All Torn Up
The meniscus is a piece of cartilage in the knee that cushions the thighbone and shinbone. Each lie between the femoral condyle and the tibial plateau on the corresponding side of the knee joint. Any activity that puts additional pressure on the knee or an over-rotation can cause a tear. Microtears, or smaller tears, can heal with rest. However, if the cartilage is severely damaged, a doctor may suggest surgery. Unfortunately, invasive surgery can be expensive, risky, and can have a longer recovery time. Luckily, minimally invasive meniscal repair surgery can help.
Understanding the menisci
There are 2 menisci in each knee called the medial and lateral meniscus. These thin fibrous pieces of cartilage distribute load, absorb shock, provide lubrication, and stabilize the femorotibial joint. The meniscus also provides vital nutrients to the knee. Unfortunately, sporting activities that include squatting and pivoting increase pressure on the cartilage. Wear and tear, namely arthritis, can also cause tears.
In many cases, meniscus tears do not need surgery. Menisci heal through rest, physical therapy, medication, and nutrition. Tears caused by arthritis often improve with treatment. Severe tears, however, can cause locking or block knee function. These usually take a longer time to heal but should become less painful over time. Menisci torn in the red zone have a rich blood supply that helps the tissue regenerate or heal post-surgery. However, if swelling and pain have not subsided in 6 weeks, a doctor may recommend surgery.
Types of meniscus surgery
There are 3 types of meniscal repair surgery, namely, meniscectomy, meniscal transplant, and meniscal reconstruction. Meniscectomy involves the surgical removal of part or all of the cartilage. Meniscal transplant, which is a bit rare, entails replacing the cartilage with a donor piece of cartilage. Finally, meniscal reconstruction, the least invasive, entails inserting small dart-like devices along the tear through small cuts. All surgery types come with some risk and increased downtime.
When is surgery required?
The need for surgery depends on the size, type, and location of the tear, which a doctor can assess through an MRI. The red zone is on the outer edge, while the white zone is inside. Red zone tears don’t require intervention as the blood supply is enough to heal naturally. Unfortunately, tears in the white zone require surgery as there is no blood supply to assist healing. White zone tears need surgery to either replace or remove damaged meniscus. Surgery can be risky, especially in older patients. Surgery is also helpful if physical therapy and rest bring no relief to pain and movement does not improve.
Look for the signs
Meniscus surgery helps when there is no improvement after 6 weeks of rest and home therapy. Tears in the red zone usually heal without surgery. However, white zone tears typically require repair. The only test that can confirm this is an MRI performed by a doctor. Speak to a medical professional to learn more about meniscal repair surgery.