Revision Meniscus and Ligament Surgery
A meniscus tear is one of the most common knee injuries, and while athletes face the highest risk for a tear, the injury can happen to anyone at any age. The meniscus is the rubbery cartilage that cushions and stabilizes the knee joint. Each knee joint is equipped with two menisci – the lateral meniscus located on the outside of the knee, and the medial meniscus located on the inside of the joint.
When initial treatment for a meniscus or ligament tear fail, a revision meniscus surgery may be required to restore full function and pre-injury ability. An initial meniscus repair can go wrong for several reasons:
- A re-tear of the meniscus from activity
- A failed original repair
- A patient not following proper rehabilitation guidelines
Although meniscus tears are most common among athletes who bear weight on their knee while forcefully rotating it, regular everyday activities such as kneeling, squatting or heavy lifting can also result in a tear.
Symptoms of a torn meniscus include:
- Locking or catching of the knee
- Feeling like the knee is giving way
- Inability to move the knee through the full range of motion
Treatment for Meniscus and Ligament Injuries
When the meniscus or ligament is re-injured, non-surgical treatment options like rest, ice, pain and anti-inflammatory medications are likely not sufficient if the goal is to return to a full pre-injury level of activity.
Meniscus revision surgery requires specialized techniques to help determine what caused the original surgery to fail to help ensure the revision will not. The overall treatment goal of revision meniscus and ligament repair is to reduce pain, swelling and loss of function in the affected knee.
Arthroscopic meniscus repair is normally the best course of action for patients with a torn meniscus – even during a revision procedure. This surgery is a minimally invasive, outpatient procedure to preserve the healthy meniscus tissue. Small instruments are inserted along with a small camera into the knee joint through two very small incisions. The torn section of the meniscus is either removed, known as a partial meniscectomy, or the torn edges are sewn back together. In extreme cases, the entire meniscus may be removed, referred to as meniscectomy.
Patients suspecting they’ve torn their meniscus or are experiencing any symptoms associated with a tear should consult their orthopaedic specialist. The physician will likely order tests that may include X-rays, magnetic resonance imaging (MRI), or ultrasounds to establish if whether the meniscus is torn.
What to Expect After Revision Meniscus and Ligament Surgery
An arthroscopy can be completed in under two hours and many patients are discharged the same day. Patients are normally advised to use crutches and a knee brace following the surgery, as well as a cryocuff (a cold compression tool) to help limit swelling in the knee. The orthopaedic surgeon will likely suggest taking it easy in the days immediately following the surgery while keeping the leg propped up. In some cases, complete immobilization of the knee for two weeks is advised.
As soon as two weeks after surgery, a physical therapy regimen may be prescribed, intended to restore stability, mobility and overall function to the repaired joint. Physical therapy may last for 2-3 months following surgery to help restore the knee and heal to complete function.