The knee joint is made up of the ends of the femur (thigh bone) and tibia (shin bone). The meniscus is a rubbery, C-shaped disc that cushions your knee. It also helps to protect the cartilage in the knee. Each knee has two menisci - one at the outer edge of the knee and one at the inner edge.
The menisci function as shock absorbers in the knee and also help to maintain stability within the knee. Injuries to the meniscus can occur after acute traumatic injuries or chronic repetitive injuries. Meniscus injuries can result in pain, swelling and stiffness of the joint.
The diagnosis of a meniscus injury within the knee is made after a thorough clinical assessment of the knee. MRI scans are done to confirm the diagnosis and to look for concomitant knee injuries, such as ligament tears and cartilage injuries.
Patients with small meniscus tears may be treated non-surgically with a course of rehabilitation. However, patients with large or displaced meniscal tears, who develop persistent pain, swelling and loss of joint function, are candidates for surgical treatment.
Surgical treatment involves minimally invasive knee arthroscopy (or keyhole surgery) and includes the following options:
Meniscus repair (See Figures below)
Given its important function within the knee, meniscus tears should be repaired as far as possible. The meniscus is repaired by placing fine sutures within its substance to keep it together while it heals.
Sometimes the meniscus tear is so severe that it precludes a repair. In this instance, the torn non-functional part of the meniscus is removed using specialized instruments
In patients who develop pain in their knee because most or all of the meniscus has been removed, meniscus tissue from a donor (allograft) may be transplanted into the knee to replace the deficient meniscus.
At the same time, concomitant ligament and cartilage injuries may need to be addressed. Such surgery is usually performed under general anaesthesia and takes about 1-2 hours. An overnight stay in hospital is usually required after the surgery and 4-6 weeks of crutch-assisted ambulation may be advised.
The rehabilitation process after the surgery is generally supervised by a physiotherapist, and consists of progressive knee range of motion exercises, muscle strengthening exercises, and sport-specific drills. The whole rehabilitation process may last to 4-6 months following the procedure. The success rate of meniscus surgery has been reported to be about 80-90%. The complications of this procedure include infection, meniscus retears and future osteoarthritis (if meniscectomy is performed).
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