What does my knee MRI actually indicate?

Patient's Query

Hi doctor,

Recently, I slipped from the bike and hurt my right knee. Though it is causing less pain during normal walk, it is hurting a lot while walking on stairs. I visited an orthopedic surgeon and he told me to take an MRI. The MRI report is as follows. Impression: Grade 3 tear involving the posterior horn and body of lateral meniscus, extending into the inferior and outer surfaces and associated with parameniscal cyst measuring 11 x 5.3 mm. What does it actually mean? My surgeon informed that I require arthroscopic partial meniscectomy for treating this issue. Is it compulsory? If I had to undergo surgery, then how many days will it take for me to get back to normal like going to the office, walking? Are there any complications associated with surgery in future? Do I need surgery immediately or can I extend this to somewhere around a month? In case of surgery, will the cyst be removed along with the tear? My surgeon informed that the cysts are very common for everyone. They have least impact on pain and there is no necessity of removing the cyst. Please help me out.

Answered by Dr. Atul Prakash

Hello,

Welcome to icliniq.com.

It would have been ideal if you had posted your MRI films for me to see as without them I can only comment and answer your questions with limited knowledge of your condition.

Cysts are not an immediate result of trauma. They develop over time and may have preceded trauma. Usually, they cause pain, but less frequently cause mechanical symptoms like giving way, locking, rarely visible swelling.

The MRI report (attachment removed to protect patient identity) says that you have a tear in the meniscus and that too is on the lateral side. This is the reason that you may have pain on weight bearing, locking sensation in the knee, giving way sensation or even falls all as a result of the tear.

Surgical treatment is based more on the symptoms rather than MRI findings alone. If you fit both criteria, then you are likely to benefit the most.

Days off from work will depend what was actually done. But, three weeks is minimum before you return to busy job while a desk job you can go back as soon as pain and swelling are down as well as the wound is settled. At least 10 days complete rest is must.

Lateral meniscectomy is like to cause long-term problems, especially osteoarthritis, but this is over a 20 year period. Also, depends on how much is torn and how much is removed. Current concept is to remove the minimum possible.

Immediate surgery is needed if your knee is locked; otherwise wait and observe the symptoms. Let your knee settle down with the injury and then decide. I agree with your doctor's treatment.