Understanding meniscus repair
The knee is the largest joint in your body. It helps provide support for your body and plays an important role in your ability to move. As a result, any problem that affects the knee can have a seemingly disproportionate effect on your life.
One of the issues that can affect a knee is damage to the cartilage in the knee, known as the meniscus. Should surgery be required to repair the damage, it is known as arthroscopic meniscal repair.
What are the menisci?
Your knee contains two pads of cartilage (‘meniscus’), one on each side of the knee. The medial meniscus lies on the inside of the knee while the lateral meniscus lies on the outside. Together, they are referred to as ‘menisci’. The menisci primarily act as shock-absorbers in your knee, helping to dissipate much of the force generated when you move.
Damage to the menisci is fairly common, especially in people who regularly play sports. You may hear sports commentators refer to an athlete tearing the cartilage in their knee; this normally means they have damaged one or both of the menisci in the knee.
Knee pain is a common complaint and damage to either of the two menisci is only one of a number of possible causes. For this reason, a knee specialist (an orthopaedic surgeon) may request one of a number of diagnostic tests to help confirm a diagnosis of meniscal damage. Tests requested may include X-rays, ultrasound or magnetic resonance imaging (MRI).
X-rays can help to rule out any other problems with the bones of the knee, while ultrasound and MRI scans may be helpful when confirming damage to either or both of the menisci.
Arthroscopy is a type of keyhole surgery, meaning it is not as invasive as traditional “open” surgery. Arthroscopic meniscus repair is normally carried out under general anaesthetic, meaning you will not be conscious during the surgery, and an anaesthetist will talk with you about the anaesthetic they will be using for the procedure.
Once you have been given the general anaesthetic, the skin around your knee will be thoroughly cleaned using an antibacterial fluid. The surgeon will make a small incision in your knee and insert a thin metal tube (known as an arthroscope) through the cut into the knee joint. The arthroscope contains a light source and a camera or lens at one end, allowing the surgeon to see the inside of the joint clearly. Sterile saline solution will be flushed through your joint to help reduce any bleeding and allow better visibility of the menisci.
Using the arthroscope, the surgeon will carefully examine the damaged meniscus, as well as the entire knee joint. Small surgical instruments will be used to repair the damage in the meniscus where possible. If the damage is too extensive to allow a full repair, they may trim part of the meniscus as much as possible in order to help relieve your symptoms.
The surgeon will then remove the arthroscope from the knee joint and close any cuts made during the surgery using stitches or special surgical tape. Your knee will then be covered with a sterile dressing to ensure it remains free of infection.
Following your surgery, you will be taken to the recovery room, where out theatre staff will monitor you carefully while you wake up from the anaesthetic. Once you have fully woken up and the theatre recovery room staff are happy with your blood pressure, heart rate and oxygen levels, you will be taken back to your ward to rest.
Complications and Risks
Although it is known as keyhole surgery, it will take time to fully recover from your arthroscopic meniscal repair. While you are recovering, it is important to take things slowly in order to gain maximum benefit from the surgery.
All surgical procedures carry risks and the potential for complications. For arthroscopic meniscal repair these include:
- Infection in the knee joint,
- Damage to the nerves near the knee joint,
- Formation of a blood clot (known as a ‘deep vein thrombosis’ or ‘DVT’).
The above risks are intended as guidelines only and are not exhaustive. We always recommend that you talk with your consultant about potential risks and complications before you decide to have any surgery.
The consultant-led orthopaedic Knee Clinic at St Joseph’s has vast experience in carrying out arthroscopic meniscal repair. Should you be experiencing pain and/or stiffness in your knee joint, please contact us to arrange a consultation with one of our knee specialists. They will assess the cause of your pain and determine the best treatment option available for you.
Should arthroscopic meniscus repair be required, the expert team in our Knee Unit will make sure you receive the best treatment and post-operative support possible.
