Surgical Options For Torn Meniscus
Meniscus tears can be treated by meniscus removal , meniscus repair, or in unusual circumstances, meniscus replacement. Since the goal of surgery is to preserve healthy meniscus, meniscus repair is attempted when the tear is repairable.
Meniscectomy, removal of the damaged meniscus tissue, has good short term results but leads to the development of arthritis ten to twenty years later.
Meniscus repair also has good results, but has a longer recovery time than meniscectomy and is limited to tears which are amenable to repair.
Meniscus replacement is considered for young, active patients who have previously had most of their meniscus removed, and develop pain in the area without having advanced degenerative changes to the articular cartilage. Please see meniscus replacement for additional information.
Arthroscopic Knee Surgery Recovery
After a meniscectomy, your surgeon will likely advise physical therapy to put you on the best path toward recovery. The day after your surgery, you will need to see your physical therapist to:
- Change your dressings
- Take initial measurements
- Learn an initial home exercise program
Your physical therapist will also review information about what to expect, how to take care of your incisions and how to manage your pain. Handouts outlining everything you will learn will be provided.
Physical therapy appointments will be scheduled twice a week for approximately 6 to 8 weeks.
About Arthroscopic Meniscus Repair
Surgery for a meniscus tear is not an emergency. Arthroscopic meniscus repair is an elective procedure that can be scheduled to minimize disruption of patients lives. Results are maximized by repairing meniscus tears within the first two months of injury.
All surgery has risks. There is likely nothing you could imagine could go wrong that has not gone wrong at some time. That being said, meniscus repair is a safe procedure with a complication rate of 1.3%. The most common complications are injuries to skin nerves, the vast majority of which resolve without additional procedures by three months post surgery. Injury to larger nerves or blood vessels is rare, as are blood clots. Knee stiffness, infections, and other problems are uncommon, but can occur. An experienced surgical team uses special techniques to minimize these risks, but unfortunately they cannot be completely eliminated.
Meniscus repair is optimally performed within the first two months after meniscus tear to maximize meniscus healing. Walking on a knee that is locked may damage the meniscus further and make a tear unrepairable. Squatting should be avoided prior to surgery, as that may displace a piece of meniscus into the joint and cause locking.
The surgeons office should provide a reasonable estimate of the surgeons fees, the hospital fee, the anesthesia fee, and the degree to which these should be covered by the patients insurance.
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Research: For Many Patients Who Are Over 50 Arthroscopic Meniscus Surgery Should Not Be Offered Instead Patients Should Continue With Nonoperative Management Until Total Knee Replacement Is Unavoidable
From many years there has been a controversy as to whether arthroscopic knee surgery should even be offered to middle age patients. Some patients may get into that situation where they have had numerous surgeries.
In December 2020, surgeons published a paper in the medical journal Arthroscopy . In this paper the doctors traced arthroscopic knee surgical outcomes over a 20 years period in patients who had the knee surgery between the ages of 50 70. Part of the research was to see how many of these patients who had the arthroscopy, had to have a total knee replacement anyway.
Here are the learning points of this research:
- The study included 289 patients aged at surgery between 50 and 70 years old with diagnosis of degenerative meniscal tear who underwent arthroscopic meniscectomy.
- Patients with more advanced knee problems, women, and older patients were at higher risk to need a knee replacement after arthroscopic meniscus surgery
- The doctors reported a 15.7% conversion rate at 20 years from arthroscopic meniscus to total knee replacement and an average time between surgeries of seven years.
- Further, patients over the ago of 60 who had a lateral meniscectomy and concurrent ACL reconstruction were at higher risk for poor clinical outcomes at 20 years follow-up.
- Therefore, if patients present negative predictor factors, the arthroscopic meniscus surgery should not be offered, continuing with nonoperative management until total knee replacement is unavoidable.
I Have No Meniscus Will Stem Cell Therapy Grow One Back
NO. Stem cell therapy, as an injection in the doctors office, will not grow a meniscus from nothing. in our article Does stem cell therapy for knee meniscus tears and post-meniscectomy work?, we offer a lot of research, patient stories and clinical observations. To summarize that article here with learning points:
The reality of stem cell therapy
- It is important to note that we do not use stem cell therapy on every patient. In fact, we use stem cell therapy in very few of our patients. We find that other simpler and less costly regenerative medicine injection treatments can work just as well. This is explained below.
Over expectation of what stem cell therapy can do may lead to patient disappointment
- In many people who reach out to our office, we find that they have an unrealistic expectation of what stem cell therapy can and cannot do. For some people, stem cell therapy cannot, in one simple injection, repair and reverse years of degenerative damage. Many treatments may be necessary.
- If you have a meniscus tear, lesion, or hole in the articular cartilage, stem cell therapy may help create a natural healing patch, but, the treatment, like any medical treatment, has its limitations. Stem cell therapy can patch a hole, but without supportive treatments to address what caused the degenerative knee condition and what caused the hole in the cartilage in the first place, , stem cell therapy will not be the single-shot cure a patient will hope for.
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How Long Does It Take To Recover From Knee Arthroscopy Surgery
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How Long Is The Recovery
There are many factors at play here. The quickest recovery is if you are young fit and healthy, have good muscle strength and only have a small operation. If you are older, have poor muscles, have significant arthritis in the knee or have a long or extensive operation your recovery will be slower. After a knee scope, the muscles of the thigh do not function very well and they can become weak very quickly. This, in turn, makes the knee feel sore and unstable and can prolong swelling. You will be given some physiotherapy exercises and it is important to perform them twice a day for a few weeks until your muscle function has returned. You should also take regular pain killers and ice the knee for the first week or so.
For a simple medial meniscal tear, you should be able to return to a desk job after a week, be able to spend a few hours on your feet after 2 weeks and be able to return to gentle exercise or heavy work after about 4 weeks. Lateral meniscal tears may take twice as long to recover from. It is common to have some mild pain and swelling for a few weeks after your surgery.
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How Do You Sleep After Microfracture Surgery
The best sleeping position just after your surgery is sleeping on your back. You should make sure that your operative leg stays as straight as possible to avoid hypertension of the knee and keep proper blood flow to the surgery site. If you are sleeping on your back, put the pillow under your calf and knee.
Precautions To Take After Knee Arthroscopy:
Go for physiotherapy after ten days:
After ten days of knee arthroscopy, make sure to approach the physiotherapist around. Physiotherapy plays an integral role in retaining mobility in the knee joint. Make sure to approach someone who is having enough experience in the same field.
Dont engage in physical exercises:
Stop engaging in physical exercises until and unless your doctor will suggest you. These physical exercises could be anything but make sure not to go for them for extensive durations. Also, dont stand for a longer duration.
Be regular with the medicines:
Dont forget to take all the medicines on time because these will act as initiatives for recovery and help you to get rid of the pain as well. If you are missing want to medicine, it will lead to some problems, and there will be constant pain.
Control your weight:
Be on a proper diet but make sure not to consume those foods which are contributing to weight gain. In the recovery period, weight gain can be harmful, and it will cause some pain as well. Therefore make sure to have a protein-rich diet, not a fat-rich one.
Understand about right sleeping posture:
Ask the doctor about the right sleeping posture. If you slept on the operated knee, chances are there you might face some pain which let you feel irritated for no reason.
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How Long Does It Take To Walk After Knee Arthroscopy
After knee arthroscopy, a person will be able to move comfortably within 4 to 6 weeks. But in the duration of 4 to 6 weeks, it is essential for them to take enough precautions. If patients are not taking any precautions during this week, it may lead to some unnecessary problems, and there will be constant pain.
Apart from waiting for 4 to 6 weeks, it is also essential for them to take enough precautions.
What Is Arthroscopy And What Types Of Procedures Can Be Done Arthroscopically
With an arthroscopic procedure, your surgeon makes a small incision and inserts a miniature camera . Using that camera, the surgeon can perform certain procedures, such as trimming a torn meniscus. Arthroscopy can be used to diagnose and treat a number of knee conditions, including a torn ACL or PCL , torn meniscus, loose cartilage or a dislocated patella .
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When To Call The Doctor
If you develop a fever or if the surgical sites become red, hot, or swollen, contact your doctor immediately as these are signs that you may have an infection.
Also contact your doctor immediately if you experience increased throbbing or cramping pain, tenderness, warmth, or redness in your calf. These are characteristic signs of a deep venous thrombosis which requires immediate medical attention.
Contact Dr Gombera To Schedule Your Knee Arthroscopy Consultation
Dr. Gombera is a fellowship-trained and board-certified orthopedic surgeon specializing in arthroscopy, sports medicine and the treatment of hip, shoulder and knee injuries. His goal is to use the most cutting-edge and innovative therapies to relieve painful symptoms so you can get back to your optimal functioning and attain overall functionality and health. He focuses on minimally invasive procedures and never rushes surgical interventions so his patients can get back to their regular activities quickly.
Contact Dr. Gombera to schedule your knee arthroscopy appointment today.
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The Research On Stem Cell Therapy For Meniscus Tears Does It Work Or Not
At our center, we have seen bone marrow aspirate stem cell therapy help many people. There are many types of stem cell therapy including Amniotic, cord blood, placenta stem cell therapy. We DO NOT USE THESE PRODUCTS. This is explained in our article: Amniotic, cord blood, placenta stem cell therapy.
What If I Have Concerns After My Surgery
Please do not hesitate to contact Dr Schluters rooms or your GP if you develop any of the following:
Heavy bleeding from the incision
Sudden severe pain or tenderness at the wound site or in the joint.
Swelling in the calf or thigh, especially if associated with pain or heat
Redness around the incision that continues to spreads.
Temperature higher than 38.5 °C or chills.
Worsening flexibility or an inability to bend the knee.
Any concerns you may have regarding your recent surgery
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Is It Worth Having A Knee Arthroscopy
Though some surgeons may believe they can predict which patients will do well from surgery, this belief has not been validated. Despite the desire for this procedure to work, arthroscopy for degenerative knee conditions puts patients at risk of harm, including death, for no important benefits.
How To Cover Swimming Pool For Winter
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When To Start Range Of Motion After Microfracture Surgery
Range-of-motion is usually initiated early on after surgery. However, if the area of microfracture treatment is on the kneecap or within its groove, then motion will be limited for several weeks. Some surgeons will elect to use a CPM, or a motion machine, to help patients move their knee early on after microfracture surgery.
Quick Recovery From Knee Arthroscopy Is Common
Knee arthroscopy is performed by inserting a tiny camera through a very small incision in the knee. Using this method gives the surgeon a clear view of the interior of the knee and allows them to diagnose and treat knee problems with great accuracy. This technique is becoming very common.
In Arthroscopy: The Journal of Arthroscopic and Related Surgery, January 2008 edition, a study was published. This study was the first to log the recovery time of several patients who had knee arthroscopy. According to this study, eighty percent of patients who had knee arthroscopy were able to go back to light activities like yard work and walking only a week or so after surgery.
Dr. James Lubowitz is the lead author of this study. He is also the director at the Taos Orthopedic Institute of New Mexico. He relates that the main question patients have is When can I get back to my regular activities? He is pleased to report that this study, gives a very definitive answer to this commonly asked question.
Be sure that your orthopedic surgeon knows about any medications or nutritional supplements you are taking. He or she will let you know if you should stop taking them before your surgery.
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What Is A Knee Meniscectomy
The surgical removal of a torn meniscus is called a meniscectomy, which is a type of arthroscopic knee surgery. The meniscus is a cushion for your knee and helps keep your knee steady by balancing your weight.
Meniscus tears are most common in the knee joints and are usually caused by twisting or turning the knee quickly.
How Long Does Swelling Last After An Arthroscopy
The amount of swelling you have following an arthroscopy will vary from person to person. Swelling is to be expected and in the majority of people this is not concerning and will settle with time. Swelling may increase over the first few days before starting to settle. It may take between a week and 12 weeks for this to reduce significantly.
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What Are The Alternatives To Knee Arthroscopy
Some knee problems can be treated using physiotherapy and medicines.
You can access a range of treatments on a pay as you go basis, including physiotherapy. Find out more about physiotherapy >
How Long Does The Pain Last After Arthroscopic Knee Surgery
Pain is quite common, most often in the area where you had pain before surgery, in the soft tissues below the knee cap, over the athroscopy wounds and occasionally the whole knee. The pain settles usually within two to three weeks, but may take upwards of six weeks. Swelling in the whole knee up to six weeks.
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Manage Pain And Swelling As Prescribed
Pain is a natural part of knee arthroscopy and the healing process. To minimize pain and swelling, take medications as prescribed. Sometimes, non-steroidal anti-inflammatory are effective.
Medications provide relief so you can move your knee to aid in the recovery process. Icing and elevating your knee as recommended will help keep swelling down and minimize the risk of complications in the area of your incisions. A few days after surgery, Dr. Absi checks your progress, examines your knee, and begins your postoperative therapy program.
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My Knee Is Still Swollen Is This Normal
It is quite normal to have swelling, bruising, clicking and discomfort in your knee for 6- 8 weeks after the operation. These ongoing symptoms are generally related to the underlying condition of the knee, the extent of the surgery and the amount of activity you have been doing.
If you are concerned about any of these symptoms please contact Dr Schluters rooms.
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