Meniscus Repair Surgery
Meniscus repair is a surgical procedure used to treat tears in the meniscus, the C-shaped cartilage that cushions and stabilizes the knee joint. The procedure is typically performed arthroscopically and aims to preserve as much of the meniscal tissue as possible.
Understanding the Meniscus
Each knee contains two menisci: the medial meniscus on the inner side of the knee and the lateral meniscus on the outer side. These wedge-shaped pieces of cartilage act as shock absorbers between the femur (thighbone) and tibia (shinbone), helping to distribute weight evenly across the joint.
The menisci also contribute to joint stability and help lubricate the knee during movement. Damage to the meniscus can affect these functions and may lead to pain, swelling, and mechanical symptoms such as catching or locking of the knee.
Meniscal tears can occur due to traumatic injury, often during sports that involve twisting or pivoting, or may develop gradually as part of degenerative changes associated with aging.
When Repair May Be Considered
Not all meniscal tears require surgical treatment, and not all tears are suitable for repair. The decision to pursue meniscus repair depends on several factors, including the type, size, and location of the tear, as well as the patient's age, activity level, and overall knee health.
Tears in the outer portion of the meniscus, known as the "red zone" due to its blood supply, tend to have better healing potential and are often candidates for repair. Tears in the inner portion, the "white zone," have limited blood supply and may be less likely to heal with repair.
When repair is not feasible, partial meniscectomy, which involves removing the damaged portion of the meniscus, may be considered as an alternative. Preserving meniscal tissue when possible may help maintain long-term joint health.
The Surgical Procedure
Meniscus repair is typically performed arthroscopically, using small incisions and a camera to visualize the inside of the knee. This minimally invasive approach generally results in less pain and faster recovery compared to open surgery.
During the procedure, the surgeon examines the tear and the surrounding tissue. The torn edges may be prepared by removing damaged tissue and stimulating blood flow to promote healing. Various techniques can be used to hold the torn pieces together, including sutures, arrows, or other fixation devices.
The specific repair technique used depends on the characteristics of the tear and the surgeon's preference. The procedure is usually performed under general or regional anesthesia and is often done on an outpatient basis.
Potential Risks and Complications
As with any surgical procedure, meniscus repair carries certain risks. General surgical risks include infection, blood clots, bleeding, and reactions to anesthesia. These complications are relatively uncommon but can occur.
Specific to meniscus repair, there is a risk that the repair may not heal completely, which could require additional surgery. Failure rates can vary depending on the tear characteristics and other factors. Knee stiffness and persistent pain are possible outcomes in some cases.
Nerve or blood vessel injury, though rare, is possible. Some patients may develop arthritis in the knee over time, though preserving meniscal tissue through repair may help reduce this risk compared to meniscectomy.
Recovery and Rehabilitation
Recovery from meniscus repair typically takes longer than recovery from meniscectomy because time is needed for the repaired tissue to heal. Weight-bearing restrictions and the use of crutches are often recommended for several weeks following surgery.
Physical therapy is an important part of rehabilitation, focusing on restoring range of motion, strength, and function. The rehabilitation program is typically progressive, with activities advancing as healing occurs.
Return to sports or high-impact activities may take several months, depending on the healing progress and individual factors. A healthcare provider can provide guidance on when it is appropriate to resume specific activities.
Following the prescribed rehabilitation protocol is important for achieving the best possible outcome. Returning to activities too quickly can increase the risk of re-injury or repair failure.