surface"

I am in my mid-30s and looking to CrossFit for at least another 20 years. No prior injury to knee before. Do my question is do I necessarily need surgery for this? Or it may just heal on its own? Anything I can do other than not squatting for now, to promote healing?

You can refer to the attached report, or enquire further here on the condition.

I understand there are mixed opinions for surgery, especially for my non-traumatic meniscus tear. Appreciate your kind helpful opinions on the above.
__________________
Sean Rockett, MD
www.orthopedicsne.com
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Old 05-31-2014, 11:01 PM   #3
Cleve Chia
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Re: Knee Pain - Horizontal tear at lateral meniscus - Surgery?

Quote:
Originally Posted by Sean Rockett View Post
So the answer is no you don't need it, but what is the alternative. If this tear has no blood supply then it will not heal. If you can live with the symptoms and modify what you do to avoid pain then some people will choose that option. I have seen both I have seen pain quiet down and people return to functioning well. I have also seen tears get bigger like hang nails that get pulled on and become bigger. If the pain is bad and you have already modified what you do and tried all the other stuff out there that you have tried, then surgery is reasonable.
Thanks Dr Rockett! I have since sourced second opinions and they have also advised to delay surgery. They reckon I should build up back to full functionality in the next 5 weeks, and see how it goes.

In the meantime, I am doing some mobility exercises e.g. terminal knee extension by Kelly Starrett.

One of the PT thinks it may not be a meniscus tear (negative for all his functional tests for meniscus tear) and suspected it could be a popliteus-related or posterior-chain imbalance issue.
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