Meniscus Repair Surgery at World Class Hospitals in India.
Meniscus Repair Surgery
The meniscus is the soft rubbery bumper cushion that sits between the thigh bone and the leg bone. There are two menisci in the knee; a medial (inside) and a lateral (outside) meniscus. These structures act as shock absorbers that decrease the stress seen by the articular cartilage found on the end of the thigh bone and leg bone. Meniscus injuries are quite common and occur in patients of all ages. An injury can occur as a result of squatting, turning or twisting during almost any activity. Once the meniscus is torn, symptoms like locking, clicking, and catching may occur due to the torn fragment. In addition, patients will frequently notice swelling in the knee. The pain will be localized along the joint line on the inside or the outside of the knee depending on the tear. The diagnosis is made based upon a history and physical exam and frequently special tests. X-rays are often normal. If there is some question regarding the diagnosis and MRI can be obtained to confirm a tear. Most tears remain symptomatic and will ultimately require treatment if they interfere with activities of daily living or sports and recreation activities.
Like a lot of knee injuries, a meniscus tear can be painful and debilitating. Unfortunately, it’s quite common. In fact, a meniscal tear is one of the most frequently occurring cartilage injuries of the knee.
So what is the meniscus? It’s a piece of cartilage in your knee that cushions and stabilizes the joint. It protects the bones from wear and tear. But all it takes is a good twist of the knee to tear the meniscus. In some cases, a piece of the shredded cartilage breaks loose and catches in the knee joint, causing it to lock up.
Symptoms of Torn Meniscus
Torn knee cartilage generally produces pain in the region of the tear and swelling in the knee joint. These symptoms are made worse with pivoting motions, squatting, and vigorous activities. Torn meniscus fragments can get caught in the knee joint and cause catching sensations. If a large enough fragment becomes lodged between the bearing surfaces, the knee may ‘lock’ and become unable to be fully bent or extended.
Types of Surgery
Described below are three types of surgery for torn meniscus, although the third (complete meniscectomy) is avoided if possible. One (partial meniscectomy) accounts for the vast majority of surgeries. Today, almost all meniscus surgery is done arthroscopically. In arthroscopic surgery, small incisions are made and a flexible tube with a miniature camera and light source attached is inserted. The procedure is guided by images from the camera. Tiny instruments are placed at the tip of the tube to perform the surgical procedure.
Partial Meniscectomy (Removal of Torn Meniscus Tissue)
If you are facing potential surgery for a knee meniscus tear, it’s very likely that you are considering a procedure called partial meniscectomy. Since the meniscus serves an important function in the knee, it is best to save as much of the meniscus as possible. A partial meniscectomy involves the removal of the torn piece of the meniscus only – the undamaged portion of the meniscus remains in place. This procedure is typically performed arthroscopically. A small shaver is used to remove the torn part of the meniscus. This is different than a surgery for meniscus repair. Meniscus repair involves suturing together the torn portions of the meniscus and allowing the meniscus to heal. Note: on the meniscus tear images, you will see the terms medial and lateral. “Medial” refers to the portion of the knee toward the midline of the body, the inside portion of the knee between the legs. “Lateral” refers to the outside portion of the knee, away from the midline of the body.
Meniscus Repair (Repairing Torn Meniscus Tissue when it can heal)
Meniscus repair is far less common than partial meniscectomy because a repair can only be done if the tear is in the area of the meniscus that has a blood supply (the outer edge or “red zone”). Other factors can also limit the success of this procedure. For example, complex tears or tears in cartilage that is very worn or thin are less likely to respond well. In a repair procedure, the surgeon will use either sutures or small bio-absorbable tacks to bring the pieces of meniscus back together
Surgery for Meniscal Tears
Surgery is typically aimed at either removing the damaged tissue, repairing it, or possibly removing the meniscus entirely. While the success of the procedure will always be contingent upon a multitude of factors, these processes are considered most effective for individuals who are under the age of 30. The likelihood of success is also higher for individuals who seek treatment promptly after injury than those who wait. The most common types of surgery for meniscal tears include:
- Meniscectomy. In this procedure, surgeons insert an arthroscopic camera into the knee of the patient to locate and view the tear. For most tears, the damaged portion of the meniscus will be removed and then sutures will be used to reaffix the disc together. This is referred to as a partial meniscectomy. In a full meniscectomy, the entirety of the meniscus is removed, though this presents a heightened risk for future complications.
- Repair. If at all possible, particularly in younger patients, doctors usually prefer a meniscal repair to a meniscectomy. In this procedure, arthroscopic cameras are used to locate the tear, and the damaged area is then repaired with the use of surgical sutures.
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