The meniscus is a patch of soft tissue which is sandwiched within the knee joint. These vital tissues can become problematic overtime due to their relative location and load-bearing purposes.
Often, 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.
The menisci are two ovular-shaped cartilage disks which are wedged between the upper (thigh bone/femur) and lower (shin bone/tibia) leg bones which make up the knee joint. One of these disks rests on the inner (medial) side of the knee joint (the portion which faces the other leg), and the other sits on the outer (lateral) side.
Together these disks act as shock absorbers, minimizing the stress our knees face from the constant weight we press 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. By resting on either side of the knee joint, the menisci help prevent awkward motions which are outside of the outer 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 – be it do 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 deepens, the symptoms will become a chronic issue. Unfortunately, meniscal tears are incapable of fully healing on their own, even with conservative 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. Over-the-counter medication and physical therapy are popular 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.
A physical exam is soon to follow. The doctor will examine the knee, test the outer limits of the knee’s inner and outer (closer to and away from the other leg) range of motion, and palpate (apply pressure) around the knee. They may rotate the knee or ask the patient to stand on their knee 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 in order 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 the meniscus is in fact the issue.
- Ultrasound: These tests use soundwaves to create a map of the soft and hard structures of the knee. They can doctors 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 is the arthroscopy. 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 throughout the year, 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 are particularly long. Additionally, while certain symptoms may be reduced, success is highly objective.
Despite these concerns, many patients still opt for surgery, thus, 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 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 hip replacement.
- 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 which 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 doctors order to a tee. 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.
- You may want to look at donating some of your blood in the weeks leading up to surgery as hip replacement may require a blood transfusion. Consult your doctor to see if this may be an option.
- 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 responded to surgery well.
- Patients are typically placed under anesthetic until they fall asleep before surgery.
- 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 small tunnel which 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 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: Recovery for meniscus surgery surgery is typically short. While regular functionality isn’t immediate, patients will be asked to move 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, and the patient will be released upon approval by the physical therapist.
- 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 does not help alleviate post-surgical pain. Consult a doctor if pain becomes excruciating or if you suffer hip injury immediately following replacement 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, albeit with minimal pain and discomfort.
- Extended use may cause flare-ups of pain, but these bouts of pain should wane overtime 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 be inevitable, these pains should not be so excruciating that they prevent functionality.
Regenerative Therapy and Meniscus Tear Surgery Recovery
While the recovery period for meniscus tear surgery is fairly short, 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 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 these tissues directly from the patient, isolating them, mixing them with growth factors, and reinjecting them, patients have been shown to have positive effects post-surgery.
Additionally, stem cell injections can help provide an environment around wounded tissues which helps increase the body’s health response. The source material for these injections is taken directly from the patient’s own healthy tissues. Fat and bone marrow can be processed into a pseudo- stem-cell state using new methods developed in the last decade.
By injecting these adult stem cells into the site of an injury, the cells can send out chemical impulses which attract the raw materials necessary in order to repair the damaged tissues. Combing both of these therapies provides relief from symptoms, boosts the healing processes, and decreases recovery time overall.
Any surgical intervention should be met with an err of caution. Adequate research and preparation should be conducted before attempting to stave off symptoms of a condition through surgery. Meniscal tears can cause a range of issues that conservative approaches simply cannot tackle.
While surgery may be beneficial in some instances, recovery can leave a patient incapacitated for number of weeks. These recovery periods are not helped by the fact that a person may not be able to work or enjoy their life throughout.
By applying regenerative therapies such as PRP or stem cell injections after surgery, a patient may be able to return to their everyday life more rapidly than if left to their own devices. Additionally, symptoms may become weaker and the surgical intervention may become more successful through these methods.
If you would like to learn more about what regenerative therapies are and how they might be able to help your knee after meniscus tear surgery, contact the CELLAXYS offices today.