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Arthroscopic meniscectomy

What the meniscus is, and where does it take place?

Anatomy of the Knee Joint
Anatomy of the Knee Joint

The meniscus is two, crescent shape fibrocartilage formation in the knee joint, between the shinbone and the thighbone. Both knee joints have 2 menisci cartilage, one on the outer (lateral) and one on the inner (medial) part of the joint.

Meniscus plays an important role in the functioning of the knee joint:

  • improve the insertion and reduce the modal differences between the femur and the tibia
  • disperse the pressure on the joint surfaces
  • absorb the mechanical shock
  • support the stability of the knee

If any of these functions are weakened, the knee joint would be exposed to increased stress, which causes knee complaints.

Meniscus tear

Due to its vulnerability, the meniscus can tear or injure as a result of a trauma, or it can become worn out with the passing of time. In some cases, the injury is accompanied with cartilage detachment, which should be eliminated as soon as possible, to avoid the destruction of the cartilage on the condyles.

The injuries of the medial meniscus are more common to the lateral ones. As the medial meniscus is more fixed to the joint capsule, it can be pinched easier between the condyles, which cause at last the tear of the meniscus cartilage.

A meniscal tear can be caused by acute or chronic stress.  A sudden force on the knee joint often leads to an acute tear. This type is more regular at a younger age, mostly between athletes, and usually accompanied by a ligament tear. Recurring, one-place-focused load could also cause the weakening of the meniscus cartilage. This type of injury is called a degenerative tear, and it is more common at an elder age.

According to the conditions of the injury, a variant type of tears can be differentiated. It is important to know, that without any treatment, even the smallest tear could become bigger and lead to cartilage detachment.

The most common types of a meniscus tear are shown in this illustration:

  • normal meniscus
  • radial tear
  • longitudinal tear
  • horizontal tear
  • bucket handle tear
  • parrot beak tear
Types of meniscus tear

What are the symptoms of a meniscus injury?

The following symptoms might refer to a meniscus injury:

  • swell around the knee
  • sudden, intense pain, typically in the articular gap
  • pain in the articular gap for twisting and rotating movements
  • in case of a bucket handle tear, the knee cannot be fully straightened and bent
  • the knee is gently bent, as the thorn part is wedged between the condyles and blocking its movement
  • popping sensation by moving the knee

How are meniscus injuries diagnosed?

If meniscus injury is suspected, the traumatologist/orthopedic specialist set the anamnesis first: he inquiries about previous or existing diseases and injuries, then he asks about the circumstances of the current injury.

Afterward, the specialist takes a physical examination, by touch he checks the pressure sensitivity, localizes the pain, and the functioning of the patella. A motion test is taken too, to examine the knee’s range of motion and the stability of the joint. This allows detecting the possible ligament injuries.

In case of a suspected meniscus injury, some special physical tests are taken as well. Depending on the suspicion of a medial or lateral meniscus injury, the specialist performs different rotational tests. In case of a medial meniscus injury, he rotates the leg outwards, to detect a lateral injury, the rotation is performed inwards.

A meniscus injury can be diagnosed by these physical tests, but in case of uncertain symptoms, MRI scan is recommended.

Meniscus repair

What kind of treatments are available for a meniscus tear?

A meniscus tear is treated surgically, by refixing (meniscus repair) or removing (meniscectomy) the torn part. At our hospital, meniscus surgeries are performed by an arthroscopic procedure. This precise, minimally invasive technique allows faster recovery, as it is performed with minimal tissue damage, without big incisions.

Meniscus surgeries are implemented in general or regional anesthesia, while the legs are in ischemia. The specialist makes 2-3 small, 0,5 mm wide incisions next to the patella tendon,  where the arthroscope and the special tools are inserted. Next, the knee joint is filled with physiological saline, which allows the doctor to see the injuries and degenerative lesions inside the joint.

Meniscus surgery
Meniscus surgery

The torn, or pinched parts of the meniscus cartilage are removed, or if possible, it is refixed to the cartilage base.

The aim of the surgery is to preserve as much cartilage, as possible, because meniscectomy (total removal) enhances instability of the knee and accelerates the abrasion of the cartilage on the condyles.

Meniscus repair
Meniscus repair

How should I prepare for the surgery?

If your doctor recommends meniscectomy, you may need a complete physical examination before surgery to assess your health condition. At the first consultation, our orthopedic specialist will inform you about the necessary examinations and the details of the surgery.

Before the surgery, inform your orthopedic surgeon about the medications you take regularly. He or she will tell you which medicines are not recommended to take before surgery.

2 weeks before your meniscus surgery:

  • You may be told to stop taking certain kind of medicines
  • Ask which medicines you should still take on the day of your surgery.
  • Tell your surgeon if you have been drinking alcohol (more than 1 or 2 drinks a day).
  • Quit smoking before surgery. Smoking can slow down wound -, and bone healing.
  • Always let your physician know about any cold, flu, fever, herpes outbreak, or other illness you have before your surgery.

On the day of your surgery:

  • Do not to drink or eat anything for 6 to 12 hours before the procedure.
  • Take the prescribed medicines with water.
  • Please arrive in time at Medicover Hospital.

What shall I do after the surgery?

After a one-day stay, the patient can leave the hospital, the orthopedist will appoint the date of the follow-up examination. Before leaving, the physiotherapist teaches some exercises, which are essential for the rehabilitation.

In case of partial meniscus removal, the knee can be loaded on the next day. After a meniscus refixation, the knee should be spared, and crutch should be used for 4 weeks. Thrombosis preventive treatment is required in both cases.

If early complications don’t take shape, the stitches will be removed after 1 week. After a partial meniscectomy, the patient can return to his daily activity in 1 week, although sport and hard physical work are allowed 3-6 weeks after the surgery. In case of a meniscus refixation, the patient can load increasingly the limb 5 weeks after the surgery.

How much does an ACL reconstruction cost?

The price of the arthroscopic meniscectomy composed of several elements. At our hospital, the listed arthroscopic meniscectomy cost includes the surgery and the  check-up one week after  surgery.

We offer a separate consultation package for the first consultation, where the orthopedic specialist decides if an arthroscopic knee surgery is recommended. The necessary pre-operative examinations can be taken at our hospital, which has an additional cost.

Our goal is to offer you the most reasonable meniscectomy price for the highest quality service and care.