Meniscus, OA, Osteotomy, Transplant?

Hello @Meniscus - and

I think you need to look for yet another second opinion. Your current surgeon is not giving you good advice.
He wants to remove the last of your meniscus, which will only make things worse, and then condemn you to using an unloader brace for ages.

Another surgeon has mentioned an osteotomy, and you've also had a meniscus transplant suggested.

I'm sorry, but what you really need - and what will fix your knee much more successfully long-term - is a total knee replacement (TKR). You're not too young for that, as many people in their forties, and even in their thirties, have had successful knee replacements. And a TKR can last for 30+ years.
You need to find a surgeon who will look first at the state of your knee before he looks at your age.

Frankly, the other suggestions are only short-term solutions. An osteotomy is very painful and the recovery is difficult. It seems to be a harder recovery than the recovery after a knee replacement.
A meniscus transplant is only likely to succeed if a very small portion of the meniscus is affected - yours is too far gone for that.

The only real solution for your knee, since you have OA and your knee is already bone-on-bone, is to have it replaced.

I would certainly not consider any other operative alternatives, because they are likely to be only a temporary fix.

I'm also going to ask @Josephine , our Nurse Director, to give you her opinion.

 

PS: What is "TLDR"? I had to look it up. I can only find that it might stand for "too long; didn't read" or that it means a summary.

On BoneSmart, we prefer people to only use the abbreviation in this article:
abbreviations and acronyms

 

This score chart may help you to assess how much your bad knee is affecting your life:
Score Chart: How bad is my arthritic knee?

 

I would never recommend anyone to have a High Tibial Osteotomy (HTO). It's a butcherous procedure and the recovery is protracted.

He is correct but it's more because they just don't work anyway.

Sorry to say this but if you think that then you are kidding yourself!

I've never quite understood why people are so keen to put off a knee replacement. They are excellent procedures with a very high success rate.

 

The recovery from an osteotomy is just as long, and possibly a bit more painful than the recovery from a TKR. In addition, the osteotomy is still probably only a short-term fix. Once your knee is bone on bone, nothing is going to cure it, apart from a TKR.
Why have two operations when just a TKR will do the trick?

Complete recovery from a TKR takes a full year. However, you will be able to do almost everything by 3 months. The first month is hard, although you will be improving all the time.
We advise going back to work at about 12 weeks post-op.

 

FWIW, a meniscus tear was the last straw that led me to my first tkr. I haven't regretted it.

 

I'm sorry but you just won't find a way. Bone is somewhat different to soft tissues. Once it's damaged, it's damaged and nothing will recover the situation.

That's not an easy question to answer because everyone's different. But the shortest time would probably be around 10 weeks and could be as long as 6 months.

 

My OS said there was no point in trying to fix the meniscus tear since my knee needed a tkr and the tkr (by its very nature) would also solve the meniscus issue.

 

@Meniscus, you’ve received a lot of good advice and information already, so I’m not going to add much more.

If you care to, give my recovery thread a review. You can access it from the link in my signature. I, too, shredded my lateral meniscus in my left knee many decades ago. Finally got to the point where something needed to be done. What you decide is a personal decision that you have to make once you have all the info you need.

Good luck and keep us posted on how things are going.

 

I've had a few of these issues myself. Here's the gist: I tore my meniscus, had the knee scoped, and my valgus knee ended up with even more valgus, which creates more stress for the knee to bend inward, which in turns stresses the meniscus and ligaments. An osteotomy was suggested to me, but after I looked it up, I didn't think much of the idea, and since then I've seen research saying that an osteotomy complicates a subsequent knee replacement.
It's possible a partial knee replacement might serve you. I explored that too but my arthritis was in all three compartments of the knee.

Having been to way too many orthopedists over the years, I will say that the very best thing one can do is find a knee doctor who does tons of knee replacements. I had a mediocre knee replacement that was a nightmare to recover from, and a superb revision just recently that has been a breeze to recover from. The acute recovery seems to be about 2 weeks, and people return to work in a few weeks depending on their line of work. But the tissues don't become completely heal until about a year.

And about that brace, I'm with you. I find unloader braces to be difficult and uncomfortable. I used an Ossur Oasys rigid brace I bought off the internet for 6 years, and it did a decent job of reducing the stress on my knee and was fairly comfortable. I even snorkeled with it on. I love not wearing a brace any longer.

 

What we've found here at BoneSmart is that, apart from the occasional exception, it takes just as long to recover from a PKR as it does from a TKR.
We've had a lot of people who are worried because they were promised a faster recovery, but it didn't happen.

I've had both a PKR and a TKR and my hardest recovery was from my first knee replacement, the PKR.

As for lasting 20 years - yes, maybe, if you're lucky. But many PKRs need to be replaced long before that some even within the first year. Mine lasted for 11 years before it had to be revised to a TKR.