For those familiar with sports medicine and orthopedics!! Need Suggestions on Meniscal Tear diagnosis!?

Question

I injured my knee running about 3 weeks ago, I went to my primary care physician right away and she said she thinks it may be a meniscal tear, although she did not do any MRI's to confirm it. She referred me to a few specialists, but finding an appointment has turned into a complete nightmare. Both myself and her office have called most of the specialists in Seattle and have not been able to find an appointment anywhere sooner than two weeks from now, which will be almost a full 5 weeks from the initial injury. At this point I can not straighten my leg, but can put weight on it. I am able to hobble around with a cane, but am very worried that the long amount of time waiting to get into a specialist may be detrimental to gaining back full range of motion. I really, really, do not want to have to get surgery. I do not know much about this type of injury, but I'm assuming that I should have started physical therapy by now. For those of you who may be familiar to sports medicine and orthopedics, would it be worth it to go into the emergency room for sooner diagnosis/treatment? Would ER doctors even be able to help, or would I just get referred out again, given it is not life threatening? I just do not want to be losing my chance at gaining back full motion without surgery while I wait to be seen. (I understand that any advice I get on this forum is not to be taken as official medical advice, I just want to hear what people with more experience in this sort of injury might think)

Anonymous · Accepted Answer

If your insurance allows you to go directly to specialist without a referral from primary care, then you should do so.  You should skip your primary care physician and directly contact a specialist for diagnosis and treatment. Going through your PCP is an extra added step that is unnecessary and wastes time.

Your PCP should've prescribed you physical therapy. The specialist would/should do so. The specialist (orthopedist) will order an MRI for you.

You can also go to the ER or urgent care to see if they can get you an MRI sooner. It really depends on the customer service quality of the health clinic and how caring the doctors are. A doctor who really cares can get you an MRI within the hour.

This site explains Meniscal tears
http://orthoinfo.aaos.org/topic.cfm?topic=a00358

Here is a selection on the types of tear and treatment:

[How your orthopaedic surgeon treats your tear will depend on the type of tear you have, its size, and location.

The outside one-third of the meniscus has a rich blood supply. A tear in this "red" zone may heal on its own, or can often be repaired with surgery. A longitudinal tear is an example of this kind of tear.

In contrast, the inner two-thirds of the meniscus lacks a blood supply. Without nutrients from blood, tears in this "white" zone cannot heal. These complex tears are often in thin, worn cartilage. Because the pieces cannot grow back together, tears in this zone are usually surgically trimmed away.

Along with the type of tear you have, your age, activity level, and any related injuries will factor into your treatment plan.

Nonsurgical Treatment

If your tear is small and on the outer edge of the meniscus, it may not require surgical repair. As long as your symptoms do not persist and your knee is stable, nonsurgical treatment may be all you need.

RICE. The RICE protocol is effective for most sports-related injuries. RICE stands for Rest, Ice, Compression, and Elevation.

Rest. Take a break from the activity that caused the injury. Your doctor may recommend that you use crutches to avoid putting weight on your leg.
    Ice. Use cold packs for 20 minutes at a time, several times a day. Do not apply ice directly to the skin.
    Compression. To prevent additional swelling and blood loss, wear an elastic compression bandage.
    Elevation. To reduce swelling, recline when you rest, and put your leg up higher than your heart.]

You should also consider prolotherapy. Some orthopedists do prolotherapy. See an orthopedist who does Dextrose (or other proliferant), Platelet Rich Plasma, and Stem Cell Therapy  (aka prolotherapy)–a low intrusive, nonsurgical procedure involving injections of the proliferant dextrose, etc., your platelets, and your stem cells. It will regenerate and heal the injury effectively and quickly.

It’s best if the doctor uses ultrasound to guide the proper placement of the injections. Be sure the doctor administers multiple injections in the whole joint, not just one injection in a single location.  The treatment should be thorough and comprehensive.

Dextrose, PRP, and SC optimizes your natural body’s healing abilities. It’s also definitely good for areas that are normally hard to heal. Here are videos that explain and demonstrates it 
http://www.youtube.com/watch?v=IefLLnEjb-o
http://www.youtube.com/watch?v=Dwrl0xRFtqw

Be sure you rest and not aggravate the injury while healing. Have a healthy diet. Otherwise you won't heal properly and fully.

I hope this helps and that you get better.

For those familiar with sports medicine and orthopedics!! Need Suggestions on Meniscal Tear diagnosis!?

1 Answer