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How Complicated Would Surgery Be, And Can The Leaking Effusion Be Repaired In The Doctor's Office?
Question: Greetings. My wife, who had partial MEDIAL meniscus surgery 10 years ago just did an MRI showing extensive LATERAL meniscus tear and joint effusion in the same knee. Please see attachments of report. This apparently did not show up on the Xray or Ultrasound because the doctor referred only to the effects of osteoarthritis. My wife has swelling and alot of discomfort and it seems to us the orthopedist will have to do surgery on this one too. How does such an injury develop, especially after the previous case 10 years ago? How complicated would surgery be, and can the leaking effusion be repaired in the doctor's office? Would it be a "simple" outpatient procedure to correct the meniscus followed by therapy? Thank you.
Brief Answer:
Answer
Detailed Answer:
Hi there,
Thanks for the query.
According to the history provided and the MRI report it appears that she has degenerative tear of the lateral meniscus. This can happen in a previously damaged cartilage which was already treated by partial meniscectomy Making it prone to damage because of the loss of normal shape.
Since there is involvement of both parts of the knee the medial and lateral, it is advisable for a total knee replacement which can provide relief from the symptoms. I would advise you to discuss with her surgeon as to what are the various options available for treatment and if total knee replacement is one of them.
Thanks and regards.
Aashish Raghu
Answer
Detailed Answer:
Hi there,
Thanks for the query.
According to the history provided and the MRI report it appears that she has degenerative tear of the lateral meniscus. This can happen in a previously damaged cartilage which was already treated by partial meniscectomy Making it prone to damage because of the loss of normal shape.
Since there is involvement of both parts of the knee the medial and lateral, it is advisable for a total knee replacement which can provide relief from the symptoms. I would advise you to discuss with her surgeon as to what are the various options available for treatment and if total knee replacement is one of them.
Thanks and regards.
Aashish Raghu
Above answer was peer-reviewed by :
Dr. Kampana
Thank you very much for your reply. Would an immediate treatment of the leaking cyst provide significant relief? Would she have to regularly take something like Tramadol to relieve the discomfort? If the meniscus needs repair and there is Grade 3-4 of the cartilage, then I guess you assess that it makes sense to replace everything?
I don't understand why the lateral meniscus was ignored when the medial surgery was done 10 years ago.
The first doctor (sports medicine) she saw a couple of months ago did an ultrasound and gave her a shot which didn't help. The ultrasound evidently did not show the meniscus or the cyst. We cannot understand why he didn't recommend an MRI. When she saw the second doctor, an orthopedic surgeon, she insisted on an MRI. We also don't understand why he didn't recommend the MRI, he agreed when she insisted.
I don't understand why the lateral meniscus was ignored when the medial surgery was done 10 years ago.
The first doctor (sports medicine) she saw a couple of months ago did an ultrasound and gave her a shot which didn't help. The ultrasound evidently did not show the meniscus or the cyst. We cannot understand why he didn't recommend an MRI. When she saw the second doctor, an orthopedic surgeon, she insisted on an MRI. We also don't understand why he didn't recommend the MRI, he agreed when she insisted.
Brief Answer:
Answer
Detailed Answer:
Hi there,
A leaking popliteal cyst usually does not deserve any sort of operative treatment. Generally doctors would advise their patients to keep the limb elevated in a apply some ice on the painful region and thus should settle the pain.
The cyst would decompress on its own and nothing needs to be done. You can repeat MRI or get ultrasound if it’s still painful or swollen calf in a week to look for any clots.
She can use Tramadol for pain.
It appears that due to an injury the medial meniscus cartilage was damaged which was why it was partially removed.
The lateral meniscus is presently degenerated due to abnormal biomechanics of the knee as the medial meniscus was partially removed leading blob normal stresses on the lateral side which can cause degeneration.
Age, activity, osteoarthritic changes and other factors like weight Can have an influence on the status of the knee.
Since these are degenerative changes and MRI done earlier would not have really helped as it was bound to occur as a complication of middle meniscus tear and at this stage a thought of knee replacement may suffice.
Answer
Detailed Answer:
Hi there,
A leaking popliteal cyst usually does not deserve any sort of operative treatment. Generally doctors would advise their patients to keep the limb elevated in a apply some ice on the painful region and thus should settle the pain.
The cyst would decompress on its own and nothing needs to be done. You can repeat MRI or get ultrasound if it’s still painful or swollen calf in a week to look for any clots.
She can use Tramadol for pain.
It appears that due to an injury the medial meniscus cartilage was damaged which was why it was partially removed.
The lateral meniscus is presently degenerated due to abnormal biomechanics of the knee as the medial meniscus was partially removed leading blob normal stresses on the lateral side which can cause degeneration.
Age, activity, osteoarthritic changes and other factors like weight Can have an influence on the status of the knee.
Since these are degenerative changes and MRI done earlier would not have really helped as it was bound to occur as a complication of middle meniscus tear and at this stage a thought of knee replacement may suffice.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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