Meniscus repair is a specialised surgical procedure aimed at restoring the functionality of the meniscus, a crucial cartilage in the knee joint. This intricate structure provides stability and cushioning, and when damaged, prompt intervention is essential to prevent further complications.
The main goal of meniscal repair surgery is to repair the torn meniscus and promote healing, thereby preserving the structure and function of the knee joint. By repairing the meniscus, the surgery aims to alleviate pain, improve knee stability, and prevent further damage to the joint.
Meniscal repair surgery is typically performed arthroscopically, using small incisions and specialised instruments. During the procedure, the surgeon will examine the inside of the knee joint using a tiny camera called an arthroscope. The torn meniscus is then repaired using sutures, anchors, or other fixation devices to hold the torn edges together while healing occurs.
Dr Shales uses various techniques to both repair the meniscus and to encourage it to heal. This decision is based on the size, type and location of the tear.
Techniques include:
- All inside: All the sutures are passed and kept inside of the knee.
- Inside – out: Sutures are placed from inside the knee outwards exiting the skin. A small incision is required where the suture exits to be able to tie off the sutures.
- Outside-In: Using a separate small incision sutures are passed from outside of the knee to the inside through the torn part of the meniscus to help repair.
Techniques to increase healing rates involve creating the best environment for healing potential. These include:
- Synovial perforation: The lining of the knee is needled or stirred up to encourage bleeding within the knee
- Marrow Venting: Small holes in the bone are made to allow blood and bone marrow full of healing factors to enter the joint and torn meniscus
- Blood Clot Augmentation: Your own blood is drawn and prepared into a workable clot. This is then passed into the tear of the meniscus and sutured in to delivery the healing properties directly to the tear itself.
Before undergoing meniscal repair surgery, patients will typically undergo a thorough evaluation, including physical examination, imaging studies (such as MRI), and medical history review. Preparing for surgery may involve:
- Consulting with the surgeon to discuss the procedure, risks, and expected outcomes.
- Following any preoperative instructions regarding medications, fasting, and hygiene.
- Planning for postoperative care and rehabilitation.
Following meniscal repair surgery, patients will need to rest and elevate the affected leg to reduce swelling and promote healing. Physiotherapy may be initiated soon after surgery to restore knee strength, flexibility, and function. Recovery timelines vary depending on the extent of the injury and the type of repair performed, but most patients can expect gradual improvement over several weeks to months.
Rehabilitation plays a crucial role in the success of meniscal repair surgery. Physiotherapy exercises are designed to strengthen the muscles surrounding the knee, improve joint stability, and enhance range of motion. Patients will work closely with a physiotherapist to progress through a structured rehabilitation program tailored to their specific needs and goals.
While meniscal repair surgery is generally safe and effective, it carries certain risks and potential complications, including:
- Infection
- Blood clots
- Nerve or blood vessel damage
- Persistent pain or stiffness
- Failure of the repair to heal
Patients should discuss these risks with Dr Shales and seek prompt medical attention if they experience any concerning symptoms after surgery.
The success rate of meniscal repair surgery depends on various factors, including the type and location of the tear, the patient's age and overall health, and adherence to rehabilitation protocols. With proper treatment and rehabilitation, many patients experience significant pain relief, improved knee function, and a return to their normal activities and sports.
Meniscal repair surgery is a valuable treatment option for individuals with symptomatic meniscal tears, aiming to preserve joint function and prevent long-term complications. By understanding the surgical process, preparing adequately, and actively participating in rehabilitation, patients can optimise their outcomes and regain confidence in their knee health.
Here are a number of the questions we often get asked.
The duration of surgery varies depending on the extent of the tear and the complexity of the repair. On average, it may take approximately one hour.
The recovery timeline varies based on the extent and type of meniscal injury, as well as the chosen repair technique. While some patients may resume light activities within a few weeks, full recovery may take several weeks to months. Rehabilitation exercises and adherence to post-operative care are crucial for optimal recovery.
