What the Surgeon Missed

This is the part of the March 18 MRI report that the ortho surgeon must not have read:

Joint Space, Articular Surfaces and Osseous Structures: There is a prominent marrow edema contusion/microtrabecular fracture throughout the medial femoral condyle with an epicenter at the weight-bearing surface medial femoral condyle adjacent to the body of the meniscus where there is particularly focal marrow edema and a subchondral plate fracture.

Additionally there is a subarticular cortical cyst at the posterior medial tibial plateau that ordinarily would be considered chronic, however there is marrow edema around it indicative of abnormal biomechanical stress and likely impaction.

The constellation of findings of marrow edema, subcortical stress fracture and impaction injury to the medial femoral condyle and similar question relative to the posterior medial tibial plateau is reminiscent of the constelltion of findings that occur with ACL rupture in the lateral compartment so that this must be a rotational impaction injury of the same type, although in this case there is a normal ACL.

Listed in order are the three major findings, typed in ALL CAPS and bolded in the original MRI report:

1. Broad horizontal cleavage tear, meniscal root through posterior horn and body of the medial meniscus.
2. Prominent impaction/contusion/microtrabecular fracture injury to the weight-bearing surface of medial femoral condyle with subchondral plate fracture.
3. Associated likely rotational impaction, subarticular cyst and marrow edema involving posterior medial tibial plateau.

The surgeon fixated on the meniscus tear to the exclusion of the rest of the MRI report. I'd like to know why? Why would an orthopedic surgeon who specializes in knee injuries fail to address the total injury? After all, there are only 3 findings, so it's not like it would have taken him that long to read 2 and 3 after reading 1.

I'll know next Thursday the results of today's MRI, which will include a comparison with the March 18 exam. I have no idea what to do about the failure of the doctor to read the complete March 18 MRI report and address the injuries detailed in it. I have no idea what to do about a licensed physician who prescribes hydrotherapy, ice/heat for the swelling, pain medication, walking, and cortisone injection for arthritis (not mentioned in the MRI, by the way), and physical therapy for the tendonitis -- that is, ironically, mentioned in the March 18 MRI report: "The quadricepts/patellar tendon extensor mechanism is normal." Voila: no tendonitis, regardless of the surgeon's vast years of experience.

If only he had been as thorough in prescribing appropriate treatment for what is in the report, instead of winging it based on his 30 years of experience, I probably would be long past this injury, not starting over.