Meniscus Tear Repair
A meniscus tear is one of the most common knee injuries. It’s primarily caused by activities that forcibly twist or hyper-flex the knee joint, especially when one’s full weight is applied on it, such as aggressive pivots, or sudden starts and stops (common in hockey, baseball, tennis and basketball).
Unfortunately, even routine activities such as kneeling, squatting or heavy lifting can provoke a meniscus tear.
What Is a Torn Meniscus?
Each knee contains two crescent shaped bands of rubbery cartilage that cushion and help protect the knee joint from the daily stress of walking, running and bending.
Aggressive twisting and pivoting can cause ruptured meniscus fragments to get trapped in the knee joint, generating a “catching” sensation. When a larger shard becomes embedded between the shin bone and the knee, the knee can ‘lock’ and lose its ability to completely bend or extend.
The degree and severity of meniscus tears can differ significantly; the meniscus may be severed in half, torn around the edge, or left suspended by a single thread to the knee joint. A tiny tear may not be discernable for many years, until an innocuous event triggers it, like tripping on the sidewalk or stumbling at home.
Meniscus tear symptoms include:
- A popping sound
- Stiffness and tightness
- A loose feeling in the joint
- Difficulty fully extending the knee
Consult your orthopaedic specialist if you believe you have a torn meniscus, or if you’ve experienced any symptoms of a meniscus tear. Your physician will likely order tests that may include X-rays, magnetic resonance imaging (MRI), or ultrasounds to establish if you have a torn meniscus.
Treatments for a Meniscus Tear
Your orthopaedic surgeon’s recommendation for treatment will depend on the size and placement of the tear, one’s age, health and medical history, activity level, and when the injury took place.
Smaller tears situated near the outer edge of the meniscus can frequently heal on their own. If a larger rupture is situated toward the middle of the meniscus, healing may be hindered, as the blood supply to the area is limited. Younger patients may initially choose surgery, because their chances of a full recovery may be greater.
Non-surgical treatment options include rest, ice, pain and anti-inflammatory medication, elevation, compression, physical therapy and muscle strengthening around the joint. Relieving the discomfort in this way buys time for the injury to recover and heal on its own.
When non-surgical measures prove ineffective, your surgeon may recommend surgery to repair the meniscus tear. Surgical restoration of the meniscus is usually accomplished through arthroscopic surgery. During the minimally invasive outpatient surgery, the physician will slide a thin tube containing a camera through tiny incisions around the knee. The surgeon will then stitch the meniscus back together, using dart-like mechanisms that are embedded across the tear to hold it in place.
If the tear cannot be fixed, a small portion of the torn meniscus may need to be surgically removed in order to restore proper knee function (partial meniscectomy), or in more extreme cases, the meniscus may need to be taken out entirely (total meniscectomy).
In general, arthroscopic meniscus repair can be completed in under two hours, and most patients will be able to return home the same day.
What To Expect After Torn Meniscus Surgery
Following surgery, patients may be fitted with a knee brace and a cryocuff (a cold compression tool to limit swelling in the knee). Patients may be instructed to take it easy the first couple of days after surgery, with the leg propped up while seated, to help minimize swelling. Patients may also be advised to keep the knee immobilized for up to two weeks after surgery.
Rehabilitation and physical therapy play a crucial role in restoring the knee to complete function, and the patient should begin working with a physical therapist as soon as possible, in order to strengthen the muscles around the knee and in the legs to secure and reinforce the joint.
Following your physician’s rehabilitation plan is crucial for a full recovery and will determine how soon you’ll be able to resume walking, running, return to sport and more strenuous activities.