Meniscus arthroscopy - arthroscopic suturing of the meniscus of the knee joint

The meniscus plays one of the leading roles in the knee joint - it is this part of the body that ensures stable functioning of the joint, and also performs a shock-absorbing function, acts as a buffer, and protects matter from abrasion. In this regard, if the meniscus is damaged, qualified specialists always strive to preserve it and proceed to complete removal only in cases where this cannot be avoided. The most optimal method of preserving the meniscus is suturing it - when a suture is applied, the function of the knee joint is restored (of course, after undergoing appropriate rehabilitation).

This operation also minimizes the risk of complications, in particular deforming arthrosis. Arthroscopic suturing of the meniscus is a high-tech operation that involves only small incisions in the affected area into which an arthroscope (a light-conducting fiber optic tube with a diameter of 5 mm) and surgical instruments are inserted.

Indications

Surgical intervention is prescribed in the following cases:

The occurrence of a “fresh” injury.
A rupture in the “red area”, where there is a high level of blood supply.
Young age of the patient.

Meniscus suturing is possible only with a fresh tear in the red zone.

Usually, the decision to carry out stitching is made by the doctor after carefully examining the damaged area with an arthroscope - it is often impossible to say in advance whether the natural “shock absorber” of the knee will be saved. The exact location of the damage plays an important role. So, if the rupture is located in the so-called white zone, where the blood supply is low, the suture will heal extremely slowly, and after some time the suture will diverge almost 100% again - while the edges of the meniscus will not be able to heal at all, and then the patient cannot avoid secondary interventions. If the gap is located in an area where the blood supply is intense, then the fusion process proceeds quickly, and the effect of the operation can last throughout life.

You may be interested in: “Treatment of a torn meniscus of the knee joint.”

Indications for surgery

For what diagnoses is surgery indicated - suturing the meniscus of the knee joint, cutting off the disintegrated edges or its complete removal, inserting a synthetic implant? Common problems requiring corrective surgery include the following types of injuries, confirmed by MRI and radiography:

separation of a flap (fragment) of the meniscus;
central longitudinal gap;
large-scale fragmentation;
rupture along the periphery with or without displacement.

Types of meniscal tears.

As for the separation of the cartilage flap: here it is urgent to perform surgery on the meniscus of the knee joint; the postoperative period will need to be taken as seriously as possible. If the necessary measures are not taken in time, the free existence of the severed body will impede movement, cause terrible pain and block the knee. The separated fragment, however, like the dangling piece, will begin to create a mechanical obstacle, since during the motor act it will fall into the main working center of the joint.

Schematic representation of the result of suturing the meniscal horn.

Important! It should be clearly understood that the speed and fullness of the return of functional potential subsequently depends on compliance with a special postoperative regimen, and it does not matter what type of manipulation was carried out - correction or removal.

Rehabilitation after surgery on the meniscus of the knee joint is no less significant than the plastic surgery of the functional element itself. Therefore, in no case should you neglect the basic recommendations that will be given by a specialist. Only flawless adherence to a recovery program based on improvement of the ligamentous apparatus and regeneration of the operated area will allow for a quick and successful rehabilitation, as well as avoiding quite dangerous complications.

Contraindications

The main contraindications for this type of arthroscopy are:

Cardiovascular diseases;
problems with the bronchi and lungs;
purulent infections;
skin diseases;
neuromuscular disorders;
allergy to anesthetic drugs.

Regardless of the presence or absence of the diseases presented, before performing arthroscopy, the doctor collects a thorough medical history, and the patient undergoes a series of tests. Only upon completion of all preparatory procedures is a decision made to carry out the operation.

You can read about knee arthroscopy on our website: “Knee arthroscopy”.

Anatomy and functions of the meniscus

The meniscus is a crescent-shaped cartilaginous formation. There are 2 menisci inside the knee joint - the outer (lateral) and the inner (medial). They form a layer between the bones of the thigh and lower leg. Menisci perform several functions in the body:

cushions when jumping, walking and running;
reduce friction of articular surfaces;
reduce the load on the knee.

The inner meniscus is less mobile than the outer one, so injuries to it occur several times more often. Men between 18 and 40 years of age are most susceptible to problems with menisci.

Rehabilitation

One of the most important elements of quickly returning to shape after a knee injury and arthroscopy is a properly selected rehabilitation program. It is selected individually, taking into account the patient’s age, volume of intervention, existing contraindications, level of physical fitness, as well as other features. Recovery necessarily includes therapeutic exercises, as well as a number of physiotherapeutic procedures, such as magnetic therapy, shockwave therapy, kinesio taping, special massage, exercise equipment and much more.

Return to section: Joint arthroscopy

Surgery for a torn meniscus

What is a meniscus tear?

A meniscus tear is one of the most common intra-articular knee problems.
Meniscus tears in young patients are most often caused by sharp twisting on a bent leg, especially in cases where it is loaded with body weight.

In each knee joint there are 2 menisci, the medial (internal) and lateral (external) - these are C-shaped pads made of dense connective tissue that ensure a tight fit between the rounded condyles of the femur and the flat condyles of the tibia.

A torn meniscus causes pain, swelling, and limited range of motion in the knee joint. In some cases, with a fairly serious rupture, a feeling of a “block” of the joint may occur, when the patient feels a mechanical obstacle in the knee and cannot fully straighten the joint.

For small tears, sometimes a short period of rest and conservative treatment is enough to alleviate or completely eliminate symptoms. In other cases, surgical treatment is required.

Depending on the morphology of the meniscal damage, either resection, that is, partial removal, or suture of the meniscus may be required.

Currently, it is believed that the meniscus needs to be restored (stitched) in all possible cases, since resection, even economical, still grossly disrupts the natural biomechanics of the knee joint. Unfortunately, not every meniscal tear can be repaired technically. Many tears are of a combined, crushed nature, and the low quality of the tissue in these cases allows only resection of the damaged area of the meniscus.

Symptoms of a meniscus tear.

If you have a torn meniscus, you may experience the following symptoms:

-crackling, crunching in the joint.

- swelling, swelling, feeling of fullness

-pain, especially when bending and twisting (rotation)

- incomplete extension of the knee joint

-feeling of a “block” of the knee joint

If you have all these symptoms, you should consult an orthopedic traumatologist who specializes in knee arthroscopy.

Causes of meniscus tear.

Typically, the meniscus ruptures due to sudden twisting and axial load on a half-bent leg, which occurs during a sharp start or, conversely, sudden braking. Deep squats and heavy lifting from a squat position can sometimes cause a torn meniscus. Degenerative changes against the background of gonarthrosis can also lead to rupture of the meniscus, more often in the form of dissection and combined damage.

Risk factors for meniscus tear.

Sports activities involving sharp twisting and turning on a fixed leg, such as football, basketball, tennis, contact martial arts. The risk of meniscus tear increases with age due to the accumulation of degenerative changes.

Consequences of meniscus damage.

The main negative consequence of a meniscal rupture is its traumatization by fragments of articular cartilage, which leads to the early formation of post-traumatic arthrosis of the knee joint. Meniscal injuries, if left unattended, lead to arthrosis over a period of varying duration, depending on the morphology of the tear. Thus, with significant paracapsular ruptures of the “watering can handle” type, pronounced arthrosis changes in the joint are observed within a few months after the injury. With small radial and degenerative ruptures, arthrosis will develop over a long period of time, over decades, and under gentle operating conditions of the joint and competent conservative treatment, it will not differ from the average in the population.

Diagnosis of meniscus tear.

A medial meniscus tear can often be identified during a physical examination. There are a number of diagnostic tests for this.

The most sensitive clinical sign is pain in the projection of the joint space at the level of the injury. Despite its high sensitivity, this method does not have high specificity specifically for meniscal tears. In addition to palpation of the joint space, there are a number of provocative tests.

Apley test. Specificity 58%

Stomach position. The hip is fixed with the examiner's knee. Traction is applied to the lower part of the lower leg and alternately external and internal rotation of the lower leg. In this case, the level of mobility is assessed.

The test is then repeated with compression performed. In this case, pain, crepitus, and range of motion are assessed.

The next test we will look at is the Thessaly test.

Sensitivity 64% specificity 53%.

The patient stands on the affected leg with the knee bent 20 degrees. After which he performs twisting alternately in the outer and inner directions; a positive result is considered when pain and clicking appear.

McMurray's test is considered more accurate

its accuracy is about 73%.

To perform the McMurray test, the patient is placed on his back, the patient's leg is fixed in a rotation position by the foot with one hand, while pressure is applied to the knee joint either from the outside or from the inside, and the leg is extended. The test must be repeated with different rotations of the tibia and different directions of pressure on the knee joint. A palpable click or click accompanied by pain confirms the diagnosis of a meniscus tear.

We remind you that these tests are preliminary in nature and are necessary to perform in order to suspect a meniscal injury. For instrumental damage, MRI is most often used.

In this case, it is possible to preliminarily assess the extent and nature of the rupture and plan surgical tactics.

Classification of meniscus tears.

There are several main classifications of meniscal tears. A simple descriptive classification is based on the location of the damage (red/pink/white zones).

Other characteristics of a meniscal tear take into account its size and nature (vertical or longitudinal, radial, horizontal). It may also indicate a specific morphological type: “watering can handle” oblique, patchwork, “parrot beak”.

In the vast majority of cases, meniscus tears are degenerative in nature and represent crushed complex damage to its free edge.

Such tears are located in the so-called “white” zone and cannot be stitched due to the poor quality of the tissue. Therefore, with this type of tear, partial resection of the damaged portion of the meniscus is performed to prevent damage to the surrounding cartilage. In this procedure, the meniscus should be resected as sparingly as possible, but within the limits of normal tissue. The use of ablation is not advisable in this case. In the case of complex tears, when, for example, there is a crushed degenerative tear of the free edge, and the body of the meniscus is stratified horizontally, it is possible to use both resection and meniscal suture at the same time. In this case, the crushed free part that cannot be restored is resected, and the part located closer to the periphery of the joint and more well supplied with blood is sutured.

Horizontal and combined degenerative tears are more common in older patients and appear without previous trauma.

Treatment of a torn meniscus.

Conservative treatment is used as the main method of treatment in the case of complex degenerative tears of the free edge without a mechanical component in the form of a joint block or jamming. Functional rest, unloading, local cold for 30 minutes 5 times a day, taking NSAIDs, intra-articular administration of hyaluronic acid or platelet-rich plasma, physical therapy with a methodologist, often give the same result as arthroscopic sanitation, without any surgical risks.

Surgical treatment of a meniscus tear.

In most cases of meniscal rupture, partial or partial resection has so far been performed. Currently, this tactic is being revised worldwide in favor of meniscus repair or suture. Resection is performed for complex, degenerative and radial tears; for all other types of tears it is possible to perform a meniscal suture.

After resection of the meniscus, in 80% of cases, improvement is observed the very next day after surgery. In 20% of cases, pain and other symptoms gradually regress over several months. Good results are observed mainly in young patients (under 40 years of age) in the absence of limb deformity and signs of arthritis, with damage to one meniscus.

Meniscus suture.

The best candidates for meniscal suture are fresh tears in the paracapsular (red) zone. Since this area is well supplied with blood, such tears heal well. Accordingly, the further from the red zone, the worse the blood supply and the greater the risk of nonunion. Longitudinal and vertical tears heal better than radial, horizontal and degenerative ones.

Depending on the morphology of the tear, various meniscus suturing techniques are used, from the outside to the inside, from the inside to the outside, or the “all inside” technique.

Below we give an example of suturing a small full-thickness vertical tear of the posterior horn of the medial meniscus in an 18-year-old patient at our clinic.

For 1 year, he experienced pain and discomfort when doing squats, running, and twisting on his previously damaged knee joint; he underwent an MRI and came to our clinic.

When performing arthroscopy, a vertical tear of the posterior horn of the medial meniscus is visualized.

The next step is to process the edges of the tear using a special probe with a diamond brush on the tip. Thanks to this, collagen fibers are exposed, which serve as a good substrate for fixation of cells, which subsequently form scar tissue at the site of the rupture.

After the edges of the tear are “refreshed,” we proceed to suturing the meniscus. In order to sew the meniscus using the “everything inside” technology, special tools are used with mini-anchors charged inside and a sliding loop between them.

The use of such instruments eliminates the need for additional access and reduces the risk of damage to the vascular and nervous structures adjacent to the meniscus.

Existing literature suggests that menisci heal better when anterior cruciate ligament repair is performed simultaneously. Apparently, this is due to the fact that during ACL plastic surgery, bone canals of significant diameter are made through which bone marrow stem cells enter the joint, facilitating better healing of the torn meniscus, as well as more gentle rehabilitation. Based on these findings, orthopedists have begun making trefunation holes in the areas of bone adjacent to the meniscus tear, as well as using the latest regenerative technologies in an attempt to increase the likelihood of a good and reliable healing of the torn meniscus. In particular, to stimulate the regenerative potential, it is possible to use the vascular-stromal fraction of mesenchymal cells of adipose tissue and platelet-rich plasma, but more on that later.

In such a situation, after resection of the damaged area of the meniscus, long-lasting pain, synovitis and progression of arthrosis can be expected, despite resection of the damaged area of the meniscus. In order to improve intra-articular homeostasis and enable cartilage tissue to adapt to altered joint biomechanics, intra-articular injection of platelet-rich plasma and adipose tissue stem cells can be used.

Modern possibilities for accelerated rehabilitation for meniscal tears and other intra-articular injuries of the knee joint.

Am J Sports Med. 2021 Feb;45(2):339-346. doi: 10.1177/0363546516665809. Epub 2021 Oct 21.

Prospective, double-blind, randomized comparison of treatment with hyaluronic acid and platelet-rich plasma.

Biology of treatment of osteoarthritis of the knee joint.

Introduction.

The use of platelet-rich plasma (PRP) in the treatment of osteoarthritis has demonstrated different results in randomized controlled trials compared with hyaluronic acid. Biological analysis of the use of BOTP showed a pronounced anti-inflammatory effect.

The aim of the study was to evaluate the clinical and biological effect of intra-articular BPTP in comparison with hyaluronic acid (HA).

Level of evidence – 1.

Methods.

111 patients with symptomatic osteoarthritis received a series of 3 injections of either BOTP or GA under ultrasound guidance. Clinical data were collected immediately before the start of treatment and then 4 times over 1 year. Synovial fluid was taken for analysis of pro-inflammatory and anti-inflammatory factors before treatment, 12 and 24 weeks after treatment. Several scales were used to assess clinical and biological outcome: (1) Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale; (2) International Knee Documentation Committee (IKDC) subjective knee evaluation, visual analog scale (VAS) for pain, and Lysholm knee score, and a comparative assessment of pro-inflammatory and anti-inflammatory factors in synovial fluid was performed.

Study results: BOTP was more effective than hyaluronic acid on all rating scales 12 and 24 weeks after treatment, and also significantly had a more pronounced anti-inflammatory effect due to a decrease in pro-inflammatory cytokines, such as interleukin 1 and tumor necrosis factor alpha.

In another study of the first level of evidence (Am J Sports Med. 2021 Apr;44(4):884-91. doi: 10.1177/0363546515624678. Epub 2021 Feb 1.), conducted by the FDA, the main body regulating the legalization of a particular treatment method or drug in the USA, the effectiveness of BOTP was also shown to be higher than that of hyaluronic acid preparations at follow-up periods of 6 and 12 months after treatment.

You can learn more about the use of BOTP and SVF from this article.

Rehabilitation after a meniscus tear

Rehabilitation after a meniscus tear varies greatly depending on the nature and extent of the operation, the age of the patient, and concomitant injuries to the knee joint. So, with a small radial or horizontal tear of the free edge, after partial resection, the patient can immediately walk with full weight bearing without any special restrictions. If resection was performed for a significant combined tear with an area of more than 30% of the meniscus, the joint can adapt for a long time to the new load distribution system. In such cases, functional rest and unloading of the knee joint are required for several weeks after the intervention. In the postoperative period, intra-articular administration of drugs may be required. Platelet-rich plasma and hyaluronic acid have proven themselves well.

In cases where a meniscus suture is performed, the axial load is limited for up to 6 weeks (the patient walks with additional support on crutches). To stimulate regeneration after meniscal suture, intra-articular injection of platelet-rich plasma is also indicated.

Review of Surgical Techniques

Surgery of the meniscus of the knee joint, which involves complete/incomplete removal, is called meniscectomy in orthopedics and traumatology. According to the method of creating access, the technique is classified into 2 types: open and closed resection of the meniscus of the knee joint.

The first type of procedure involves a cavity opening of the joint (incision length up to 8 cm) and manipulation through a completely open surgical field. Such outdated tactics are practically not used, because they are associated with significant intra- and postoperative risks. In addition, postoperative treatment of a removed meniscus after open radical surgery is long and very difficult for patients to tolerate.

The second option is based on the use of modern minimally invasive endoscopic technology – high-tech arthroscopy. The method makes it possible to productively eliminate a meniscal tear through 2-3 puncture punctures (5 mm in size), while the operation is characterized by reliable safety. The arthroscopic procedure today is the basis for the provision of highly effective and gentle surgical care to people with various meniscal injuries. Let's look at how arthroscopic meniscectomy works.

Initially, of course, anesthesia is administered. The most common type of anesthesia for such a session is spinal anesthesia. Of course, a general anesthetic can also be administered. Even at the stage of preoperative preparation of the patient, the anesthesiologist takes care of the competent selection of the most optimal pain reliever.
Next, the surgeon inserts into the joint through a miniature access a thin arthroscope tube equipped with a video camera, thanks to which the problematic component is displayed on the monitor screen in a greatly enlarged format. Then, through the same small incision, the non-functional fragment or the entire meniscus is removed using special microsurgical instruments. Note that replacing the menisci of the knee joints with donor material or a prosthesis is not practiced in this area.
Non-viable tissues are removed through the outlet channel of the instrument. If the menisci are torn, surgery can help if you need to stitch the torn area. To do this, using a guide needle and special braided polyester threads, the doctor applies a strong longitudinal or transverse suture. At the end of all activities, the joint is sanitized (washed) in order to disinfect and thoroughly clean the cavity from small segments of cartilage.

Another example of a meniscus injury as seen through an arthroscope.

A minimally invasive operation, meniscal arthroscopy, has multifaceted possibilities. It is also used for detailed diagnosis of various knee pathologies. Today, arthroscopy is the most informative and 100% reliable way to determine even microscopic defects in hyaline and meniscal cartilage, ligaments, bones, condyles, bursae, capsule and other components of the articulation.

During the operation.

Modern medical technologies have undoubtedly reached the pinnacle of development, thanks to which many serious joint diseases requiring surgical intervention are treated safely, bloodlessly and relatively painlessly. Minimal trauma makes it possible to reduce the time of postoperative treatment of a removed meniscus and significantly minimize the likelihood of complications.

Diagnostics

A rupture is diagnosed after examining and interviewing the patient and conducting tests that allow the presence of damage to be determined with high accuracy. The doctor uses the Shteiman, Roche, and Baikov tests to determine the symptom of compression.

For an accurate diagnosis, MRI of the knee joint, radiography, and ultrasound are prescribed. X-rays are needed to rule out fractures and ligament tears. Magnetic resonance imaging shows the highest accuracy. Diagnostic arthroscopy is sometimes performed.

1.What is meniscectomy and indications for surgery?

Meniscectomy

is a surgical
operation to remove a torn meniscus
or part of it.
A torn knee meniscus
is a fairly common problem that surgeons have to deal with. Orthopedic surgeons who perform meniscectomies make decisions about surgery based on whether the meniscus can be completely healed, as well as your age, health, and activity level.

Your doctor will suggest treatment that he or she considers best for the nature of the injury. The nature of the meniscus tear is determined by the location, structure and magnitude of the injury. Your medical conditions will also affect the nature of your treatment. In some cases, the surgeon makes the final decision directly during the operation, when he can accurately determine the nature of the injury.

If you have a small tear on the outer surface of the meniscus (doctors call it a “red zone”), the best treatment is to rest at home. The meniscus will heal on its own over time.

For a moderate to large meniscus tear, surgery is the most appropriate treatment. Typically, this type of meniscal tear heals well after surgery.

If you have a tear that extends two-thirds of the way into the meniscus (the white zone), surgery is not usually used. Your doctor will suggest a different treatment option for you.

If you have a tear in the white zone of the meniscus, then surgery is used to reduce pain. However, a partial meniscectomy will not cure the meniscus completely.

The structure of the tear also influences the nature of treatment. A horizontal, flat tear usually requires removal of at least part of the meniscus.

Meniscus diseases

Pathology of the meniscus can be caused by degenerative-dystrophic changes in the joint. The reason may be:

arthritis of the knee joint of various origins - infectious, autoimmune, etc.;
arthrosis – non-inflammatory degenerative lesions;
gout is a metabolic disorder in which uric acid crystals are deposited in the joint and damage the meniscus;
frequent repeated microtraumas in people doing hard work or spending a lot of time on their feet;
age-related thinning of cartilage in older people.

These changes lead to thinning of the meniscus, the appearance of microcracks and tears. Inflammation of the meniscus develops as a result of injury or infection.

Symptoms of meniscus damage

Recognizing a meniscal injury is not always easy due to the similarity of symptoms to other diseases of the knee joint. In the acute period of injury, the patient experiences severe pain in the knee, cannot bend or straighten the leg, or step on it. After 1-2 weeks the following symptoms appear:

knee pain increases;
a painful cushion forms at the level of the joint space;
the joint increases in volume due to fluid accumulated in it;
the skin over the joint is hot to the touch;
range of motion in the knee is sharply limited;
the patient has difficulty walking, especially on steps;
When bending the joint, a crunching or clicking sound is heard.

If timely assistance is not provided, the nutrition of the leg muscles is disrupted and their atrophy develops. X-rays of the knee joint, as well as ultrasound and MRI, will help you make an accurate diagnosis and choose the optimal treatment regimen for the meniscus at the 100med clinic.

Choosing an arthroscopic surgery method

Using miniature instruments for surgical intervention, the surgeon performs various types of manipulations, including plastic surgery of ligaments, removal (partial resection) or repair of a meniscal tear by suturing, and removal of pathological formations.

Therapeutic arthroscopy includes a number of surgical interventions:

reconstruction of ligaments in case of ruptures;
removal of cartilage and synovial tumors;
stabilization (plasty of ligaments) of the patella (in case of habitual dislocation);
plastic surgery of cartilage tissue;
resection or removal of menisci;
suturing the lateral or medial meniscus (suturing).

The last two methods are used more often than others.

Meniscus resection

The diagnosis of a meniscal tear often involves removal of the damaged part. In this case, they resort to a minimally invasive method of surgical treatment (arthroscopy).

The operation is performed by making small incisions in the knee joint, through which an arthroscope (a fiber optic probe equipped with a video camera and a light source) is inserted into the joint cavity. The operation is reduced to removing the torn part of the medial or lateral meniscus.

During arthroscopic resection of the meniscus, tissues are not injured, so the patient can stand on the injured leg within a few hours after surgery. If the operation goes without complications, the patient is discharged the next day after the operation. It is imperative to follow the correct daily routine for 10-12 days, excluding any stress on the leg.

Arthroscopic resection is guaranteed to have a positive effect; after the operation, the motor function of the joint is completely restored. A person can normally engage in sports disciplines or physical labor.

A. degenerative rupture of the medial meniscus, chondromalacia of the medial condyle of the femur, grade 2-3.

b. after resection of the medial meniscus, treatment of cartilage with an ablator

Meniscus seam

The technique was developed not so long ago, but is already widely used in domestic surgery. It is aimed at restoring the meniscus when it is partially damaged (longitudinal, flap tear).

Today, modern orthopedic surgery, like other areas of medicine, gives preference to surgical interventions that preserve tissue integrity. This type of procedure includes suturing a damaged meniscus. The operation makes it possible to carry out treatment without causing severe tissue damage and prevents the development of degenerative changes in the joints.

The operation is performed using an arthroscope under general, spinal or conduction anesthesia. The patient lies on his back, the injured leg is bent at the knee, then placed on a stand. The doctor makes two incisions on the front of the knee and inserts an instrument inside.

The first stage of the procedure is to rinse the joint cavity and remove blood clots. After this, the edges of the damaged part of the meniscus are refreshed, and the surgeon applies sutures (absorbable arrows or threads are used). The procedure ends with several stitches placed on the skin where the incisions were made.

These areas are then covered with a sterile gauze bandage. To immobilize the joint, the leg is fixed with an orthosis. The duration of the operation depends on the severity of the meniscus tear.

Progress of the operation

An arthroscopic suture of the meniscus is applied using special surgical instruments and an arthroscope. The patient is under general anesthesia or spinal anesthesia. Small skin incisions are made to insert instruments.

Step-by-step management of the surgical operation:

Removing blood clots and washing the area of the rupture.
Restoring the integrity of the meniscus using anchors and threads.
Apply single sutures in the incision area and cover the wounds with aseptic dressings.
Immobilization of the injured limb with a plaster splint.

Since the operation is low-traumatic and short-lived, rehabilitation treatment can begin within a week after the procedure. Full recovery can be achieved within 4–5 weeks.

At the Sports Trauma Center, arthroscopic suture of the meniscus is performed using the latest equipment. The cost of the procedure is acceptable for patients of various categories.

Rehabilitation and recovery after arthroscopy

Recovery regimen for a torn meniscus includes:

lack of loads (walk with full load on the operated leg after resection of the meniscus; when suturing the meniscus, you will have to walk for several weeks with a splint or orthosis, first without load on the leg, then with a dosed load, the function of the joint is usually completely restored after 5-6 weeks);
taking special medications (painkillers and anti-inflammatory drugs);
gymnastics (exercises to restore joint function, which prevent relapse of the disease and the occurrence of other problems);
return to a normal rhythm of life gradually (even after removing part of the meniscus, it is important to gradually return to an active lifestyle).

Arthroscopy is widely used in traumatology for the treatment and diagnosis of meniscal tears and other injuries of the knee joint without negative consequences for human life and health. The price of the procedure is quite acceptable for most patients. The method significantly shortens the postoperative period and restoration of knee joint function.

Features of the method

Arthroscopy is indicated for meniscus tears, as well as most injuries accompanied by damage to the internal elements of the knee joint. The intervention is carried out without much discomfort for the patient. The orthopedic surgeon makes 2 small incisions, after which an arthroscope and a special liquid under pressure (mostly saline, 0.9% aqueous solution of sodium chloride NaCl) is inserted into the joint cavity, which expands the joint.

This way, the doctor can see the damage to the meniscus on the monitor, assess the condition of the ligaments and cartilage of the articular surfaces in order to decide on further actions. After diagnosing the joint and performing surgical intervention, the joint is washed with saline solution, then small skin incisions (wounds) are sutured.

Why do they trust us and choose CELT?

The multidisciplinary clinic CELT has been operating in the paid medical services market for more than twenty years. By contacting us, you can count on comprehensive diagnostics, extensive experience and highly qualified doctors, and the use of modern, gentle treatment methods. Why is it best to choose our clinic for meniscectomy?

We have modern arthroscopic equipment, which eliminates damage to periarticular tissues and depressurization of the joint.
We use materials and tools from the best world-famous manufacturers in our work.
We employ surgeons who have successfully performed hundreds of operations in this area.
We carry out individual selection of anesthesia in accordance with the wishes of the patient and the state of his physical health.
We use modern, gentle techniques that ensure a minimal recovery period.

Meniscus injuries - causes and risk groups

There are 2 main types of meniscus damage - rupture of the body and separation from the place of attachment to the joint capsule. Causes of injury may include:

sharp turn of the lower leg with a fixed foot;
blow to the knee joint;
falling to one's knee;
sudden excessive extension of the knee.

People at risk for meniscus injury include:

people with untreated knee injuries;
professional athletes;
patients with gout;
patients with excessively mobile joints and weak connective tissue.

Complications after meniscus removal

Incomplete or total removal of the meniscus can have consequences, like any surgical intervention, although the likelihood of negative reactions occurring is low. According to statistics, about 90% of operations to remove the menisci of the knee joints predict a successful outcome without postoperative problems. Of course, with high precision of manipulation, compliance with asepsis and antisepsis during the procedure and proper postoperative care. But still, let’s announce possible complications:

thrombotic formations in the operated limb;
bleeding due to damage to blood vessels;
injury to the nerve bundle;
pathogenic infection inside a joint or in a surgical wound.

There is an opinion that a common consequence after meniscus removal is arthrosis. We do not argue, but it is also important to take into account the fact that total surgery, namely, it threatens the appearance of degenerative pathogenesis in 15 years, is a rarely used tactic, used exclusively in particularly difficult cases, as a last resort. For example, if the scale and severity of the lesion are not subject to corrective plastic surgery or partial resection of the meniscus of the knee joint, which is very rare.

Specialists always try to leave as much of a functional unit as possible, understanding that the biomechanics of the bone joint of the knee rests on it. Therefore, being guided by the fact that removal of the meniscus will provoke consequences in the form of gonarthrosis of the knee joint, and not going to the doctor, is a huge mistake. Serious osteochondral degenerations, plus atrophy of the thigh muscles, will definitely not take long to occur. And even simple defects in the collagen structures of cartilage left to chance, which at one time could have been completely cured conservatively, promise a similar outcome.

Valuable information! First of all, the operation saves the meniscus, which means that the pathological source that interferes with the normal interaction of the articular bones will no longer act on the knee. By eliminating the damaging factor, the likelihood of the formation of a degenerative-dystrophic focus in the structures of the bone joint is also reduced.