Professor MD Thomas Gösling
Meniscus is a cartilage disk in the knee joint which is balancing articulation surfaces during movement and distributing the load. There are two menisci in shape of “C”: medial meniscus and lateral meniscus. Medial meniscus is connected with the medial ligament and is injured more often. Torn meniscus is a painful condition needed to be treated to avoid joint dysfunction.
Tear of meniscus of the most common knee injuries. The symptoms can differ depending on tear degree.
Micro injuries of meniscus cause moderate pain and swelling that go away in a few weeks.
Medium degree tear may result in pain which gets worse and causes stiffness in the knee. You are able to walk but feel acute pain when twisting or bending your knee. It is often difficult to go down the stairs. If not treated torn meniscus can become chronic condition.
Severe meniscus damage. With age meniscus loses its elasticity and ability to regenerate itself and becomes worn. Small pieces of injured meniscus can move to the joint space and give significant pain. Your knee may pop or lock. The knee can also wobble and feel unstable. When chronic it causes permanent pain and stiffness.
As pain and swelling may have different reasons, you need careful examination to precise diagnostics. First, your doctor fill check you both knee, how they move and react to various range of motions. X-rays is also recommended. In some cases, MRI and other tests may be needed to determine exact location and extend of the problem.
Depending on severity of disease and patient’s age treatment can be different. In some cases physical therapy and bandaging is recommended. Minor tears can go away theirselves as the cartilage has ability to regenerate but with age it loses the elasticity and turns more difficult to restore. In case of chronic meniscus disorder surgery is common way to improve the situation.
There are a few type of surgery to treat tear of meniscus.
Meniscectomy. It is a partial removal of the torn pieces. During this operation the surgeon cuts torn or worn out edge of the meniscus leaving the healthy tissues.
Sometimes total removal of severely worn meniscus is require but it is not very popular surgery as it lead to complications as rubbing the bone against each other and developing of arthritis.
Repair of torn meniscus. While meniscectomy involves only cutting of diseased pieces repair has its aim in healing damaged meniscus. The surgeon suture together worn pieces and leave them grow. This procedure has limited success as it is possible only in zones where the meniscus has blood supplier.
Torn meniscus removal or repair can be done in open surgery or by arthroscopy. German orthopedic surgery more and more give their preference to minimally invasive methods but sometimes traditional operation also may take place, especially when the patient has traumatic injury involving ligaments tears, bone fractures and tissues damage.
Arthroscopy growing popular as it cause less pain and have shorter recovery. During arthroscopic operation access to the knee is provided via two small cuts (not more than 1cm long). A small camera is inserted into the first one to translate image to monitor where the surgeon can see operational space. Another incision is used to deliver surgical instruments inside. Special miniature shavers and scissors are used for torn meniscus removing.
Surgery can be done under general, regional (including spinal) or local anesthesia. After the wounds are sutured the patient may need ice for a few days and pain relieving medicine , though arthroscopy is associated with minimal pain.
After meniscectomy many patients may resume their activities in a few day feeling like nothing special has happened. For 2-3 weeks it is better to refrain from jogging and active sport. In some cases it can take longer and you should consult with your doctor if special regime is required. With GMG you always have possibility to make a call online.
If you suffer of pain and swelling in your knee but not sure what causes it, please ask an expert. The best surgeons from Clinic of Braunschweig will advise on your treatment. Make your appointment online.