Nonoperative Knee Treatment Dallas TX: Why I Chose to Repair My Knee Before It Became Surgical

By Deborah Westergaard, MD | Pain Experts | Dallas–Plano

Nonoperative Knee Treatment Dallas TX

There are moments in medicine when clinical judgment is refined not by theory, but by lived experience.

This was one of those moments.

After a knee injury that dramatically altered my stability, comfort, and function, I found myself standing in front of the mirror one morning realizing something important:

My knee finally felt normal again.

No guarding. No instability. No persistent pain demanding attention.

That realization—and the MRI that followed—is what prompted this discussion about nonoperative knee treatment in Dallas, TX, when it may be appropriate, and why timing can be the difference between preservation and surgery.

Mirror, Mirror: When the Knee Finally Stops Demanding Attention

There is a very specific moment in recovery when a joint stops occupying mental space.

You walk without hesitation. You climb stairs without calculation. You move without subconsciously protecting one side.

That absence of vigilance is often the first true indicator that biomechanics, not just symptoms have improved. It was also the moment I decided to revisit my post-procedure MRI, not because something was wrong, but because function had returned.

The Injury: Partial PCL Tear With a Significant, Painful Posterior Medial Meniscus Tear

In 2023, I sustained a violent fall that resulted in a complex knee injury involving both ligamentous and meniscal structures.

MRI findings demonstrated:

• A partial tear of the posterior cruciate ligament (PCL)

• A significant, painful posterior meniscus tear

• A significant lateral meniscus tear

The knee did not swell modestly. It swelled to the size of a small soccer ball.

That degree of swelling is not incidental. It signals substantial intra-articular trauma, synovial irritation, and mechanical disruption.

Why Partial PCL Tears Are Not Always Benign

This distinction is critical.

A partial PCL tear is often considered nonoperative initially. But that does not mean it is inconsequential.

If a partially torn PCL:

• Does not heal in a timely manner

• Continues to experience mechanical stress

• Is paired with a painful meniscal tear and instability

it can progress, propagate, and ultimately become surgical.

In other words, partial does not mean safe to ignore.

Why “Waiting It Out” Was Not a Good Strategy in This Case

Given the degree of swelling, pain, and mechanical instability, a passive “wait and see” approach carried real risk.

The concern was not only pain, it was tear extension.

Allowing ongoing instability increases the likelihood that:

• Partial ligament tears worsen

• Meniscal pathology progresses

• The knee crosses the threshold from nonoperative to operative

In this setting, accelerated healing was desirable. Allowing prolonged inflammation and instability was not.

Why Nonoperative Knee Treatment Dallas TX Is Reasonable to Consider

There is a widespread misconception that ligament or meniscus tears inevitably require surgery.

That is not always true.

In cases involving:

• Partial ligament tears

• Preserved fiber continuity

• No gross retraction

• Significant swelling suggesting acute injury (not chronic degeneration)

• A strong desire to preserve native tissue

Nonoperative knee treatment may be clinically appropriate when applied early and precisely.

The goal is not to avoid surgery at all costs. The goal is to prevent progression to surgery when biology still allows repair.

Timing matters.

An Important Clarification: Where My Treatment Was Performed

I did not perform my own procedure.

My knee was treated by an exceptionally experienced Regenexx physician.

That choice was intentional:

• To preserve objectivity

• To protect biomechanics

• To ensure precise biologic application

Even physicians need physicians.

While my own treatment occurred in outside of Texas, patients do not need to travel. Advanced nonoperative knee treatment is available in Dallas and Plano, TX, using the same principles of image guidance, biologic selection, and biomechanical preservation.

Before and After MRI: What Changed

Reviewing the MRI before and after treatment was instructive.

Before treatment:

• Partial disruption of PCL fibers

• Significant posterior medial meniscus pathology

• Marked joint effusion

• Functional instability

After treatment:

• Improved ligament fiber continuity

• Meniscal stabilization

• Resolution of excessive swelling

• Restored joint mechanics

We do not routinely obtain post-procedure MRIs when patients are functioning well. In this case, imaging served as confirmation, not justification.

Function always comes first.

Why Stabilizing This Knee Changed More Than Just My Knee

One year later, I required a hip replacement, an unavoidable and appropriate surgical decision.

That previously injured knee became my primary support limb during recovery.

Had the knee not been stabilized earlier, rehabilitation would have been significantly more difficult.

This reinforced a principle I now emphasize even more strongly:

Joints do not fail in isolation. They fail in systems.

Early stabilization of one joint can dramatically alter outcomes elsewhere.

Insurance Coverage vs Surgical Risk in Nonoperative Knee Treatment Dallas TX

It is true that surgery is often covered by insurance, while nonoperative knee treatment frequently is not.

But coverage does not equal appropriateness.

Surgery introduces:

• Anesthesia risk

• Infection risk

• Hardware considerations

• Extended rehabilitation

For some patients particularly those with partial ligament injuries, painful meniscal tears, and acute swelling nonoperative knee treatment may reduce risk while preserving function and preventing progression.

Surgery remains essential in many cases. It simply should not be the default when biology still allows repair.

What This Experience Changed in My Practice

This experience refined how I approach knee injuries:

• Greater urgency around partial tears with large effusions

• Earlier intervention to prevent tear propagation

• More nuanced meniscal decision-making

• Strategic sequencing of joint care

• Stronger focus on preserving biomechanics

Getting older does not mean surrendering function. It means managing it intelligently and early.

Final Thought

Nonoperative knee treatment in Dallas TX is not appropriate for every injury or every patient.

Outcomes vary. Surgery remains necessary in many cases.

But when a partial tear shows signs of progression, swelling is severe, and biology is still favorable, it is worth asking:

Can we repair this now before it becomes surgical?

That is the conversation I have every day.

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