What is meniscus repair surgery?

What is meniscus repair surgery?

‍

Meniscus repair surgery is a surgical procedure performed to treat a tear in the meniscus, a C-shaped cartilage structure in the knee joint. The menisci act as shock absorbers and help stabilize the knee by distributing the load between the femur (thigh bone) and tibia (shin bone).

‍

Meniscal tears are common knee injuries, often occurring during activities that involve twisting or sudden changes in direction. It can cause acute locking of the knee or chronic symptoms with intermittent catching/locking. Pain during forced knee movements and joint swelling also occurs. Depending on the location, size, and type of meniscal tear, as well as the patient's age and activity level, meniscus repair surgery may be recommended.

‍

During meniscus repair surgery, the surgeon uses arthroscopic techniques, which involve small incisions and a camera (arthroscope) to visualize the inside of the knee joint. The arthroscope provides a clear view of the torn meniscus, allowing the surgeon to assess the tear's characteristics and extent.

‍

If the meniscus tear is in a location that has a good blood supply (usually the outer third or red zone of the meniscus), the surgeon may attempt to repair the tear using sutures or other fixation devices. This is known as meniscal repair. Repairing the meniscus helps preserve the natural cushioning and stability of the knee joint.

‍

However, not all meniscal tears are repairable. In some cases, especially when the tear is in the inner two-thirds or white zone of the meniscus with a limited blood supply, the damaged portion of the meniscus may need to be trimmed or removed through a procedure called meniscectomy.

‍

The decision to perform meniscus repair surgery or meniscectomy is made by the surgeon based on the specific characteristics of the meniscal tear and the patient's individual circumstances.

‍

After meniscus repair surgery, patients undergo a rehabilitation program, including physical therapy, to promote healing, regain knee strength and range of motion, and gradually return to normal activities and sports.

‍

Meniscus repair surgery has a higher success rate in younger patients with appropriate tear characteristics and good tissue quality. It can help prevent long-term knee problems, preserve knee function, and reduce the risk of arthritis in the affected knee joint.

‍

Who can benefit from meniscus repair surgery?

‍

Meniscus repair surgery can benefit individuals who have a significant tear or rupture of the meniscus or if nonoperative management of a partial tear has been unsuccessful. The decision to perform meniscus repair surgery is based on various factors, including the type, location, nature, and extent of the meniscal tear, the patient's age, activity level, and overall knee health. Not all meniscal tears are repairable, and the surgeon will carefully assess the tear's characteristics to determine the most appropriate treatment approach.

‍

The following are some factors that may indicate a patient can benefit from meniscus repair surgery:

‍

1. Red zone tear: Meniscal tears that occur in the outer third of the meniscus (red zone) tend to have a better blood supply, making them more amenable to repair.
2. Acute tears: Meniscal tears that result from a sudden injury (acute tears) are more likely to be repairable than chronic or degenerative tears.
3. Younger age: Younger patients generally have a better healing potential and may benefit more from meniscus repair surgery.
4. Good tissue quality: The quality of the meniscal tissue is a critical factor in successful repair. If the tissue is healthy and strong, the chances of a successful repair increase.
5. Stable knee joint: Meniscal repair is more likely to be successful in knees that are stable without significant ligament injuries or instability.
6. Active lifestyle: Individuals with an active lifestyle, especially athletes, may benefit from meniscal repair surgery to preserve knee function and return to their pre-injury level of activity.

‍

It's important to note that not all meniscal tears are candidates for repair. Some tears, especially those that occur in the inner two-thirds of the meniscus (white zone) with limited blood supply, may not heal well with repair techniques. In such cases, meniscectomy (partial removal of the damaged meniscus) may be considered.

‍

The decision to undergo meniscus repair surgery should be made in consultation with an orthopedic surgeon who specializes in knee injuries. The surgeon will thoroughly assess the patient's knee condition, the specific characteristics of the meniscal tear, and other individual factors to determine the most appropriate treatment plan. If meniscus repair is not possible, the surgeon will discuss alternative treatment options, such as meniscectomy or other non-surgical treatments, to address the meniscal tear and alleviate knee symptoms.

‍

After meniscus repair surgery: What to expect

‍

After meniscus repair surgery, the recovery process is essential to ensure proper healing and successful rehabilitation. Here's what you can generally expect during the recovery period:

‍

1. Hospital stay: Meniscus repair surgery is typically performed on an outpatient basis, meaning you can go home the same day of the surgery.
2. Pain management: You may experience pain and discomfort in the knee after the surgery. Your healthcare team will prescribe pain medications to manage post-operative pain.
3. Immobilization: You may be required to wear a knee brace or a hinged knee immobilizer to protect the surgical site and limit knee movement during the initial healing phase. The duration of immobilization will depend on the surgeon's recommendation.
4. Weight-bearing: Depending on the specific surgical technique used and the extent of the repair, your surgeon will provide instructions on weight-bearing restrictions. The use of crutches upon standing and walking is also recommended after surgery.
5. Physical therapy: Physical therapy is a crucial component for the recovery process after meniscus repair surgery. You will begin physical therapy exercises early on to promote healing, regain knee strength, and improve range of motion.
6. Swelling: Swelling in the knee is common after surgery. Your physical therapist will guide you in using ice and elevation to manage swelling. In some cases, thigh-high compression stocking is prescribed to control the swelling on the affected leg.
7. Range of motion: Gradual improvement in knee range of motion is expected during the recovery process. Physical therapy exercises will focus on restoring full knee mobility.
8. Gradual return to activities: Your surgeon and physical therapist will guide you in a step-by-step approach to return to daily activities, work, and sports. Returning to sports may take several months.
9. Follow-up appointments: You will have regular follow-up appointments with your surgeon to monitor your progress and adjust your treatment plan as needed.

‍

It's crucial to follow your surgeon's and physical therapist's instructions diligently to ensure a successful recovery. The rehabilitation process may take several weeks to months, patience and commitment to the prescribed exercises are essential for achieving the best possible outcomes. Your healthcare team will guide you throughout the recovery process, addressing any concerns and ensuring your safety and well-being.

‍

How can physical therapy help? 

‍

Physical therapy plays a crucial role in the recovery process after meniscus repair surgery. A physical therapist will design a customized rehabilitation program to promote healing, regain knee strength, improve range of motion, and gradually return you to your normal activities and sports. Here's how physical therapy can help with meniscus repair surgery:

‍

1. Protecting the repair: Physical therapists will provide instructions on how to protect the repaired meniscus during the first few postoperative weeks. It includes wearing the range limiting brace continuously (day and night) as prescribed. The percent of body weight permitted during weight bearing is also discussed to ensure that the patient will not put excessive stress on the knee joint.
2. Pain management: Physical therapists use various techniques and modalities such as ice, heat, ultrasound, and electrical stimulation to manage post-operative pain. Leg elevation and ankle pumping exercises are also prescribed to help manage swelling and prevent vascular complications
3. Range of motion exercises: Early after surgery, gentle range of motion exercises such as passive to active range of motion with or without assistance are prescribed to prevent stiffness and maintain the available range of motion of the affected knee. Patellar mobilization may also be prescribed. As the patient improves, stretching exercises are utilized to increase muscle flexibility and joint range of motion.
4. Strengthening exercises: As healing progresses, physical therapists prescribe progressive strengthening exercises to increase muscle strength, endurance, and performance. These exercises includes; stationary cycling against light to moderate resistance, squats and lunges with the use of elastic resistance bands, and other progressive strengthening exercises for the lower extremity. 
5. Neuromuscular control, balance and proprioception training: These exercises are an essential component of the postoperative rehabilitation program. It improves your joint position sense  (proprioception), and control as well as dynamic and static balance, reducing the risk of reinjury and promoting confidence in knee movements.
6. Gait training: In the first phase of the rehabilitation program, early ambulation (walking) is prescribed. The physical therapists will teach the patients about appropriate gait patterns with the use of crutches, while considering the weight bearing restrictions. As the patient improves, the therapists will utilize progressive gait training in full weight bearing without crutches. Emphasizing on symmetrical alignment, step length and timing to reestablish a normal gait pattern. 
7. Gradual weight-bearing progression: Physical therapists will guide you through a gradual weight-bearing progression to help you safely regain the use of your knee.
8. Aerobic exercises: Physical therapists will prescribe aerobic exercises to improve cardiopulmonary endurance of the postoperative patients. Initially, it includes stationary cycling or pool-walking, and later on will progress to treadmill training, land walking or use of an elliptical trainer as tolerated.
9. Plyometric training and agility drills:  Plyometric training, also referred to as stretch-shortening drills, is designed to improve power, and develop quick neuromuscular responses. This type of training involves high speed movements and quick changes of direction such as; forward-backward and side-to-side shuffles, jumping on and off surfaces of varying heights and landing using proper mechanics to reduce the risk of re-injury. On the other hand, agility drills are designed to develop coordination, balance and quick neuromuscular responses. It involves activities such as; stepping over obstacles in the environment first while walking then while running or pivoting. These forms of training are appropriate during the advanced phase of rehabilitation for selected patients intending to return to high-demand work- or sport-related activities. 
10. Sports-specific training: Physical therapists tailor exercises to the specific demands of your chosen sport, preparing you for a safe return to sports participation.
11. Functional training: As the knee muscle strength, endurance, performance, balance and proprioception improve, functional training is prescribed. It involves practicing activities that simulate the physical demands of a patient’s work or desired recreational or sport activity. Simulated activities and drills enable a patient to practice under supervised conditions to receive feedback on correct mechanics. 
12. Patient education: Physical therapists educate patients about meniscus repair, its indications and benefits as well as the role and importance of postoperative rehabilitation programs. They also teach patients about  proper knee care, activity modifications, and injury prevention strategies.
13. Home exercise program: A specialized home exercise program is provided by the physical therapists. They also teach the patients how to safely incorporate it into their daily routine to reinforce the intervention and promote optimal recovery. 
14. Progress monitoring: Physical therapists continually monitor your progress and adjust the treatment plan as needed to ensure a successful recovery.

‍

The duration and intensity of physical therapy will vary depending on individual factors, including the extent of the meniscus repair, your surgeon's recommendations, and your progress. The therapist's expertise and guidance are essential to optimize your recovery, prevent complications, and support your safe return to your desired level of activity and sports participation after meniscus repair surgery.

Trust PeteHealth for recovery from meniscus repair surgery

Looking for a physical therapist to help you recover from meniscus repair surgery? PeteHealth is the trusted physical therapy solution that you can access on your schedule, bringing you the care you need wherever you need it – including your home or office. Our licensed physical therapists are at the top of their profession, and we accept most insurance carriers.

‍

Finally – the all-in-one, professional, convenient approach to physical therapy that you deserve with PeteHealth.

‍