Knee meniscus surgery

Meniscus surgery in Germany is a common procedure, because in approximately 80% of cases, an injury to such a structure becomes an indication for surgical intervention. Such a service may be needed by both athletes (football players, handball players, gymnasts, hockey players) and people far from professional sports. Sometimes small tears can be treated without the help of a surgeon, but only a doctor can determine the extent of the required medical care. In case of severe injuries, it may be necessary to transplant the damaged tissue; meniscus implantation in Germany allows you to restore the mobility of the knee and return the possibility of full movement.

Meniscus treatment - stages

Carrying out diagnostics, during which the doctor finds out the cause of the violation of integrity, pays attention to the main symptoms of the pathological process, and also prescribes additional research methods with visualization of the knee structures (radiography, ultrasound, computed tomography or magnetic resonance imaging, arthroscopy).
After analyzing the results of the study, with the help of which the meniscus of the knee is visualized, the operation is selected individually, taking into account a number of factors (the nature and duration of the injury, the anatomical individual characteristics of the patient, his age, the presence of concomitant pathology).
The preparatory stage before surgery that affects the meniscus of the knee. Treatment is carried out using drugs of various pharmacological groups in order to reduce the severity of the inflammatory reaction, suppress the infectious process, normalize the general condition and adaptive capabilities of the patient's body.
The main stage of therapeutic measures in which meniscus damage is restored. The operation is performed using various techniques (arthroscopic plastic surgery, open surgery).
Recovery stage. After knee (meniscus) surgery has been performed, rehabilitation is an important stage that determines the complete restoration of functional activity. Its duration depends on the method of surgical intervention.

In most cases, all stages of therapeutic measures if the meniscus is damaged (surgery, treatment, recovery) are alternated sequentially. Each subsequent stage begins after the previous one has been completed.

Surgical methods of treatment

Since conservative therapy does not make sense in all cases, sometimes (especially with ruptures) surgical intervention is performed. A huge advantage of this method these days is that there is no need to open the joint and heal the wound. This type of surgery, arthroscopy, involves minimal incisions - doctors make several punctures: a special camera with a cold light source is inserted into one to provide the doctor with a good view, and a surgical instrument is inserted through the second to carry out the necessary manipulations. The operation involves suturing the torn edges of the meniscus, or completely removing it. The type of action to be performed is determined in advance by studying x-rays, MRI results of the knee joint or ultrasound.

After the operation there is a period of postoperative rehabilitation. The patient should take care of his knee, not overload it and monitor its condition. The inflammatory process should not become chronic or cause problems with other parts of the musculoskeletal system.

To avoid thrombosis and thromboembolism, it is necessary to engage in therapeutic exercises, accelerating the blood and improving metabolic processes. Modern methods allow you to quickly get rid of this problem and prevent its recurrence.

Get a consultation on MRI diagnostics. Consultation on the service does not oblige you to anything.

Meniscus damaged

The meniscus is damaged.
In most cases, surgery is the only method of radical treatment. The exception is minor damage to the connective tissue fibers of the ligaments without disturbing the general anatomical structure. In this case, conservative therapeutic measures are prescribed, including the use of medications and physiotherapy techniques.

In case of severe violations of integrity, surgery is prescribed to restore the meniscus, its partial (resection) or complete removal. The method of surgical intervention and its volume are determined depending on the nature and location of the injury or pathological process in which the meniscus was damaged. The operation is selected by the doctor individually.

What are the dangers of meniscus injuries?

During training or at home, a person falls on his kneecap or the knee is subjected to a strong blow, for example in football. The meniscus ruptures or tears. If the body already has disorders, for example, the endocrine system suffers, or there is a history of gout or rheumatoid arthritis, recovery will not occur. A damaged meniscus ceases to perform its functions and does not alleviate pressure on the joint. This creates the preconditions for knee arthrosis.

With an injured meniscus, the cartilage layer is not able to smooth out dynamic loads on the knee joint. The joints begin to deform, friction of the cartilage causes pain. The situation is aggravated if a person is overweight.

Meniscus injury is the first step to knee arthrosis

Medial meniscus surgery

The cartilaginous structure of the knee, localized in the area of the inner surface, is quite often subject to injury. Damage occurs due to a direct mechanical blow to the knee or rotation (rotation) of the thigh with a fixed shin. Surgery on the internal meniscus can be performed arthroscopically or through an open approach.

In modern clinics, the method of choice is arthroscopy, which is less traumatic. Its essence lies in introducing a tube with a camera, lighting and micro-instruments into the joint cavity through small incisions, which allows manipulations to be carried out under visual control on a monitor.

If the meniscus is torn, surgery is usually performed using an open approach, as the cartilage structure may need to be completely removed.

Symptoms and signs

In most cases, acute rupture of the medial meniscus of the knee joint occurs from the unnatural position of the joint elements at the time of injury or pinching of the cartilage between the tibia and femur. A torn meniscus is often associated with other knee injuries, so differential diagnosis can sometimes be difficult.

Symptoms that may indicate a tear of the internal meniscus of the knee joint:

pain - can be very sharp at the time of injury for 1-2 minutes. The appearance of acute pain in the knee may be preceded by something like a click. After some time, the strong painful sensations may subside, and the person can even walk, albeit with force. However, in the morning there is a feeling of a “nail” in the knee. When you try to sharply bend or straighten your leg, the pain intensifies, but at rest it subsides a little. Intense pain is typical for young people;
blockade or “jamming” of the joint is a very common sign that characterizes a rupture of the posterior horn of the internal meniscus. A blockade occurs when a torn or torn part of the meniscus bends between the bones and impairs the motor function of the joint. True, this can also happen from torn ligaments;
hemarthrosis (blood in the joint) appears when the area of the meniscus, penetrated by capillaries, is torn;
swelling of the joint - usually occurs on 2-3 days.

Meniscus suturing surgery

Surgery to stitch the meniscus.
Regeneration of cartilage tissue is a long process, so rehabilitation is carried out to avoid suture dehiscence. This is important to prevent the need for procedures such as meniscus revision surgery.

If therapeutic measures are carried out correctly to restore meniscus damage, treatment is effective and gives a favorable prognosis for the functional state of the knee. Surgery for a torn meniscus provides a good therapeutic effect and a favorable prognosis.

How is a meniscus injury treated?

Injuries to the meniscus can be different: the tendon can be partially torn or completely torn, separated from the joint capsule longitudinally or transversely. The problem can be eliminated conservatively or surgically, but only after the inflammation has subsided.

After a severe knee injury, it is important to rest the leg, cool the affected area and secure the joint with an elastic bandage. If the patient is transported to the hospital in a horizontal position, the leg is placed above the chest to prevent swelling of the knee.

To make a diagnosis, MRI or CT is prescribed, sometimes together with arthroscopy. If the meniscus is displaced, a cast is applied for 20 days, and a course of restorative therapy is also prescribed.

For meniscus injuries, the following is prescribed:

non-steroidal anti-inflammatory drugs;
chondroprotectors to stimulate cartilage tissue and improve the structure of synovial fluid;
rubbing agents with anti-inflammatory, analgesic and antipyretic effects;
collagen, for example in food (strengthens tissue trophism and nourishes the meniscus).

Most often, meniscal injuries are treated with medication.

Surgery to remove part of the meniscus

Removing part of the cartilage structure of the knee is called resection. This is a necessary measure. It is carried out in cases of significant damage in which normal restoration of the anatomical relationship and integrity is impossible. Meniscus resection surgery is usually performed using an arthroscope.

Further therapeutic tactics depend on the volume of tissue removed. It may include a recovery period or replacing the area of removed tissue with special implants. If partial removal was carried out due to an injury such as a torn meniscus, surgery, rehabilitation, and physiotherapeutic procedures are carried out over a sufficiently long period of time.

Causes

Medicine knows only one clear cause of such a common injury as a rupture of the posterior horn of the medial meniscus of the knee joint - acute injury. However, not every aggressive impact on the joint leads to damage to the shock-absorbing cartilage. It is necessary to highlight the following predisposing factors that can cause, for example, a rupture of the posterior horn of the meniscus:

twisting on one leg without lifting the limb from the surface;
vigorous running and jumping when joints are unstable or on uneven surfaces;
long periods of squatting or active walking in single file;
heavy load with significant excess weight;
minor trauma due to degenerative joint diseases;
congenital weakness of joints and ligaments.

Surgery to completely remove the meniscus

Complete removal of anatomical cartilaginous structures is performed when there is significant damage, leading to the formation of a large number of fragments. For small fragments, surgery is performed arthroscopically. If the fragments are of significant size, and there is also a violation of the anatomical integrity of other structures of the knee, then surgical manipulations are performed using an open approach.

After an operation to remove the meniscus has been performed, the doctor immediately decides on the need to replace this cartilaginous structure with an implant. In general, the cost of meniscus removal surgery is higher than other techniques, since it may include a one-stage implantation.

Meniscus replacement surgery

Meniscus replacement surgery
Replacement of the cartilage structure of the knee is carried out after its partial or complete removal. For this purpose, donor biological material or artificial implants are used, which are highly durable and do not lead to the development of an inflammatory reaction and rejection.

Surgery is usually performed using arthroscopy. If it is necessary to perform a significant amount of manipulation, surgery on the meniscus is possible only through open access. When performing an operation to replace a meniscus, the price includes not only the manipulation itself, but also the cost of the implant or donor biological material.

In what cases is surgery necessary?

Unfortunately, conservative treatment does not always help. If, after several weeks after a knee injury, the pain does not go away, the joint bends with difficulty, the doctor suggests surgery. Surgical intervention is also indicated in the following conditions:

if the result of a meniscus injury is hemorrhage inside the articular cavity;
if the meniscus is severely deformed - torn or radically displaced;
if the meniscus has separated from the joint capsule.

Most often, damaged menisci are sutured; in severe cases, they are replaced with artificial analogues. The operation is as complex as joint replacement for gonarthrosis, and requires a long recovery - at least four months. After meniscus replacement, the pain goes away almost immediately. Training on an exercise bike, swimming in the pool, proper nutrition and therapeutic exercises help speed up recovery.

A meniscus injury can cause no less discomfort than arthrosis of the knee joint. Moreover, it often leads to degenerative-dystrophic changes in the knee joint. Therefore, be especially careful if you are injured. Don’t let the situation take its course: see a specialist.

Surgery for old meniscus tear

The lack of timely provision of specialized medical care after a knee injury leads to the formation of calluses in the area of rupture of cartilage structures, which prevent the regeneration of the cartilage tissue that makes up the meniscus. The operation and restoration in this case have certain difficulties associated with the need for preliminary excision of calluses in order to allow their subsequent full regeneration with the restoration of anatomical integrity.

Surgery for minor injuries is performed primarily using arthroscopy.

Diagnosis and treatment

Since this type of joint problem is quite difficult to diagnose without the help of a doctor, you should go to the hospital at the first symptoms. An experienced doctor, in addition to interviewing the patient, will refer him for tests and conduct one of the hardware diagnostic methods: ultrasound, MRI of the joint or x-ray.

The problem with x-ray examination is that it cannot always detect microscopic damage, so tomography is considered the most rational. A tomograph uses magnetic waves to study the smallest violations of the integrity of tissues and muscles, ligaments and other components of the joint, and then provides the doctor with the results of the study in 3D. The doctor can examine the images in detail, zooming in on the required area to the maximum.

If the x-ray does not show any abnormalities, but you are sure that changes are occurring in the joint, go for a tomography.

Get a consultation on MRI diagnostics. Consultation on the service does not oblige you to anything.

First aid

If a joint blockage occurs immediately after an injury, it is necessary to eliminate it, as well as get rid of other unpleasant consequences, numb the knee and give the leg rest for 3-4 weeks. To do this, the patient takes analgesics and wears a special bandage that reduces the load on the joint and saves the person from unnecessary movements that can aggravate the situation.

rehabilitation

rehabilitation
A fairly important stage in the treatment of traumatic injuries to the structures of the knee, on the correct implementation of which the prognosis depends, is rehabilitation after surgery on the meniscus. It includes a number of measures that are aimed at preventing complications (secondary infection, bleeding), as well as the gradual restoration of joint function.

For this, various medications, physiotherapy (magnetic therapy, mud baths, electrophoresis), as well as therapeutic exercises with a gradual increase in the load on the knee are used.

After the meniscus has been removed, rehabilitation is longer and lasts at least six months. If there is a minor injury affecting the meniscus or ligaments, the operation was performed using arthroscopy, then the recovery period will be shorter.

Recovery after meniscus resection

After the patient has had the meniscus or part of it removed, the knee area requires the use of a cold compress. Additionally, painkillers may be prescribed. If, after removal, nothing bothers the patient, and no signs of infection are detected, you can begin to develop the knee joint. The patient is recommended to walk with crutches, perform flexion-extension movements with the legs and other exercise therapy exercises. Physiotherapeutic procedures and massage help shorten the rehabilitation period.

You can learn more about complete or partial meniscectomy (removal of the meniscus) in consultation with the doctors of our clinic. Make an appointment online and receive qualified medical care for meniscus damage in a comfortable environment for you!

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