Actually got 12 minutes..
Ok people, what's a meniscus tear? How easy is the fix and how likely do they fix it vs just sending me to pt?
I have a fair amount of experience with this.
The answer depends on a few things, including where the tear is, what symptoms it’s causing, the condition of the joint overall and who your surgeon is.
If the tear is way inside, away from the red perimeter, they’ll typically shave or trim it and close you back up. Near the perimeter, where there is more blood supply, they might try to repair, but this very much depends on the surgeon.
If they trim the meniscus, the recovery time is typically pretty short. If it's repaired (rarer), the recovery time is longer, as they want weight off of it until some healing takes place. Even in the red perimeter, the rate of healing is not fast.
Taking my own knee as an example (the only one I have), the knee began locking a little over 30 years ago. The injury occurred while I was climbing, standing up on a hold with my leg fully flexed, with no handholds to assist. Something went pop inside the joint and the knee locked. I had two arthroscopies over the next several years, both of which found small meniscus tears. Each surgeon thought they had found the cause. Neither did; the tears were one of the symptoms. I stopped trying, as it seemed the state of the art was to blame the problem on a torn meniscus and cleaning tears wasn't helping.
About six years ago, I saw Art Ting in Fremont. He diagnosed the issue as probably being a hypermobile meniscus. The meniscus is anchored around the tibial plateau by connective tissue called fascicles. The theory was mine had torn loose and the meniscus would slide around and get stuck in the joint now and then. Sometimes the locking knee would tear the stuck part a little more. This tended to explain why surgeons would find these tears. Their training was that these tears were the root cause, whereas, in this case, they were a symptom. The fascicle tears are not visible on MRI or other imaging and the only way to diagnose is to get in there and tug on the meniscus, something surgeons generally don't do, because most have no experience with this condition.
At the time I saw Ting, the timing wasn't good for having another procedure. More recently, I decided to try again and saw a surgeon in my town. This guy was pretty dismissive of the hypermobile theory and suggested PT. It was clear he had no curiosity about the situation and preferred to crank out procedures he had done hundreds of times. I found a surgeon at UCSF who took the idea seriously and looked at imaging with that in mind. She saw indications that might really be the issue, scheduled the surgery and found exactly that. The repair involved trimming a tear where the meniscus had again gotten stuck in the joint, and then anchoring the meniscus to the joint capsule with five PEEK anchors. She poked a few holes in the top of the tibia to make it leak marrow and blood into the site, using my own stem cells to promote healing so the meniscus would attach to the bone. Recovery time will be a lot longer than either a trim or a total replacement would be, but the outcome should be a return to full function.
The point of the story is that there are variables. Some injuries are straightforward and others less so. None of these tears heal on their own. Sometimes the surgery itself is part of the diagnostic procedure, as imaging may not tell the whole story. Sometimes an individual surgeon's motivations don't align with the patient's, so the patient must consider whether the doctor's recommendation makes sense.
scratch in the throat 
face
