Arthroscopic meniscus surgery has become one of the most common knee operations that orthopedic surgeons are performing. Often referred to as a cartilage tear, a meniscus injury can be a result from high impact sports or degeneration changes in the knees as we get older. Since meniscus tears are so common, orthopedic surgeons have had a lot of of practice repairing this injury and success rates are high.
Meniscus tears in athletes can occur from body movements where the upper body twists or pivots while the foot is firmly planted. This forceful twisting or pivoting movement that athletes make during direction changes or line cutting can cause the meniscus to tear. Even everyday activities like jogging or squat movements can initiate the knee injury. Older patients experience degenerative tears of the meniscus as the knee cartilage ages and becomes weaker.
Upon the initial meniscus injury a "popping" sensation is common followed by pain along the joint line of the tear. Depending on the severity of the injury and if other ligaments were damaged, people may be able to continue walking on the injured knee. Other classic meniscus tear symptoms include swelling, locking or catching of the knee, quadricep weakness, clicking in the knee, sharp pain felt from a twisting or squat position, and knee instability.
Menisci are pieces of cartilage between the thigh bone (femur) and tibia and is responsible for load transmission across the knee joint, cushion between the joints, and is a primary knee stabilizer next to the anterior cruciate ligament (ACL). Meniscus and ACL tears often accompany each other and knee doctors typically repair both at the same time during surgery. The menisci is also a secondary stabilizer of the knee when the ACL is compromised. Without the C-shaped pieces of cartilage in the knee, the impact between the knee joint is essentially bone on bone with no shock absorption.
Arthroscopic meniscus surgery will follow a series of diagnostic testing like X-rays and MRI's so the doctor can get a visual on the damage. X-rays done at the emergency room or knee surgeons office are used to assess the overall knee damage. Only the MRI can be used to verify the repairablility of the cartilage. Doctors also use a McMurray Test for this injury which involves bending and rotating the knee in an attempt to entrap the tear within the knee joint. If the meniscus tear is present, this movement will cause discomfort and clicking.
Types of meniscus tears include Parrot-Beak, Flap, Radial, Bucket Handle, Peripheral, Complex degenerative, and Horizontal cleavage. Knee surgeons also classify tears by the location to the blood supply. Damaged cartilage in the knee that isn't getting access to blood being pumped by the vascular system cannot repair itself. In this situation, surgeons do a meniscectomy which is the removal of damaged cartilage. Other factors that determine repairability are activity level of the patient, age, tear pattern, healing potential, and the presence of other associated ligament damage.
Knee doctors refer to arthroscopic meniscus surgery as being minimally invasive. Arthroscopes (small surgical tool with a camera) allow doctors to view and repair the damaged cartilage by only making a couple small incisions. The main benefit of this procedure is quicker recovery time and less trauma to the patient. Meniscus repairs are done at an outpatient facility and patients can return home the same day. Following surgery, you'll have prescription pain medication, knee brace, crutches, and a lot of ice for swelling. Lower impact activities begin around three months and full sports release around six months. Recovery depends a lot on how aggressive the physical therapy sessions are, athleticism of the patient, and quality of the orthopedic surgeon doing the meniscus knee surgery.
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