A torn meniscus is one of the most common knee injuries that requires surgical repair. It usually results from twisting the knee and can affect people of any age and fitness level. Fortunately, repair of this injury can be done quickly and successfully, and full recovery of function is the expected outcome.
What is the Meniscus?
Your knee joint is where your thigh bone, or femur, and your shin bone, or tibia, are joined. Between these bones are two tough, wedge-shaped pieces of cartilage which together make up the meniscus. The purpose of the meniscus is to act as a cushion and shock absorber between the femur and the tibia.
What Causes a Tear of the Meniscus?
The most common cause of a meniscus tear is when you twist your knee with your foot planted. This puts undue stress on the cartilage and causes it to rip. Athletes are especially prone to these twisting tears, but the elderly are susceptible, too. As you age, your cartilage becomes worn, and an everyday action like twisting your knee when you rise from a chair can cause a tear in the meniscus.
Other actions that can lead to a tear include rising from a squat with a load in your arms or kneeling repetitively.
What Are the Symptoms of a Meniscus Tear?
You will often hear a pop. While your knee will continue to function, it will shortly begin to swell and become stiff. Your doctor will likely perform the diagnostic McMurray test, which consists of bending, straightening, and rotating your knee and listening for characteristic sounds. The diagnosis may be confirmed with an MRI.
Can Meniscus Tears Be Repaired?
Some tears of the meniscus are repairable, and some are not. The outer third of the cartilage is well supplied with blood vessels, while the inner two thirds are not. Because healing requires a blood supply, damage to the inner section is usually trimmed away rather than repaired. If the tear is in the outer third, it can be successfully repaired. The treatment of choice is arthroscopic surgery. While a meniscus tear is not an emergency, having it repaired within two months of the injury will result in the most successful outcome.
How is Arthroscopic Surgery Performed?
Arthroscopic repair of a meniscus tear is an outpatient procedure. It usually takes from 30 minutes to an hour and a half. After an hour or two of recovery, you can go home.
The first step of the procedure is to administer anesthesia. You will be placed under general anesthesia and will have a local anesthetic at the knee. Then the surgeon will make two small incisions, called portals, into your knee. Into one portal is inserted a tiny camera that allows the surgeon to see into the joint. Surgical instruments are inserted through the second portal.
After thoroughly inspecting the damaged tissue, the surgeon may first scrape the injured area. This can stimulate the body’s natural healing processes and hasten recovery. Then the tear will be repaired with one of several available options. It may be stitched together with sutures, fastened with tacks that dissolve over time, or pulled together by other similar methods.
What is the Recovery Process?
You will go home from the hospital with a dressing on the knee. You will be instructed to apply cold packs and keep the knee elevated as much as possible. There will be moderate pain that can be treated with oral pain relievers and anti-inflammatory medications.
Your knee will most likely be painful and swollen for about three days, and you will have limited mobility. If possible, you should arrange to have someone in your home to help you during this time. Some people will need to wear a cast or brace, and patients will be on crutches for about a month. Physical therapy will help to restore full range of motion and strength to your knee. You should expect to regain full function of the joint within five months.
Arthroscopic meniscus repair is considered a routine surgery with a high success rate. Not only can you return to normal activities after the repair, but it will help stave off the development of degenerative process like arthritis as you age.