What is the procedure for meniscal injury?
Meniscal injury can be traumatic or degenerative. Traumatic can be isolated or in association with other knee ligament injury. The main complaints are difficulty while climbing stairs or squatting activities, locking of joints. It can cause pain while doing regular activities, swelling of joints due to irritation. Meniscus have a significant role not only in load bearing, load transmission and cushioning of the joint but also in overall joint stability, preservation of meniscus is the main focus in the treatment of meniscus injury. Meniscal injuries are diagnosed by MRI. A good MRI imaging can help a lot in preoperative planning. The repair or balancing of the meniscal tear is done to prevent the further damage. Meniscus may be avulsed from insertion point or a torn can happen at different parts of the body of the meniscus in different patterns. Aim in all meniscus surgery is to preserve as much as possible in a balanced way. All meniscus surgery can be done with arthroscopy.
How is the procedure done?
Meniscal injury repair can be done with arthroscopic keyhole surgery and the patient will have minimal scar over knee. The torn meniscus will be freshened and repair will be done with the help of sutures and anchors. There are different techniques for repair like all-inside, inside-out or outside-in depending on how the suture thread is passed through the substance of the meniscus to hold them in position. In inside-out suture are passed from inside to outside and in outside-in method the vis a versa. In both the methods the repair is held by applying a knot. In all inside method suture and knot is held in position with the help of anchor and in-situ knot mechanism. Which method will be applied for repair depends on what type of meniscal injury is there and in what technique the surgeon prefers. Inside-out technique is always a stronger repair in comparison with all inside technique.
How does recovery happen?
After meniscal repair initially the patient will be on knee ROM brace to restrict knee movement to avoid stress on repair and also the patient is mobilised by elbow-crutch aided partial weight bearing. After 3-4 weeks range of motion is increased and allowed to bear more weight while walking. Knee physiotherapy in the form of quadriceps-hamstring strengthening and balancing, body balancing and core strengthening exercises are being done as a protocol like any other knee ligament injury. At the end of 5-6 months one can be back to complete full activities with no restrictions.
What should you expect from the procedure?
Following repair and recovery meniscal injury patients will be feeling better, pain free while doing squatting activities or while climbing stairs.
Why is this procedure done?
Meniscal repair is mainly advised for prevention of damage to cartilage because these will be acting as support for knee joints to prevent force or weight on knee during activities. Chances of arthritis will be higher if the meniscal injury is left untreated and may also lead to deformity or chronic pain which may affect day to day life of the patient.