Meniscal repair surgery, also known as arthroscopic meniscus repair, is an outpatient keyhole-style surgery that is designed to repair a torn meniscus in a minimally invasive way. A small camera is inserted through an incision of about 1 centimetre to diagnose the issue, after which the meniscus is either sutured together or the damaged portion is trimmed away.
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Meniscal repair surgery, used to repair torn knee cartilage, is a keyhole surgery that is carried out by making a small incision or incisions in the knee area through which a keyhole camera is then placed. The surgeon will then assess the extent and nature of the damage to the meniscus and will then choose a course of action based on their findings. Depending on their decision, fine instruments will then be used to remove any loose bodies and an excision or repair of the meniscus will be carried out. The aim of the surgery is to create a situation in which the meniscus is allowed to heal and function in the most optimum way available, given the damage that has already occurred.
In many cases, a meniscus tear is able to heal fully with no invasive surgery required. This is why, during your consultation, your doctor will take a complete medical history and carry out a number of tests to see if you are a good candidate for arthroscopic surgery. They will look for relevant symptoms such as locking or catching and assess the level of tenderness along the line at which the meniscus is located. Your doctor will also likely recommend one or a number of image tests, which will almost certainly include an MRI, as this is one of the most reliable ways to diagnose a meniscus tear.
During your consultation, your doctor will also go through your options regarding anaesthesia. Meniscal repair surgery can be carried out using a number of different types of anaesthetic including epidural and spinal anaesthesia and local anaesthesia. Most methods involve the patients remaining awake during the surgery.
1. During the procedure, your surgeon will begin by creating a small (usually around 1 centimetre) hole on the lateral side of the knee cap, though they may also create a secondary hole above it. These holes will be used to insert the camera to assess the damage and to provide access for instruments to carry out repairs.
2. During the initial camera assessment, your doctor will evaluate the levels of damage, distinguish it from damage caused by wear and tear and identify any loose ligament pieces that may have broken away.
3. Once this assessment is completed, they will decide on one of two main courses of action and either repair or excise part of the meniscus. Once this has been completed, the entry incisions will be closed with sutures, which may be placed outside or underneath the skin. In very rare circumstances the meniscus may be replaced, but this is very unusual.
There are two main kinds of techniques or procedures used to repair the meniscus. Your doctor will decide upon one only after having assessed the interior of your knee using the keyhole camera.
Meniscus repair: If your surgeon believes that the portion of the meniscus that is torn has the potential to heal back to close to its original state, they will opt for a meniscus repair. In this procedure, the torn meniscus is sutured back together. Of the two techniques, the meniscus repair involves the longest recovery period. Your doctor will place restrictions on the amount of weight you can put on your knee and the range of motion you should allow yourself in order to create the optimum conditions for quick and successful healing.
Meniscectomy: The potential for the meniscus to heal will depend on the type and the location of the tear. If your doctor does not believe it can heal, they will opt for a meniscectomy. This procedure involves the use of shavers or scissors to trim away the damaged portion of the meniscus to relieve symptoms such as clicking and locking and restore to knee to a good level of proper function.
After the surgery, you may feel tired for several days and experience numbness and swelling around the knee and incisions. Total restoration of function to the knee can take several weeks or even months. A great deal will depend on the healing ability and conditions and your ability to stick to a strict post-op and rehab procedure.
It is important to give your knee the requisite amount of rest and freedom from weight during the initial weeks, following by a disciplined approach to any physio and strength building exercise your doctor or physiotherapist may provide. The speed at which you can return to sport or exercise will depend on a number of factors but you should keep in close communication with your medical advisors if this is a priority for you so that they can offer guidance and adjust your rehab procedure if necessary.