Sorry to hear that. I've heard (not a doctor here) that they can do some surgery to get some marrow into the joint which will repair the meniscus, but it sounds like the doctors are giving you something similar or at least as beneficial.
How do you think the degeneration started?
According the docs and what I've read online, the meniscus gets a very poor blood supply, and so doesn't have the regenerative ability of, say, skin. I've led a pretty active life, and probably have a genetic predisposition to greater degeneration than most people. But it's a very common condition for people in their fourth or fifth decades.
Nummi, I appreciate your concerns, and I myself am always skeptical about anything when power or material interest intersect. If the government blathers on about freedom and democracy, for example, I ask who's profiting from policy. I know doctors are normal human beings, and at the University of Chicago the academics even call each other Mr/Mrs/Ms so as not be confused with medical doctors, mere consumers of other people's research. But the guy I saw two days ago is a researcher, as is the guy I'll be seeing in a few weeks. Those guys are motivated by curiosity and prestige just as much or more than by money. I've also read about the study where arthroscopic surgery and a placebo had the same
short term effect on patient's outcomes. I've read about people who run and squat with torn menisci, and I've read about how running is actually good for one's knees, as knee flexion pumps in nutrients. Right now I am pain free and could probably run if I wanted to. I could probably manage this condition for several years. My concern, rather, is long-term. What will be the long-term effect of not treating this issue?
Well, first of all, there's a difference between an acute injury, one caused by a traumatic event, and a degenerative injury, which is when the body is unable to repair normal wear and tear. I am injured because my body is unable to maintain the meniscus, which has led to its degradation and greater susceptibility to tears and trauma that, in a healthy meniscus, would not occur. So it's unrealistic to expect my body to now repair something it couldn't even maintain. It's quite possible I was doing something wrong and don't run with perfect form, and it doesn't help that I'm overweight, but the bottom line is the meniscus isn't coming back on its own. It's physiologically impossible, like regrowing an amputated finger.
So then the question is how can I best manage this problem. Right now my right knee clicks a bit sometimes when bending it. That's a little flap from the meniscus tear. Last fall the knee would actually lock up painfully, and I had to massage around the top of the knee to get it to unlock. Surgery would fix that. If it's fixed then I can continue with all the activities that will keep my knee strong and otherwise healthy. The meniscus will continue to degrade, but perhaps at a slow enough rate that future interventions can be avoided.
I've also been taking supplements like you've recommended that are supposed to be good for the cartilage, although the evidence is anecdotal. That's fine, it doesn't cost too much and there's no harm even if it's just a placebo too.
The marrow transplant Halfhazzrd mentioned sounds similar to the technique the third doc I'm going to see has been researching and developing. The basic idea is to give the meniscus a better ability to regenerate itself. I can't understand why anyone wouldn't want to give that a try. And if these techniques exist and are getting better all the time, I don't see why I would want to risk further injuring my meniscus by running. A few weeks ago I could barely walk. That really stinks. My son would beg me to walk down to the park after dinner, but I couldn't. I would really like to be able to walk problem-free for the rest of my life. That's a much bigger quality of life issue than being able to run an hour a day three times a week.
Also, surgery would also give my femur a chance to scar over the area where the articular cartilage has worn away, which would protect the bone. My bones are otherwise quite healthy, supposedly as good as those of a man 20 years younger, so that intervention is also quite appealing to me.
Anyway, thanks everyone for your concern, support, and encouragement. It really means a lot to me. I hope I don't come off as dismissive of alternative therapies. A few weeks ago I didn't even know what the meniscus cartilage was, but I've been reading up on this stuff quite a bit since then. I will continue to consider my options so please continue to offer counterarguments to surgery, but I think the most helpful would be links to articles and studies. But please, also keep in mind that very few scientific studies are ever independently confirmed or replicated.
There's also the outside possibility that I will indulge in a short run once or twice a week. We'll see what the third doc says. The second doc recommended against any sort of running, but he was aware that some people just can't give it up, and seemed OK with some very mild version of it for total running addicts. I think he even suggested running once a week if I must, and then doing alternative forms of aerobic exercise the rest of the time. My perspective right now, however, is that it's best to avoid running altogether if that will in fact better conserve the joint long-term. We'll see. In any case, any pretensions of running regularly, long, or faster are fading now. Given what I know at the moment, it just doesn't seem worth it. It really, really sucks not to be able to walk, and I want to do everything to prevent that from happening again. If I were a total running addict, maybe I would be willing to put up with meniscus flare-ups every few months, be temporarily crippled, gradually rehab it, and get back out there, but I'm not. I've been in a continual state or injury/rehab for close to a year now and I'm really sick of it.