We all have grown up with knee injuries, endless memories of bandages and antiseptics, some even more severe have wrapped our growing years. Knee injuries can be quite complicated, sometimes an injury may be critical enough to call for a surgery. We will discuss the meniscus removal, which is one of the treatments for a knee injury, dealing with a damaged or torn cartilage. Our knee joint has two cartilages, out of the two, one cartilage is called the meniscus cartilage also called fibrocartilage. It has a 'C' shaped structure that is responsible for providing lubrication, nutrition, and preventing friction to the knee joint.
There are two menisci (plural of meniscus) in the knee, they are situated in the femur (the thigh bone) and tibia (the shin bone, that is the leg bone). They are named lateral meniscus and medial meniscus respectively. Lateral meniscus covers the outer area of the knee joint, whereas the medial meniscus covers the inner side of the knee joint. A certain part of the meniscus gets blood supply, however, almost two third (that is the inner part) of the meniscus does not get blood supply. Due to this, in case of any injury or damage to the inner meniscus, it will not heal completely by repair or rest. For these injuries where the cartilage is torn beyond repair a surgery, that is, removal of meniscus is suggested.
Meniscus Tear - Causes and Symptoms
This can happen with any damage to the knee, sudden twist or trauma. It happens typically during any rigorous sports activity that has sudden stops, turns and twists like movements. Age also causes the meniscus to tear. Symptoms will be inability to move or stretch and extend the leg, along with swelling, tightness and stiffness in the knee, severe pain, etc.
Surgery for Damaged Meniscus
The kind of tear and damage will enable the surgeon to decide how to treat the meniscus. If there is no repair option, a removal will be advised. Traditionally, an open surgery is performed to remove the torn cartilage, however, doctors suggest a minimally invasive surgery, that is called arthroscopic surgery, for meniscus removal. It is also termed as meniscectomy. This surgery uses anesthesia, usually local or partial. A surgeon will use an arthroscope, that is a thin tube, with a camera and light. An incision will be made and this arthroscope will be inserted in the knee joint. Once the torn cartilage is examined, the surgeon will decide whether a partial removal (only the damaged part of the cartilage will be removed) or a total removal is required.
Also depending on the area of damage, an option like medial meniscus removal (when the tear is on the inner side of the knee joint), or a lateral meniscus removal (if the torn cartilage is on the outer covering of the knee joint) can be decided. The surgeon will insert instruments through the incision to remove the damaged part of the cartilage. This surgery has two types - Arthroscopic partial meniscectomy, which is partial removal, where if the tear is small, only the damaged part of cartilage is removed. Arthroscopic total meniscectomy, which is total removal of the meniscus if the tear covers a larger area, the entire cartilage is removed. This is mostly used for lateral meniscus tear.
The surgeon will look at various factors before conducting the surgery, like age, overall health, the type, location, and severity of the tear, recovery time, etc. The surgery may also have certain risks like blood clots, infection, anesthetic risks, damage to the blood vessels and nerves in and around the knee joint. If a large area has to be removed, the greater is the risk of the knee not being capable of bearing load and pressure. Activities like cycling, walking and others, may not be easy. Removal or the meniscus exposes the knee to greater risks of degeneration, osteoarthritis, etc.
Depending on the type of surgery, recovery time can be concluded. A partial meniscectomy generally heals faster than total meniscectomy. After two hours of the surgery, the surgeon may allow you to leave. Along with medications, knee supports, braces, and even crutches may be prescribed by the surgeon, for recovery. The surgeon will also advise to strictly follow given instructions and care after the surgery. Physical therapy is also continued throughout the recovery time after the surgery. Returning to work and activities can be after 2 days or even 2 weeks, depending on the type of surgery and the progress in healing. However, recovery time can be around 2 to 3 months, to be completely healed for sports like activities.
Factors like completely removing the meniscus result in a lot of pain, and a meniscus transplant option is a good solution. Study all aspects carefully before opting for any surgery. Taking timely care of the knee when indulging in sports and other activities is advisable, rather than dealing with surgery and pain after the damage.