Knee meniscus tears: non-surgical treatment options

The knee has two fibrocartilage strips between the femur(thigh bone) and tibia (shin bone) that are termed meniscus.  They function to disperse the forces generated by activity and reduce friction.

Tears to the meniscus can occur from normal everyday activity, traumatic injuries  and degenerative changes.  Tears can lead to pain and or swelling of the knee. Locking of the knee with inability to fully straighten the leg can also occur.  Diagnosis can be  made by both ultrasound and MRI.  Conservative therapy typically involves rest and physical therapy. Surgical therapy involves resection of the torn area referred to as meniscectomy.  This has significant implications and can actually accelerate the degenerative process.

Stem cell therapy is now a viable option.  The Regenexx procedure allows patients the opportunity to use their own stem cells thereby avoiding the risks of surgery and anesthesia in addition to the extensive post surgical rehabilitation.

DS is a patient who successfully underwent the Regenexx procedure for her arthritic hip pain.  As a result of her mesenchymal stem cell therapy she had significant reduction in hip pain which enabled her to  increase her activity  level. DS has returned to her regular yoga practice.  Unfortunately, during a recent practice she heard a loud pop with abrupt onset of knee pain.  Her MRI is significant for a tear of medial meniscus and laxity of the medial collateral ligament as evidenced by bowing out of the ligament. These findings are illustrated below.  She has declined surgery and is scheduled to return to  Centeno-Schultz Clinic for re-evaluation and probable Regenexx SD procedure along with platelet derived growth factors therapy.

Nip and Tuck of Meniscus: Advancing The Degenerative Cascade

The knee meniscus is tough fibrocartilage that is positioned between the thigh(femur) and shin bone(tibia).

Each knee has a two meniscus:   lateral and medial.  They are C shaped.

They function as a shock absorber protecting the delicate cartilage in your knee.

Arthroscopic view of knee

Injury can result in a meniscal tear.  There are several different types:  horizontal, radial, oblique and longitudinal.

Surgery is often recommended despite the fact that 60% of meniscal tears are not associated with pain.

Menisectomy is where a portion of the “damaged” meniscus is surgically removed.  While the “damaged” area is removed often patients fail to obtain significant pain relief.  Furthermore studies have demonstrated that menisectomies increase the rate of cartilage loss in the joint.  This make sense since by removing a portion of the shock absorber, the forces of daily living are transmitted to the delicate cartilage.  The cartilage was not intended to bear this increased stress and therefore starts to degenerate.

The use of your own stem cells is now an option for patients with meniscus tears and degenerative changes in the knee-joint.

MRI and Knee Pain

Knee pain can be located on the inside (medial) or outside aspect of the joint (lateral).

Common causes of lateral knee pain include meniscal damage, cartilage defects or injury to the lateral collateral ligament.

Accurate diagnosis requires a thorough history and physical examination along with a review of the MRI.   Dependence solely upon MRI studies puts a patient at risk for mis-diagnosis and treatment failure.  At Centeno-Schultz Clinic and Regenerative Sciences this is the standard of care.  Please review a recent patient case report.  Try to identify the source of pain.

Patient underwent Regenexx procedure on the other knee.  After injection of autologous mesenchymal stem cells he had reduction in pain, improved meniscal structure and reduction in  bone swelling.

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Open Knee Surgery Blogs

Open knee surgery blogs are common.

Open knee surgery blogs detail many issues including the reason for the surgery, the postoperative pain, the rehabilitation and the results.

Some blogs highlight the ” success” of surgical procedures on well known athletes such as Jordan Farmar and Tiger Woods.

While open knee surgery blogs are often times insightful they lack evidence based information. Rarely are peer reviewed articles are cited. The information can be incomplete or biased leaving readers with little or no meaningful information. Two cases in point. No knee surgery blog I read today mentioned that knee arthroscope was found to be no better than physical therapy in patients with osteoarthritis. Nor did I see any mention that meniscal tears are not by default painful and are seen with increasing age on MRI. Both articles were published in the New England Journal of Medicine.

Open knee surgery blogs often fail to mention alternatives. Cutting ones knee open, cutting ligaments and meniscus and sometimes placing artificial grafts or screws into the bone is a serious undertaking with inherent risks and pain.

Regenexx offers patients an alternative. Utilizing your own stem cells, knee cartilage can be regenerated. Centeno published these results in a peer review journal. Stem cells can also be utilized to repair torn or damaged ligaments including the collateral ligaments and the cruciate. The procedure is does not require anesthesia or surgery. Rather it is a simple needle in, needle out procedure.Click here to see a video from a patient that underwent the Regenexx stem cell therapy.

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