Meniscal Surgery
What is a torn meniscus?
A torn meniscus is damaged from a tear in the cartilage, which is positioned on top of the tibia, to allow the femur to glide when the knee joint moves.
While physical examination may predict whether it is the medial or lateral meniscus that is damaged, a diagnostic procedure, like an MRI or arthroscopic surgery, can locate the specific part of the cartilage anatomy that is torn and its appearance.
Symptoms of a torn meniscus
Very often, meniscal tears do not cause symptoms or problems. There may be an acute onset of knee pain and the patient may actually hear or feel a pop in their knee.
Pain and swelling within the knee joint can take a few hours to develop and the knee may become difficult to move, fully extend or straighten the knee.
Sometimes the swelling is not noticeable and the patient isn’t aware of the initial injury, but starts noticing symptoms that develop later.
Knee cartilage can become damaged as a consequence of aging, arthritis, and wearing away of the meniscus causing a degenerative meniscal tear.
Other symptoms after injury and over time may include:
• Pain with running or walking longer distances
• Intermittent swelling of the knee joint – the knee with a torn meniscus feels “tight”
• Knee popping, especially when climbing up or downstairs
• Giving way or buckling
• Locking of the knee
Causes
A forceful twist or sudden stop can cause the end of the femur to grind into the top of the tibia, pinching and potentially tearing the cartilage of the meniscus. This knee injury can also occur with deep squatting or kneeling, especially when lifting a heavyweight.
Meniscus tear injuries often occur during athletic activities, especially in contact sports like football and hockey. Motions that require pivoting and sudden stops, in sports like tennis, basketball, and golf, can also cause meniscus damage. The sports injury does not have to occur during a game, but can also occur in practise, where the same motions lead to meniscus damage.
The risk of developing a torn meniscus also increases with age.
Types of meniscus tears
The menisci can be torn in different ways, and the type of tear can help determine the best course of treatment:
- Flap tear
- Radial tear
- Horizontal cleavage tear
- A bucket-handle tear
- Degenerative tears
Symptoms of a torn meniscus include sharp pain in the knee joint along with swelling, stiffness and a “catching” sensation when the joint is moved.
Those suffering from a torn meniscus may also experience a “popping” sensation when the tear occurs.
Meniscal Repair
A meniscal repair is a surgical procedure to repair a torn meniscus via keyhole surgery. It is a minimally invasive procedure often undergone as an outpatient. Factors affecting success include tear age, location and pattern, age of the patient, as well as any associated injuries.
Meniscal repair to repair a torn meniscus through keyhole surgery.
Treatment
Your treatment will depend on the type and extent of the tear and any surrounding damage in the knee.
An X-ray or MRI (or both) combined with a physical evaluation of the joint will help guide your treatment.
Minor meniscus tears and many degenerative tears respond well to conservative treatment options like rest, application of ice, anti-inflammatory medications, and sometimes injections directly to the joint to relieve inflammation and pain.
In other cases, a minimally-invasive procedure called knee arthroscopy may be the better option.
Surgical Procedure
This procedure is called a meniscectomy, and it’s performed using special instruments through tiny incisions in the knee.
In most cases, you can be up and moving about, bearing weight on your knee shortly after surgery.
The video below shows a patient post meniscal surgery.
Recovery
Meniscus repair typically requires a longer recovery period than a meniscectomy since the repaired meniscus needs time to heal.
Weight-bearing may be restricted and you’ll probably need to wear a knee brace during the initial stages of recovery.
After care
At home, you should have someone look after you, at least for the first day.
Try to keep your leg elevated and put ice on it for a day or two to reduce swelling and pain. You’ll also need to change your dressing.
Dr Al-Khateeb will tell you when to do these things and for how long. You will probably need a follow-up appointment a few days after the procedure.
Exercise
Dr Al-Khateeb will give you an exercise regimen to follow at home to help your knee recover or will recommend a physiotherapist to see you until you’re able to use your knee normally.
The exercises are necessary to help restore your full range of motion and to strengthen your muscles. With the proper care, your outlook after having this procedure is excellent.
Address
Clemenceau Medical Center Hospital, Dubai