The three main approaches for treating a meniscus injury are non-surgical management (rest, PT), surgical repair (stitching the tear), and partial meniscectomy (removing the damaged piece). While repair aims to preserve the meniscus, meniscectomy removes the torn part, and a transplant replaces the whole meniscus. The choice depends on the tear's location, type, patient's age, and symptoms.
Meniscal repairs can be performed by open, inside-out, outside-in and all-inside techniques. But not all meniscus tears have the ability to heal, the meniscal tear pattern and the presence of adequate vascularity are both key.
Symptoms depend on the cause and they range from mild to severe swelling. Pain, tenderness, redness, fever, and chills can also occur. Knees can have bruises or become stiff so that walking is hard.
In most patients, meniscus tear repair is preferred over meniscus removal. That's because studies have shown when the meniscus is repaired and preserved, patients tend to experience better overall healing and better long-term joint function.
You can safely use your knee without your whole meniscus, but having a section removed during a partial meniscectomy can increase stress and friction inside that knee for the rest of your life.
Perimeniscal injections: a new gold standard for meniscus tear treatment. Perimeniscal injections offer a promising new pathway in the conservative management of degenerative meniscus tears. Degenerative meniscus tears are a common cause of persistent knee pain, especially in ageing and active populations.
Understand exactly what surgery is planned, along with the risks, benefits, and other options. If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.)
General Guidelines/Precautions: Patient will be placed in a hinged knee brace locked in full extension immediately post operatively. Patient will be non-weight bearing for 6 weeks immediately following surgery unless otherwise directed.
While injections temporarily reduce pain, they will not help heal the meniscus tear. Researchers have been developing stem-cell therapies that may help heal the injured tissue.
In general, especially after an injury, cold is probably going to feel better. When you have a meniscus tear and arthritis, you tend you have swelling and pain from inflammation. Cold helps decrease swelling and inflammation. If heat feels better on your knee, however, there's no downside to using it.
What causes pain behind the knee? There are many different causes of posterior knee pain, including injury, inflammation or infection of the knee joint, overuse, wear and tear with age, osteoarthritis, rheumatoid arthritis, cysts or in very rare cases, cancer. Leg cramps occur when your leg muscles tighten up.
If a meniscus suture is performed, the operated leg may only be partially loaded for a few weeks to allow the meniscus tear to heal. Depending on the shape of the tear, forearm support crutches should be used for 4-6 weeks.
Meniscus Bucket Handle Tear
A bucket handle tear is a severe form of a vertical tear. In this case, a large portion of the meniscus flips inward into the knee joint, making it difficult to bend or straighten the knee. It often causes locking and typically requires surgery to correct.
New advances now offer patients less invasive options that encourage the meniscus to heal itself. Two promising techniques are arthroscopic meniscus repair combined with biologic therapies, and the use of biomaterial scaffolds.
Depending on the type of procedure you received, some patients may be unable to walk (and therefore climb stairs) for up to six weeks. You may need to stay off your knee completely for a few days after surgery. After that, you will likely be encouraged by your doctor to bear some weight and move around.
Most meniscus repair surgeries require two to four weeks on crutches with a knee brace for the first six weeks. Physical therapy starts right away to help the knee regain range of motion. Most patients are out of the brace by six to eight weeks.
Most patients use crutches for two to six weeks after surgery. The exact duration depends on your personal recovery progress, muscle strength, balance, and doctor or physiotherapist recommendations. Returning to unaided walking too soon can increase your risk of falls or joint problems.
Three signs that you may have a torn cartilage (meniscus tear) are: Pain along the sides of the joint, or pain in the back of the knee which moves towards the back of the calf. The pain is usually worse when you put weight on the knee. It may be aggravated with twisting movements.
Your vital signs, like your heart rate and blood pressure, will be monitored during the operation. You may have a breathing tube inserted down your throat during the operation to help you breathe. After cleaning the affected area, your surgeon will make a small incision through the skin and muscle of your knee.
Corticosteroid Injections
Although corticosteroids injected directly into the knee do not heal a meniscus tear, they may reduce swelling and discomfort. Some people may experience long-lasting relief. Your doctor may inject a small amount of anesthetic into the knee along with corticosteroids.
The most common side effect is mild pain and swelling at the injection site that goes away on its own. About 1% of people have a more severe reaction called an injection flare. It causes fluid to accumulate in the joint, with significant swelling and pain.
How many treatments do you need? One to three treatments depending on the degree of injury and how long the injury has been there. These are typically done about 4-6 weeks apart in order to achieve optimal results.