MENISCUS SURGERY

DO I NEED MENISCUS SURGERY?

The meniscus can tear in a few different ways:

• Acute tears are caused by an injury, often as a result of twisting on a bent knee during sporting activities. Meniscal tears often occur in conjunction with anterior cruciate ligament (ACL) tears.

• Degenerative tears develop later in life and can be caused by everyday activities such as standing up from a squatting position or simply turning on the knee.

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An operation is necessary if:

• the knee is locked due to the torn part being stuck in the middle of the knee preventing full extension

• a so called bucket-handle tear is present on MRI scan which seems repairable

• the knee has not settled down after a few months of rest and a course of anti-inflammatory medication or a steroid injection

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Meniscal tears in the presence of significant arthritis are seen as part of the arthritic process and treating just them is unlikely to improve symptoms.

WHAT IS INVOLVED?

• Preparing for your operation

  • We need to make sure you are as fit and prepared as possible to minimise the risk of complications and to ensure a speedy and smooth recovery. You will have a pre-assessment to identify any correctable abnormalities. We advise that you stop smoking and try to loose weight if applicable. Your BMI tells you if you are overweight. 

• Surgical procedure

  • This operation is done as day case surgery.

  • Meniscal surgery requires a general anaesthetic and the consultant carrying this out will discuss the details with you on the day.

  • Meniscal surgery is a keyhole procedure so you will only have a few tiny stab incisions around the knee. If the tear is repairable we repair it using special instruments to apply tiny sutures into the meniscus tissue to hold it in place. As blood clots help the healing process we make small holes by piercing the bone in the middle of the knee to encourage bleeding.
    If the tear cannot be repaired the torn part is removed sparingly.

• Recovery

  • You should be able to walk within a few hours after the procedure. If you had meniscal repair you will use crutches to walk offloading your knee and we may limit the range of movement too. After removal of the torn part of the meniscus you can fully weight bear and move your knee as comfortable. We will give you an exercise program for home and our physiotherapists will assess your progress regularly. Learn more.

WHAT ARE THE BENEFITS?

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• Your pain should gradually ease and any giving way sensation or locking will cease. 

• The range of movement returns to normal with a few weeks. The initial swelling should also settle down during this time. This may take longer if you had meniscal repair.

• Your knee should feel stronger so you can rely on it better when doing sports or heavy manual work.

• You can return to sporting activity and manual work as you feel comfortable and if the knee is not swollen. This can take a few weeks after removal of the torn meniscus, but significantly longer if you had a meniscal repair.

WHAT ARE THE RISKS?

• Residual pain. You may experience some pain for a few months or even longer. This may be caused by inflammation in the knee or tear and wear of the cartilage surfaces.

• Re-tear and failure to heal. If you need the torn part of the meniscus removed we aim to preserve as much tissue as we can. If you have another injury later the meniscus can re-tear.
  The meniscus has poor blood supply so it is difficult to get to heal. Meniscal repairs therefore can fail even if carried out well technically.

• Infection is rare and may only need a course of antibiotics. In severe cases a second operation is necessary to clear it.

• Significant bleeding or nerve injury is uncommon.

• Blood clots can form in the deep veins of the leg or travel to the lungs and cause a blockage of the arteries of the lung. Rarely, this can be fatal. This is very unlikely to occur when you are fully mobile and we will give you blood thinners if you need to offload your knee.