This Meniscus Tear Treatment is BETTER than Surgery
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- Опубліковано 8 лют 2023
- I go over my meniscus tear treatment & recovery protocol to prevent arthritis. I also review more clinical evidence that surgery (arthroscopic partial meniscectomy) should be seen as a last resort.
www.oarsijournal.com/article/...
bmcmusculoskeletdisord.biomed...
pubmed.ncbi.nlm.nih.gov/35124...
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► ABOUT ME
Jeffrey Peng MD is a nonoperative orthopedist and sports medicine specialist. He created a UA-cam channel and blog to translate cutting edge medical knowledge and clinical research to benefit all those looking to live an active and healthy lifestyle. He focuses on maximizing non-surgical treatments for sports injuries and orthopedic conditions. He specializes in using orthobiologics and ultrasound guided minimally invasive techniques to treat osteoarthritis, tendinopathies, and musculoskeletal disorders.
Dr. Peng is board certified in sports medicine and family medicine. He completed residency with the Stanford family medicine residency program and completed his sports medicine training with the Stanford primary care sports medicine fellowship in San Jose. He is an active faculty member for both programs and is excited about training the next generation of physicians.
Dr. Peng’s sports medicine clinic is located in Campbell, California.
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After suffering a couple tears to the meniscus in my right knee (diagnosed after months of pain that wasn't responding too well to physical therapy) my Dr referred me to a specialist who referred me to a surgeon. The surgeon basically gave me the information and advice Dr Peng gave in this video. Referring to the same studies, he recommended no surgery, prescribed a custom brace, and told me to work out a pain management plan and non-surgical treatments with my GP, and that I work on building strength in the structure surrounding my knee - focused on the quads. Following that advice, I have a good 80% of my mobility back (& improving every day), and next to no pain. I have a plan for non-surgical interventions (cortisone or HA) if required and a schedule for follow up appointments to monitor my progress and ensure I am getting interventions when I need them. I am thankful everyday for a surgeon who believed that my original knee (with some help) would serve me better than a premature surgical intervention!
Thank God you helping people ❤❤❤❤
Hallo sir I am suffering very pain in my knee please help me
4:13 BINGO .. that's brilliant. I did PT 2 wks and cont those exercises daily at home. Meniscus pain and immobility 100% resolved. It is 9 years later and still all good. Listen to Dr Peng!
Nice! Thanks for sharing
Love it. Thank you, doctor.
Thank you for your expertise doctor
Very good information, thank you
I think you so much for the information Doc.
Thank you for sharing the latest state of affairs and adding your own experience to it :)
Very good information.
Thanks
Wow…I wish this video had been available two years ago…my story is exactly as the one you related, except that I had little or no arthritis in my right knee for a 75 year old. It was in the beginning of the pandemic and my family physician said that surgery was necessary so I went ahead in a rush because the hospitals were being over run with COVID! Anyway, the upshot of my story is that my life as a physically fit, able to walk normally, human being was over. Depression set in and months of just wishing to end the whole pain thing, but, finally, I found a naturopath that did PRP. We first tried months of prolotherapy with not much effect and then PRP which seems to be working. I’m not quite there yet, but I do see a light at the end of the tunnel…just hoping that it’s not a train 😂
How r u now? Has the prp helped?
Thank you doctor. ❤ Greetings from the other side of the globe.🙂🙂🙂
Even in midlife I managed to maintain the fitness I enjoyed as a college athlete. I took up power walking in my 50s and tore my right meniscus in half - tripped over an uneven sidewalk plate. I'd never heard of PRP so agreed to have the loose half removed, and the pain only got worse with time. Even with an unloader brace, my other knee took the load and became arthritic. The pain is indescribable, and I have become quite sedentary in old age. I HATE that! PRP injections are being lined up for me now, and I do hope they work for me. I can't wait to be active again.
Good luck!
Check your arches with a podiatrist because it sounds as though you have runners knee too.
Happy New Year, Dr Peng. I’m a 49yo registered nurse in the Bay Area recently diagnosed with bilateral moderate OA and bilateral complete medial meniscus tears. You’re video helps me a lot to decide the path for my treatment. I have opted to do non-surgical route since arthroscopic procedure can worsen my OA. I’m learning more and more and pray I won’t have to be in this pain for long.
AMEN 🙏
Depending on type of degenerative tear the trimming of the meniscus worked for me. I had went through a lot of PT, no improvement , them tried a prp shot , which worked for almost a year then pain came back. Took another prp shot but it was ineffective and didn’t work. Then did the trim of the flapping area of the meniscus that was protruding outside and this procedure removed the pain. Been almost two years and still going well. Avoid any jumping , heavy squats, use stationary bike, walking. PRP is not always effective , less than 50% chance and those shots are not covered by insurance and cost over $600 or More for one shot. It may not be cost effective compared to the trimming of the meniscus which is covered by insurance. Eventually you’ll neeed a partial knee or full knee replacement. I had the surgery at age 67. Be aware of docs who push the prp shots. My doc explained all the pluses and minuses , pro does not heal a torn meniscus it serves as an anti inflammatory. As a qualified orthopedic surgeon that also does biologics.
Thank you for this information, I consulted two different doctors and the first wanted to operate and the second didn’t. So glad I watched this video because I decided with no surgery. He also recommended a Cingal injection?
Great information
Dr. Peng. Thanks a million for the information and i just wanna let you know that this is the 2nd opinion I kinda was hoping for since I found out 2 weeks ago what the problem was in my right knee.. Trust me this video needs to be shared cause i feel that going under the knife as a first option that's been given around needs to be stopped and I know u feel me on that. U R a blessing doctor and coming across this video for me is the answer to my prayer. THANK YOU.
You're welcome! Glad it was helpful
I was given the arthroscopic option as well and had the op but now have more pain than before. I did not have excruciating pain just discomfort but that was not analized
Great video Dr. Im 62 and have stage 3 OA in my left knee with a medial meniscus tear. I have been using your videos to adjust my treatment plan with my orthopedist and so far it’s working well. I’m doing PRP and HA as well as physical therapy and treatment for weight loss. Thank you for everything.
Amazing! Glad it was helpful
How r u now? I am also having medial meniscus complex tear n walking is painful?what do u feel about prp? Did it help n how long did it take for meniscus to heal?
Excellent doc. Thank you for telling the truth rather than looking to chase $$$ thru unnecessary surgeries🤙
Thanks for commenting!
@@JeffreyPengMDwhat about regenexx?
Love the content, Dr. Peng. How about a video about BPC-157 + PRP injections? I've played volleyball for the majority of my life, collegiately and professionally and now I'm a strength & conditioning coach. I have a degenerative meniscus tear on the left knee and am looking at best practice and protocols for surgery free recovery. And also always looking to learn as I train volleyball athletes for living. Thanks!
There are 0 randomized controlled trials involving BPC 157. Until those are trials are done, I would say highly experimental with unknown results.
Dr. Peng , I do not see you speak about acute meniscus injuries. Unfortunately, watching your videos makes me fear that I have been taken advantage of by my doctors and have made the wrong decision. I have a partial medial meniscus removal on both knees. I exercise and PT my body so I can stay active and live the lifestyle I want. But I feel my knees getting worse with time. You seem to be very knowledgeable about these things, your advice would be incredibly appreciated
I'm 70 years old. No medical issues other than a 20 mg statin. Lucky. (adopted) I lift heavy weights (Up to 50 lb. dumbbells) 2-3 days a week for 50-60 minutes. I speed walk at a pace of 4 MG for 3 miles for 3-4 days a week. Some uphill. No issues at all, other than my recent torn meniscus tear. (I used to carry a 30 lb. backpack while walking uphill,) I wear a Fitbit. I still walked today. What do you recommend?
I can’t thank you enough for this information. I was diagnosed with exactly that, osteoarthritis and a meniscus tear. I have been a dancer all my life! I have been so in the dark regarding any further help other that just surgery which was offered to me a week after this diagnosis!! It was all happening too fast and my gut said no.
I’m just so happy to hear there are alternatives and I will look into some physical therapy now and start some home exercises.
Can I ask how you are getting on ? I tore my medial meniscus about 3 months ago, complex degenerative tear with very early osteoarthritis as well. I am 39, very active and going to try PRP before even considering surgery. Just wondering if you tried it?
@@user-xj5mh3kh9jI have been diagnosed with exactly the same. What treatment r u taking?
How are you now
@@user-xj5mh3kh9j hey sorry for late reply. I never went down the route of surgery. I feel the physio and exercises help a lot! It doesn’t of course take it away but it certainly helps. I just know some days that I can’t over do! I’m still a little lost with it some days but trying to learn bit by bit. Hope you’re doing okay. It isn’t easy
Dr thank you for the information. I have a meniscus tear in one knee and degeneration in the other knee. For the meniscus tear, what repair surgery is suggested? My doctor suggested me to do 3 times prp and I did 2 of it. However, I want to know should I also look for the repair surgery? Some doctors suggested me to cut the tear part. Some doctors suggested as I am young prp is a good candidate. I am very worried about future that I can walk as before. Is prp help me or I have also do repair surgery? Thanks
This could be my case also. I am 65. While I am convinced I do suffer of osteo arthritis. I submitted that pain at the back right side of my knee that feels like being pulled from a tight press is released as it sounds a click is part of the osteoarthritis ordeal. My doc does not speak of probobility ofminiscus teat tho. Am in the Phils, seeing you is not workable even in the near future. Thankyou for this learning Doc. You are a blessing to many
Thanks for commenting!
Dr Peng thank you for all the information you give us. I had an unnecessary arthroscopy and now have more pain which is travelling into my thigh.I have since learnt so much from your channel. ❤
Wow! I wish I knew this info before my arthroscopic 2 Wednesday's ago. I can't Bend or straighten my knee it seems swelling but Is not there no pain when I stand on my left leg but my leg is weak. If I bend my knee it is very painful. I can stand straight with both legs but knee still bends out and there pain in my thigh,ankle, shin. Docter did say I had mild orthritus in my knee and that he cleaned it up a bit. My Dr is also stumped because he said he's done this surgery for 25 years and never seen a post recovery so horrible. There is no fluid in my knee and before the surgery I could at least walk on treadmill and swim a little with some pain. Now I'm almost immobile with 1 crutch trying to walk and get my knee back. I am 39 and very active this is quite disheartening. Please help with any advice!
Best of luck!
What are your thoughts on meniscus replacement, either a cadaver graft or a man-made prosthesis?
I have a medial compartment posterior root avulsion. I love your videos and the information you give out. I am 65 years old very active and very dedicated workout person. I have decided not to do the surgery for meniscus root avulsion. Can do almost everything not much pain. But still have stiffness. I have listened to all your PRP videos. My question to you is would I get any benefit with PRP for root avulsion? Thanks Ted
PRP can potentially help reduce symptoms in any degenerative knee
Is Radial tear, treated with PRP?
My doc said my acute radial tear should be trimmed out because it's not repairable and I'm in a lot of pain. And he also said that part of the meniscus that's torn isn't doing it's job anyways so might as well trim it. But this video says it's better to leave torn meniscus in. I don't know what to believe 😖 (btw the tear is not in the red/red white zone.) he said the part that's gonna be trimmed won't even be in a major load bearing area so it won't be bad but Idk.
Is there need for surgery for a small radial tear in the white zone. No pain etc, will this inevitable get worse over time now that the tear has begun?
Hello Dr, where are you located? How to contact you? I would like to get second opinion from you in my knee issue.
Your data is statistical in nature. If a person had a meniscus tear, and he got PRP injection. How did the MRI change after 1 month, 3 months or 1 year? What repairs can the PRP elicit?
What about bucket handle meniscus tear
Thank s
Welcome!
Would you recommend injections before trying physical therapy?
First of all thank you very much for advice. I am Indian 67 years old, have osteoarthritis of left knee. I don't have pain in knee but have inner lateral restrictions, like folding left leg more than 45 degrees and squatting movements and heaviness in both the thighees, also less speed while walking. I am taking glucosamine daily and doing exercise regularly. Do you suggest any thing more to reduce heaviness in both the legs.
You may find this helpful: ua-cam.com/video/z3veeAgR8AQ/v-deo.html
Do you know if BPC-157 to treat the symptoms of meniscus tear and/or arthritis is effective? I don't want surgery. I can get a hyaluronic acid injection but PRP may be to costly since I don't think my insurance will cover it.
🟢❗Hello Jeffrey, I am 27 years old and recently underwent an MRI on my leg due to persistent pain and occasional swelling in my knee, which locks up without any apparent cause. The MRI results indicate that I have a complex tear of the medial meniscus in my left leg. I have been researching extensively and want to understand the best solution for my long-term knee health. Could you please advise me on the best course of action in this situation? I would greatly appreciate your help. Thank you very much.
Is a radial meniscus tear in a 63 year old man considered a degenerative tear ? The tear is in the white zone about 50% of the way through my meniscus and the surgeon who is removing a calcified loose object from my knee says he will not do the surgery unless I allow him to cut the meniscus away at a 45 degree angle from the tear .He says otherwise there is a chance that the tear will go all the way through...(of course there's also a chance that it will heal and become smaller )
Hello I have fluid on my knee what can I do to get some relief? Thank you.
Dr. Peng, would you recommend my 16 year old daughter get the surgery for a complex tear of posterior horn of medial meniscus?? Thanks
Best to discuss with your docs
When should someone get PRP injections? Like how long post-injury?
Can you suggest some info on Shoulder Rotator Cuff meniscus tears. Thank you.
I'm assuming you mean the labrum? www.jeffreypengmd.com/_files/ugd/3b3e5d_f083141fb284479d9b1a14bb84fc2294.pdf
Dr Peng where do you practice? Suppose I wanted a second opinion. How would this be possible? I had a meniscus tear, a possible meniscus root tear. I was offered arthroscopic meniscus surgery but not offered PRP injections despite my request for it. I do not know what to do next.
I'm from Europe, do I don't know your system, but generally I'd say while arthroscopy and partial meniscectomy are part of the system usually, and routinely prescribed - PRP and other regenerative treatments are not. So you'll have to look for other doctors and facilities that offer this.
Keep believing your mind, your intuition and gathering information. All these doctors at different facilities will tell you totally different things but keep looking.
I have degenerative tear for cca 16 months, and in this time I've done phisiotherapy and saw 5 different doctors. Their opinions on partial meniscectomy were split down the middle. I wasn't sure, but I canceled 2 surgeries. Only now am I pretty sure (and happy) I didn't do it.
I think I will do PRP and hyperbaric oxygen chamber.
It may be late because the time from issues onset also plays a role.
What about baker cyst behind knee and pain put me to urgent care
Hello doctor
Myself umar from Coimbatore, Tamilnadu , I have a meniscus bucket handle tear in 2021 September and underwent a Meniscal repair in the same month , but yesterday I had a locking of Knee while getting up from ground and today went for an MRI and found out that the meniscus tore again - bucket handle tear . Sending you both the reports now , let me know what should be done now . Thanks
I need to find a MD in my area (Minnesota) who has the same approach to knee surgery or the lack there of as Dr. Peng? I've been to two over the past 4 years and each one suggests surgery right off the bat. I have a small meniscus tear almost no arthritis.
Your videos are outstanding, if you add hyluronic acid and do not only intra-articular guided injection but intradiscal injection then a better outcome
What about acute trauma root tears that are not degenerative? I’m 43 and tore it completely at the posterior root (radial) while playing soccer. One doctor wants to do the root repair surgery. Another says it’s okay to wait and see. Is there significant value vs risk with the surgery? I read mixed reviews.
What do you think about steroids as an anti inflammatory? Would they work or make it worse?
As with everything in medicine, it depends. You may find this helpful: ua-cam.com/video/qO6-xvWl4o4/v-deo.html
Can I avoid surgery if I can’t straighten my knee all the way? It doesn’t lock up like how some people describe it. It just feels stuck and stiff. I can’t bend both knees all the way either, even my good knee now. I don’t know what happened to it. Might I have locked knee? I didn’t want surgery I’m only 19 :(
My mom 60 years old has radial tear in the posterior root attachment of the medial meniscus with mild adjacent stress response and mild associated medial meniscal extrusion. Some doctor said about surgery and some other there is no treatment. We are far away from you but i want an opinion. Thank you so much! Greetings from Cyprus
There's PRP in Europe as well. And there are stem cells (more expensive though). But just keep googling, look it up, perhaps even in Cyprus.
I’m from Canada can I make a virtual appointment with you ?
Sorry, I can only do virtual appointments for people in California.
does the tear heal you don't say
I really want to avoid surgery for my my degenerative lateral meniscus tear ( I'm 52), but the prp I had 3 weeks ago isn't showing signs of improvement yet. ( I still can't flex my leg without pain).Do you recommend more than one PRP? I fear if the first doesn't work, I'll be wasting my money on a 2nd, but would prefer PRP to surgery.
3 weeks is still very early for PRP! Best to discuss with your health care providers
Thank you for your reply. This is good to know and gives me some context. I will be more patient! Out of interest, do you think two injections increase likelihood of success? After nearly a year off the tennis court, I'll do anything to get back to it. I'm doing physio to rebuild quads in injured leg too.
How was it after 3 months just with PRP.. Please share
Can your PRP strategy work and help? I have a medial side complex meniscus tear of the body that extends into the root ligament? I had a partial knee replacement to lateral side of left knee 5/1/2019 and now just injured the medial side of knee. Hoping for possible solutions to avoid a total knee replacement now. Thank you for review and if possible are you seeing new patients? Robert
PRP can 100% help a degenerative knee. Yes, our clinic takes new patients, but only in California
@JeffreyPengMD perfect! I'm in San Diego! I will call Tuesday!
@@JeffreyPengMDHi. I'm 25 years old with a posterior corn meniscus tear grade 2. I already had a PRP shot 3 weeks ago and it still hurts to walk. Not much improvement actually. Should I try another shot? The doctor didn't use ultrasound. Just blind intra-articular shot
@soldatintelectual6544 try prolozone and brace,and collegen supplements, use cane for bit right after shot and dont use or bend couple days after,
I been doing 3 shot PRP but still gt pain at knees improvement and healing slow .My clinic doc ask to do 4 shot prp is it still necessary?If no improvement.
Gym bikes are okay for meniscus tear?
What about stem cells as another alternative?
My case is the same as that man's. (Same age and I literally wasn't moving for 4 year, then started working out, with 20 pounds of surplus weight).
Except that I had phisiotherapy. That didn't really stop my pain. It reduced but became more random (pain also without doing anything in particular).
I year on, I was taking supplements for 6 months, then one day the pain stopped. It was exactly after I went skiing for 3h, and had 3 sauna visits in 2 weeks, sone was IR sauna.
My meniscus isnt healed. It's still degenerated. But something changed.
I don't know which one thing or combination it was, but I think movement is a plus, and all the other stuff I mentioned.
What supplements did you take?
@@simonround2439 collagen, glucosamine & Chandroitin & MSM, Boswelia with Tumeric, silicone with Choline, different B vitamins, D3, K2, magnesium, omega 3. (From B vitamins on it's general, not for knees).
But I have to say I think these supplements are probably working temporarily. I also started taking them for pain in my finger joints, due to hormonal changes.
I think the most important things is exercise, building the correct muscles (including Glutes!), maybe the sauna, and time. I didn't do workouts that hurt the knees, mostly. And the pain went up and down. You need to be patient.
But that's just my experience. If you have a different kind of tear that may not work.
I'm passing on surgery
New stem cell medical procedure a possible solution
What if the patient was an avid gym goer and runner. No super muscles but obviously has been working strengthening the muscles and that didn't stop injury from happening. Injection offered was cortisone and rejected. Inflammation goes but as soon as I go back to an easy, normal routine, to just work and house chores, it comes back.
Why do you look so different than in your video "Why You Don't Need Surgery For Your Meniscus Tear"?
What about root tears for degenerative meniscus for 60+ patients
I recommend ALL my patients with degenerative tears to try an extensive trial of exercise and injection therapy
WRONG! I had this series done, the first 2 series were wonderful after the initial soreness wore off!! However, no benefit after 3rd shot, finished the series with no benefit after first 2!!
Wat about meniscus replacement ?
I had it done and it’s made mine even worse for me so I wouldn’t recommend this to anybody 😡
Really? Doctors told me to have operation. I am hesitant.
Not true it dose not help