Meniscal Surgery

(Surgery to the "Footballer's" or "Sportsman's" Cartilage)

The meniscus is a structure within the knee that works as a shock absorber and contributes to the stability of the knee. There are 2 menisci in either knee - one on the inner side and one on the outer. They serve an important role in improving knee function. A tear of the meniscus can occur either as a result of degeneration (wear and tear) that makes it less pliable or when the knee is injured - normally in a twisting type injury.

When torn, the meniscus can cause serious problems within the knee joint: jamming or locking; giving way or a sensation that the knee cannot be trusted; pain and swelling. If an arthroscopy is recommended then the surgeon has the opportunity to assess the tear and decide whether the tear can be repaired or trimmed back to healthy tissue. Tears that cannot be repaired need to be trimmed back to a stable edge. Only as much tissue as is necessary is removed as the remainder of the meniscus has an important role in reducing the contact pressure in the knee joint.

The images below are of healthy meniscal cartilages being gently assessed for damage.

      Knee Surgery        Knee Surgery

Meniscal Repair

Only about 1 in 10 tears can be repaired. This is because the blood supply to most of the meniscus is very poor and many tears are very severely damaged and cannot be put back into place.  

If the meniscus can be "reduced" (put back into the position where it came from) and is not too badly torn, then it can sometimes be repaired.

Several techniques exist to repair the tear but most involve either suturing/stitching the tear or using devices that are inserted "all-inside" the knee that secure the torn parts of the meniscal cartilage back into place.

FOR A VIDEO TO SHOW WHY MENISCAL REPAIR MAY WELL BE PREFERABLE TO PARTIAL MENISECTOMY CLICK HERE

Recovering From a Meniscal Repair Procedure

Gradual rehabilitation with a physiotherapist is essential after most arthroscopic procedures.

After a meniscal repair you must not bend your knee beyond 90 degrees for 6 weeks as a minimum.

If you do, the chance of the repair healing is reduced. This is because the femur (thigh bone) moves backwards on the shin-bone (tibia) as the knee bends.

As the knee bends the meniscus is loaded at the back. This puts a lot of force on the back of the meniscus and could easily lead to the repair failing. About 80% of meniscal repairs heal adequately.

 

The following video by a knee specialist from Belgium is very informative and (hopefully in a not too technical level) explains the philosopy that Mr Arbuthnot subscribes to, encouraging meniscal presevation where possible. CLICK HERE

 

http://www.healio.com/orthopedics/total-joint-reconstruction/news/print/orthopaedics-today-europe/%7b8d4bc873-2569-44c1-93b3-a03789f85f11%7d/video-verdonk-discusses-procedures-used-for-meniscal-injury-treatment