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Meniscectomy

Definition

Removal of all or part of a damaged cartilage, called the meniscus, in the knee. The meniscus helps to stabilize the joint.

Arthroscopic Meniscectomy

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Parts of the Body Involved

Meniscectomy is performed on the knee.

Reasons for Procedure

  • To prevent permanent damage to the knee joint
  • To alleviate discomfort caused by injured cartilage and increase function
  • Usually, only persistently symptomatic menisceal injuries are referred for surgery

Risk Factors for Complications During the Procedure

  • Smoking
  • Poor nutrition
  • History of blood clots
  • Recent or chronic illness
  • Use of certain medications

What to Expect

Prior to Procedure

Your doctor will likely do the following:

  • Medical history
  • Physical exam
  • X-ray of both knees
  • MRI scan—a test that uses a strong magnetic field to make pictures of the inside of the knee
  • Blood test

During Procedure

Anesthesia and/or sedation will be administered.

Anesthesia

Local, spinal, or general anesthesia will be used depending on individual procedure.

Description of the Procedure

There are two methods for meniscectomy, arthroscopy and the open technique called arthrotomy, which is rarely used today.

Arthroscopy: A small incision is made into the knee, and a fiberoptic instrument used to view the surgical area is inserted into this incision. The surgeon makes another incision through which to insert small instruments to either repair (sew back together using tiny stitches) or remove the damaged meniscus. Whenever possible, the surgeon will remove only the damaged portion of cartilage, rather than all of the cartilage. A drain may be inserted through an additional incision, to drain away fluid. The incisions are closed with stitches, which are usually removed in the surgeon's office one week later.

Open meniscectomy/arthrotomy: A larger incision is made, which exposes the interior of the knee. This involves cutting through more skin and muscle than for an arthroscopy, and generally results in a longer recovery period. This technique is usually reserved for more complicated situations, such as associated bone fracture or ligament damage.

How Long Will It Take?

An arthroscopy usually takes less than one hour, but this varies.

Will It Hurt?

Anesthesia prevents pain during the procedure. You'll likely have pain during recovery for which your doctor may prescribe pain medication or recommend over-the-counter drugs.

Possible Complications

  • Persistent swelling
  • Excessive bleeding
  • Infection
  • Blood clot in the calf
  • Chronic weakness in knee joint
  • Exacerbated or unchanged pain

Average Hospital Stay

None, this procedure is usually done on an outpatient basis.

Postoperative Care

  • Reduce swelling by using compression and ice for 48 to 72 hours after surgery.
  • Move and elevate legs often while resting in bed.
  • Use crutches for the first few days following surgery, with only partial weight bearing on the operated leg.
  • Do rehabilitative exercises as recommended by your surgeon.
  • Take pain medications and antibiotics (to prevent infection) as recommended by your doctor.

Outcome

Physical rehabilitation will be required after surgery. If the meniscus was removed, it generally takes three to six weeks to return to full activities, and if the cartilage was repaired, it can take up to four months for full recovery. The goal of the first week is to reduce pain and swelling, and after this, the goals are to increase range of motion and weight-bearing. Most patients begin performing simple thigh muscle exercises the day after surgery, and more strengthening exercises are added later. Surgeons and rehabilitation physicians (physiatrists) often recommend physical therapy sessions several times a week for four weeks or more, depending on the individual.

At 6 to 8 weeks, low impact activities can often be added, in preparation for return to sport or activity. Running, cutting, and rotation are avoided usually for at least 16 weeks.

Call Your Doctor If Any of the Following Occurs

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
  • Cold, discolored, or numb toes
  • Calf pain
  • Cough, shortness of breath, chest pain, or severe nausea or vomiting
  • New, unexplained symptoms

RESOURCES:

American Academy of Orthopaedic Surgeons
http://orthoinfo.aaos.org

National Library of Medicine
http://www.nlm.nih.gov/

CANADIAN RESOURCES:

Canada Health Network
http://www.canadian-health-network.ca/

Physical Therapy Canada
http://www.physicaltherapy.ca/

References:

American Academy of Orthopaedic Surgeons website. Available at: http://www.aaos.org .

Lento P, Akuthota V. Frontera: Essentials of Physical Medicine and Rehabilitation. 1st ed. Philadelphia; Hanley and Belfus; 2002. Ch. 66.



Last reviewed December 2007 by John C. Keel, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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