The meniscus is a patch of soft tissue which is sandwiched within the knee joint. These vital tissues can become problematic over time due to their location in the body and load-bearing purposes.
The symptoms of meniscus issues tend to require surgical intervention. While these surgeries can help return a knee to normal function, they may interfere with the person’s lifestyle. These issues may be helped through adequate research, extensive preparation, and the application of regenerative therapies.
Anatomy of the Meniscus
There are two menisci, oval-shaped cartilage disks which are wedged between the upper leg (thigh bone/femur) and lower leg (shin bone/tibia) that make up the knee joint. One of these disks rests on the inner (medial) side of the knee joint, and the other sits on the outer (lateral) side. The patella (knee cap) is positioned at the front of the knee and slightly above both the menisci.
Together these disks act as shock absorbers, minimizing the stress our knees face from the constant pressure we place on them. Most importantly, the menisci help ensure that the articular cartilage which coats the bones stays intact, for if this thin layer of cartilage degrades, pain, instability, and a host of other symptoms may occur.
In addition to these protective elements, the menisci also improve the stability of the knee. Their placement on either side of the knee joint prevents awkward motions which are outside of the normal range of knee movement. In a way, they act similar to blocks you might place behind a tire to stop a car from slipping out of place.
When a meniscal tear occurs, due to acute injury of the knee or simple age-related degeneration, the tear usually leads to a range of problems.
A person with a tear in their meniscus may experience:
- Pain, especially when the knee bears weight or the outer knee is touched
- Popping and clicking sensations
- Reduced range of motion
- Knee locking or “catching”
- Knee instability
As the meniscal tear worsens, the symptoms will become a chronic issue. Unfortunately, meniscal tears are incapable of fully healing on their own or with conservative (non-invasive) treatment. Thus, one option many turn to once a meniscal tear is diagnosed is surgical intervention.
Before surgery can take place, a doctor must fully qualify and diagnose a person’s meniscal tear.
Meniscus Tear Diagnosis
Patients who believe they would benefit from surgery for their meniscus tear must first approach their symptoms conservatively. Depending on the severity of the tear, over-the-counter medication and physical therapy may be recommended for first-round treatments.
If these fail to restore function or reduce symptoms, doctors will move on to a second, more-extensive diagnostic procedure before recommending the patient for surgery.
Physical exam and medical history
Before any doctor-sponsored intervention takes place, a physical exam and medical history report must be prepared. The doctor will talk to their patient about their symptoms and look through past medical reports in order to reduce the probability that other conditions may be causing the symptoms.
The doctor will examine the knee, test the limits of the knee’s inner and outer range of motion, and palpate (apply pressure) around the knee. They may rotate the knee or ask the patient to stand on the affected leg while turning their body as well.
If these tests come out positive and if medical history indicates an issue, then doctors will move on to medical imaging to get an inside view of the knee joint and its structures.
Imaging tests are ordered to confirm the suspicion of a meniscal tear. These include:
- X-ray: While these tests do not show the meniscus, they will be used to identify issues with the bones of the knee in order to determine if another issue such as osteoarthritis is linked to the patient’s pain.
- MRI: By using magnetic fields and image capturing devices, doctors can examine the health of the soft tissues within the knee with an MRI. While these tests are helpful, they may be a bit unreliable as certain structures within the knee may resemble a meniscus tear. Using MRIs in addition to other tests listed here will help ensure that a meniscus tear is in fact the issue.
- Ultrasound: These tests use soundwaves to create a map of the soft and hard structures of the knee. Doctors can determine if soft tissues are in their proper location or if some may be getting caught in the knee joint during movement.
- Arthroscopy: The most invasive of these tests, but by far the most accurate. If doctors cannot determine the state of the meniscus using the above-mentioned conservative imaging techniques, they will create an incision in the knee and place a small camera within the incision. This technique gives doctors a crystal-clear image of the condition of the meniscus and will eliminate any other probable cause.
With other possibilities eliminated and conservative treatments failed, surgical intervention is ultimately the last option. While many patients opt for this treatment, quite a few come into surgery unprepared for what to expect.
Be sure to research and ask a healthcare professional before choosing to apply any type of surgical intervention to a health issue.
Meniscus Tear Surgery Recovery Timeline
Surgery for meniscal tears is minimally invasive, though recovery times can be surprisingly long. Additionally, while certain symptoms are often reduced, overall success is highly subjective to the individual patient.
Despite these concerns, many patients still opt for surgery. In order to ensure the highest degree of success, patients should be as prepared as possible. Below, we’ve outlined some critical points in the surgical process and what to expect once the surgical intervention has taken place.
Be sure to talk to your doctor about any concerns you have, and any questions raised while studying the following notes.
- Preparing for Meniscus Tear Surgery: Successful surgeries begin with adequate preparation. These preliminary steps help ensure patient safety and may be critical in determining the outcome of the meniscus repair surgery.
- Schedule bloodwork to reduce outside risks such as aversion to anesthetics or uncover any unknown blood or autoimmune disorders.
- Arrange for a ride to and from the hospital. Patients undergoing meniscus tear surgery will be prescribed medications that may prevent them from driving, it is best to have options when going to and from the hospital.
- Prepare a small parcel of luggage for about two- or three days’ worth of trip. Toiletries, entertainment, and clothes may be necessary for the hospital stay.
- Follow your doctor’s order completely. If they give a timeline to refrain from eating or drinking, it is important to follow these guidelines as anesthetics may interfere with the body’s natural digestive processes leading to complications during surgery.
- Maintaining an adequate sleep schedule can help boost the body’s resilience to post-surgical pain and may amplify its healing processes as well.
- Once all preparatory steps are complete, make sure to check into the hospital in a timely manner to ensure doctors have enough time to go through their pre-surgical procedures.
- The Procedure: Meniscus tear surgery is typically performed through the aid of minimally invasive tools such as an arthroscope. Surgery may take a couple of hours, after which doctors will monitor the patient’s vital signs to ensure the body has responded to surgery well.
- Patients are typically placed under anesthetic before surgery, causing the patient to become medically unconscious.
- Doctors will begin the surgery with small incisions in the knee followed by the insertion of a tiny device known as an arthroscope. The arthroscope creates a small tunnel that burrows through the knee, pushing away surrounding tissues.
- The doctors can place several small tools within the arthroscope to both see what they’re working on as well operate on the tissues directly.
- Depending on the condition of the meniscus, the doctor will remove small portions of it or the entire thing if its condition is unacceptable.
- Once the surgery is finished, doctors will remove the arthroscope and close the incisions.
- First Few Hours After Surgery: Anesthetic will be applied routinely throughout the first few hours after the surgery. Doctors will monitor vital signs to ensure the surgery was successful. Typically, meniscal surgery is very low-risk and complications are rare.
- 1-2 Days After Surgery: Hospitalization for meniscus surgery is typically short. While regular functionality isn’t immediate, patients will be asked to move the knee within 1-2 days after surgery.
- A physical therapist will be assigned to you and begin a routine of light exercise to help stabilize the knee.
- Assisted standing and walking may be asked of you during the sessions immediately following surgery.
- In some cases, patients may be asked to perform these light tasks on the same day of their surgery.
- One Week Post Operation: Patient activity levels will gradually be increased.
- Once the patient is home, they will be asked to follow the routines their physical therapist taught them as well as apply any medication the doctors have prescribed.
- Creams, ointments, and medication should be taken as routinely as the doctors have prescribed and activity levels should be moderate.
- Simple physical therapy such as massage and hot/cold treatments can be applied if medication and rest do not help alleviate post-surgical pain. Consult a doctor if the pain becomes excruciating or if you suffer knee injury immediately following surgery.
- One Month Post Operation: Light activities can resume, and physical therapy may intensify.
- At this point, the surgical wounds should be healed and normal activity levels should resume with minimal pain and discomfort.
- Extended use may cause flare-ups of pain, but these bouts of pain should wane over time as the wounds fully recover.
- One Year Post Operation: By this time the surgical pains should be gone, and normal activity levels should return. While pain and discomfort may still be present, these pains should be minimal and should not prevent functionality.
Regenerative Therapy and Meniscus Tear Surgery Recovery
The recovery period for meniscus tear surgery is 6 weeks to 3 months, and patient discomfort may last for periods upwards of 6 months as they acclimate to their new condition. Conservative treatments such as medication, physical therapy, and the use of assisted walking devices such as braces or canes may help, but ultimately, their effects are minimal when compared with regenerative therapies.
By applying regenerative therapies such as platelet-rich plasma (PRP) or autologous stem cell injections after surgery, recovery times for meniscal tear surgery may be reduced. These treatments can offer relief from symptoms as well as amplify the body’s natural healing responses.
PRP injections use one of the body’s natural healing factors (platelets) to boost the body’s natural healing mechanisms. By harvesting and concentrating the platelets we can deliver 10 different growth factors to aid the healing post-operatively.
Additionally, autologous stem cell injections can help provide an environment around damaged tissues which helps increase the body’s recovery/healing response. The source material for these injections is taken directly from the patient’s own healthy tissues. Fat and bone marrow can be processed with new methods into concentrated, stem cell-rich tissue developed within the last decade.
By injecting these adult stem cells into the site of an injury, the cells can aid in the repair and recovery of the damaged tissues. Combining both of these therapies provides relief from symptoms, boosts the healing processes, and decreases recovery time overall.