Menisectomy / Meniscus Repair

Anatomy

The knee is the largest joint in the body and consists of the femur (thigh bone), patella (knee cap) and tibia (shin bone). The surface of each bone is covered in cartilage, a smooth and slippery material that helps bones glide and move without pain.  In addition, the knee is unique in that it has two pieces of ring-shaped cartilage that act as “shock absorbers” for the knee during activities, called the lateral and medial meniscus. These menisci (plural of meniscus) are tough but rubbery and protect the knee from injury, but can also become injured themselves as a result of wear and tear or athletic injuries. There are also four primary ligaments that stabilize the knee: anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL). These ligaments are frequently injured during activities, with the ACL being most common.

Injury

Injury to a meniscus comes in the form of a “tear.”  There are different types of tears with names such as radial, longitudinal, bucket-handle, flap, and mixed/complex. In addition, there are degenerative tears that are caused by age and long-term wear, not by a single injury. Often, meniscus tears are associated with other injuries, such as rupture of the anterior cruciate ligament (ACL).  Specific information about your injury, the time from injury, your age and activity level, and the type of tear (size and location) all play a role in determining the type of treatment that is best.

Treatment

Most meniscus tears do not cause serious problems or pain and typically respond well to the RICE protocol (rest, ice, compression, and elevation). Drugs such as ibuprofen and aspirin can help reduce pain and swelling. In addition, rehabilitation with strengthening can often improve symptoms and enhance recovery.

In some cases, arthroscopic surgical treatment is recommended to either repair or remove an injured meniscus.  During arthroscopy your surgeon places a miniature camera and miniature instruments through small incisions to look inside your knee and either fix or remove the damaged meniscus.  This is usually performed on an out-patient setting, meaning that you can return home the same day.

Rehabilitation

After a menisectomy or meniscus repair your surgeon may put you in a knee brace.  You will then be prescribed specific rehabilitation exercises based on the procedure performed and your surgeon’s preferences. These exercises are important for improving strength, maintaining motion, and re-training your muscles and balance. Exercises should be performed in a supervised setting, as well as at home on your own time.  Your commitment to rehabilitation is key to a successful outcome.

 

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