torn Meniscus question

I've had an MRI that revealed a torn left meniscus and
degeneration of the cartilage from 3mm down to 1mm. I have
surgery May 28th to trim and remove the torn meniscus and
smooth out the bone. My surgeon doesn't me running at all or
at least not the way I was (4 Ironmans, 7 marathons, well
over 50 other triatlhlons, etc.) but he will be making a
recommendation following the surgery (outpatient,
arthroscopic, walk in and out, heavy sedation) but he said
if I continued the long heavy stuff I could be headed next
for a total knee replacement. Hope this helps,
--
Bernie Hall o __o </\_ \ < __/\ /\o__ (0) (0) / \__o
^^^^^^ ^ ^
2.4 - 112 - 26.2 Great Floridian Triathlon 2000~12.40.14
2001~12:30.36 2002~13:18.22 The Duke Blue Devil
2002~12:26.39 Philmont Scout Ranch 1972, 2003 "RIP"
<[email hidden]> wrote in message news:82f92b95.-
[email hidden]...

Quoted message said:

I am a 39 year old male fairly active and need some
advice. I finally had an MRI done last week on my left
knee that bothered me back in Sept 2003 (hurt it during a
Soccer tournament. I have been playing soccer 2-3 times a
week since last June and running twice a week on it
(under 10K runs usually 6-8KM) and have had little
discomfort ocassianlly my knees ar sore but nothing major
and it usually seems to be the right knee that hurts
more? Anyhow, the results of my MRI are " A slightly
irregular but oblique horizontal tear is noted in the
Posterior horn and body of the medial meniscus. There are
areas of fraying in the body and posterior horn. Mild
sprain of the MCL. Tracking Baker's Cyst. There is a
bunch of other things written down but such as normal
muscle, patellea well aligned, ACL,PCL, LCL, and extensor
mechanism normal etc.

I am not too intersted in getting surgery but from what I
have read it seems I may be asking for trouble if I do
not? The surgery from my understanding is simple but is a
partial removal and not a re stitching. This makes me
think even a "torn cushion is better then a small cushion"
and I should wait it out?

I am sure many of you have had similar problems and I am
curious to see what you have chosen and what has happened?

RIP said:

...I have had little discomfort ocassianlly my knees are
sore but nothing major and it usually seems to be the
right knee that hurts more? Anyhow, the results of my MRI
are " A slightly irregular but oblique horizontal tear ...
[blah, blah, blah]

The surgery from my understanding is simple but is a
partial removal and not a re stitching. This makes me
think even a "torn cushion is better then a small cushion"
and I should wait it out?

No, it is not necessarily like you think. You imagine "more
meniscus [cartilage cushioning] is better". But a frayed
loose moving bit of shredded cartilage impairs smooth
movement of the surfaces of bones against each other. It's
like throwing a stone into a finely meshing system of gears.
Removing the strands of free frayed meniscus may leave you
less "cushioning" in theory, but in fact it might remove the
impediment to smooth free comfortable and athletically
successful motion.

Mind you, I have no real idea what your MRI shows! Only your
orthopedic surgeon knows you, your situation, your symptoms,
and what the pictures say about your injury. Only he/she can
truly advise you about what might happen should you choose
surgery or should you choose to be patient and not operate.
Not operating might be a perfectly fine choice. And in fact,
the best surgeons are never eager to operate and incur it's
risks and consequences. But only your experienced
orthopedist can advise you about what the future likely
holds if you do or don't operate.

With all your caution and appropriate reluctance to go
"under the knife", I suggest you get a second opinion. That
way you can be more confident that your surgeon is making a
reasonable interpretation of all the issues and is
recommending care for you guided by wisdom and experience,
not just the desire to collect a surgical fee. All surgeons
expect patients to be apprehensive enough to want
reassurance from second opinions, so he/she won't be
offended. I'd march in and ask your surgeon who he/she'd
recommend for a second opinion. In fact, rather than be
offended, most surgeons are glad for patients to get second
opinions. An informed, reassured patient goes into surgery
more confident, expects the outcomes good or bad more
comfortably, and is more likely to be happy with the result
good or bad (as in, less likely to sue).

Best of luck. -- Josh Steinberg MD, Syracuse

Quoted message said:

I am sure many of you have had similar problems and I am
curious to see what you have chosen and what has happened?

For what it's worth - I'm also 39 and I've had a lot of knee
work done. ACL and 2 scopes.Although my left knee does make
a lot of noise, I really don't have any discomfort nor do I
notice any lack of cushioning.As was mentioned, unrepaired
this injury will grow worse. I believe some small meniscus
tears will heal in areas where blood supply is good, but
your ortho would probably have already told you if you were
in that postion. I have done long runs up to 20 miles and up
to 40 mpw at times. I have never, ever had any trouble with
that knee since I started running 2 years ago.

Best of luck! Mike L