Knee arthroscopy yes or no
January 17, 2015 | 25,00 EUR | answered by Dr. med. Ralf Berg
For several weeks, I have been experiencing discomfort on the inside of my right knee joint. There is also a limitation in movement, complete extension, flexion, or rotation of the knee without pain is no longer possible. The intensity of the pain varies, with good and bad days.
Due to these symptoms, an MRI of the right knee joint was performed. Here is an excerpt: "The inner meniscus is advanced degenerated from the posterior horn to the pars intermedia with diffuse changes and multiple fine tears with contact to the tibial surface. The anterior horn is only mildly degenerated, with overall slight subluxation medially. This results in tension and irritation of the medial ligament.
Laterally, there is a good cartilage covering. The outer meniscus is well-preserved in shape, with mild degeneration."
My orthopedic surgeon is now recommending a knee arthroscopy. I am not sure if I should go through with it. Therefore, I would like to hear a second opinion. Are there any alternatives?
Dear inquirer,
Of course, you can try a conservative treatment approach. This means instead of surgery, starting with physical therapy, cold therapy, medication, but also avoiding heavy loads to alleviate the situation. The fact that there are also better days gives hope. In principle, physical therapy serves to strengthen muscle control and relieve the meniscus. Whether and how well this succeeds cannot be predicted.
If one undergoes an arthroscopy, one must always consider the following:
Do you want a "smoothing (shaving) of the meniscus" for minor damage?
Do you want a partial resection of the meniscus for moderate damage?
Are you willing to undergo a total (subtotal) removal of the meniscus for severe damage?
Depending on the location, changes in the MRI are described as advanced or only first-degree. However, it is also a fact that only with arthroscopy and direct inspection can one truly determine how worn out the meniscus really is.
But this can also be done after 8-10 weeks of conservative therapy.
In this sense, best wishes for a speedy recovery,
R. Berg
