Meniscus Repair and Meniscectomy
Meniscus tears are one of the most common knee injuries for anyone at any age. However, athletes who play contact sports, such as football or hockey, are at a higher risk for meniscus tears. If you ever hear about torn cartilage in the knee, that generally refers to a torn meniscus.
Three bones meet and form the knee joint, including your femur (thighbone), tibia (shinbone), and patella (kneecap). The menisci are two wedge-shaped cartilage between the shinbone and thighbone that serve as a “shock absorber”. A meniscus is tough but rubbery to help cushion and stabilize the knee joint with impact. The menisci can tear in different ways, including common tears: bucket handle, flap, and radial. Tears are characterized by the location and the physical attributes of the tear. Sports-related meniscus tears generally occur along with other knee injuries, including ACL injuries.
When a meniscus tear occurs, you may feel or hear a popping sound. In most cases, individuals are still able to walk on torn meniscus, but over the course of a few days, your knee will become more swollen and stiff. Typical symptoms of meniscus tears include:
- Moderate to severe pain
- Stiffness and swelling
- Locking or catching of the knee
- Looseness or “giving away” kneeUnable to move knee in full range of motion
During your evaluation in Vail, Colorado, Dr. Hackett will examine the knee for swelling and tenderness. He may perform the McMurray’s maneuver to see what positions cause pain or catches, which indicates a meniscal tear. Dr. Hackett will also order imaging tests to confirm the meniscus tear. Without treatment, you may be at a risk for your knee to slip, pop, or completely lock.
Depending on the severity, type, and location of the meniscus tear, treatment recommendations will vary. With the meniscus, the outside one-third (called the “red zone”) has a rich blood supply, giving it the ability to heal on its own or with surgery. However, the inner two-thirds of the meniscus (called the “white zone”) does not have sufficient blood supply, which makes it unable to heal or grow back together. In this case, the cartilage is surgically trimmed away.
If your tear is mild and occurred on the outer edge of the meniscus, you may benefit from non-surgical methods. The RICE method is generally adequate for most sports-related injuries, which stands for Rest, Ice, Compression, and Elevation. Anti-inflammatory medicines including ibuprofen or aspirin can also help reduce pain and swelling associated with the meniscus tear.
If your symptoms are continuous and don’t respond well to non-surgical techniques, Dr. Hackett may recommend a particular arthroscopic surgery to repair your torn meniscus. During an arthroscopic procedure, a microscopic camera is inserted through a small incision, which provides a full view of the inside of the knee. Then Dr. Hackett utilizes miniature surgical tools to repair, trim, or remove the torn meniscus.
- Partial Meniscectomy – During this procedure, the torn and damaged meniscus tissue is cut or trimmed away and eliminated. This is performed for tears located in the inner two-thirds where there is insufficient blood supply. The objective of this procedure is to stabilize the meniscus by removing as little of the inner meniscus as possible, which generally does not involve complications, like arthritis, over time.
- Meniscus Repair – Certain types of meniscus tears can be repaired with sutures or stitches. This kind of procedure is only performed on tears near the outer one-third, where sufficient blood supply exists. The sutures join the torn edges of the meniscus so they can heal properly.
- Complete Meniscectomy – This procedure involves the complete removal of the torn or damaged meniscus. This surgical technique is performed if only completely necessary, since the removal of the meniscus frequently leads to the development of arthritis.
After your surgery, Dr. Hackett may administer a cast or brace for your knee to maintain its position. If you underwent a meniscus repair, you might be required to use crutches for at least a month to keep weight off your knee. Once your first healing steps are complete, rehabilitation exercises are necessary to restore your knee mobility and strength. This program will begin with a range of motion exercises that gradually turn into strengthening exercises.
In most cases, rehabilitation can be performed at home or a physical therapy office. Although healing times vary depending on a variety of factors, recovery generally takes patients about three months to return to their pre-injury abilities