Assume if you will that your physician receives your MRI report with the description of a torn meniscus. You had recently been to the medical office with a chief complaint of pain in your knee, an X-Ray was completed, and then you were sent for an MRI. Not everyone with an MRI describing a meniscal tear should have arthroscopic surgery nor should everyone with a “positive” MRI for a meniscal tear receive stem cells. The adage in medicine: “never say always or never”.
Many scientific studies in the last ten years have shown the absence of value and probable harm of arthroscopic surgery in the face of arthritic meniscal tears. On the other hand, the sports medicine community ha s been very successful in the athletic world when the meniscal injury was acute and the result of trauma indicating a “bucket handle” tear. What about the patient population who seeks medical attention for a painful knee and the mechanical symptoms of giving way, pivot shifts, locking or “clunking” no matter at what age? I fit into that description as ten years ago on the left and nine years ago on the right. I had sustained a trauma on one occasion while playing tennis and on a second, when while running on a treadmill, a third party tripped the chord and the treadmill suddenly stopped. A few days later, I was running with my dog in the park and down I went, but, I hadn’t stepped in a hole or tripped over anything. Then the pivot shifts started and the “clunking”. The MRI was consistent with meniscal cleavage tears. Arthroscopy and partial meniscectomy promptly resolved the problem on both occasions and I returned to my unlimited athletic and recreational pursuits.
My point, never say always or never. Each patient is unique even if that patient falls into a certain age category. In general, when the younger patient sustains a traumatic meniscal tear that is not accompanied by ligamentous or articular damage, arthroscopy is the way to go. (There is emerging evidence that any knee injury at any age wherein intra-articular damage results should be considered for early BMAC intervention to prevent arthritis but I will cover that in a future blog.). At the other end of the spectrum, if the MRI of a patient overage 60 indicates a meniscal tear but with accompanying arthritic changes, our data clearly shows a Bone Marrow Aspirate Concentrate intervention is the treatment of choice. Then there are the “tweeners”. When there are arthritic changes with mechanical symptoms, there is a role for arthroscopy in conjunction with a BMAC-Stem Cell procedure. If you are confused, you are not alone. Arthroscopy is the most common orthopedic procedure in the United States costing Medicare and the insurance industry, hundreds of millions, perhaps billions a year; but with little scientific evidence to support the economic burdens imposed. A chance to cut is not necessarily a chance to cure. Rarely is there an emergent or even urgent need for arthroscopy in the knee. If you have been told that your MRI indicates a “torn meniscus”, it may be amenable to Bone Marrow Aspirate Concentrate and stem cells alone or in conjunction with arthroscopy. I am always available for a second opinion or to answer your questions. 312 475 1893
Tags: arthritis, athletes, Benefits and Risk, bone marrow, Bone Marrow Concentrate, Interventional Orthopedics, Knee, Knee Pain Relief, medicine, Orthopedic Care, Orthopedic Surgeon, Osteoarthritis, Pain Management, stem cells, treatment