This nursy plays dirty and does it with pain...

Tuesday, May 8, 2007

Walking through it... meniscal tear

In a span of two years, I fell off the ladder twice and hurt the same knee - my left one. The first injury was minor in that I had some bruising and swelling which went away. The second time brought some persistent pain and swelling and affected my range of motion. I eventually had MRI and found out that I have 16 percent meniscus tear on my outer part of left knee. My option is live through it or have an arthroscopic surgery.

In humans the knee supports nearly the entire weight of the body. The knee functions as a living, self-maintaining, biologic transmission, the purpose of which is to accept and transfer biomechanical loads between the femur; or thigh bone which is the longest, most voluminous, and strongest bone of the body and forms part of the hip and part of the knee, tibia; or shin bone, patella; or kneecap which is a thick, triangular bone that articulates with the femur and covers and protects the front of the knee joint, and fibula; or calf bone. In short, our knees are hinge joints.

Menisci are cartilaginous/rubbery tissue within the knee joint which serve to protect the ends of the bones from rubbing on each other; acts as a shock absorber between the upper and lower leg bones and stabilizes the knee joint by evenly distributing the load across the knee. There are two menisci in each knee, the medial meniscus, the inner side of the knee and the lateral meniscus, the outer side of the knee. Either or both may be cracked, or torn, when the knee is forcefully rotated and/or bent.
In a typical minor tear, there may be slight pain and swelling at first. These symptoms usually go away in 2 to 3 weeks.
A typical moderate tear can cause pain at the side or center of the knee, depending on where the tear is located. Swelling increases gradually over 2 to 3 days. This may make the knee feel stiff and limit bending, but walking is usually possible. There's often sharp pain with twisting or squatting. These symptoms go away but tend to recur with minor twisting or overuse. In severe tears, pieces of the torn meniscus can dislocate into the joint space. This can make the knee catch, pop, or lock. You may not be able to straighten it. And the knee can feel "wobbly" or unstable, or give way without warning. It may swell and become stiff right after the injury, or over 2 to 3 days.

A physical examination is done to determine if a torn meniscus is the cause of your pain and to rule out other knee injuries. Your health professional will examine both knees and evaluate tenderness, range of motion, knee stability, and how the injury has affected your knee. X-rays are usually done. Your health professional may suggest that you follow up with an orthopedic surgeon for further testing. MRI is the best imaging modality available today for diagnosing soft-tissue injuries. While X-Ray and CT are excellent tools for detecting bone injuries, they have limited value for patients with severe ligament or meniscus damage.
Treatment for meniscus tear depends upon the extent, type, and location of the tear, your age and activity level, and when the injury occurred. Treatment options include nonsurgical treatment with rest, ice, compression, elevation, and physical therapy; surgical repair; surgical removal of the torn section (partial meniscectomy); and surgical removal of the entire meniscus (total meniscectomy).

Rehabilitation varies depending on the injury, the type of surgery, your orthopedist's preference, and your age, health status, and activity demands. Time periods often vary, although in general, meniscus surgery is usually followed by a period of rest, walking, and selected exercises.
I decided to live through it until the arthroscopic surgery deems necessary. I do have pain which is bearable. Depending on the activity I engage my knee in, I would take Motrin 600 mg or a heating pad or gentle massage on the area. I can no longer subject my knees to any strenuous exercise and find that walking is the best exercise it can tolerate. Even the Pilates exercise I do causes pain that I just have to remember to put my knee pad when the left knee is sore.

7 comments:

Belle TH said...

wow, very impressive! bow ako saiyo talaga E. thanks for this valuable information.

A Mother of Two said...

Another great post, MsE! I love reading your entries, very informative. You are those who can be great teachers, did it ever cross your mind? Like teach in nursing school?

Belle TH said...

E, what is wrong with your recent post? is the comment box off?

Jay said...

uhmmm.. do U have any ideas on how would a meniscal repair cost here in the Phils? both of my knees have meniscus injuries and i think it is at its severe state. i read some posts that it costs so much in the States. so i wonder how much it would cost here... :-S

NursyE said...

Honestly, I do not have a clue!!! Being gone From the country since 1982, I do not have a good grasp on how much things cost. Here in the US, having a medical insurance helps. My concern with having a surgery is that the fact that I will need at least 8 weeks off work to recover. To me, that is just too long to be off work.

I am not planning to have the corrective surgery. The long term effect of that decision is of course ...pain which I have high tolerance so I should be okay with that issue. What I do not particularly look forward to is developing arthritis in that area which will definitely happen eventually on any injured orthopedic area.

Good luck to you!!! Thank you for visiting...

Flatfooter said...

Thank you for sharing your personal experience. I've found it very helpful. I'm a dancer and now have a large tear in the medial meniscus of my left leg, which I can live with as I have little pain. Although I'm now favouring my right leg which is throwing my pelvis out and causing referred pain down my right leg. It's painful and uncomfortable to sit for any length of time. I'm trying to find a way to walk normally again and that's how I came across your website. All the best with your injury. You may not get arthritis in that knee.

Anonymous said...

This information was very encouraging as I, too, have a meniscal tear and am looking at alternatives to surgery. The pain has lessened from the origin 3 months ago (8-9) to a (2-3) with activity and only a .5 after resting. I feel that so much progress has been made I'm willing to wait if there is a prayer of this issue resolving itself non-surgically (my orthopedic surgeon's suggestion was for the arthroscopic surgery). I am 72 and have read that this surgery isn't always successful in persons of my age and that the situation could actually be made worse. I see that the last post was 2 years ago. Would you mind sharing how you are doing NOW? Much appreciated - thank you in advance.