Meniscus or Articular Cartilage Injury?

[juggernette397]

I used to play a lot of soccer and have not in years, but I remember having knee and ankle pain quite often, enough so that I frequently wore knee braces and wrapped both ankles.

I now play golf, and after playing one day I noticed some knee pain.  There was no specific incident or sudden onset of pain - it just gradually appeared.  I also started hearing more popping noises than usual, but now it hurt and I felt movement.  To straighten my knee I had to wiggle it and it would "clunk".  Sometimes when kneeling, I felt a cushiony sensation even though my knee didn't look swollen - and that sometimes it would pop painfully and "settle" down.

I saw my regular doctor after the first week, and an x-ray didn't show anything abnormal.  2 weeks in a knee stabilizer didn't help.  An orthopedic doctor said it could be one of three things - a meniscal tear, a piece of meniscus getting caught in my knee joint, or inflammation.  He scheduled a follow-up appointment after 4 weeks, and said I could continue to play golf and even walk to exercise my knee.

It's been a couple of weeks since I saw him, and now I can't walk up or down stairs or hills without pain.  There is also pain when I inadvertently twist my knee (if I turn while walking but not during golf) or when I get up from a sitting position using mainly that leg.

I'm confused because I don't have all the usual symptoms of meniscal injuries - I've had no swelling, and my knee doesn't lock completely.  Is this a meniscal tear?  Could this be from an old injury?  Do my symptoms seem to warrant surgical repair or is there some way I can get it to heal without surgery?  I've tried a knee brace, no help, and NSAIDS just treat the pain.  I've recently found something about "chondral injury" or "articular cartilage injury" and my symptoms seem more in line with this.  Could that be possible as well?

Thank you!

[Michael L Gross, MD]

Conventional wisdom is that for an acute meniscal tear, in a young, active individual, the most reliable meathod of treatment is arthroscopic partial menisectomy.  The large majority of meniscus tears do not have the potential for healing on their own, and physical therapy does not promote healing of the meniscus.  I compare a torn meniscus to a pebble in your shoe.  Until the pebble is removed, you are still going to have pain.  Once the torn meniscus (the pebble) is removed, you can feel better. The incidence risk of arthritis after arthroscopic partial menisectomy is quite low. Combine this with the probability that leaving the torn tissue in place has a greater chance of causing arthritic changes in the knee.

[AJ52]

I have a Meniscus tear that I got last year at a camp in centerville texas and My doctor said if it wasn't that bad. But this summer when I went to a different one it
started to hurt more when I did like walking and swimming it swelled up so bad that
the nurse at the camp had to put Ice and wrap it. Could you please give me some answers on what to do cause I am at lost right now and my doctor said if it didn't get
better that it would need surgery.

amy

[Michael L Gross, MD]

At this point, your symptoms could be caused by any one, or any combination of the injuries you've read about on the net.  They are fairly non-specific injuries.  I think an MRI would be useful to give you a specific diagnosis, and then you and your orthopedist can develope a treatment plan that is appropriate for you.