I had an MRI done on my knee last week and the results were unfortunately not very good. I got the radiologist’s report on Friday and met in person with the orthopedic surgeon today. I have done a fair amount of research and realize that the bucket handle tear is pretty much the worst meniscus tear, but I was hoping that mine wasn’t on the bad end of the already bad spectrum. No such luck. Most of my meniscus is folded back into the joint and the (very experienced) surgeon described it as a pretty extensive tear, that’s definitely bad.

I’ve read about advocates of repairing the meniscus and those that advocate a partial meniscetomy or shaving of the part of the torn meniscus that is stuck in the joint. The plus side of shaving the tear is that it comes with a quicker rehab period. The downside appears to be a slightly higher probability of arthritis in the joint, and in my case I’m going to lose a lot of the meniscus. The reattachment procedure comes with a much longer rehab period, but less likelihood of arthritis. Normally, I’d take the longer rehab in the short term, so here comes the part that I’m concerned about.

My surgeon immediately jumped to the shaving procedure. I asked him if there was any chance to save the meniscus via repair. He completely understood my concerns and seemed glad that I did my research. He said to me that there’s no guarantee that I’ll get arthritis in my knee either way, and no guarantee that I won’t either way and pointed to some studies indicating that meniscectomies are not a reliable predictor of arthritis. He also encouraged me that even if arthritis sets in down the road that there’s no guarantee that it means I’ll need a knee replacement either. He also told me that he’d consider reattaching the meniscus as a viable option if I was 25 years old, but at 44, the likelihood of the procedure being successful and having a permanent repair was less than half in his experience. He seems pretty confident that I’m not a good candidate for a repair as opposed to a partial meniscetomy.

I really do trust the surgeon as he successfully repaired my mother’s badly fractured ankle about 6 years ago, and another surgeon in the practice repaired my wrist with a plate and screws with zero complications even 20 years later. He is well regarded, highly rated, and very experienced, especially with cutting edge procedures. Having said that, once the meniscus is gone, there’s no take backs, so I think it’s wise to ask for some more personal experiences. Has anyone hear had a bucket handle tear? How was your repaired? Any regrets, suggestions, or advice? I’m very encouraged by the surgeon’s confidence in my ability to bear some weight on the knee the day of the surgery and return to light duty within a week or two of surgery. He believes that I’ll be able to return to full duty in 6 weeks and be able to return to running at that time as well. But as my virtual home away from home, I wanted to share some of my concerns, and ask for your experiences as well. Thanks!

Second opinion. I had an experienced ortho surgeon tell me I would have to live with some version of my ACL tear as well as the meniscus tear for the rest of my life (in my late 40s). I spent three months living with it til my husband convinced me to get a second opinion, and I had it repaired within a week of that second opinion. It now has the same degree of motion as the other knee.
Please get that second opinion.

Yes, had the bucket-handle meniscus tear in 1983 (now 40 years ago). Surgically treated, removing the torn portion, about 2 months with a leg brace and crutches for mobility. Did my own physical therapy by swimming, daily walking, finally jogging laps (after graduating from the crutches).

Now 73 years old. Osteoarthritis affects all of my joints, but the knee is no worse than any of the rest. Knee remains sensitive to lateral (side-to-side) stresses, occasional sharp pains under such stress, but nothing requiring more than a few minutes discomfort.

Completed my career in law enforcement, then spent another 20 years running a business. Fishing, hunting (Colorado mountains), very active life with no big impairments or limitations.

Not the end of the world. Today's procedures are probably even better than 40 years ago.

I would opt for the intra-op opinion. Your surgeon sounds knowledgeable, and its easier to diagnose once he's inside the knee with the scope.

Good luck with the surgery and fast healing!

I had one back in ‘89. They went in and removed the torn part and some other loose bodies. I was able to resume high impact sports and the knee doesn’t bother me any more than my other aging joints. Just be sure to do your rehab exercises. If you don’t, you will end up creating new issues with the joint. I lived in the Capital District and had it done at Albany Med.

I am not a Dr, and do not offer medical advice, only my personal opinion based on having had both of the surgeries you are considering. If you are over the age of 35 I would get the removal. If you are younger, I would consider the root repair if you have not had any previous cartilage injury to that knee. The root repair is a harder recovery than a total knee, it is a 6 month or more investment with a chance for a better outcome, but the flip side is the chance for the procedure to fail. For me the juice was not worth the squeeze, everyone’s circumstances are different, but the removal is a nearly sure instant improvement, but with a greater chance of arthritis many years down the road. the repair is a chance for the knee to be nearly as good as it was before the injury, with a much larger investment in time, or you could be left with a half assed knee that is not quite bad enough to fix, but not good enough to use. No certainties in either case, just odds. Listen to your Dr, then make the call, you pays your money and takes your chances!

OP,

no chance at Regonkine or cartilage transplant ?