Knee Arthroscopy for meniscus tear

[scubascuba3]

My knee meniscus tear is playing up. I've had it for 10 years, occasionally the meniscus gets caught in the joint but i can free it quickly usually, this time it's being stubborn, so I'm investigating an op.

 

Any suggestions for vicinity of Pattaya?

 

Queen Sirikit probably too much hassle

 

Jomtien Hospital doesn't do

 

Bangkok Hospital to be avoided if possible 

 

I've emailed Gavin at Phyathai

 

Any others or good and bad experiences? or recommendations?

[rexpotter]

Best guy I know is in Chiang Mai, too far fro you probably. Has dual US Thai citezenship and went to University of Michigan and worked in ER in Detroit. Dr. Chanakarn, at  Rajavej hospital. Only guy I would use. He has an office nearby.

[sungod]

Not Pattaya, but Bangkok- this guy is worth the travel.

 

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

[scubascuba3]

Interestingly the meniscus has just freed itself from the joint and it's back to normal, now i have time I'll pursue with Queen Sirikit, i already have an appointment, but whole process will take months most likely

[scubascuba3]

380,000+ baht, cheaper to fly back to UK

[richard_smith237]

6 hours ago, sungod said:

Not Pattaya, but Bangkok- this guy is worth the travel.

 

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

 

+1 on this.....     Very professional.

 

Dr. Payna did my meniscus repair at Bumrungrad last year...     

 

Initial MRI and Consultations were 24,000 baht.

The Cost of Operation itself was directly charged to insurance but was about 360,00 baht.

 

 

 

 

 

 

[Lacessit]

IME the operation is less significant than the rehab process.

[SamSanuk]

I had this issue decades ago in USA.

 

Although I don’t have any specific doctor to recommend….I can say I had it done with laser treatment and it was minimal incision and was outpatient. So I suggest laser if offered.

[richard_smith237]

21 minutes ago, SamSanuk said:

I had this issue decades ago in USA.

 

Although I don’t have any specific doctor to recommend….I can say I had it done with laser treatment and it was minimal incision and was outpatient. So I suggest laser if offered.

 

Curiosity has struck me... Laser with minimal incision for arthroscopic repair of the meniscus ???

 

 

My complex tear was irreparable, so it looked like it was trimmed back with what I can only describe as a probe similar to a 'nose hair trimmer'....  (difficult to clearly identify in the video so I made assumptions)... that itself could have been the laser you mention which instead of 'trimming in back' it burnt it back ???? so that the tear was cleaned up / trimmed up so it doesn't propagate further. 

 

 

[newbee2022]

On 4/11/2024 at 9:20 AM, scubascuba3 said:

My knee meniscus tear is playing up. I've had it for 10 years, occasionally the meniscus gets caught in the joint but i can free it quickly usually, this time it's being stubborn, so I'm investigating an op.

 

Any suggestions for vicinity of Pattaya?

 

Queen Sirikit probably too much hassle

 

Jomtien Hospital doesn't do

 

Bangkok Hospital to be avoided if possible 

 

I've emailed Gavin at Phyathai

 

Any others or good and bad experiences? or recommendations?

You can find a lot of information as here:

https://www.bangkokhospital.com/en/package/sport-medicine-surgery-packages

There are more hospitals in BKK

[billd766]

On 4/11/2024 at 9:20 AM, scubascuba3 said:

My knee meniscus tear is playing up. I've had it for 10 years, occasionally the meniscus gets caught in the joint but i can free it quickly usually, this time it's being stubborn, so I'm investigating an op.

 

Any suggestions for vicinity of Pattaya?

 

Queen Sirikit probably too much hassle

 

Jomtien Hospital doesn't do

 

Bangkok Hospital to be avoided if possible 

 

I've emailed Gavin at Phyathai

 

Any others or good and bad experiences? or recommendations?

I believe that there is, or used to be a Red Cross Hospital at Sri Racha.

 

An old friend used to use it when he lived in Jomtien. I can't ask him because he moved up to Loie and we lost contact about 3 years ago.

[scubascuba3]

20 minutes ago, richard_smith237 said:

 

Curiosity has struck me... Laser with minimal incision for arthroscopic repair of the meniscus ???

 

 

My complex tear was irreparable, so it looked like it was trimmed back with what I can only describe as a probe similar to a 'nose hair trimmer'....  (difficult to clearly identify in the video so I made assumptions)... that itself could have been the laser you mention which instead of 'trimming in back' it burnt it back ???? so that the tear was cleaned up / trimmed up so it doesn't propagate further. 

 

 

what symptoms did you have with a complex tear?

[SamSanuk]

19 minutes ago, richard_smith237 said:

 

Curiosity has struck me... Laser with minimal incision for arthroscopic repair of the meniscus ???

 

 

My complex tear was irreparable, so it looked like it was trimmed back with what I can only describe as a probe similar to a 'nose hair trimmer'....  (difficult to clearly identify in the video so I made assumptions)... that itself could have been the laser you mention which instead of 'trimming in back' it burnt it back ???? so that the tear was cleaned up / trimmed up so it doesn't propagate further. 

 

 

Three small incisions in my case, about 1/2 inch in length. It was explained to me as a trimming of the meniscus tissue. Maybe my situation wasn’t complex. But yes, the laser does cause immediate tissue burning which allows healing to begin.

I got lucky with the technology, as previous operations required the meniscus taken out. Terrible option as this would allow bone on bone.

[lavender19]

I am off to the Apollo hospital in Madras. Even with flights it's a third of the price here and good surgeons 

[scubascuba3]

31 minutes ago, lavender19 said:

I am off to the Apollo hospital in Madras. Even with flights it's a third of the price here and good surgeons 

Interesting you say that, i was considering the same now i have time. How much is it costing you? what are they doing?

[rexpotter]

Be aware that most of these smaller deals heal on their own with stretching, exercise and a decent diet. I had a knee injury 3 years ago in Bali. Drove home plastered, and when I finally got there, turned off my 125 honda dream, and I fell over and then the bike fell on top of me and twisted my knee. All better now, absolutely no issues.

[rexpotter]

1 minute ago, rexpotter said:

Be aware that most of these smaller deals heal on their own with stretching, exercise and a decent diet. I had a knee injury 3 years ago in Bali. Drove home plastered, and when I finally got there, turned off my 125 honda dream, and I fell over and then the bike fell on top of me and twisted my knee. All better now, absolutely no issues.

I was at that time considering flying to cnx to have surgery. Now it's fine. You do not have to fly to India bro.

[rumak]

36 minutes ago, rexpotter said:

I was at that time considering flying to cnx to have surgery. Now it's fine. You do not have to fly to India bro.

what was your age at the time of injury ?   SO MUCH depends on the age and type of injury .

 

I am just having knee "issues"  now ...... at 73 .    In good health, not overweight,  exercise ( nothing heavy anymore) , but lo and behold the knee started hurting.   Has gotten better (somewhat)   with some rest and very light stretching.  good diet. Now i have added COLAGEN  ..... which IMO  now,   i should have taken for a number of years.   The body produces

less and less with age ...especially after 40 !    Ligaments and muscles require more protein than when young to keep everything from going downhill .   

 

So..... I am about 4 months in ( 2 on collagen)  and notice a difference.   Whether the knee(S) will completely heal remains to be seen.    But definitely not hurting as much as 4 months ago. I am now doing light strengthening , stationary bike best for me .   I will try to keep improving .... before heading for an operation.    All our situations are "unique" ..... and hearing others situations can help with comparisons on how to fix,  going forward 

https://thenutritioninsider.com/wellness/bovine-collagen/

Edited April 12 by rumak

[rexpotter]

14 minutes ago, rumak said:

what was your age at the time of injury ?   SO MUCH depends on the age and type of injury .

 

I am just having knee "issues"  now ...... at 73 .    In good health, not overweight,  exercise ( nothing heavy anymore) , but lo and behold the knee started hurting.   Has gotten better (somewhat)   with some rest and very light stretching.  good diet. Now i have added COLAGEN  ..... which IMO  now,   i should have taken for a number of years.   The body produces

less and less with age ...especially after 40 !    Ligaments and muscles require more protein than when young to keep everything from going downhill .   

 

So..... I am about 4 months in ( 2 on collagen)  and notice a difference.   Whether the knee(S) will completely heal remains to be seen.    But definitely not hurting as much as 4 months ago. I am now doing light strengthening , stationary bike best for me .   I will try to keep improving .... before heading for an operation.    All our situations are "unique" ..... and hearing others situations can help with comparisons on how to fix,  going forward 

https://thenutritioninsider.com/wellness/bovine-collagen/

66, not overweight. Pretty good athletic person for that age.

[Sheryl]

3 hours ago, rumak said:

what was your age at the time of injury ?   SO MUCH depends on the age and type of injury .

 

I am just having knee "issues"  now ...... at 73 .    In good health, not overweight,  exercise ( nothing heavy anymore) , but lo and behold the knee started hurting.   Has gotten better (somewhat)   with some rest and very light stretching.  good diet. Now i have added COLAGEN  ..... which IMO  now,   i should have taken for a number of years.   The body produces

less and less with age ...especially after 40 !    Ligaments and muscles require more protein than when young to keep everything from going downhill .   

 

So..... I am about 4 months in ( 2 on collagen)  and notice a difference.   Whether the knee(S) will completely heal remains to be seen.    But definitely not hurting as much as 4 months ago. I am now doing light strengthening , stationary bike best for me .   I will try to keep improving .... before heading for an operation.    All our situations are "unique" ..... and hearing others situations can help with comparisons on how to fix,  going forward 

https://thenutritioninsider.com/wellness/bovine-collagen/

What you describes does not sound at all  like a torn meniscus. More likely arthritis. 

 

As with anything rlse, an accurate diagnosis is essential.

 

In my experience people's self diagnoses are wring more often than right. 

[rumak]

32 minutes ago, Sheryl said:

What you describes does not sound at all  like a torn meniscus. More likely arthritis. 

 

As emwith anything rlse, an accurate diagnosis is essential.

 

In my experience people's self diagnoses are wring more often than right. 

 

Oh,  you are so right !   I also encourage people to get an accurate diagnosis ,  and encourage people to use their own critical thinking abilities in the process.  

 

Are you taking colagen or any supplements to maintain your own health ?

[lavender19]

On 4/12/2024 at 4:51 PM, scubascuba3 said:

Interesting you say that, i was considering the same now i have time. How much is it costing you? what are they doing?

I am going for the full knee replacement. All in with flights about 5000 dollars

[scubascuba3]

11 minutes ago, lavender19 said:

I am going for the full knee replacement. All in with flights about 5000 dollars

Let us know how it goes

[BigStar]

On 4/12/2024 at 5:20 PM, rumak said:

. I am now doing light strengthening

 

Suggest Poliquin Step-Up:

 

 

 

And isometric leg extensions:

 

 

Don't need a machine, you can improvise at home. I do one long hold twice a week and find it beneficial.

 

Same, with bodyweight: https://www.backpacker.com/video/leg-extensions/

 

 

[BigStar]

On 4/12/2024 at 5:20 PM, rumak said:

I am now doing light strengthening , stationary bike best for me .

 

The bike instead of running is well-advised. Made the same change myself and am going to get rid of my old treadmill. Some walking is still good and needed, however. I do a fast walk of about 20 min a few times a week on the beach and then walk up a mere 5 flights of stairs on the way back in. 

 

About a month ago I started using the side stepper machine at the gym for 10 min sessions. Doesn't stress the knees, and it's great for helping your balance. Lazada has home versions:

 

https://www.lazada.co.th/tag/side-stepper/?q=side stepper&catalog_redirect_tag=true

 

Danger is that pain or debilitation may stop the exercising. So I hope your working to resolve it helps enough. Doesn't have to be 100%, just manageable and not getting worse. (Consulting orthopedist recommended, of course.) I might also suggest knee supports during exercise that stress the knee, like this:

 

https://www.lazada.co.th/products/2-aolikes-i314588943.html

 

https://www.lazada.co.th/products/2-aolikes-i314588943.html

 

I wear the straps during my interval sessions on the bike and I find them helpful. Keep the kneecaps from wandering around and getting into positions they don't like.

 

 

 

 

[rumak]

3 hours ago, BigStar said:

 

The bike instead of running is well-advised. Made the same change myself and am going to get rid of my old treadmill. Some walking is still good and needed, however. I do a fast walk of about 20 min a few times a week on the beach and then walk up a mere 5 flights of stairs on the way back in. 

 

About a month ago I started using the side stepper machine at the gym for 10 min sessions. Doesn't stress the knees, and it's great for helping your balance. Lazada has home versions:

 

https://www.lazada.co.th/tag/side-stepper/?q=side stepper&catalog_redirect_tag=true

 

Danger is that pain or debilitation may stop the exercising. So I hope your working to resolve it helps enough. Doesn't have to be 100%, just manageable and not getting worse. (Consulting orthopedist recommended, of course.) I might also suggest knee supports during exercise that stress the knee, like this:

 

https://www.lazada.co.th/products/2-aolikes-i314588943.html

 

https://www.lazada.co.th/products/2-aolikes-i314588943.html

 

I wear the straps during my interval sessions on the bike and I find them helpful. Keep the kneecaps from wandering around and getting into positions they don't like.

 

 

 

 

 

i believe you are one of a small number of poeple that try to find the source of the knee ( and other)  problems , and then work at finding what works best to alleviate the pain and regain normality ,  as much as possible for your condition.  

The average "expert" , no matter what credentials they flash,  do not lead me to blindly following their "this is what it is,  and this is what you must do" .

Note:  i have remained quite healthy , with many challenges to tackle, IN SPITE of receiving many varied suggested regimens .   Mostly R and P .  ( rest and pills !)   

Anything resembling getting to the root problem has mostly been ignored or misdiagnosed. ( and i have been to numerous "orthopedics"  in the CM area over the years) .   The average "consultation"  almost always gets a cursory movement of the troubled area,  a quick analysis starting with " i think you have ......" ,   followed by trying to sell me 3 packages of colored pills ( always paracetomin among them ! ), and of course some latest anti-inflamatory drug .   "come back if you don't get better " ....  Of course, now that i am older .... the standard remark is that we all age and have these "arthritic type pains ) .     What they don't know or say is that there are many, many types of arthritis ... and in the case of the knee... a ton of factors that could be involved :  https://orthoinfo.aaos.org/en/diseases--conditions/common-knee-injuries

Since i look in very good shape,  and have strength in my leg ( relative to other old farts) ...... they basically give me a thumbs up and say " take alleve, be careful with diclofenac ( does work for me, but not good for the body ) .     blah blah blah  times up.

Sure could use a basketball players orthopedist to tell me what the real cause is ..  maybe i will start a Go Fund me    hahaha 

ligaments, bones, meniscus, deterioration, tendons .     How to figure out the inner workings as time wears the body down .    Diet, exercise,  suplements,  stretches, and lets not forget standing on our heads and rubbing crystals.  

and,  a bit of laughter never hurts either..... 

btw:  i walk a bit,  stretch a bit,  stationary bike a bit ,  take magnesium and boron,   and collagen ...... don't eat crap , ....

doing the best i can  🙂

Edited April 15 by rumak

[richard_smith237]

On 4/12/2024 at 3:09 PM, scubascuba3 said:

On 4/12/2024 at 2:49 PM, richard_smith237 said:

 

Curiosity has struck me... Laser with minimal incision for arthroscopic repair of the meniscus ???

 

 

My complex tear was irreparable, so it looked like it was trimmed back with what I can only describe as a probe similar to a 'nose hair trimmer'....  (difficult to clearly identify in the video so I made assumptions)... that itself could have been the laser you mention which instead of 'trimming in back' it burnt it back ???? so that the tear was cleaned up / trimmed up so it doesn't propagate further. 

 

 

Expand  

what symptoms did you have with a complex tear?

 

Clicking - and the knee kind of jamming... 

This was with an initial simple tear that the physician at BASEM (BKK Hospital) identified after and MRI and said an Op was not necessary. 

A few months later I could hardly walk (after playing football)... Another MRI at Bumrungrad highlighted a complex tear which needed 'trimming' back to prevent further propagation. 

[rumak]

3 minutes ago, richard_smith237 said:

 

Clicking - and the knee kind of jamming... 

This was with an initial simple tear that the physician at BASEM (BKK Hospital) identified after and MRI and said an Op was not necessary. 

A few months later I could hardly walk (after playing football)... Another MRI at Bumrungrad highlighted a complex tear which needed 'trimming' back to prevent further propagation. 

 

Did the BKK doc give you instructions and time needed to get healed before playing football ?    Do you find fault with any of the consultations/recommendations which you feel contributed to your worsening condition?

[BigStar]

47 minutes ago, rumak said:

Mostly R and P .  ( rest and pills !)   

Anything resembling getting to the root problem has mostly been ignored or misdiagnosed. ( and i have been to numerous "orthopedics"  in the CM area over the years) .   The average "consultation"  almost always gets a cursory movement of the troubled area,  a quick analysis starting with " i think you have ......" ,   followed by trying to sell me 3 packages of colored pills ( always paracetomin among them ! ), and of course some latest anti-inflamatory drug .   "come back if you don't get better " ....  Of course, now that i am older .... the standard remark is that we all age and have these "arthritic type pains ) . 

 

Yup, that's EXACTLY what they do and say. Overpriced paracetamol + anti-inflammatory a must. They don't know sports medicine, and they're not accustomed to dealing with seniors who exercise.

 

Been there, done that. Once I figured I had tennis elbow and I talked to the ortho at THE private hospital in Pattaya. He said, "You have tennis elbow," and told me to rest and take pills. I fixed it on my own w/ stretching and particular exercise, done regularly. Thank you, Dr. Youtube.

 

Now the problem is that doing nothing may (or may not) make the pain go away, but soon as you do your exercise again, it will start back up. So it's necessary to be proactive and find some potential stretching & strengthening exercises from the gurus on youtube. I've had great success that way, but it takes time, like a month, to see good results--if you get good results.

 

In case of a serious show-stopper, it seems only the best at Bumrungrad can come up w/ a good diagnosis and treatment that might work. So my idea is to get the initial X-rays and MRI at a public hsp then bring them to the Big Guns. If the problem isn't that structural (requiring surgery) chances are that therapy will fix it IF you find the right therapy--and you have the discipline to stick to the routine. Tough to keep it up for hoped-for results weeks later . . . .

 

 

[rumak]

1 hour ago, BigStar said:

 

Yup, that's EXACTLY what they do and say. Overpriced paracetamol + anti-inflammatory a must. They don't know sports medicine, and they're not accustomed to dealing with seniors who exercise.

 

Been there, done that. Once I figured I had tennis elbow and I talked to the ortho at THE private hospital in Pattaya. He said, "You have tennis elbow," and told me to rest and take pills. I fixed it on my own w/ stretching and particular exercise, done regularly. Thank you, Dr. Youtube.

 

Now the problem is that doing nothing may (or may not) make the pain go away, but soon as you do your exercise again, it will start back up. So it's necessary to be proactive and find some potential stretching & strengthening exercises from the gurus on youtube. I've had great success that way, but it takes time, like a month, to see good results--if you get good results.

 

In case of a serious show-stopper, it seems only the best at Bumrungrad can come up w/ a good diagnosis and treatment that might work. So my idea is to get the initial X-rays and MRI at a public hsp then bring them to the Big Guns. If the problem isn't that structural (requiring surgery) chances are that therapy will fix it IF you find the right therapy--and you have the discipline to stick to the routine. Tough to keep it up for hoped-for results weeks later . . . .

 

 

You have pretty well described the exact procedure (s)  I go through .  Youtube has plenty ( too much really) of ideas, but i'm sure you have a few favorites to check out when needed.   I always get a kick out of the overweight housewife in her dining room trying to show the correct way to fix a herniated disk.... or some such thing !

Very importantly , in my case and i think many other "seniors" .  is establishing which body functions are not producing what they did at early and mid life.   For example ,  why vit D supplementation, and magnesium, and collagen etc are so important as our body produces less as time goes by .  ( of course,  this is a simplification of a .imo,  vital if not foremost reason for our bodies degeneration ( hope i die before i get old  55 ..... well, that didn't happen so i guess even some ageing rockers are now going "healthy" .   

As you wisely state ..... DISCIPLINE  is the key .      And it seems that key seems to have been lost many moons ago for

the comfort seeking homosapien race .   Just give em a bag of fritos and one of those hypnotic devices glued onto everyones hand .   

btw:  what is your age ?   i will be 74 in a few months .   ( i don't believe it !!! )

Edited April 15 by rumak