The menisci, there are two in each knee, are made of cartilage, act as shock absorbers and are fundamental for joint stability. The menisci are responsible for the health and longevity of the knee; so, it is vital to preserve the menisci to protect the articular cartilage at the ends of the bones to prevent or delay the onset of osteoarthritis.
Meniscal injury is common in young active sports people and in the elderly. Acute, traumatic tears accelerate cartilage wear and lead to early onset osteoarthritis. The goal of treatment is to preserve the meniscus wherever possible.
What is meniscus repair?
Meniscus repair is a procedure designed to preserve the meniscus. The goal of repair is to achieve meniscal healing, eliminate pain and restore full function and return to play. Meniscus repair is an outpatient procedure. It is a safe and low risk operation using a special instrument called an arthroscope. Recovery takes about three months. Repair is indicated for most acute, traumatic tears.
Your orthopedic consultation
Sports medicine physician and orthopedic surgeon Dr. Godin is an expert knee surgeon who is accomplished in specialized meniscus repair procedures for his young active patients.
During your consultation, he will review your medical history, examine your injured knee, and discuss your symptoms and the circumstances surrounding your injury. He will order x-rays and imaging studies to evaluate the soft tissues in the knee including your meniscus. With this information he will recommend the most appropriate treatment for you.
Dr. Godin will determine whether repair is an option for you based on the type and size of the tear and its location; the presence of other knee injuries such as an ACL tear; and the general health of the meniscus. When the injury is severe, and you are a good candidate for repair, he will explain the procedure to you. You will schedule your procedure and receive preop instructions and prescriptions.
Arthroscopic repair is minimally invasive surgery under general or regional anesthesia. Dr. Godin will make several small punctures in and around the knee to insert the arthroscope, a lighted tube attached to a monitor. Once inserted he will be able to visualize the inside of the knee and confirm the diagnosis of a tear, its extent and location, and evaluate the health of all the knee structures.
There are several surgical techniques. Using his preferred technique, he will suture the torn edges together and suture the meniscus to the bone. He may also use techniques to enhance healing called augmentation including the use of Platelet-Rich Plasma, needling, and stem cells.
After surgery, you will use crutches and most often be sent home that day. Physical therapy will be started to restore strength and mobility. Recovery typically takes about three months.
The advantages of meniscal repair
When the meniscus is torn, the goal is to preserve the meniscus by repairing the tear. Other options include removing part or all of the damaged meniscus. Compared with other options, repair has a better long-term functional outcome, allows a better activity level, and lower failure rates than either a partial or total meniscus removal (meniscectomy). One drawback is that repair has a higher reoperation rate than a partial meniscectomy. However, the advantages out weight the risk.
Repair is now recommended for all repairable tears especially in young and physically active patients. When the tear cannot be repaired the treatment is removal and replacement. Partial meniscus implants have also shown excellent outcomes.
Dr. Jonathan Godin is a board-certified orthopedic surgeon and sports medicine expert and the go-to choice of professional athletes. Patients who love their sports and are not pro athletes including young adults and geriatric patients receive the same expert orthopedic care at Vail Orthopedic Surgery in Colorado. Contact the Steadman Clinic to schedule a consultation with Dr. Godin.