Meniscal injuries are the most common knee injuries. These are amenable to treatment with an instrument called arthroscope. Your surgeon inserts this small instrument into your knee to get an excellent visualization of structure in your knee. He can appreciate the normal and abnormal or torn structures with its help.
Our surgeons are well trained to repair your meniscus and preserve it if they can, but unfortunately only few of meniscal tears are amenable to get repaired. They use the latest guidelines in order to make their decisions.The patients treated with meniscal injuries do see a dramatic improvement in the pain postoperative.
Meniscal tear : Group discussion
Juggerstitch Meniscal repair device is one of the recent advances in meniscal repair. This is an all inside Meniscal Repair device. It is made up only of sutures that means that there is no plastic parts as were seen in older devices.
The technical details of the particular device are explained in detail in the video.
It is quite a simple to use device with very high accuracy
Many patients approach us with a grade 1 meniscal tear finding in the MRI and they are very tense that they may need surgery . They should understand that grade 1 meniscal signal on the MRI is actually not a tear and all such patients may not need an arthroscopic surgery.MRI findings are many times deceptive and have to be interpreted with caution.As a general rule a grade 3 meniscal signal is equivalent to a tear . Grade 1 meniscal signal will almost never need arthroscopic procedure. Grade 2 meniscal signal also will very ocassionally need an arthroscopic procedure.
Meniscus tear : Public awareness
Post meniscal repair
Most meniscal injuries can be diagnosed by obtaining a detailed history. Important points to address include the following:
Mechanism of injury
Meniscus tears are sometimes related to trauma, but significant trauma is not necessary. A sudden twist or repeated squatting can tear the meniscus. The timing of the injury is important to note, although patients often cannot describe a specific event.
Meniscus tears typically occur as a result of twisting or change of position of the weight-bearing knee in varying degrees of flexion or extension.
Pain from meniscus injuries is commonly intermittent and is usually the result of synovitis or abnormal motion of the unstable meniscus fragment.
The pain is usually localized to the joint line.
Mechanical complaints: Descriptions by patients are often nonspecific but include reports of clicking, catching, locking, pinching, or a sensation of giving way.
Swelling usually occurs as a delayed symptom or may not occur at all. Immediate swelling indicates a tear in the peripheral vascular aspect.
Degenerative tears often manifest with recurrent effusions due to synovitis.
If symptoms persist, if the patient cannot risk the delay of a potentially unsuccessful period of observation (eg, elite athletes), or in cases of a locked knee, surgical treatment is indicated.
The basic principle of meniscus surgery is to save the meniscus. Tears with a high probability of healing with surgical intervention are repaired. However, most tears are not repairable and resection must be restricted to only the dysfunctional portions, preserving as much normal meniscus as possible.
Surgical options include partial meniscectomy or meniscus repair (and in cases of previous total or subtotal meniscectomy, meniscus transplantation). Arthroscopy, a minimally invasive outpatient procedure with lower morbidity, improved visualization, faster rehabilitation, and better outcomes than open meniscal surgery, is now the standard of care.
Partial meniscectomy is the treatment of choice for tears in the avascular portion of the meniscus or complex tears that are not amenable to repair. Torn tissue is removed, and the remaining healthy meniscal tissue is contoured to a stable, balanced peripheral rim.
Meniscus repair is recommended for tears that occur in the vascular region (red zone or red-white zone), are longer than 1 cm, involve greater than 50% of the meniscal thickness, and are unstable to arthroscopic probing. A stable knee is important for successful meniscus repair and healing. Thus, associated ligamentous injuries must be addressed. The most commonly associated ligamentous disruption is complete tear of the ACL, which must be reconstructed to prevent recurrent meniscal tears. Fortunately, the increased blood and growth factors in the knee during meniscal repair combined with cruciate reconstruction significantly improves the outcome of the meniscal repair. In ACL-intact knees with isolated meniscal tears, healing rates are less than those in ACL-reconstructed knees, but they are higher than those in ACL-deficient knees.