Meniscectomy

What is the meniscus?

The meniscus is a shock-absorbing pad of cartilage in the knee that lubricates, supports and protects the bones in the knee joint. There are two menisci in each knee, one on the inner edge and the other on the outer edge of the knee. The menisci perform critical functions including stability during range of motion, even distribution of weight on the knee bones for balance and proprioception, and smooth movement in many directions. 

What is a meniscus tear?

Meniscus tears are common sports injuries in athletes, especially those who play contact sports like football and hockey.  Sports-related tears frequently occur along with other knee injuries, including an ACL injury. The meniscus can tear in a single incident often due to twisting the knee with a planted foot or a sudden change of direction. Deep squats with weights or getting kicked in the knee can also tear the meniscus. This is called a traumatic tear. A meniscus tear can also result from wear and tear on the knee over time as you age. These are called degenerative tears. When someone says they have torn cartilage in the knee they are often referring to a torn meniscus.

Symptoms include:

• A popping sound when the meniscus tears.
• The pain may worsen when the knee is bent.
• Swelling, clicking, stiffness and catching in the knee.
• A feeling the knee is giving way.
• It may be difficult to walk, or do a deep knee bend, and you may be unable to straighten the knee without pain.

What are the types of meniscus tears?

The type of menisci tear depends on its location and the physical attributes of the tear. There are several types such as bucket handle tears, flap tears and radial tears.

Your orthopedic consultation

At your orthopedic consultation Dr. Hackett will discuss your symptoms and medical history.  During the physical exam, he will check for tenderness which helps diagnose a tear. The McMurray test is often used to diagnose meniscus tears. During this test the doctor will bend and straighten the knee and rotate it. If a tear exists, these movements will cause a clicking sound.

Imaging tests will be ordered to confirm the diagnosis since the symptoms of a meniscus tear are also symptoms of other common knee problems. X-rays can show other causes of knee pain, while an MRI will show soft tissue damage and can confirm the diagnosis.

What are the treatment options for a torn meniscus?

Dr. Hackett will consider your symptoms, age and activity level and the location and size of the tear when determining your treatment options. Treatment options include conservative management, surgical repair of the tear, partial removal of the torn part of the meniscus, and complete removal.

When the tear is in an area with good blood supply conservative management will allow the tear to heal. When the tear is in an area with poor blood supply it cannot heal or grow back together. Dr. Hackett will recommend a surgical trimming of the cartilage called a partial meniscectomy. The goal is to stabilize the meniscus by removing as little of the meniscus as possible.

Surgery may be recommended when:

• conservative management has been tried and failed to resolve symptoms
• the knee joint is locked due to pieces of the meniscus caught in the joint, and
• the knee joint is unstable.

The meniscus is a necessary structure vital for biomechanical function. A meniscus injury is a major cause of functional impairment in the knee. The goal of meniscus surgery is to relieve pain and instability and preserve the joint.

What is a meniscectomy?

A meniscectomy is an arthroscopic surgical procedure that removes the meniscus or trims the damaged meniscus tissue. Removal of the entire meniscus is called a total meniscectomy, but this is only recommended when necessary, since removal frequently leads to the development of knee arthritis.

Removal of damaged parts is called a partial meniscectomy. A partial meniscectomy is very successful in reducing symptoms and restoring function.

Most of the time, a meniscectomy is arthroscopic surgery using a small, thin tube that contains a camera. It is inserted into the knee joint to examine and repair the meniscus. Small tools are inserted into small incisions for repair. This less invasive surgery will limit damage to the surrounding tissues, which helps to promote fast and complete recovery. It is usually an outpatient surgery. Physical therapy will be recommended. Most patients are able to fully recover and return to normal activity within 2-4 weeks.

Every patient’s case is unique. Dr. Hackett will explain his recommended treatment options and listen to your concerns. Contact him to schedule a consultation and get an accurate diagnosis and all your treatment options.