The cartilage of the knee, known as the meniscus, can tear due to an injury or long-term degeneration. These tears, known as meniscus tears, can be very painful and severely limit the range of motion in the knee. If the tear occurs in the red zone of the meniscus – the outer 1/3, these can often be repaired. However, if the cartilage tears on the inner 2/3, that does not have rich blood flow, the only option when conservative treatment fails is surgery to remove the damaged cartilage.
Known as a partial meniscectomy, this arthroscopic or minimally invasive procedure is performed on an outpatient basis, which means the patients do not have to stay in the hospital or surgery center overnight. Further, a partial meniscectomy does not require general anesthesia – it is usually performed with local or regional anesthesia.
How a Partial Meniscectomy Works
The procedure begins with a diagnostic arthroscopy. This requires the insertion of a miniature camera into the knee to inspect the cartilage and surrounding ligaments. This diagnostic procedure allows Dr. Manning to visualize the injury and decide on the best course of action to address it. It also allows us to understand if any surrounding ligaments or cartilage structures have been damaged along with the meniscus. A common cooccurring injury is an Anterior Cruciate Ligament or ACL tear.
Once the diagnostic arthroscopy is complete, the procedure continues by inserting specially made medical devices into the knee in order to trim and remove damaged cartilage. During the procedure, we try to minimize the amount of healthy cartilage removed to ensure the most support and stability within the knee after surgery.
Unlike a total meniscectomy, a partial meniscectomy only removes some of the cartilage. We rarely perform a total meniscectomy as it can severely reduce the stability of the knee and hastens the onset of arthritis.
Ince the cartilage has been trimmed, the small incisions are sutured, and the patient is transferred to a recovery room for a short period of time. Patients will be discharged with narcotic and anti-inflammatory medication and will require crutches for a couple days to minimize the weight placed on the knee. Many patients will not require the narcotic medications and should take the least powerful analgesic medication to mitigate their discomfort.
Risks of a Partial Meniscectomy
The risks of a partial meniscectomy are very low – for most patients, less than 1%. Rare complications may include infection, blood clots in the leg, pain and swelling. Employing an expert orthopedic surgeon with extensive experience like Dr. Manning and following the postoperative discharge packet are the best ways to mitigate these risks.
The Recovery Process
After discharge, patients may undergo a short course of physical therapy to improve the supportive musculature around the knee and improve range of motion. Normal daily function is typically acceptable within a week after surgery. Strenuous activities and sports can often be resumed within two months after the procedure.
The Long-Term Prognosis
Most patients will regain their full range of motion and be able to perform any activity they desire after approximately two months. However, the very nature of removing cartilage from the knee increases the risk of arthritis 10 or 20 years into the future. As a result, depending on the severity of the tear in the progression of recovery, Dr. Manning may suggest avoiding particularly strenuous activities or sports that could put undue pressure on the knees and bring on arthritis more quickly. To schedule a consultation with Dr. Manning and learn more about the procedure and expectations for recovery, please contact us.