Common Questions
About Arthroscopy
- Joint line tenderness and effusion
- Symptoms are frequently worsened by flexing and loading the knee, activities such as squatting and kneeling are poorly tolerated
- Complaints of ‘clicking’, ‘locking’ and ‘giving way’ are common
- Functionally unstable knee
- Symptoms are frequently worsened by flexing and loading the knee, activities such as squatting and kneeling are poorly tolerated because of stiffness and pain
Typically an athlete or active individual tears a meniscus with a twisting injury. Younger athletes often suffer more significant injuries than do older adults. Often older athletes will note feel pain with such injuries. Occasionally older patients do not remember a specific injury at all.
When meniscus tear is in the nonvascular area and symptomatic than with the use of arthroscopic instruments like scissors and shaver , the surgeon cuts out the torn portion of the meniscus and leave a stable rim.
Meniscectomy refers to the removal meniscus in the knee. Total removal takes the entire meniscus out. This includes surfaces all the way around the knee joint–front, side, and back. Partial meniscectomy is the removal of less than half of the meniscus only the significant tear piece. The edge of the cartilage around the rim of the knee joint is left in place.
There are differences in the results of partial and total meniscectomies. Without the meniscus, the joint space narrows and more stress is placed on the knee. Long-term studies show some functional changes as well.
The meniscus acts as a shock absorber, so, removing part of it would lead to more stress on the articular cartilage and bones. While there is no way to predict if patient will develop later arthritis or how quickly, it is a potential concern.
Despite this concern for long-term wear on the articular cartilage and subsequent arthritis, the inner torn fragment probably provides little protection to this cartilage either. Plus the pain is unlikely to improve without trimming that part out. Therefore patients often undergo surgery to relieve pain and get back to activities even if they could develop degenerative problems in later years or decades.
As such there is no major or common complication known with the procedure. Rare complications known are, the blood vessels and nerves around the knee may be injured causing numbness or weakness in the leg below the knee. There is a risk of deep vein thrombosis, a condition in which a blood clot forms within a deep-lying vein. There is a rare risk of infection and bleeding.
Some meniscus tears are not painful. Unfortunately, it is difficult to predict whether a patient with a painful meniscus tear will get relief of that pain from ice, rest,NSAIDS, or physical therapy.
Only the outer 1/3rd of the meniscus is vascular, or receives blood. Therefore, this is the only portion of the knee which can actually heal itself. Tears that are in the outer 1/3rd of the meniscus, and which are relatively new, are typically the best candidates for a MENISCAL REPAIR. In this case the surgeon will go in and actually suture the torn pieces together, immobilizes the knee so that it can’t be moved for several weeks after the surgery. The benefit of this procedure is that the biggest portion of meniscus is preserved and , if successful patient’ll have complete meniscus in the future. But rehabilitation is much lengthier, often taking up to 6 months to get back to full recovery.
In contrast, for older injuries or in tears that occur within in the inner 2/3rd’s of the meniscus, a partial meniscectomy is generally performed. In this case the surgeon will go in and remove the torn segments, and then attempt to smooth out the remaining portions of the meniscus. The benefit here is that patient will return back to routine activities very quickly; on the down side, patient will lose some of the shock-absorbing capacity at the joint, leaving patients at increased risk of long-term knee issues such as arthritis