If you are a conventional person then this may not be for you. If you believe everything your doctor tells you then this may not be for you.
But if you are a big thinker and you want to heal your meniscus (ideally without surgery) so you can get back to your day to day life then this is probably for you.
If you are open to both established scientific studies and more underground tactics (but not snake oil) for healing then this might be for you.
WELCOME TO THE TERROR DOME.
It’s called the red and white zone.
If your tear is in the red zone it has a chance to heal. And if your tear is in the white zone you are out of luck and you probably need a partial meniscectomy to “fix” it.
Is it really that black and white?
There is some truth to that to say that the white zone is not vascular.
But to say it can’t heal there isn’t a fact.
You’re not getting the most up to date information when you consult your ‘average’ orthopedic doctor.
You’re not getting the best medical advice or attention you could receive.
You’re getting old information and practices.
Do you want to heal your meniscus without surgery?
Chances are you can.
However, if your tear is displaced or it’s completely torn in half then maybe you do need surgery. If it’s catching or locking then maybe you do need surgery.
Although that ‘could’ also be inflammation from trauma and not just a piece of torn meniscus.
I’ve torn my meniscus in judo and jiu-jitsu 2 times. Aside from that I’ve had countless injuries from snowboarding, basketball and even drunk bike riding at 2am in the morning 20+ years ago.
A torn MCL, fractured arm, fractured clavicle, fractured finger, torn cartilage, torn rotator cuff, dislocated finger, bruised tibia and ribs, and plenty of undiagnosed injuries.
And maybe you too.
So how does your knee feel now?
Does it feel like someone sliced up the inside of your knee with an x-acto and then kicked it?
Are you limping?
Does it feel sketchy to walk?
Does it feel like it could give out at any moment?
Well, I can teach you how to heal it (most likely without surgery) and if you decide to get surgery I can even help you recover faster and better from it.
The most common practice to fix a torn meniscus is a partial meniscectomy.
Chances are if you get a partial meniscectomy that you will develop osteoarthritis (OA) in that knee.
One source suggests that if you cut out as little as 10% of your meniscus that it increases joint stress by 70%. Your chances of developing arthritis increase exponentially the more they remove.
If you remove part of your meniscus then you change the biomechanics of the knee.
Some people can quickly return to sports and activity within a few weeks after partial meniscectomy.
A partial meniscectomy often removes the symptoms (pain) now.
But how will you fare down the road?
1 year, 5 years, 10 years later?
Well, according to this study…
“Nearly 63% of knee meniscus surgery patients developed knee arthritis in the meniscectomy knee within 8 years, on average, following surgery. Compare this to the opposite knee that was not operated on: 28% developed arthritis in that same time period.”
“Early after surgery, 92% of patients had excellent or good results, in term of knee pain, swelling, ROM, squatting, but at a mean of eight years after surgery, only 62% of the patients rated their knees as excellent or good.” – Source
92% said they felt ok after surgery, but then 8 years later 38% didn’t.
Your odds of needing a knee replacement in the future increase 3 fold when you get a meniscectomy according to this study.
“In patients with knee osteoarthritis arthroscopic knee surgery with meniscectomy is associated with a three fold increase in the risk for future knee replacement surgery.”
Yeah, but what about a ‘partial’ meniscectomy?
“Partial meniscectomy, the most common orthopedic surgical intervention, is recognized as a strong risk factor for knee OA.” – Source
Any sort of meniscectomy (partial or full) removes the torn bit before it has any chance to heal.
And of course they’ll tell you that it won’t heal…
But you should be very careful about what any orthopedic surgeon tells you because you are likely getting dated information and practices.
What about meniscus repair vs. partial meniscectomy?
Is repair better?
Yes, it can be.
But it is not without risk.
And many surgeons will not decide what treatment they will do until they go inside your knee with a scope. So even if you lean towards repair many will not be able to guarantee you that they will do a repair and you could wake up with less of a meniscus.
In the BJJ forum on Reddit someone commented on their stitches.
“Meniscal repairs have a higher re-operation rate than partial meniscectomies, although they are associated with better long-term outcomes.” – Source
What’s the failure rate?
- In this study (2008-2011) the failure rate for 25 year olds and older was just 15%.
- In this study (1996-2001) the failure rate was 36%.
- In this study the failure rate was 22%.
- In this study 96% were said to regain their pre-injury activity level.
- It is mentioned here that in one study the failure rate was 29%.
And the weird thing is that many doctors may only try the repair surgery if you’re of a certain age or if the tear is in the red-zone.
But if it’s in the red zone why even try to repair it?
It doesn’t make sense.
They say your meniscus tear won’t heal because there is no blood flow to part of the meniscus and tears in the red zone have a better chance of healing.
So if it could heal there why even mess with it?
But doctors have financial interest$ to mess with it. Your torn meniscus is no tragedy to him – it’s money in the bank.
Your doctor is biased like everyone else including me (and more on me later). And while he may be good at using that trimming tool…
There goes your meniscus…
He has limited experience and training because he’s a ‘specialist’.
You’re not getting the big picture when you go see an orthopedic surgeon for your knee.
Your getting a particular orthopedic ‘surgeons’ view on how to fix your meniscus.
They don’t all agree and they don’t all use the same practices to surgically repair your meniscus either.
There’s not necessarily one way to heal your knee, but he is likely practicing one way.
And he is working for a slow changing institution – MEDICINE.
Even if you find a great surgeon working privately he still has to confirm to certain ‘standards’.
Medicine like education, government and religion is slow to change.
“Changing clinical practice is a difficult process, best illustrated by the time lag between evidence and use in practice and the extensive use of low-value care.” – Source
It’s big and slow.
And I can guarantee you that the medicine and treatments for a torn meniscus will be very different 50 years from now.
DO YOU THINK I AM TALKING NONSENSE HERE????
“A staggering 36,000 randomized controlled trials (RCTs) are published each year, on average, and it typically takes about 17 years for findings to reach clinical practice.” – Source
Like I said…
You’re getting ‘old’ medicine.
Old beliefs and old practices.
I can’t say all orthopedic surgeons will do you in and mess up your knee.
You may have good luck and get a great surgeon.
Some people do.
Yet many people don’t.
Here’s another study.
Do you know the search related to feature on the bottom of the Google search results page?
Check this data out.
This is like a study in itself.
These ones stood out the most to me.
- knee pain one year after surgery
- knee pain two years after surgery
You read above that the chances of getting arthritis after partial meniscectomy are fairly high and that there is a sizable chance of repairs failing.
And what that image just showed you was another metric of what might happen if you get surgery.
So if you don’t want to flip a coin…
Then maybe you should explore some other options to optimize your healing.