Our Summary

This research paper is about a condition called ‘discoid meniscus’, which is a birth defect that affects the shape of the meniscus in the knee, making it more prone to tearing and affecting the way a person walks. This condition is more common in Asia and often affects both knees. Some people with a discoid meniscus may have symptoms such as pain or a locking sensation in the knee, often caused by a tear in the meniscus or its detachment from the knee. If there are no symptoms, no treatment is usually needed. However, if there are symptoms and the meniscus is not locked, a more cautious approach to treatment is usually taken. If the meniscus is detached, it needs to be stabilised while preserving as much of it as possible. After a surgical repair, patients may need a personalised rehabilitation program and may be able to return to sports after more than four months. The paper suggests that in the long term, patients who have their discoid meniscus reshaped and repaired tend to have better outcomes than those who have most of their meniscus removed. However, the evidence is not strong enough to definitively say that repair is the best option. The prognosis is worse for patients who have their entire meniscus removed, are older when they present with the condition, or have a misalignment in their knee.

FAQs

  1. What is a discoid meniscus and what symptoms might it cause?
  2. What treatment options are available for individuals with a discoid meniscus?
  3. What factors might influence the prognosis after treatment for a discoid meniscus?

Doctor’s Tip

A helpful tip a doctor might tell a patient about meniscectomy is to follow their post-operative rehabilitation plan closely, including physical therapy exercises to help regain strength and range of motion in the knee. It is important to gradually increase activity levels and avoid high-impact activities to prevent re-injury. Additionally, maintaining a healthy weight can help reduce stress on the knee joint and improve overall outcomes following surgery. It is important to communicate any concerns or changes in symptoms to your healthcare provider to ensure proper healing and recovery.

Suitable For

Patients who are typically recommended for a meniscectomy procedure include those with a discoid meniscus who have symptoms such as pain, locking, or instability in the knee. Patients who have a tear in the meniscus or detachment of the meniscus from the knee may also be candidates for a meniscectomy. It is important for the surgery to be considered carefully, as removing too much of the meniscus can lead to long-term issues such as increased risk of arthritis in the knee. Patients who are younger, have a well-aligned knee, and have a discoid meniscus that can be repaired and preserved may have better outcomes with a meniscus repair rather than a meniscectomy. Ultimately, the decision to recommend a meniscectomy will depend on the individual patient’s symptoms, the severity of the meniscus injury, and their overall health and activity level.

Timeline

Before meniscectomy, a patient may experience symptoms such as pain, swelling, catching or locking of the knee, and difficulty moving or straightening the knee. They may undergo imaging tests such as an MRI to confirm a tear in the meniscus.

After meniscectomy, the patient will undergo surgery to remove the torn part of the meniscus. They will then begin a rehabilitation program to strengthen the knee and regain range of motion. This may involve physical therapy, exercises, and possibly the use of crutches or a brace.

In the long term, the patient may experience improved knee function and reduced pain. However, they may also be at risk for developing arthritis in the affected knee due to the loss of cushioning from the meniscus. It is important for the patient to follow their healthcare provider’s instructions for rehabilitation and ongoing care to optimize their outcomes.

What to Ask Your Doctor

Some questions a patient should ask their doctor about meniscectomy include:

  1. What is a meniscectomy and why is it recommended for my condition?
  2. Are there any alternative treatments to meniscectomy that I should consider?
  3. What are the risks and potential complications of a meniscectomy procedure?
  4. How long is the recovery period after a meniscectomy and what can I expect during this time?
  5. Will I need physical therapy or rehabilitation after the surgery?
  6. What are the long-term effects of having a meniscectomy, particularly in terms of knee function and risk of future knee issues?
  7. Are there any specific factors about my case (such as age, activity level, or the extent of the meniscus damage) that may affect the success of a meniscectomy?
  8. How will having a discoid meniscus impact my treatment options and outcomes compared to a traditional meniscus tear?
  9. What is the likelihood of needing additional surgeries or treatments in the future after a meniscectomy?
  10. Are there any lifestyle modifications or precautions I should take after the surgery to prevent further knee issues?

Reference

Authors: Tapasvi S, Shekhar A, Eriksson K. Journal: J ISAKOS. 2021 Jan;6(1):14-21. doi: 10.1136/jisakos-2017-000162. Epub 2020 Sep 16. PMID: 33833041