Arthroscopic Meniscectomy-Minimally Invasive Arthroscopic Surgery for Torn Meniscus Cartilage in the Knee.
Edited By: Carol C. Teitz, M.D.
Last updated Friday, January 02, 2009
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Considering surgeryTypes of surgery recommended The surgical treatment for a torn meniscus is either to remove or
repair the torn segment of the meniscus using an arthroscope and
specially designed instruments. Because only the outer 1/4 of the
meniscus has blood supply, repairs are successful when the tear occurs
in this vascular region of the meniscus. Tears in the non-vascular
region are unlikely to heal and therefore are removed. (For information
on meniscal repair, see article on that topic).Who should consider arthroscopic meniscectomy-minimally invasive arthroscopic surgery? Occasionally the symptoms from a degenerative tear will quiet down
without surgery. Surgery for a torn meniscus should be considered when
the knee is "locked",
the knee is persistently swollen,
the patient can not participate in normal activities,
the patient understands and accepts the risks, and the surgeon is
fellowship trained and experienced in arthroscopic meniscectomy.
What happens without surgery? In the best case scenario, the symptoms of swelling and pain will
resolve and the patient will be able to resume activities.
In the worst case scenario, the torn fragment of meniscus will "lock"
the knee, preventing all but a small amount of motion. This makes
activities of daily living difficult.
Effectiveness In the hands of an experienced fellowship trained orthopedic surgeon,
removal of the torn part of a meniscus is very effective in restoring
comfort and function to the knee. The knee will usually function
normally for decades. If an entire meniscus needs to be removed, that
section of the knee is likely to become arthritic 10-15 years later.Urgency Removal of a torn segment of meniscus is urgent only when the knee is
locked. Even then the urgency is about the patient's comfort and
ability to get around more than it is about the long term effects on
the rest of the knee joint. A torn segment of meniscus that catches,
locks, or produces swelling on a frequent basis should be removed
relatively quickly (within a few months) so that it does not damage the
articular (gliding) cartilage in the rest of the knee. Waiting to
remove the mobile torn fragment can also lead to muscle atrophy and
joint contracture which make it more difficult for the patient to
ultimately regain normal function after surgery.Risks The risks of arthroscopic meniscectomy include but are not limited
to infection and deep vein thrombosis ( blood clot) in the operated
leg. If a clot forms and travels to the lung, the situation can be life
threatening. Fortunately this is uncommon. Sometimes there will be
numbness around the small scars where the instruments have entered the
knee. There are also risks to anesthesia. An experienced team will take
care to minimize these risks, but cannot totally eliminate them.
Managing risk The risk of infection can be decreased by using intravenous
antibiotics during surgery. If infection occurs, the patient is taken
back to the operating room where the knee is washed out using
arthroscopic equipment. The patient is then put on intravenous
antibiotics, usually for 6 weeks depending on the organism causing the
infection.
If a blood clot forms in the leg, the patient is usually put on blood
thinners to prevent the clot from expanding or moving. If the patient
has concerns about the post operative course of events, the surgeon
should be informed as soon as possible.
Surgery for Torn Meniscus Cartilage in the Knee at the University of Washington, Department of Orthopaedics and Sports Medicine, Seattle, Washington If you are interested in making an appointment to discuss this procedure in Seattle, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call 206-543-1552 or 425-646-7777 to make an appointment. Our clinical center is located in Seattle Washington, USA
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