Ep. 4: Meniscal Tears
PART 1: Hello everyone, I’m Dr. Jay Bowen. I’m a board-certified physiatrist here at New Jersey Regenerative Institute[2] , or NJRI. Recently, I posted a video on the 8 most common knee problems we see here at NJRI, and another video with more detail on osteoarthritis. Since you all loved the last video so much, we decided to make another in depth video today on the second most common knee problem we see in the office – meniscal tears . I hope you like this video, and if you do, don’t forget to like, subscribe, and leave a comment [5] letting us know what other videos you’d like to see from us. Alright, let’s get into it!
PART 2: The second most common knee problem we treat are Knee Meniscal Tears. The menisci are C shaped shock absorbers between the thigh bone or femur and lower leg or tibia. There are two types of tears that happen in this area. The first is an acute traumatic tear from a specific event. The second is more general degenerative wearing/tearing that occurs overtime and the pain comes on without a specific incident inducing it. How would you know you have a meniscal issue? With the first type of injury, there can be a sudden pop and pain. This is usually from an abrupt stop and turn or twisting motion. With both types, there can be painful clicking and a feeling of the joint getting “stuck”. Additionally, you may experience swelling or stiffness and this could cause the knee to give way. If your symptoms don’t resolve within some time and you seek medical care you will be asked about your symptoms and a physical examination will be performed. Here at NJRI, we do an exam of your entire leg to view you more holistically. Oftentimes, you’ll need additional screening with an x-ray or MRI.
PART 3: There are lots of treatment options for meniscal tears. If you watched our last video, you will probably recognize most of them as many of the treatments are similar! Physical treatments include ice and electrical stimulation to reduce the swelling and maintain strength and decrease fluid in the knee. This fluid build up inhibits the quadriceps muscle from working causing increased pain. A physician will likely tell you to temporarily modify your activities to avoid things that cause pain. They may also prescribe a course of physical therapy to address biomechanical impairments. Often a trial of non-steroidal anti-inflammatories are recommended. Some physicians will perform a steroid injection, but here at NJRI we stay away from these since there is limited evidence for long term benefit. I also recommend a trial of acupuncture to patients with this condition.
PART 4: Now, let’s talk surgical fixes. There are various surgeries with the goal to save the meniscus. Since 2005, there has been a huge increase in the performance of meniscus repair surgeries. However, these surgeries are still not the best way to fix meniscus tears and are often only done for patients under 40 years old who are very active . Meniscectomy is taking a portion of the C shaped cushion that is torn or unstable and causing mechanical symptoms. Unfortunately, this causes increased load and wear on the articular cartilage and leads to or accelerates arthritis. There has been a reduced rate of meniscectomies for degenerative tears in the older population since research has demonstrated a lack of benefit greater than conservative care. This leaves people seeking alternatives.
PART 5: Here at NJRI, we want to provide you with alternatives if conservative care is not enough, and you’d like to avoid surgery. Our regenerative procedures can include Platelet rich plasma or PRP injections as well as MFAT procedures. Usually, I see more success with the MFAT procedure, though. MFAT stands for microfractured adipose tissue. Essentially, this is a liquid that we create from extracting your own fat and processing it. This is a quick process done in our office. For an MFAT procedure you are in and out of our office in less than 2 hours!
Since the field of regenerative medicine or orthobiologics is new and there are many questions, we started a database to collect outcomes from these procedures to determine the optimal treatment for patients. That’s how we’ve figured out that MFATs are better for meniscus tears than PRPs! Our database is called DataBiologics and the growing data will help inform our future decisions. So, not only is your treatment here helping you, it’s helping future patients who will benefit from the data we collect from your treatment!
PART 6: Now, if any of these options seem confusing stay tuned for upcoming videos explaining more on what these procedures are and what the science is behind them. In the next few weeks I’ll be doing a more in depth explanation of PRPs and MFAT procedures, the science behind them, and what the procedure actually looks like. I hope you enjoyed this video, and that you now have a better understanding of meniscus tears! If you feel like you may be struggling with a meniscus tear, give our office a call. NJRI is located in Parsippany, New Jersey. [19] We would love to examine you in the office and help you get back to full function. Wherever you choose to receive treatment, we hope this video helps to inform you, and all of us here at NJRI wish you good health!
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