Our Summary

This research paper investigates the best methods for a specific type of knee surgery, called arthroscopic medial meniscectomy. This procedure involves removing part of a damaged or torn meniscus in the knee. Sometimes, surgeons need to release a ligament in the knee, known as the medial collateral ligament, to carry out this operation.

The paper suggests that it’s better to release this ligament either through a small skin puncture (percutaneous pie crust) or from within the joint (intra-articular release) rather than risk damaging the cartilage of the medial femoral condyle (a part of the thigh bone that interacts with the knee).

For patients who have a ’tight’ medial compartment (a smaller than usual space on the inside of the knee), the paper recommends releasing this ligament. Importantly, the study found that releasing the medial collateral ligament during this kind of surgery does not lead to complications or additional health issues, so it should be considered a safe and beneficial part of the procedure.

FAQs

  1. What is the preferred procedure in patients having arthroscopic medial meniscectomy?
  2. Why is release of the proximal medial collateral ligament recommended in patients with tight medial compartments?
  3. Does the release of the medial collateral ligament during arthroscopic partial medial meniscectomy result in any morbidity?

Doctor’s Tip

A helpful tip a doctor might tell a patient about meniscectomy is to follow post-operative rehabilitation protocols carefully, including physical therapy exercises to help strengthen the knee and improve range of motion. This can help speed up recovery and improve overall outcomes after surgery. Additionally, maintaining a healthy weight and avoiding activities that put excessive strain on the knee can also help prevent future knee problems.

Suitable For

Patients who are typically recommended for meniscectomy include those with a torn meniscus that is causing pain, swelling, and limited range of motion in the knee. Other factors that may indicate the need for meniscectomy include a locking or catching sensation in the knee, instability or giving way of the knee, and failure to improve with conservative treatments such as physical therapy and medication. Additionally, patients with degenerative meniscus tears or those with recurrent knee pain and swelling despite previous meniscus repairs may also be candidates for meniscectomy. Ultimately, the decision to undergo meniscectomy should be made in consultation with a healthcare provider after a thorough evaluation of the patient’s symptoms and imaging studies.

Timeline

Before meniscectomy:

  • Patient may have been experiencing knee pain, swelling, and decreased range of motion
  • Doctor may have performed physical exams, imaging tests (such as MRI), and possibly tried conservative treatments like physical therapy or medications
  • Decision is made to proceed with arthroscopic medial meniscectomy

After meniscectomy:

  • Patient undergoes arthroscopic surgery to remove a portion of the damaged meniscus
  • Recovery typically involves physical therapy to regain strength and range of motion in the knee
  • Patient may experience some pain, swelling, and stiffness in the knee in the days and weeks following surgery
  • Full recovery and return to normal activities can take several weeks to months, depending on the individual and the extent of the surgery.

What to Ask Your Doctor

  1. What is a meniscectomy and why do I need one?
  2. What are the potential risks and complications associated with a meniscectomy procedure?
  3. How long is the recovery time after a meniscectomy surgery?
  4. Will I need physical therapy after the surgery? If so, for how long?
  5. What kind of activities should I avoid after the surgery?
  6. How long before I can return to normal activities or sports?
  7. Are there any alternative treatments to a meniscectomy that I should consider?
  8. Will the surgery affect my long-term joint health or increase my risk for arthritis?
  9. How often will I need to follow up with you after the surgery?
  10. Can you explain the potential benefits of percutaneous pie crust or intra-articular release of the proximal medial collateral ligament during the procedure?

Reference

Authors: Bert JM. Journal: Arthroscopy. 2019 May;35(5):1525-1526. doi: 10.1016/j.arthro.2019.01.052. PMID: 31054728