Meniscal Repair Surgery
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Meniscal repair surgery is a type of orthopaedic surgery that repairs the meniscus in the knee. The menisci in the knee act as shock absorbers and can be torn or damaged, causing pain and some mobility issues. Meniscal repair surgery can greatly reduce these symptoms for patients that are a good candidate for surgery.
Why have meniscal repair surgery?
Preservation of healthy meniscal tissue is often one of the primary goals of meniscus repair surgery. This is particularly motivating for active patients who may be sidelined because of their knee pain caused by injury to their meniscus.
Generally, patients are a better fit for surgery if they are younger and very active with tears located on the outer edge of the meniscus. This is because the outer parts of the meniscus have a much better blood supply than the inner portion.
A stronger blood supply means there is a much higher likelihood the tear will heal on its own after surgery with the aid of dissolvable sutures to keep it in the correct place.
You may be recommended for meniscus surgery if:
- Your knee becomes misaligned or feels unstable
- Your knee locks up when you move
- You have strong muscles in your legs or are able to build their strength before surgery
- You are a very active person or activity is important for you
- You have a physical or active job and immobility would negatively affect your income
- The meniscus injury has not healed or responded to non-surgical treatments
- You are able to adhere to a strict physiotherapy regimen
- You have healthy meniscus tissue with a strong blood supply
How is meniscal repair surgery performed?
While more traditional and invasive techniques are sometimes used to perform meniscus repair, arthroscopic methods are very popular currently.
Arthroscopic surgery, also called keyhole surgery, is far less invasive and associated with shorter healing times compared to more invasive methods. This article focuses only on the procedure of arthroscopic meniscus repair surgery.
Generally, arthroscopic meniscal repair takes anywhere from 30 minutes to one hour to complete.
The length of the surgery varies from patient to patient because there are many different ways to correct or address a meniscus injury depending on where the injury is located.
Arthroscopy is a very versatile surgical technique that can address and/or diagnose many knee injuries or joint diseases so the length of the operation varies from patient to patient.
Your surgeon will walk you through the exact steps they will take during your meniscal repair before your day of surgery (likely during a preoperative assessment).
Types of meniscal repair Incisions
Arthroscopy is a low-invasive surgery technique that requires just 3 small incisions on and surrounding the knee.
Below is a photo of a patient’s knee shortly after arthroscopy surgery before the stitches were removed.
Depending on the exact techniques your surgeon will use, the placement of the incisions can differ from the placement of the incisions in this photo.
Surgical Techniques for Meniscal Repair
After the incisions are made on the knee, surgical instruments and a camera with light are inserted into the knee as seen in the diagram below.
The joint is filled with sterile water via the instrument labelled cannula in the diagram. Filling the joint with water allows the camera to get a better view of the joint. The water also allows the surgical tools more room to move.
The surgeon then accesses the meniscus and joint via a screen showing what the camera is capturing inside the knee.
After seeing the meniscus damage, there are a number of ways the surgeon can proceed.
Depending on their diagnosis, the surgeon can:
- Reshape the existing meniscus and smooth any tears to make movement easier
- Remove damaged parts of the meniscus to make movement easier
- Repair tears in the outer portion of the meniscus with dissolvable sutures to aid in healing
- Completely remove the meniscus, also called a meniscectomy
Once the surgeon is happy with their work, they remove the water and any debris from the knee with the cannula.
When all the instruments are removed from the knee, the incisions are closed and the operation is complete.
After Meniscal Repair
Most patients are able to go home the same day as their meniscal repair procedure providing the surgeon is happy with their recovery and deem it safe to do so.
As meniscal repair is often used to diagnose knee injury or disease, the surgeon will share results and further treatment options during a postoperative appointment.
Physiotherapy may also be prescribed to some patients after arthroscopic meniscus repair surgery. It is vital you follow the advice and exercise or stretching plan given to you by your physiotherapist and surgeon. Everything they request you do is necessary to get the best results possible from your meniscal repair.
Potential Risks & Complications Related to meniscal repair Surgery
As with all surgical procedures, there are potential risks and complications that you should be aware of. General risks associated with surgery include blood clots, complications related to anaesthesia, nausea, vomiting, and pain at the location of the operation.
The risks and complications associated with meniscal repair include:
- Swelling and bruising of the knee
- Excessive bleeding
- Damage to surrounding nerves, tendons or other structures surrounding the knee
It is important that you understand the potential risks and complications before agreeing to any procedure. Your surgeon will be happy to discuss these in full with you ahead of your operation or at any step along the way.
Why choose Medbelle for your meniscal repair Surgery?
Medbelle is a private orthopaedic surgery provider. When compared to public options, there are many reasons to choose a private orthopaedic option, including radically shorter waiting times, more choice and flexibility regarding appointments and rescheduling as well as an overall more individualised experience.
Choosing Medbelle also comes with some specific benefits compared to other private orthopaedic care options.
Along with waiting times as short as a few weeks, you’re guaranteed individualised care with Medbelle because of our Patient Care Advisers.
You are assigned to a Patient Care Adviser as soon as you contact Medbelle, and they remain your main point of contact throughout your orthopaedic surgery journey. They are always there to answer your questions and they also take care of scheduling and rescheduling appointments for you.
Medbelle wants to remove as much stress as possible from orthopaedic surgery for every patient.
Our flexible finance options are another way we’re making orthopaedic surgery better for patients. Despite the benefits, the cost of orthopaedic surgery can be prohibitive. Financing is the perfect way to break the price of your meniscal repair into budget-friendly monthly payments so you can get back to feeling your best without having to fret over the price.
Preparing for Your Treatment
How Can I Prepare for Meniscal Repair Surgery?
To prepare your knee for surgery and recovery, you may be prescribed a course of physiotherapy that will help ensure the muscles in your leg are as strong as they can be. Leg strength and overall good health are a great way to give yourself the best chance at the quickest and easiest recovery possible.
It is very important you do not take ibuprofen or medicines in the Nsaid category for at least 1 to 2 weeks before the operation because they are related to an increased risk of excessive bleeding during and after surgery. You may also need to avoid taking them for a period after surgery. Your surgeon will give you specific advice on this.
You will likely be advised by your surgeon to stop smoking or using any nicotine products for at least 2 weeks before surgery and throughout your recovery. This is because nicotine restricts blood flow which can delay healing and lead to less than perfect results.
You may be advised not to shave your knee before surgery. Shaving causes microscopic damage to the skin which can harbour bacteria. This can put you at a higher risk of infection.
What Can I Expect After Meniscal Repair Surgery?
Please also see ‘is there anything I need to do in the first 24 hours?’
Depending on the technique used during your meniscus repair surgery, you will be advised not to bear weight on your knee for some time. This may last for several weeks. To make your daily life easier, you will be given a mobility aid like crutches to use during this period. You will also be given advice on how to gradually reduce the amount of time you use them as you recover.
You may be required to wear a brace on your knee for between 4 to 6 weeks after surgery, especially if other knee repairs were performed on your knee. Wearing the brace helps ensure your knee only flexes a certain amount and prevents injury. Your surgeon or physiotherapist will set this brace and it is very important you do not alter the settings yourself.
You will be given guidance on how to perform day-to-day activities with the brace, for example, using stairs, the ideal sleeping posture, and how to bathe.
A physiotherapy programme will be individually designed for you and your needs after meniscus repair surgery. This will likely last between 2 and 6 months. This programme is vital to how you recover and how well your knee functions in the long-term.
You will likely have gentle exercises to do at home before physiotherapy starts. These may include things like walking with your mobility aid. A typical physiotherapy programme begins a 1 or 2 weeks after surgery.
Rehabilitation after a meniscectomy is often intensive to ensure the internal structures of the knee are not over-protected as they heal. Some programmes may also include hydrotherapy meaning exercises are performed in a pool to reduce strain on the joint.
Course contents will vary depending on your needs, but all physiotherapy programmes focus on:
- Building strength in the leg muscles
- Ensuring the knee’s range of movement as good as possible
- Keeping you and your knee active
Wound Care, Ice Packs, and Wound Dressings
You will have a wound dressing and a bandage on your knee when you wake up from surgery. It is important that you keep these clean and do not get them wet or remove them yourself.
Wounds are usually closed with stitches or staples. If staples or non-dissolvable stitches are used, you will be given an appointment to see your surgeon 7 to 14 days later to have them removed. Sterilised wound tape is often used after this to support the skin as it heals completely.
You may be advised to apply ice packs or special ice dressings to your knee after surgery to help reduce swelling. Take care not to keep ice in contact with your bare skin.
Showering and Bathing
You may be advised to use a special plastic cover on your leg when you shower to prevent the wounds on your knee from getting wet. You will likely be advised not to wash your wounds until they are healed. After this point, often gentle soap and clean water are all that is needed to clean them. Carefully pat (never rub) wounds dry with a clean towel after bathing.
You will likely experience some pain and discomfort after your meniscus repair surgery. This is normal after a surgical procedure and you will be given advice on how to manage the pain. You may be given medication to take home with you or be advised on the best type of pain-relief to use as you recover.
How will I feel after surgery?
It is normal to experience some pain both after surgery and during recovery, but this should ease over time. Your surgeon will give you advice on what pain relievers are suitable for you as you may need to avoid ibuprofen and similar drugs because of bleeding risk.
Surgery can be quite tiring emotionally and physically so it is normal to feel tired and out of sorts for some time after. Anaesthesia, especially general anaesthesia, may add to these feelings as it can take several days to ensure the effects are completely worn off.
Is there anything I need to do in the first 24 hours after meniscal repair surgery?
Some patients are able to go home on the day of surgery, but others may need to stay a night in hospital. As anaesthesia can affect your judgement and coordination for up to 48 hours after surgery, you must arrange for someone to take you home from hospital and to stay with for at least the first 24 hours.
After this, you will likely need a friend or family member to help you take care of yourself as well as any dependents such as children or pets for some time because your mobility will be limited.
Before going home you will be given a mobility aid like crutches and you may be fitted for a brace. You will be given explanations on how to use these things as well as advice on how to safely do daily activities like washing and driving.
To help prevent blood clots you will be advised on special exercises and be fitted for compression socks. Some people may need injections to help thin the blood. You or someone who is caring for you will be shown how to do this.
Elevation and icing is a vital part of recovery and you will be given an icing schedule to follow.
Everything you need to know or do in the first 24 hours after surgery will be explained to you by your surgical team in the hospital before you are discharged. Always follow the advice given to you by your surgeon or their team.
How much time do I need to take off work?
When you go back to work will depend largely on the kind of meniscus surgery you had and what you do for work. For a sedentary position that mainly involves sitting at a desk, you may be able to return after 2 to 3 weeks. More strenuous jobs that involve standing or walking may require a 4 to 6 week break. Jobs involving manual work, physical labour, or a long journey to work may need to be avoided for anywhere between 3 and 6 months.
When can I return to exercise and sport?
The length of time it takes to return to sports or physical activity varies from person to person and is largely dependant on the type of meniscus surgery performed. A period of 3 to 6 months is expected for a typical patient. Elite athletes may need to take 8 to 12 months or longer to return to competitive training.
What other points should I consider?
Your surgeon will advise you not to drive for some time after surgery. Driving against your surgeon’s advice may impact your insurance coverage. Often it is recommended that you do not drive for several weeks or until you are able to bear weight comfortably on your knee.