Our Summary

The meniscus is a piece of cartilage in the knee that helps distribute weight and absorb shock. If it gets damaged or removed, the knee doesn’t work as well and is more likely to develop arthritis. Fixing the meniscus when it’s damaged should be the first option. Although patients who get their meniscus repaired might need more surgeries, they generally do better in the long run and are less likely to develop severe arthritis than those who just have part of the meniscus removed.

In the past, there were limitations to repairing the meniscus, but advancements in techniques have made it more feasible. The best scenario for healing is when there’s a vertical tear in the outer part of the meniscus. The choice of repair method depends on the specifics of the injury. If the root of the meniscus is torn, it needs to be fixed to prevent arthritis.

If someone has already had part of their meniscus removed and is having symptoms, they might be a candidate for a transplant or a collagen implant. A new area of interest is meniscus extrusion, which is when the meniscus slips out of place and can lead to early arthritis. There are techniques to center the meniscus by stitching it to the edge of the shinbone, and the long-term results of this could change how meniscus extrusion is treated. If the leg is misaligned and causing meniscus problems, a knee realignment surgery is a good option.

There have also been advancements in enhancing the biology of the meniscus, like using bone marrow stimulation, clots, platelet-rich plasma, stem cell therapy, and scaffolds. These could expand the possibilities for meniscus surgery. All in all, these improvements make fixing the meniscus a better option for injuries that would have previously been considered beyond repair. However, more research is needed to confirm the effectiveness of these new techniques.

FAQs

  1. What is the role of the meniscus in the knee?
  2. What are the potential treatment options if part of the meniscus has already been removed?
  3. What are some of the new advancements in meniscus repair techniques?

Doctor’s Tip

In terms of recovery after a meniscectomy, it is important for patients to follow their doctor’s rehabilitation plan closely. This may include physical therapy to help regain strength and range of motion in the knee. It is also important to avoid high-impact activities that could put stress on the knee and potentially cause further damage.

Additionally, maintaining a healthy weight can help reduce the strain on the knee joint and improve overall outcomes. It is also important to listen to your body and not push through pain or discomfort during recovery. If you experience persistent pain or swelling in the knee after surgery, be sure to follow up with your doctor for further evaluation and treatment.

Suitable For

Typically, patients who are recommended for meniscectomy are those with meniscus tears that cannot be repaired, especially in cases where the tear is in the inner part of the meniscus or in a location with poor blood supply that hinders healing. Patients who have already had part of their meniscus removed and are experiencing symptoms may also be considered for meniscectomy alternatives such as transplants or collagen implants. Additionally, patients with meniscus extrusion, misaligned legs causing meniscus problems, or other structural issues in the knee may also be recommended for meniscectomy or other related surgeries. Ultimately, the decision for meniscectomy or any other treatment option should be made based on the specifics of the injury and the patient’s individual circumstances.

Timeline

Before meniscectomy:

  1. Patient experiences knee pain, swelling, stiffness, and limited range of motion.
  2. Patient undergoes physical examination, imaging tests (such as MRI), and possibly arthroscopy to diagnose the meniscus tear.
  3. Non-surgical treatments such as rest, ice, physical therapy, and anti-inflammatory medications are tried first.
  4. If non-surgical treatments are not effective, the patient may undergo meniscectomy surgery to remove the damaged part of the meniscus.

After meniscectomy:

  1. Patient undergoes the surgical procedure to remove the damaged part of the meniscus.
  2. Recovery period involves physical therapy to regain strength, flexibility, and range of motion in the knee.
  3. Patient may experience some pain, swelling, and stiffness in the knee post-surgery.
  4. Long-term effects of meniscectomy may include increased risk of arthritis in the knee due to the loss of the meniscus.
  5. In some cases, patients may require further surgeries or treatments to address ongoing knee problems or complications from the meniscectomy.

What to Ask Your Doctor

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

  1. What are the risks and benefits of meniscectomy compared to other treatment options?
  2. Can my meniscus injury be repaired instead of partially removed?
  3. How long is the recovery process after meniscectomy and what can I expect in terms of pain and mobility?
  4. Will I need physical therapy after the surgery and for how long?
  5. Are there any long-term consequences or complications associated with meniscectomy?
  6. If I have already had part of my meniscus removed, am I a candidate for a transplant or collagen implant?
  7. What are the latest advancements in meniscus surgery and would any of these options be suitable for my injury?
  8. How can I prevent further damage to my meniscus in the future?
  9. Will my age or activity level affect the success of the surgery?
  10. Are there any alternative treatments or therapies that could help with my meniscus injury?

Reference

Authors: Ozeki N, Seil R, Krych AJ, Koga H. Journal: J ISAKOS. 2021 Jan;6(1):35-45. doi: 10.1136/jisakos-2019-000380. Epub 2020 Sep 17. PMID: 33833044