Recently we saw a retired school teacher. She twisted her knee getting out of a car. She had an MRI which showed a meniscus tear. Surgery was recommended with the impression that it would be repaired and that she would regain full pain-free function of her knee. What did her surgery report show? As with nearly all of these “meniscus repair” reports that we see, most show that the meniscus was indeed not repaired, but removed.
Excerpt from the Surgery Report:
Pre-op Diagnosis: torn lateral meniscus, left knee.
Post-op Diagnosis: torn lateral meniscus, left knee, grade III and IV chondromalacia left medial facet, left patella.
Procedure done: …Left knee arthroscopy, debridement of chondromalacia with ensuing partial lateral meniscectomy and chondroplasty…
Findings: severe grade 4 chondromalacia of the medial compartment. Mild patellofemoral changes were seen.
As you can see from the above report, part of this patient’s meniscus was removed, not repaired.
Not only did the surgeon perform a chondroplasty on the other side of the knee which involves “reshaping the joint surface,” which basically means the removal of cartilage tissue. Simply put the definition of chondroplasty is a surgical technique where the joint surface is cut, scraped, lasered or burred away in the hope that the healthy joint surface will heal over the defect. Are you willing to let someone give you general anesthesia for something that you hope will work? We are all for hope and one of our mottos here is “hope practiced here.” However, we don’t usually tell our patients “We hope this will work.” We tell our patients that in 90% of cases such as yours we have been able to resolve the problem. There are no guarantees in medicine, but the chances for recovery are excellent with Prolotherapy.
Knee surgery such as arthroscopy can worsen the pain
The main point in this example is that the patient came to us post arthroscopy complaining of much more pain and swelling in her knee after this arthroscopy! She went in with lateral knee pain and ended up with lateral and medial knee pain! We suspect some of her medial knee pain was due to the fact that the chondroplasty was not successful and somehow in a negative way altered her chondromalacia! Remember chondromalacia means cartilage deterioration beneath the knee cap. The best treatment for this is Prolotherapy. We do not know of any study that shows long term help for chondromalacia by arthroscopy! We have documented before and after Prolotherapy x-rays that Prolotherapy does indeed improve cartilage. This is not this patient’s knee, but another patient’s knees – see below:
Should meniscus tears be removed?
You might be thinking to yourself, “Shouldn’t a meniscus tear be removed?” We feel that the answer to this question is an emphatic “no!” A person with a torn meniscus should see an experienced Prolotherapy doctor such as Dr. Hauser and receive comprehensive Prolotherapy to stimulate the tear to repair. Yes, you need to alter your activity/exercise regime while it heals, (ie tennis is probably not a good idea while the meniscus tear is healing from Prolotherapy), but there are plenty of exercises you can do while getting Prolotherapy, and we discuss these at length with our patients. Prolotherapy works extremely well for meniscus tears. In a study we published in the Journal of Prolotherapy, 27 of 28 patients with pain from meniscus injuries and tears were satisfied with the results with Prolotherapy. Only one patient needed surgery!1. At Caring Medical, we also offer more aggressive forms of Prolotherapy such as PRP (platelet rich plasma) or stem cell therapy (bone marrow Prolotherapy) to treat these types of injuries.
What to do if you have a torn meniscus or chondromalacia?
Do you or a loved one have a meniscal tear or chondromalacia? It is our opinion that the best option is to choose Prolotherapy, not arthroscopy! Arthroscopy accelerates the road to arthritis. Prolotherapy, by stimulating the repair of the injured tissue, has a much better chance at providing a long term solution to your knee pain. Arthroscopic removal of tissue decreases the knee’s chances for long term health. By removing tissue such as the meniscus or cartilage you are in essence “aging” the knee at an accelerated rate. Aging the knee by 15-20 years with one procedure, (which can, certainly happen if a lot of the cartilage or meniscus is removed), just gets the person closer to a knee replacement. If you don’t want a knee replacement then consider Prolotherapy instead of arthroscopy!
If you have gotten an arthroscopy, like and still have the symptoms or you experience worsening of your symptoms, most likely you will need some Prolotherapy. Our patient received eight Prolotherapy treatments and is now entirely well. If we would have seen her before the arthroscopic removal of her meniscus and cartilage, she would have most likely required only half as many treatments.
1. The case for utilizing Prolotherapy as first-line treatment for meniscal pathology: A retrospective study shows Prolotherapy effective in the treatment of MRI-documented meniscal tears and degeneration. Journal of Prolotherapy. 2010;(2)3:416-437.