Meniscus Issues: Treatment Options and Pain Management

Q: Meniscus Issues: Treatment Options and Pain Management

Hello, internet user： Osteoarthritis of the knee is more common in the elderly, women, individuals who are overweight, or those who have previously sustained injuries. <br>Many people suffer from knee osteoarthritis, and the exact causes are not entirely clear. <br>Approximately

Please inquire about meniscus issues?

In June of this year, I underwent arthroscopy and received hyaluronic acid injections.
I have joint degeneration, and only 20% of the medial meniscus in my right knee remains, while the rest is damaged.
This has resulted in slight pain while walking, making it difficult to squat, climb stairs, and walk on slopes.
I experience pain when standing on one leg, and slight squatting produces a cracking sound.
Occasionally, my leg feels weak and painful.
The doctor informed me that currently, there are no surgical options for meniscus transplantation, and I will have to wait until I am 70 years old before considering a knee replacement.
Chang Gung Hospital mentioned that they would need to order a custom prosthesis from abroad (costing over 100,000 NTD), but I heard that this is still in the experimental stage.
My questions are: Are there any surgical options for meniscus transplantation available domestically? Are there methods to alleviate my pain and discomfort? Should I undergo an MRI for further confirmation?

KIKI, 60~69 year old female. Ask Date: 2016/08/20

Dr. Shen Boquan reply Orthopedics

Hello, internet user: Osteoarthritis of the knee is more common in the elderly, women, individuals who are overweight, or those who have previously sustained injuries.
Many people suffer from knee osteoarthritis, and the exact causes are not entirely clear.
Approximately 70% of patients experience more severe wear on the medial compartment, specifically the medial meniscus.
Medial meniscus transplantation seems to be a promising area for research; however, it has not yet become a widely successful and commonly performed procedure in clinical practice.
I am not aware of any hospitals in the country that have performed many successful cases.
Generally, the pain and stiffness associated with knee osteoarthritis can be alleviated using anti-inflammatory pain medications, glucosamine, hyaluronic acid, and PRP (platelet-rich plasma), but these treatments do not promote cartilage regeneration or restore the joint to a pre-degeneration state.
If the wear is severe and pain cannot be relieved, joint replacement surgery may be a consideration.
You have already undergone arthroscopy to assess the condition of the joint; unless there are new developments, an MRI may not provide additional information.
Wishing you good health.

Reply Date: 2016/08/20

More Info

Understanding meniscus issues, particularly in the context of knee pain and degeneration, is crucial for effective treatment and pain management. Given your situation, where you have undergone arthroscopy and received hyaluronic acid injections, it's clear that you are dealing with significant knee joint degeneration and meniscal damage. The meniscus is a crucial structure in the knee that provides cushioning and stability, and when it is damaged, it can lead to pain, swelling, and decreased mobility.

Current Treatment Options
1. Physical Therapy: Engaging in a structured physical therapy program can help strengthen the muscles around the knee, improve flexibility, and enhance overall function. A physical therapist can design a program tailored to your specific needs, focusing on exercises that do not exacerbate your pain.

2. Pain Management: Non-steroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation. If over-the-counter options are insufficient, your doctor may prescribe stronger medications. Additionally, corticosteroid injections can provide temporary relief by reducing inflammation in the joint.

3. Hyaluronic Acid Injections: You have already received these injections, which can help lubricate the joint and reduce pain. While the effects can vary, some patients experience significant relief.

4. Bracing: A knee brace can provide support and stability, which may help alleviate pain during activities. It can also help in redistributing weight away from the damaged areas of the meniscus.

5. Activity Modification: Avoiding activities that exacerbate your pain, such as deep squatting or climbing stairs, can help manage symptoms. Finding alternative low-impact exercises, such as swimming or cycling, can maintain your fitness without putting undue stress on your knee.

6. Surgical Options: While you mentioned that your doctor indicated there is currently no surgical option for meniscus transplantation, it is worth noting that some centers may offer experimental procedures or clinical trials. However, these options may not be widely available and could involve risks.

Meniscus Transplantation
Meniscus transplantation is indeed a complex procedure and is typically reserved for younger patients with significant meniscal loss and knee pain. The success of this procedure depends on various factors, including the condition of the knee joint and the presence of arthritis. Since you mentioned that your meniscus is significantly damaged and that you are experiencing osteoarthritis, it may not be an ideal candidate for transplantation at this time.

MRI and Further Evaluation
An MRI can provide detailed images of the knee joint, including the meniscus, cartilage, and surrounding structures. Given your ongoing symptoms and the extent of your meniscal damage, an MRI may be beneficial to assess the current state of your knee and rule out any additional issues, such as cartilage damage or ligament injuries. This information can help guide your treatment plan moving forward.

Conclusion
In summary, while meniscus issues can be challenging, there are several treatment options available to manage pain and improve function. Engaging in physical therapy, exploring pain management strategies, and considering the potential for surgical options in the future are all important steps. Additionally, an MRI may provide valuable insights into your knee's condition, helping to tailor your treatment approach. It is essential to maintain open communication with your healthcare provider to ensure that your treatment plan aligns with your goals and needs.

Similar Q&A

Effective Treatments for Meniscus Tears and Joint Pain in the Knee

Hello Doctor, last year in May and June 2023, I fell three times on a brick path, landing on my right knee. During this time, I consulted Western medicine, underwent rehabilitation, took medications, and received injections. I also tried acupuncture and massage from Traditional C...

Dr. Chen Yongxue reply Orthopedics
The degree of damage to the meniscus varies significantly, and the treatment methods differ accordingly. It is advisable to conduct further examinations.

Understanding Meniscus Injuries: Recovery and Surgical Options

The doctor diagnosed an abnormality in the meniscus and recommended a one-month rest. However, I am currently experiencing severe knee pain and cannot bend or straighten it. Would surgery help? Thanks.

Dr. Chen Yongxue reply Orthopedics
Hello, In response to your inquiry regarding your knee meniscus injury, meniscus damage can generally be categorized into two main types: traumatic and degenerative. Traumatic meniscus tears can be managed through various approaches depending on the nature of the tear, includin...

Treating Meniscus Tears: Alternatives to Surgery and Recovery Tips

1. There is a crack at the one-third mark, causing pain when walking and going up and down stairs. The doctor suggested surgical removal. Are there any other treatment options available? Is it possible to repair it or use PRP therapy? 2. This pain has been present for several ye...

Dr. Li Yongheng reply Orthopedics
Hello, if there is a tear in the outer third of the meniscus that has been present for several years, it is usually recommended to perform arthroscopic partial meniscectomy (if it is an acute injury, meniscal repair along with PRP treatment is advised). After surgery, it is impor...

Understanding Meniscus Issues: Symptoms, Treatment, and Recovery

Hello, Doctor: I discovered at the end of December last year that my right knee often makes a popping sound. Later, I experienced pain when going up and down stairs for about 2-3 weeks. In mid-January 2021, I went to the hospital, and the doctor prescribed a 14-day course of anti...

Dr. Chen Yongxue reply Orthopedics
Hello, 1. Whether the condition will worsen without surgery depends on the extent of the meniscal damage. Generally speaking, it is possible for the condition to become more severe. 2. Is there an option for insurance coverage for the surgery, or is it only out-of-pocket? The...