The Biggest Mistake People Make After Knee Meniscus Surgery
Did you have any meniscus surgery in the past and youre still dealing with pain, swelling and possibly even losing motion in your knee? Well, this is not normal. But youre also not alone. This happens way more often than I like to admit. And the good news is that it can be helped without another surgery. If youre watching this video today, and youre considering having a meniscus surgery for your knee, then youll want to listen closely so that you dont make this mistake after you have your meniscus surgery.
And if youve already had your meniscus surgery, then you know what to do so that youre not getting more swelling, pain and not losing motion than that knee and youre staying out of the surgeons office, so you dont have to go back again for another knee surgery.
My name is Dr. David Middaugh. And Im a specialist physical therapist El Paso manual physical therapy. And this channel is dedicated to helping people stay healthy, active and mobile. while avoiding unnecessary surgery, injections, and medications. Please subscribe to this channel and turn on your notifications so that you dont miss a single video with great tips and advice that we put out every single week. So lets get to it.
What Happens During Arthroscopic Meniscus Surgery
The most common procedure for a torn meniscus is knee arthroscopy. It usually takes less than an hour.
First, you receive anesthesia. The surgical team cleans the skin on your knee and covers the rest of your leg with a surgical drape. The team might place a clamp on your upper thigh to help with positioning during surgery.
The surgeon makes a few small stab incisions in your knee called portals. The team then fills the knee joint with a sterile fluid. The fluid helps control minor bleeding in the joint and washes away debris, which helps the surgeon see inside the joint.
The surgeon inserts a small tool called an arthroscope into the incision. An arthroscope is a thin tube with a small light and video camera at the end. The camera projects video images from inside your knee onto a monitor.
The surgeon uses the arthroscope to look at the tear and decide what surgical technique to perform:
- Meniscus repair: The surgeon sews torn pieces of cartilage back together so they can heal on their own. However, because of tear type and blood supply, less than 10%of tears are actually repairable.
- Partial meniscectomy: The surgeon trims and removes the damaged cartilage and leaves healthy meniscus tissue in place.
Your surgeon inserts other surgical tools depending on the technique used. When the meniscectomy or meniscus repair is complete, the surgeon closes the portals with stitches or surgical strips. Then the team will cover your knee with a bandage.
Recovery From Arthroscopic Knee Repair Surgery
Recovery times vary depending on each persons circumstance. Age, injury, health status and the ability and commitment to follow through with physical therapy will all impact healing time. However, it is important to understand that it may take many months to feel better. Arthroscopic knee repair in minimally invasive surgery uses local or spinal anesthesia, small incisions and offers less bleeding with faster healing times and less damage to soft tissue. Arthroscopy is often an outpatient procedure. ACL reconstruction and meniscus tear repairs are often done together, arthroscopically. The orthopedic specialists at Orthopedic Specialists North County are experts in arthroscopic knee procedures.
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Can You Still Walk With A Torn Meniscus
Simple walking and other activities that do not require twisting, pivoting, rapid change of direction, etc., are generally well-tolerated after a meniscus tear. Tears can progress over time, but the rate of progression is generally gradual and highly variable. Pain is the guide. If a tear is being made worse, there will generally be associated symptoms of increased pain.
What Can You Do If You Have Pain
First, dont get another meniscus surgery! Second, consider new orthobiologic treatments rather than more surgery. Platelet-rich plasma has been shown to be effective in many different high-level clinical trials .
The upshot? Meniscus surgery where the doctor yanks the torn piece out is not a good idea. In fact, it causes more and not less arthritis. If you find yourself in this bad spot, dont get more surgery. Find a Regenexx physician to see if we can help you make your next move.
Montgomery SR, Zhang A, Ngo SS, Wang JC, Hame SL. Cross-sectional analysis of trends in meniscectomy and meniscus repair. Orthopedics. 2013 Aug 36:e1007-13. doi:10.3928/01477447-20130724-15
Fairbank, TJ. Knee joint changes after meniscectomy. J Bone Joint Surg Br. 1948 Nov 30B:664-70.
Baratz ME, Fu FH, Mengato R. Meniscal tears: the effect of meniscectomy and of repair on intraarticular contact areas and stress in the human knee. A preliminary report. Am J Sports Med. 1986 Jul-Aug 14:270-5. doi:10.1177/036354658601400405
N Engl J MedN Engl J MedN Engl J Med
Collins JE, Losina E1,2, Marx RG3, Guermazi A, MeTeOR Investigator Group. Early MRI-based Changes in Patients with Meniscal Tear and Osteoarthritis. Arthritis Care Res . 2019 Apr 1. doi:10.1002/acr.23891
Chris Centeno, MD
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How Long Is Non Weight Bearing After Meniscus Repair
As this healing occurs, patients progress towards bearing weight, increasing their range of motion, and leaving the knee brace behind. How quickly this progress occurs varies by surgeon, but a typical range is 4-8 weeks. Patients are usually out of the brace and walking without crutches around 2-3 months.
What Kind Of Complications May Occur After Surgery
Although complications are rare and the surgery is considered low-risk, the following list are possible complications of having meniscus surgery.
- Damage to skin nerves
How to prevent, reduce or minimize knee swelling?
Many people are familiar with the acronym RICE: signifying rest, ice, compression and elevation to help reduce and minimize swelling. This is also helpful to remember when thinking of preventing excessive knee swelling after meniscus surgery.
After surgery the knee is typically wrapped with a bandagethis is to both protect the knee but also serves to help reduce and prevent excessive swelling. If you have knee swelling further out in the recovery period consider asking your physician about using a wrap at home to gently compress the area.
Ice is often used to reduce swelling and pain after knee meniscus repair. When icing the affected area it is important to remember to keep a cloth of some sort between the ice pack and the skin and not to ice for more than 20-30 minutes at a time.
Resting and elevating the knee above the level of the heart with a few pillows can help to increase circulation which helps to prevent, reduce and minimize swelling. Lay with your back flat on a bed or couch and elevate the foot/lower leg with a few pillows until the knee is above the level of your heart.
A good way to also provide rest to your healing knee and meniscus is to follow your doctors recommendations on weight bearing restrictions.
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Expectations / Risks / Recovery:
This surgery has a very high success rate. In almost all cases, your recovery will be smooth and relatively quick, allowing you to resume all activities that you want to participate in within 4 to 6 weeks. However, everyone heals from knee surgery at a different pace a small number of people still experience pain and swelling several months after surgery.
Arthroscopic knee surgery has a very low complication rate . The standard risks of surgery include post-operative infection, blood clots in the leg , nerve or blood vessel injury, or anesthesia complications.
Immediately after surgery, if your pain is minimal when walking, then the use of crutches or a walker is not required. If necessary due to pain, patients may opt to use crutches or a walker for a few days after surgery. Once more comfortable, most people are able to walk with a minimal limp within one or two weeks after surgery. Most patients realize a benefit from arthroscopic knee surgery within 4 to 6 weeks. Reduction of pain and swelling, and improvement in knee strength, motion, and coordination may continue for three to four months after surgery.
How Do I Know If My Meniscus Repair Failed
If the knee does well and there are no significant symptoms, then it follows that the tear must have healed up and the repair was successful. If, however, a patient is unlucky enough to develop recurrent symptoms and ongoing problems with the knee, then the assumption is that the attempted repair has failed.
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Why Do My Knees Ache
Knee pain may be the result of an injury, such as a ruptured ligament or torn cartilage. Medical conditions including arthritis, gout and infections also can cause knee pain. Many types of minor knee pain respond well to self-care measures. Physical therapy and knee braces also can help relieve pain.
How Long Is Recovery For Meniscus Surgery
Recovery time depends on the severity of the meniscus injury and type of repair that was donewhether it was full or partial. Generally, for about four weeks after surgery patients will use crutches to keep weight off of the affected side. Some medical professionals may also require the use of a stabilizing device such as wearing either a cast or brace for the first few weeks after surgery.
If the meniscus was only partially injured and partially repaired, recovery time will be shorterperhaps within one month. If the whole meniscus was damaged and repaired, recovery time is expected to be longersuch as up to three months.
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Possible Benefits Of Arthroscopic Meniscus Repair
The meniscus is an important structure for load transmission and shock absorption in the knee. The knee is subjected to up to 5 times body weight during activity, and half this force is transmitted through the meniscus with the knee straight, and 85% of the force goes through the meniscus with the knee bent ninety degrees. Loss of the meniscus increases the pressure on the articular cartilage, which leads to degenerative changes. A successful meniscus repair preserves meniscus tissue and mitigates these changes.
What Does Knee Replacement Surgery Recovery Look Like
During knee replacement surgery, your doctor will make an incision before moving your knee cap and cutting away any damaged bone, cartilage, and joint surfaces. Artificial joints will then be attached and tested by bending and rotating your knee before your doctor closes your incision with stitches.
Whether youre having a total or partial knee replacement will have an effect on your pain level and recovery.
A traditional total knee replacement will typically require one to three months of recovery with the use of a walker or a cane. On the other hand, a partial knee replacement is much less invasive. Patients usually walk without assistance within two weeks. This is because the incision is much smaller and there is significantly less blood loss. While this may sound more appealing than a total knee replacement, only about 10% of patients are good candidates for a partial knee replacement procedure.
After your surgery, youll follow weight-bearing guidelines. How much pressure your new knee can initially support will depend on the condition of your natural bone, as well as the type of prosthesis you have.
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How Soon Can You Bend Your Knee After Meniscus Surgery
The First Weeks: Patients can remove the knee brace or immobilizer while not walking, and bend the knee. Your surgeon will typically restrict the amount you can bend your knee, since pressure on the meniscus increases as you bend your knee.
Knee Swelling After Meniscus Surgery
Many people may experience swelling around the knee as a result of their meniscus surgery. While this can be concerning, swelling can also be a normal part of the healing process. It is important to understand swelling, how to reduce swelling and when to recognize if it is problematic after meniscus repair surgery.
People in need of knee meniscus surgery are likely people who have a torn or ruptured meniscus. This article serves to provide information on torn meniscus, meniscus surgery and knee swellinga common complaint after knee meniscus surgery.
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Meniscus Repair Surgery Success And Failure
Most meniscus surgeries do not try to repair the meniscus, instead the surgery removes the meniscus tissue that is damaged. A 2020 study in The archives of bone and joint surgery offers an updated opinion on meniscus repair surgery. Here are some points brought up by the surgeon researchers.
Rehabilitation after meniscal repair is slower and different from rehabilitation after meniscectomy or meniscus removal
- Rehabilitation after meniscal repair is slower and different from rehabilitation after meniscectomy. The physiotherapist and surgeon should respect the slow process of biological healing of the meniscus and therefore they need to be careful with the rehabilitation program especially in active flexion. The return to sport should be delayed for up to 6 months however, 86 to 91% of patients could back to play. It is also crucial for the patient to know there is 8 to 20% risk of failure and re-operation . . .
Meniscus repair is not a small surgery without complication.
- Meniscus repair is not a small surgery without complication. It is technically challenging . . . specific complication including nerve injuries, ligamentous injury, iatrogenic cartilage lesions, and poor suture techniques can happen during meniscal repair. . .
Failure of meniscal repair occur in up to 25 % of patients
Arthroscopic Acl Ligament Reconstruction
On average full recovery from ACL reconstruction is 6-9 months for healthy, active patients. Surgical healing takes 6-8 weeks. A rehabilitation program to restore range of motion, strengthen muscles and regain balance will be part of your recovery. Patents can expect swelling and stiffness.
Patients go home immediately after surgery with crutches and a brace, plus a prescription for pain medication. Medication may be needed for 2-3 weeks. Rehabilitation begins within a week of surgery.
Crutches will be used until the patient can walk without a limp on the repaired knee, which takes about 2 weeks after surgery. The knee will be swollen for 2-3 months. Patients will be instructed on the use of ice to reduce swelling.
If the meniscus is also torn, and repaired at the same time, crutches will be needed for longer period. Total recovery time for an ACL reconstruction with meniscus repair is 12-16 weeks, and it varies with each individual.
Patients may drive after pain medication, but when the right knee is affected, the patient must wait for 4-6 weeks before resuming driving.
If the patient has a desk job, they may be able to return 7days after surgery. However, if their job requires lots of standing, the patient should wait to return until 4-6 weeks after surgery.
Resumption of sports will depend on the type of repair and your surgeon will determine when you can resume sports.
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Persistent Knee Pain After Arthroscopy
Persistent Knee Pain after Arthroscopy
So youve had knee arthroscopy but your knee still hurts. This is something I frequently see in my office especially for second opinions. The usual scenario is one where a patient had arthroscopic knee surgery for a torn meniscus. The surgery went well but the patient still has pain even though its now 2-3 months later. These patients are usually quite frustrated because they were under the impression that they would bounce back fast after their simple surgery. Adding insult to injury is the fact that almost every patient has had a neighbor or co worker who had the same surgery and who was back doing everything in 2 weeks.
In order to really understand what is happening I need information. I spend a lot of time trying to understand the current symptoms but I also ask about the symptoms before the surgery. It is also extremely helpful when a patient brings in their Op report, Pre-operative MRI and surgical pictures. Patients can usually borrow the surgical photographs or perhaps even get their own copy. These pictures allow me to see the state of the articular cartilage and the severity of the treated meniscus tear.
I like to see recent X-rays. I usually take standing weight bearing views of both knees, Lateral and Patellofemoral Sunrise view. These X-ray films are very important because they tell you information that the MRI does not.
In most cases a good ear to listen and the tip of my finger are the best diagnostic tools.
Whats The Recovery Time For Arthroscopic Knee Surgery
Recovery time after arthroscopic knee surgery differs based on the circumstances of the individual. Healing time is affected by age, injuries, health state, the capacity and willingness to complete physical treatment. It is crucial to remember that feeling better might take months. Arthroscopic knee repair is a minimally invasive procedure involving local anaesthetic, tiny incisions, less bleeding, faster healing, and less soft tissue injury.
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