Our Summary

The menisci, the two pieces of cartilage that cushion and stabilize your knee, are crucial for the knee’s function and protection. They can get torn, which is a common injury in young athletes and older people with early signs of knee degeneration. If not treated properly, these tears can lead to more serious knee problems.

Recently, the medical community has shown interest in improving the methods used to repair the menisci. Indeed, some studies suggest that it’s possible to fix tears that were previously considered beyond repair, as long as the cartilage is still in good condition.

However, the choice of the repair method depends on the surgeon’s knowledge and skills. They need to be familiar with the different techniques available and be ready to mix them if necessary to get the best results.

There is also ongoing research on biological enhancement methods, which involve using natural substances to aid the healing process. These methods show some early promise, but more research is needed before we can confidently recommend them.

FAQs

  1. What role does the meniscus play in knee function?
  2. What advancements have been made in meniscus repair techniques?
  3. Can biological augmentation be recommended for meniscus repairs based on current data?

Doctor’s Tip

One helpful tip a doctor might tell a patient about meniscectomy is to follow a structured rehabilitation program to ensure proper healing and recovery. This may include physical therapy exercises, activity modification, and gradual return to normal activities. It is important to follow the recommendations of your healthcare provider to optimize the outcomes of the surgery and prevent further complications.

Suitable For

Patients with meniscus tears, both acute and chronic, are typically recommended for meniscectomy. This includes young athletes who have sustained a tear during sports activities, as well as older patients with early degenerative changes in the knee. Additionally, patients with physiological derangement and chondral injury after a meniscus injury may also be considered for meniscectomy. In some cases, attempts at meniscus repair may be recommended if the tissue quality allows, especially in tear patterns that were previously considered irreparable. Orthopedic surgeons should be knowledgeable about the various techniques available for meniscus repair and be prepared to combine techniques to optimize the quality of the repair construct. While biological augmentation may show promise in improving outcomes, more research is needed before strong recommendations can be made in favor of this approach.

Timeline

Before Meniscectomy:

  1. Patient experiences knee pain, swelling, and instability.
  2. Patient undergoes physical examination and imaging studies (such as MRI) to diagnose meniscus tear.
  3. Conservative treatment options such as rest, ice, physical therapy, and corticosteroid injections may be attempted.
  4. If conservative treatment fails, the orthopedic surgeon may recommend meniscectomy to remove the torn portion of the meniscus.

After Meniscectomy:

  1. Patient undergoes meniscectomy surgery, which can be done arthroscopically.
  2. Patient may experience post-operative pain, swelling, and stiffness.
  3. Physical therapy is initiated to help the patient regain strength and range of motion in the knee.
  4. Patient gradually returns to normal activities, with varying levels of success depending on the extent of the meniscus removal.
  5. Long-term consequences of meniscectomy may include increased risk of osteoarthritis due to altered biomechanics and increased stress on the remaining meniscus and articular cartilage.

It is important for patients to follow their surgeon’s post-operative instructions and attend all recommended follow-up appointments to optimize their recovery and long-term knee health.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with meniscectomy surgery?
  2. How long is the recovery process after a meniscectomy and what can I expect during this time?
  3. Will I need physical therapy after the surgery, and if so, for how long?
  4. Are there alternative treatments to meniscectomy that may be more beneficial for my specific situation?
  5. What is the likelihood of developing arthritis in the future after undergoing a meniscectomy?
  6. Can a meniscus tear be repaired instead of partially or completely removed through meniscectomy?
  7. What is the success rate of meniscus repair compared to meniscectomy in terms of long-term outcomes?
  8. Will I be able to return to my normal activities or sports after a meniscectomy, and if so, how soon?
  9. Are there any lifestyle changes or precautions I should take after the surgery to prevent further injury to my knee?
  10. How often will I need follow-up appointments to monitor my progress and knee health after a meniscectomy?

Reference

Authors: Mcclain WD, DeFoor MT, Patzkowski JC. Journal: Sports Med Arthrosc Rev. 2021 Sep 1;29(3):e34-e43. doi: 10.1097/JSA.0000000000000320. PMID: 34398120