About Meniscus

 

About Normal Meniscus

About Meniscus Tear

About Meniscus Tear Removal Vs Suturing

About Meniscus Repair

Is Meniscus Surgery a complication free surgery?

Problems that can occur while removing torn Meniscus

About Post-Operative Schedule

About Return to Work after Meniscus Surgery

About Return to Sports after Meniscus Surgery

 

About Normal Meniscus

There are two meniscus in each knee. they are 'C' shaped structures when looking from above. But on cut section, there are like a small triangle with base of triangle towards outer side of knee and tip of it looking towards inside of our Knee Joints. Only outer one third of Meniscus has blood supply, hence on majority of cases it fails to heal when torn. With increasing age, it tends to degenerate, that further decreases its blood supply and increases chances of degenerative tear. They help to provide buffer between two joint surfaces and hence acts as a shock absorbers. They also provide stability (secondary) to the knee joint.

 

About Meniscus tear

The meniscus is a cartilage disc that cushions the point where the upper and lower leg bones meet in the knee joint. The meniscus can tear because of different reasons like; an accident, heavy load over a long period of time or deterioration due to old age. Twisting injury like while playing or fall from bike are the common causes. The tear in the meniscus leads to a hanging loose piece floating in the joint, which in turn leads to deterioration of the cartilage surfaces of the leg bones. In acute cases, the pain can be very intense and the joint may even lose most of its mobility, or even "lock". Old cases of meniscal injury usually complaints of grating pain, something catching inside or locking of joint. In the long-term, arthritis may develop.

A meniscal tear

A large tear displaced inside the joint

About Meniscus Tear Removal Vs Suturing

There are two ways to treat a torn meniscus. As soon as a piece is detached, advantages and disadvantages of suturing the torn meniscus Vs removing it should be assessed. Some tears can be repaired with stitches that are similar to staples and dissolve after a few weeks - a procedure which is performed arthroscopically (microsurgery). If it cannot be sutured back because of the patient's age or the localization of the tear, the torn part has to be removed. Torn piece has lost its weight-bearing function and it is the far better to remove it rather than to leave it in place. Although removing a portion of the meniscus reduces its size slightly, it alleviates the irritation in the joint, which is what really causes damage. In addition, we remove as little of the meniscus as possible. We must understand that if torn meniscus is left in place, it will be equivalent to putting a pebble in the engine of your car.

 

About Meniscus Repair

Only tears near the joint capsule, where there is sufficient blood supply, have a good tendency to heal. If the tear is located a few millimeters away from that zone towards the free edge of the meniscus, healing is insecure, even in a young individual.

A Torn meniscus being stapled (Meniscus Repair)

Is Meniscus Surgery a complication free surgery?

In experienced hands, it can be a simple and short surgery. But one should not forget that commonly the tear is in the deepest (farthest) portion of Meniscus. It is a difficult to reach that area and requires expertise, special instruments and skills. Sometimes the joint is so tight that it may not allow surgeon to reach the required spot. In such case, it may not remain a simple surgery.

Problems that can occur while removing torn Meniscus

The surgeon might fail to look real deep and can fail to remove the whole torn portion. This can cause persistence of similar symptoms as before surgery. The patient has to undergo a second arthroscopic surgery to get the job completed.

Sometimes a surgeon might force his instruments in, to remove meniscus from difficult to reach area. In such cases he may damage the articular cartilage. He may succeed in removing the torn meniscus from posterior and not-easy-to-reach area, but at the expense of damaged articular cartilage. Such additional damage to important structures may give rise to the development of osteoarthritis at a later date.

About Post-Operative Schedule

An active physiotherapy program is then initiated in an effort to rebuild the muscle strength in the muscles around the knee, thus relieving the stress on the Bones and Meniscus. Some type of activity restriction may be needed depending upon type of surgery undergone. A successful rehabilitation may take upto six weeks in certain cases. But, most patients are able to walk without crutches within 48 hours. Obviously these general guidelines must be individualized and may change during the recovery phase. Arthroscopy is much less traumatic to the muscles, ligaments and the tissues than the traditional method of opening the knee.

About Return to Work after Meniscus Surgery

After meniscus repair, one can expect to be off work for two to three weeks, during which time he/ she will need to use crutches. Heavy manual workers should expect to be off work for six to eight weeks. If a part of the meniscus is removed, one should remain off office for one to two weeks, but two-three weeks if one is a manual worker. Depending on the extent of the damage to the leg bones, it may take anywhere from one to six weeks before you are "back to normal".

About Return to Sports after Meniscus Surgery

If the tear is detected early on, i.e. there is no major damage to the surfaces of the leg bones (Cartilage), then one can return to any sports after a carefully guided recovery period of four to six weeks.  But if the major damage to the bone surface (Cartilage) is already done or if the patient is late for surgery, than one has to choose sports on a limited basis.

 

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