Medial & Lateral Menisci Surgeries & Repair in Kirkland, WA
The meniscus is a pad of specialized cartilage that is located between the femur and tibia bones in the knee joint. There are two menisci in the knee – one on the inside of the knee (medial meniscus) and one on the outside of the knee (lateral meniscus). The meniscus has several functions including: acting as a shock absorber or cushion, distributing load across the knee, decreasing friction, and adding to the stability of the knee.
Meniscus tears typically occur as a result of twisting injuries to the knee. They can be caused by a traumatic injury, but also can occur from a subtle injury or just a twisting motion during daily activities. The symptoms of a meniscus tear include pain, swelling, locking, and inability to completely straighten the knee joint. An MRI is frequently obtained to diagnose a meniscus tear.
Treatment of meniscal tears depends on several factors including the type of tear, the location of the tear, and the activity level of the patient. Some patients can be treated nonoperatively. If surgery is necessary, minimally invasive arthroscopic techniques are used to either trim out the torn portion of the meniscus (partial meniscectomy) or to repair the meniscus.
Meniscus Surgeries and Repair
Meniscus tears can be relatively painless, especially when they are small and in less active patients. Larger meniscus tears can be quite painful, however. They can lead to locking, swelling, pain, and can lead to an increase in size of the meniscus over time – especially in the active patient.
The meniscus surgeries usually involve trimming out the torn portion of the meniscus. This is known as a partial meniscectomy. During this procedure, only the portion of meniscus that is torn is removed and the healthy remaining meniscus is preserved. The size and configuration of the tear determine how much meniscus is removed.
The meniscus portion of the knee is an important structure. It contributes to the stability of the knee, provides cushioning, distributes forces over a larger area, and reduces contact stress to help preserve the articular cartilage of the knee. If the meniscus is removed completely this leads to relatively rapid arthritis. Small meniscus tears can easily be removed with little or no measurable impact on the knee. However, the loss of large sections of meniscus can lead to pain, swelling, and long-term arthritic changes. For these reasons, when possible, meniscus repairs are preferred over meniscectomy.
In order for the meniscus to be repaired and heal successfully, certain criteria must be met. The tear must also be near the outer edge of the meniscus so that it has a blood supply to allow for healing. The tear must also be in a configuration that allows for repair.
Minimally invasive arthroscopic techniques are utilized to repair the meniscus. Patients who undergo a meniscal repair must be more cautious postoperatively, and typically have more restrictions, than those undergoing a partial meniscectomy.
Losing a large portion of, or an entire meniscus, can lead to pain and early arthritis. Because of this in some patients who have had nearly their entire meniscus removed, are candidates for meniscus transplant. This involves placing a meniscus from a cadaver into a patients knee and securing it. This provides some of the cushioning back to the knee and may help with pain and delay arthritis.