DISCOID MENISCUS in 8 YEAR OLD Can physical therapy help avoid surgery?

[mirandan50]

My daughter is 8 years old and has had popping in her knee for a few years. When it first started it was very random and not often. We thought maybe growing pains, but it was not really an issue. She didn’t have any pain or swelling associated with it and was keeping to her regular activities. Then we noticed that not only did it not go away it was becoming more frequent (still no pain) so we went to see the doctor who said everything was fine.  We came home after and kept an eye on it.

A few months later we went back to the doctor because it had not stopped and was happening more often (still no pain) but now she did say that her knee felt wobbly.  We get them to do an X-ray which shows that her knee is fine again.  We insist on an MRI and have recently been advised that it is a discoid meniscus.

The doctor we saw suggested that we “could” do surgery and that it would “probably” get rid of her symptoms.  I am having hard time with this decision.  Her knee does pop on a consistent basis now, and she says that is feels wobbly (still no pain) and she remains active.  The doctor says that doing surgery now will help reduce the risk of tears in the future. That sounds great except when I ask what else could happen he states that he could have to take more than he would like or all of the meniscus depending on what he finds when he is in there.  This is shocking to me. The idea that she could come out worse than what she went in and for a surgery that I was told we “could” do vs. “have” to do.

It seems like an easy NO except I don’t know much about the knee or what she might be feeling. She is 8 I can’t imagine her knee getting in the way of her living her life. She is tough too – is it possible she is downplaying what it actually feels like?  

Do you know if it is possible to alleviate these symptoms (cracking knee, knee feels wobbly, and she prefers it to be extended vs. bent) without surgery? Or is this something she will suffer from her whole life and will only get worse?

I prefer to avoid surgery if possible but also do not want to prolong her discomfort if it will end in surgery anyway. Any tips or advice that you might have would be greatly appreciated.

[babs0321]

I was wondering what you decided. My daughter, almost 4, has been complaining of left knee pain for a year and a half. We figured it was growing pains at first and then consulted with a pediatric rheumatologist. She ruled out systemic arthritis but did say she was reacting to her exam of her left knee and to keep an eye on it. After another 6 months of intermittent late night crying episodes, a popping sound and some very expensive sneakers we saw a pediatric orthopedist last week. After X rays and an exam he immediately said he thought it was disoid lateral meniscus and ordered an MRI (under anesthesia because of her age).  I am scared to find out if he is right and to have to weigh the options.

If you did the surgery, what was the recovery like?  Did they say there was any long term effects?  

I can't seem to find much information about this condition.

Thanks

[S. Kaul, MD]

Hi there!

Well, if your doctor has suggested a ‘could do’ over a ‘have to’ surgery; I personally would not be too keen on the surgery and may suggest avoiding one unless there are ‘significant’ symptoms. A surgery might have to be considered at a later stage in life or if the symptoms get worse, but may not be necessary at this stage. She may try physiotherapy for stretching and strengthening exercises for the quadriceps and hamstring muscles and see if these may help. You may also seek a second opinion with another orthopedician to get his/ her views on the matter.
Hope this was helpful.

Take care!

[sara_eagle]

Odds are, it will end in surgery anyway.  I'm sure your Dr. is hesitant due to her age.  I'd recommend seeking a 2nd opinion with a pediatric orthopedic surgeon.  Best of luck!