Medial Meniscus - Can it rip in two?

[celinenj03]

Is it possible to tear your meniscus in the posterior section in two thereby redering it completely useless? My OS was telling me of such a case. He said he had a woman who stepped up into a truck and tore the back part of the meniscus and once you do that there is no fixing it. The woman had to get a total knee a year later after having no knee problems other than ripping the back of the medial meniscus in two.

He said when you do that it spreads open and doesn't support the femur on the tibia and the femur sits right on top of the tibia. The meniscus gets pushed wide open and doesn't do it's job.

Anyone hear of anything like this and if so is there a better option than Total Knee? This makes me nervous as she didnt even do anything crazy except step up and put all her weight on her knee and the thing tore in two.

[jathib]

I'm not sure why you're worried about all this. There really is no fixing a meniscus no matter where it's torn. There's no blood supply except close to the edge so they don't heal on their own. They can sew them together in some cases but it's a surgery that fails often. Some people tear their meniscus and need a knee replacement within a couple years. Others can go on and live their lives. Nowadays they can do partial knee replacements and only replace the part of the knee that is bad so a total knee is not necessary. It took me 34 years after my tear before I needed a partial knee replacement. My husband tore his about 25 years ago and he hasn't had any more problems since having the torn part removed.

Sometimes it doesn't take much to tear a meniscus but I wouldn't spend my days worrying about that sort of thing.

[celinenj03]

Thanks for the reply, I know you know your stuff. My question or I guess my anxiety surrounds tearing the back of the meniscus in two. Basically the skinniest part of the meniscus like the bottom of the C, the part that attaches to the bone. My OS said if you tear your meniscus back there it means auto. knee replacement because the meniscus would sort of be detached, expanded and essentially worthless. The bottom part of the C would reprsent where I'm talking about if you can picture it. They are just doing studies on it now. It's not like tearing into the meniscus at the middle and getting that piece taken out.

I know I never heard of this before and I've done a lot of reading on it. My OS doesn't advise me to risk this as he said I have some deterioration back in that area that concerns him and naturally me! It's not torn, but frayed a bit. Hearing about this other woman naturally scared the heck out of me.

[jathib]

Are you worried because you tore yours there or you just heard about someone else tearing theirs? I'm a little confused by your anxiety. I never paid attention to where mine was torn as it really didn't matter. I don't believe there is anything automatic when it comes to knee injuries. My meniscus was removed completely and it still took five years before I needed only a partial replacement. You should never need a total knee replacement if only one meniscus is torn. Some people can have an injury and deteriorate rapidly and others get better and never have another problem. Why that happens is anyone's guess. Doctors don't even know why.

[EricCrake]

Since you people seem to know alot about the meniscus, my medial meniscal root is torn. But OS seems to think that its not a problem(since my actual meniscus pad is in perfect condition). Is it really not a cause of pain? And can it be repaired? From what i understand the root hold the meniscus between the bones and keeps it from slipping out. Its seems like it would be important

[celinenj03]

Sorry to seem so anxious. Here is more information. It is a meniscal root tear than can result in avulsion which comprises the hoop stress thereby drastically accelerating the progression of OA. That is why that woman went from meniscal tear to TKR within 1 year. Eric, you're right in your comment, that is what the hoop stress is.

Here is an article I found that sort of describes it in more detail. It even says down the bottom these tears are relatively rare 2-9% in meniscal tears, but they seem to be the most serious because if they occur at the root of the meniscus it affects the hoop stress of the meniscus and if it tears the lateral condyle basically just sits right on top of the tibia with no cusion in between. They say it's the same as a total meniscectomy. Naturally I'm concerned. My OS didn't say I had this but he said I had some deterioration at the root so to be careful not to invite a tear back there by doing any twisting or anything crazy one it. Check out this website and pictures.

Jathib, I guess for me I have to be careful cause this problem is on the "good side" of my knee. My chondral damage is on the lateral side (but of course that meniscus is fine... go figure).

http://www.radsource.us/rf/RADS/Internal.aspx?PID=707

[EricCrake]

no, no im not suggesting that my meniscus would tear in 2. Im just asking if you guys knew anything about meniscal root tears?

[jathib]

I don't know anything about tears in the root. But I had a total menisectomy so everything, including roots, were removed. I was completely bone on bone. This happened about 30 years after my initial tear. Even without a meniscus it took five years before I needed a PKR. My point is, that nothing means you're automatically going to need a PKR or TKR in a couple of years. There's just no predicting. Yes, it happens to some people but that doesn't mean it will happen to you.

[celinenj03]

Thanks. Meniscal root tears probably aren't good I'd imagine based on this theory. You have to research hoop stress of meniscus to understand it.

[slyguy1]

I don't know if you read the regenerex stem cell procedure.......is it possible that it might work on meniscus problems? A 67 year old guy was bone on bone and is out doing triatholons?

[EricCrake]

im just concerned because the doc acts like a root tear is just no big deal. And im thinking how is that possible?

[celinenj03]

From what my Os told me, they just recently did a study on it so the findings are absolutely new. He told me never any twiting or sharp cuts or anything crazy ever again. I don't want knee replacement so I won't chance it. Ask your doc what would happen if your root tear opened up and tore completely. Could be your case is somehow different so dont panic yet.