Suggest Treatment For Posterior Lateral Meniscal Root Tears
Question: I have received advice from several other physicians here on this topic recently, and I would like to seek one additional opinion. I was diagnosed several weeks ago with a tear of the posterior root of the left lateral meniscus. My symptoms began in early January with mild tightness, but I did not begin experiencing pain until late February. For the last few years, I have run 6-8 miles per day, but I had to stop running in late February due to knee pain. I have uploaded a copy of my MRI scans to my Dropbox account, which is linked below:
https://www.dropbox.com/s/2z60sgg5nos50a8/Knee%20MRI%20Complete.zip?dl=0
Based on my MRI scans, how bad does the root tear look? Is it only a partial tear of a few millimeters, or is it much bigger? Is it likely to heal on its own, or will it likely require surgical intervention? Also, does it appear to be in the red zone (healing zone) or white zone (non-healing zone) of the meniscus?
Thank you...
https://www.dropbox.com/s/2z60sgg5nos50a8/Knee%20MRI%20Complete.zip?dl=0
Based on my MRI scans, how bad does the root tear look? Is it only a partial tear of a few millimeters, or is it much bigger? Is it likely to heal on its own, or will it likely require surgical intervention? Also, does it appear to be in the red zone (healing zone) or white zone (non-healing zone) of the meniscus?
Thank you...
Brief Answer:
Tear is small and it is expected to heal.
Detailed Answer:
Hello
As we discussed earlier,tear is small in your case and this condition should be tried to manage conservatively.
Arthroscopy and partial meniscectomy should be the last option.
As tear is peripheral and peripheral part of meniscus has good blood supply,so it is expected to heal.
Outcome are same in both cases that are managed conservatively and those which are managed surgically.So,every attempt should be made to manage conservatively.
Clinical findings also need corroboration.
Get well soon.
Hope I have answered your question.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
Tear is small and it is expected to heal.
Detailed Answer:
Hello
As we discussed earlier,tear is small in your case and this condition should be tried to manage conservatively.
Arthroscopy and partial meniscectomy should be the last option.
As tear is peripheral and peripheral part of meniscus has good blood supply,so it is expected to heal.
Outcome are same in both cases that are managed conservatively and those which are managed surgically.So,every attempt should be made to manage conservatively.
Clinical findings also need corroboration.
Get well soon.
Hope I have answered your question.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by :
Dr. Pradeep Vitta
Dr. XXXXXXX thanks for answering. In your opinion, do you believe that the tear is approx. 4-5 mm in length? Also, is the entire meniscal root generally considered to be vascularized?
Brief Answer:
Exact measurement can only be done by MRI software.
Detailed Answer:
Hello
Exact measurement can only be done by MRI software.Roughly it appears around 7-8 mm.
Only peripheral meniscus has good blood supply and it respond well to conservative treatment.
Central part doesn't heal due to absence of blood supply and it is difficult to treat conservatively.
Get well soon.
Hope I have answered your question.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
Exact measurement can only be done by MRI software.
Detailed Answer:
Hello
Exact measurement can only be done by MRI software.Roughly it appears around 7-8 mm.
Only peripheral meniscus has good blood supply and it respond well to conservative treatment.
Central part doesn't heal due to absence of blood supply and it is difficult to treat conservatively.
Get well soon.
Hope I have answered your question.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
Dr. XXXXXXX do you know how wide my entire posterior meniscal root at the attachment is? The reason I ask is because I am curious as to how much of the root remains attached to the tibia. (For example, if the entire root is 12 mm in width, and the tear is 7-8 mm long, then that would leave 4-5 mm of root still attached.)
Brief Answer:
As discussed earlier,we can do just rough estimation by uploaded images.
Detailed Answer:
Hello
As discussed earlier,we can do just rough estimation of tear by uploaded images.
Tear appears small and I don't think it should be over 10% of total root attachment.
Don't worry much about size of tear.Size and site of tear is favorable in your case.
Get well soon.
Hope I have answered your question.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
As discussed earlier,we can do just rough estimation by uploaded images.
Detailed Answer:
Hello
As discussed earlier,we can do just rough estimation of tear by uploaded images.
Tear appears small and I don't think it should be over 10% of total root attachment.
Don't worry much about size of tear.Size and site of tear is favorable in your case.
Get well soon.
Hope I have answered your question.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr. Buhshan, thanks for the advice. In your estimation., how long do you think the injury should take to heal? My pain first began in late February, but I still have some pain, so I was wondering if it should have been healed by now or if it still needs a few weeks to heal.
Brief Answer:
It can take 10-12 weeks for healing.
Detailed Answer:
Hello
It can take 10-12 weeks for complete healing.Response varies with patient.
As injury happened in last February,we can expect
for better results by May end.
Get well soon.
Hope I have answered your question.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
It can take 10-12 weeks for healing.
Detailed Answer:
Hello
It can take 10-12 weeks for complete healing.Response varies with patient.
As injury happened in last February,we can expect
for better results by May end.
Get well soon.
Hope I have answered your question.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar