Knee surgery - complex tear at posterior horn of the medial meniscus

[nathan1980]

Hi, I have recently had an MRI scan at Bangkok Hospital in Pattaya.

 

They have said that I have - complex tear at posterior horn of the medial meniscus and need keyhole surgery 

 

I am questioning if I should get a second opinion from another orthopedic doctor at another private hospital as after researching (on the internet) some people say to repair and some people say to leave alone. 

 

Any advice would be much appreciated.

 

Thanks,

Nathan 

[Lacessit]

If you are in pain, you should have it done. I had to sleep upright in a chair for a month waiting for the surgery, the knee started aching about 10 seconds after I laid down in bed.

I used to have a video of the surgery on my knee, it's like a tiny crocodile nibbling away at the loose bits and removing them.

The most important part is not the surgery, but the rehabilitation afterwards. Make sure you get a good physiotherapist.

I had my surgery about 15 years ago, still walk 9 holes of golf, do 18 occasionally.

[GroveHillWanderer]

I would say it depends on whether it's adversely affecting you or not.

 

I had a partial tear of my left medial meniscus that for the first couple of years after it happened, caused me only occasional pain and a slight feeling as if the knee were partially "locking up" now and again but only while walking downstairs and only if I wasn't careful.

 

So I left it alone for about three years until it started to cause me more frequent and more persistent pain. At that point I chose to have an arthroscopic procedure (keyhole surgery). It took about a half an hour under local anaesthetic and I walked out of the hospital unaided and without even using the crutches they gave me, 3 hours later.

 

The knee has remained largely trouble-free ever since. I do get the occasional twinge although having said that, I also occasionally get similar amounts of pain in my other knee, which was never operated on.

[Lacessit]

4 minutes ago, GroveHillWanderer said:

I would say it depends on whether it's adversely affecting you or not.

 

I had a partial tear of my left medial meniscus that for the first couple of years after it happened, caused me only occasional pain and a slight feeling as if the knee were partially "locking up" now and again but only while walking downstairs and only if I wasn't careful.

 

So I left it alone for about three years until it started to cause me more frequent and more persistent pain. At that point I chose to have an arthroscopic procedure (keyhole surgery). It took about a half an hour under local anaesthetic and I walked out of the hospital unaided and without even using the crutches they gave me, 3 hours later.

 

The knee has remained largely trouble-free ever since. I do get the occasional twinge although having said that, I also occasionally get similar amounts of pain in my other knee, which was never operated on.

I'm quite amazed you were able to walk out of the hospital, my rehab took about six weeks. Although from your description of the preceding symptoms, maybe your tear was not as severe.

[GroveHillWanderer]

5 minutes ago, Lacessit said:

I'm quite amazed you were able to walk out of the hospital, my rehab took about six weeks. Although from your description of the preceding symptoms, maybe your tear was not as severe.

Indeed - it was only a partial tear and all they had to do (according to the surgeon) was trim it slightly and suction out a bit of debris. As I say, the procedure was very quick and that, along with it being a minimally invasive arthroscopic procedure, probably contributed to the minor nature of the discomfort I experienced.

[blackcab]

Moved to the Health Forum.

[scubascuba3]

I have a meniscus tear right side of right knee, was due an op in UK but I cancelled, it settled down after a year, still fine 2 years later, glad I didn't have the op, but when it interferes with walking you want one. 

 

I have tear in right shoulder joint, I declined an op and it settled down. 

 

I had a golf wrist injury, possible op required, I decided not to and it healed over 6 months

 

 

Edited October 17, 2020 by scubascuba3

[izod10]

19 hours ago, GroveHillWanderer said:

Indeed - it was only a partial tear and all they had to do (according to the surgeon) was trim it slightly and suction out a bit of debris. As I say, the procedure was very quick and that, along with it being a minimally invasive arthroscopic procedure, probably contributed to the minor nature of the discomfort I experienced.

Just what I experienced. painful?it knocked the breath out of me,quick trip to India,mri scan,few calls to local hospitals,fitted in the day after for the op,day later on plane back to BKK.  Took 6 weeks to get pain free

[DuiDui48]

On 10/17/2020 at 11:28 AM, GroveHillWanderer said:

Indeed - it was only a partial tear and all they had to do (according to the surgeon) was trim it slightly and suction out a bit of debris. As I say, the procedure was very quick and that, along with it being a minimally invasive arthroscopic procedure, probably contributed to the minor nature of the discomfort I experienced.

Maybe same i had 30 years ago,a flaptear...walked out drove my car home..rehab.

[pmk1000]

Nathan have it repaired i tore mine many years ago skiing and now that leg and hip gives me trouble from time to time. You are better off getting it done 

[Sheryl]

By all means get a second opinion. For which I highly recommend Dr. Panya at Bumrungrad. It means a trip to Bkk I know, but he is the top knee specialist in Thailand and if he confirms that surgery is indicated you can then proceed with full confidence.

https://www.bumrungrad.com/en/doctors/Panya-Wongpatimachai

 

Note that a partial tear, which is what many of the posters replying had, differs fro ma complex tear - and the definition of the latter also can vary in ways that much affect the advisabilty of surgery.

"What is a complex medial meniscus tear?

Complex medial meniscus tears can mean many things.  They can mean that they are large tears, which are reparable, or they can mean that  they are very complex or macerated tears that are not reparable.  It is important to define the difference between these two in choosing a treatment going forward.

Complex reparable medial meniscal tear can include long tears along the junction of the back of the meniscus and the joint lining (meniscocapsular tears, meniscal root tears, or radial tears).  While these tears are felt to be very complex in many circumstances, with the correct surgical team and tools, they can often be repaired.

This contrasts with tears where there is significant maceration, separation, or chronicity of the tear where the chance of a repair is slim to none.  In these circumstances, due to the fact the meniscus has a relatively poor blood supply, the only option is to learn to live with the symptoms, and possibly end up with a bigger tear over time, or to consider having a meniscus resection.  Unfortunately, meniscus resections almost always lead to the onset or progression of arthritis, so this must be carefully chosen as an option in these circumstances."

https://drrobertlaprademd.com/complex-tear-of-the-medial-meniscus-medial-knee-injury/

 

[Lacessit]

5 hours ago, scubascuba3 said:

I have a meniscus tear right side of right knee, was due an op in UK but I cancelled, it settled down after a year, still fine 2 years later, glad I didn't have the op, but when it interferes with walking you want one. 

 

I have tear in right shoulder joint, I declined an op and it settled down. 

 

I had a golf wrist injury, possible op required, I decided not to and it healed over 6 months

 

 

My meniscal tear never interfered with walking or sitting at all. It was only when I laid down that the pain kicked in, about 7-8 on a scale of 10.

Had golfer's elbow once, two sessions of acupuncture fixed it, even though I was skeptical.

You really shouldn't be mentioning wrist injuries, that's just laying out temptation.

[scubascuba3]

22 minutes ago, Lacessit said:

 

You really shouldn't be mentioning wrist injuries, that's just laying out temptation.

Funny enough wrist injuries have a very low occurrence in Thailand 

[Lacessit]

27 minutes ago, scubascuba3 said:

Funny enough wrist injuries have a very low occurrence in Thailand 

You're right, good one.

[bwanajohn]

I had this procedure done at Dr Wong hospital in Chiang Mai..Initial injury was caused by a massage girl losing her balance while walking on my back and stepping heavily on the back of my knee. I limped quite badly for a couple years before a finally realized it wasn't going to heal itself. Saw various doctors and finally got a recommendation from the Lok Kroh clinic for a good orthopedic doc and got the x rays and MRI. and then the keyhole surgery and given the video after. This was 16 years ago.

Was in hospital two or three nights fabulous room two young nurses taking care of me . Anaesthesia was the spinal Bloc procedure.. very weird sensation.

Was on crutches for a few days ..and was careful for a few months not to over do it. I'm 69 now and jog a mile every morning and walk a mile every night. Never had a problem ..one of the nurses gave me her phone number .

 Can't recommend it enough.Had a problem with the other knee some years ago that went away but did find out the surgeon had retired.

  Key is the rehab and finding a recommended surgeon with good track record.

 

[Pedrogaz]

Get a second opinion. I had a mate who had a camera up his backside for a prolapsed polyp. The doctor told him it was cancerous and he needed quick surgery to take his bowel out. 

He went back to his home country and it turned out it was a benign polyp that was cut out. 

[nathan1980]

Thanks for all your comments. 

 

Do any of you know another good private hospital closer to Pattaya that have a knee specialist I could take the MRI cd and doctors report to get the second opinion.

 

Thanks,

 

Nathan 

[Letseng]

I would get a 2nd opinion. After I was advised surgery in Bumrungrad I went to Singapore to see another specialist. He told me to leave it alone and get physiotherapy. Also had acupuncture for pain management.

I followed his advice. 7 years later I'm pleased I didn't follow Bumrungrad's advice. However, no 2 tears are exactly the same. Get another opinion. Bangkok Hospital Bangkok has an excellent knee surgeon.

[Sheryl]

1 hour ago, nathan1980 said:

Thanks for all your comments. 

 

Do any of you know another good private hospital closer to Pattaya that have a knee specialist I could take the MRI cd and doctors report to get the second opinion.

 

Thanks,

 

Nathan 

 

Every hospital has orth specialists. None have a specialist of Dr. Panya's caliber.

 

Why get a second opinion iof nto from a top notch specialist? It is well worth the trip. As mentioned in my post, the issues for a complex tear can be quite complicated.

[rumak]

2 hours ago, bwanajohn said:

..Initial injury was caused by a massage girl losing her balance while walking on my back

i always like to have recommendations on what their specialties are  .........

 

 

[Oliver Holzerfilled]

2 hours ago, rumak said:

i always like to have recommendations on what their specialties are  .........

 

 

I was thinking the same thing when he said this -

"one of the nurses gave me her phone number..."

[teacherclaire]

OP, I'd get a second opinion. There are doctors and doctors..........

[nathan1980]

Hi guys I got a second opinion from Dr Panya who confirmed that I need surgery on the complex tear to the medial meniscus on my right knee.

 

Can anyone recommend a good doctor at a government hospital who could quote me a price for the surgery to repair it.  
 

The price for surgery at Bangkok Hopsital Pattaya and Bumrungrad in Bangkok privately is very expensive.

 

Any feedback would be appreciated.

 

Thanks,

 

Nathan 

[Sheryl]

1. Prof Dr. SORAWUT THAMYONGKIT  Ramathibodhi Hospital, through their Premium Clinic  https://med.mahidol.ac.th/qsmc/th/service/premium_clinic-th/

Not sure if you can make appointment on the phone, can try. Usually have to go in person to make appointment at a government hospital

 

Prof. Sowaut (who trained at Joihns Hopkins in the US) can also be seen on Saturdays at Sikarin Hospital, a small poivate hospital than costs significantly less than BPH or Bumrungrad (but probably still more than Ramathibodhi) , located near Swampy  https://www.sikarin.com/en/doctor/detail/1975/dr-sorawut-thamyongkit

 

 

2. Assoc. Prof. Pongsak Yuktanandana

Chulalongkorn Hosp (try through their after hours clinic, 13th floor OPD building, starts around 4). You may have to make several trips, one just for the appointment then return to see the doctor, no way to do by phone or online. And there may be a wait list.

 

Prof. Pongsak is also available on Sundays  at St Louis Hospital which will cost less than BPH or Bumrungrad but still more than Chula (but unlike Chula can make appointment by phone in advance and little waiting)

https://www.saintlouis.or.th/index