Does my sister need knee surgery?

Q: My 33 years old sister has been diagnosed with the following after a fall from the scooter 2 months back, after which an MRI was done. All this time, she was not on any medication and only applications of pain killer ointment was done. The impression of the MRI report is that of – Moderate joint effusion, bone contusion at upper tibia, tear of posterior horn of medial meniscus. The report concludes "Please Correlate Clinically. I want to ask you if surgery is the only solution. Are there alternatives in Ayurveda or Homeopathy? Is physiotherapy also a way out? Are there any dietary supplements or certain foods that will aid the recovery process? Can you also suggest some exercises for her that will help her maintain the current health of the affected part?

A:The MRI report that you have sent clearly specifies that findings need to be co-related clinically. This is true for most medical problems. MRI reports of contusion and effusion in the joints are quite common reports in MRIs. The report of grade II / III posterior horn of middle meniscus is also to be correlated clinically. It does not necessarily mean surgical intervention. Surgical decision based on a combination of patient symptom, functional loss, physical findings and correlation with investigative and imaging modalities. It is this correlation which helps reduce the possibility of false negative and false positive interventions. In view of this, I recommend that your sister should be examined carefully by a competent orthopaedic surgeon and only then a decision to be taken on intervention. To answer your specific questions:

• Surgery is not required in all cases as explained above.
• I am not competent to comment on Ayurveda and Homeopathy. However, knowing the anatomy and blood supply of menisci I can only say that most menisci do not heal after injury.
• Yes, physiotherapy is required to maintain good knee function and to prevent wasting of muscles.
• I don’t think you need to have special diet supplements for this problem.
• The exercises that benefit you most are called Isometric quadriceps exercises to be done 10 – 15 times a day. You will have to learn this from a physiotherapist.