Posterior Horn Medial Meniscus (Left Knee)

[zj4041]

Long story short Im looking for a good knee doctor for anthroscopy and possible meniscus repair near the Encino, Ca. 

 

Long Story Long:

 

2012: Awkward Fall off dirtbike: dirt bike pushed hard on my left calf forward as a fell backward and a heard a pop, had severe pain and swelling.

-went do doctor: xray & mri just showed bruising & strain, but nothing major. doctor said everything is fine just take it easy.

-6 months later went in for a dive in a pool, and it popped again; pain and swelling as bad as the first time.

- went to doctor no mri, he said everything is fine just take it easy

-since then it has popped several times, when it pops under no load it doesnt hurt, but when it pops with my weight on it hurts like HELL.

-2014: Popped again after a hard landing and it swelled like crazy; im sure this time i atleast strained the mcl because it popped out of place big time and went back in. 

 

because of this im scared of jumping or even hoping because if it that knuckle pops during land its gonna hurt.. 

the lateral meniscus feels fine and has never popped

 

even when running or jogging I am watching my eveystep so i dont dislocate my left knee medial knuckle

 

i read that posterior horns are very hard to diagnose, im sure the doctor missed it.

 

I refuse to go to the same doctor because I felt like he really didn't care much, and didn't want to listen (the first and second time i saw him)

 

if anyone can relate or have any advice; im all ears

 

Thank you,

Robert

 

 

[zj4041]

anybody?

[DrMark]

Are you bowlegged?

[zj4041]

i think im not.. ..my knees almost touch when i stand straight.... i do have a slight flat foot and my shoes usually wear out on the outer heels 

[DrMark]

Now you need to find someone who will repair, rather than remove you meniscus.

[zj4041]

local doctor in westlake, ca  told me to get a new mri done by a mri meniscus specialist.... he said if meniscus is torn near the outside where there is blood-flow he can sow it back in place using arthroscopy... but if its near the center there is no hope, so hell just clean it up..... 

 

Doc even said he can do microfracture surgery to stimulate blood flow for better healing. 

 

at this point im speculating (until the mri) ... but based on how my knee knuckle ( medial condyleo the femur) pops out of place (towards the posterior) and strains the mcl everytime it pops leads me to believe that its gotta be meniscus horn....any thoughts??

 

I greatly appreciate your comments Dr.Mark...im 30 years old and I really want my old knee back im willing to sacrifice some down time and surgery to get it back.... thats why im here researching every bit of information i can to look at every possible option given the technology available...

 

 

any thoughts on:

Platelet Rich Plasma Therapy 

 

or 

 

Stem Cell Therapy

Edited May 9, 2014 by zj4041

[DrMark]

Despite the hype platelet rich plasma is monkey business.

In a 30 year old, I would repair the meniscus. Period.

[zj4041]

​below is the outcome of my mri. doc says i need acl reconstruction and meniscus appendicitis...doc says " wont know if meniscus is repairable until we go in there".. he says if theres something we can suture (sow) we will, otherwise we will just clean up... . going to see surgeon soon.. not gonna let anyone operate yet... thinking of getting a second opinion.... 

 

see attached for pictures

 

MAGNETIC RESONANCE IMAGING OF THE LEFT KNEE

 

TECHNIQUE

 

The following imaging sequences were acquired on a Phillips 1.5 Tesla Intera MRI scanner:

1. Coronal, sagittal, and axial localizer images.
2. Axial 3D gradient echo images.
3. Sagittal proton density, proton density fat saturated, and T2 images.
4. Coronal T1, proton density, and proton density fat saturated images.
5. Oblique coronal T2 FSE images parallel to the anterior cruciate ligament.

 

FINDINGS

 

Tendons and Ligaments:

There is a complete tear of the anterior cruciate ligament.  The anterior cruciate ligament is fragmented, torn, and distorted with fragments of torn tissue remaining along the course of the torn anterior cruciate ligament.  The posterior cruciate ligament appears intact without evidence of cruciate ligamentous laxity.  The patellar tendon and quadriceps tendon appear normal.  The collateral ligaments of the knee demonstrate no abnormality.

 

Menisci:

There is a complex tear of the posterior horn and body of the medial meniscus consisting of an oblique signal abnormality in the peripheral capsular third of the posterior horn and body of the medial meniscus.  This signal abnormality extends centrally and inferiorly from the peripheral capsular surface and freely communicates with the inferior meniscal surface.  This tear represents a horizontal cleavage tear of the posterior horn and body of the medial meniscus.  This tear is associated with meniscocapsular tearing and separation of the posterior horn of the medial meniscus.  The above finding represents a Grade III/IV tear of the posterior horn and body of the medial meniscus.  The anterior horn of the medial meniscus appears intact.  The lateral meniscus demonstrates no significant abnormality.

 

Osseous Structures:

Extensive bone bruising is noted in the fibular head, the tibial metaphysis and epiphysis predominantly posteriorly, in the lateral femoral condyle centrally and medially and in the inferior surface of the patella.  The bone bruising is manifest by mottled areas of T2 hyperintensity and T1 hypointensity in the medullary bone representing microtrabecular fractures and/or hemorrhage and/or edema of the medullary bone.

 

Soft Tissue Structures:

A knee joint effusion is present with fluid in the suprapatellar bursa.  The volume of this effusion is less than 10 cc.  A lobulated 1.5 x 1 x 8 cm popliteal cyst is noted medially in the popliteal fossa.  The infrapatellar fat-pad appears intact.

 

IMPRESSION

 

1.      Torn, anterior cruciate ligament, (Grade III).

 

2.      Tear, posterior horn and body (grade III/IV), medial meniscus consisting of:

Ø  Horizontal cleavage tear of the posterior horn and body of the medial meniscus.

Ø  Meniscocapsular separation of the posterior horn.

 

3.      Bone bruising of the medial femoral condyle and medial and lateral tibial plateau epiphysis and metaphysis, and the inferior surface of the patella.

 

4.      Knee joint effusion and popliteal cyst.

 

5.      Bone bruising of the fibular head.

 

 

 

 

[DrMark]

Now you need to find a respectable doctor who is familiar with your sport.

[SMarquez]

Try here. Not the valley but...

http://www.kerlanjobe.com/Physicians/daniel_kharrazi_md.aspx

 

Not sure if he does opposite patella lig like Dr. Sanders but they do lots of sports medicine.

[zj4041]

one doc told me something contradictory: first he said meniscus tear is only repairable if theres good blood supply (usually on the outskirts) .... then on another day he says in the many years hes been a surgeon he hasn't seen any meniscus heal even with repair... so what is more accurate?... shud I just walk away from this guy?.. this is after reviewing my mri , which shows the tear is on the outside where there is  typically good blood supply ....I have two other doctors im going to see... how much time do i have to shop around with a torn acl and meniscus?

 

[irishhunter]

I cant speak to the ACL but I went 6 months with a torn Meniscus and just had it repaired three weeks ago.

[DrMark]

If its done right you will forget about your knee.  When its done wrong, you will never forget about your knee.

[gscx]

one doc told me something contradictory: first he said meniscus tear is only repairable if theres good blood supply (usually on the outskirts) .... then on another day he says in the many years hes been a surgeon he hasn't seen any meniscus heal even with repair... so what is more accurate?... shud I just walk away from this guy?.. this is after reviewing my mri , which shows the tear is on the outside where there is typically good blood supply ....I have two other doctors im going to see... how much time do i have to shop around with a torn acl and meniscus?

dude, are you not getting the hints that are being dropped? Take the plane ride to Texas, get it done right. Holy shit.

[zj4041]

i would if i could.... is someone forcing you to read this? you don't have to get upset.

[j368]

I cant speak to the ACL but I went 6 months with a torn Meniscus and just had it repaired three weeks ago.

Are you 100% now? Can you jog now? What can't you do?

[irishhunter]

I would say I am 90 /95 % back, I can definately tell when I have pushed it too far. It will swell up an be stiff in the AM .

 

I am doing the bike and eliptical right now and have been working in air sqats in addition to the PT excersizes that I have been doing daily. Glad I did it, I was at the point that I could not run due to inner knee pain.

 

I am hoping to be back running and wake boarding in a few weeks. I have been doing light rides ( I had to see if I could kick start my bike so I figured while its started I might as well take a hot lap) wife was not too happy.

 

I would suggest you find out who does your local NFL or sports team. My guy does the Colts players so I felt comfortable that if they let him work on their studs he would probably do a good job on me.

[DrMark]

There are many pathways that a doctor can choose with their career. Some people choose to spend their time in the training room and the press room. Others in the dissection room, the classroom and the operating room. Others just chill and probably smoke a lot of pot.

While there are many extraordinary NFL doctors, many have gotten there based on their ability to schmooze and their hospital (employer)

paying up for the sponsorship which allows the hospital administrator to choose who the nominal team doctor is.

A perfect example is the doc that I have always spoken most highly about from Indy. (Veterans of this website will know exactly who I am talking about) He was the Colt's team physician for decades before the team expected him to ante up about $400,000 for the "sponsorship" As a man above reproach, he told them to go to he11. Now they have someone else.

Edited May 29, 2014 by DrMark

[irishhunter]

Great point Dr. Mark

 

Hope I didnt get the dope smoker LOL

 

So far its been good

[zj4041]

Am i allowed to list a few docs names here to see if anyone has had any experience with them?