Meniscus Tears
The meniscus is a shock-absorbing cartilage in the middle of your knee. There are two menisci – one on the inside (“medial”) and another on the outside of the knee (“lateral”).

Patients with meniscus tears will complain of pain on either side of the knee. Sometimes there is associated swelling of the knee. Twisting or squatting can cause increased pain. Occasionally, if there is a large meniscus tear, a patient can complain that their knee locks, that is, it gets stuck in a certain position then needs to be “wiggled” to get it back into place.

The meniscus can be torn in two main ways.

  1. Traumatic tear – twisting injuries to the knee can cause meniscus tears. This can happen during sports or even while doing things around the house or office. Road accidents are another common way of injuring the meniscus.
  2. Degenerative tear – as you age, so do your menisci. They “wear out” and can tear with minimal trauma. Often people don’t remember what caused the tear at all!

Meniscal tears are usually diagnosed from the patients history and physical examination but a Magnetic Resonance Imaging (MRI) scan is very useful for confirming the diagnosis. If your knee continues to produce pain, your physician may recommend keyhole or arthroscopic surgery.  However, not all people with a meniscus tear require surgery. Some people are able avoid surgery if they can cope with their symptoms.
What is arthroscopy?
Arthroscopy is a surgical procedure in which a small camera (arthroscope) is inserted into the knee joint. Usually the surgery is viewed on a monitor so that the whole operating team is aware of the type of surgical procedure that is being performed.

 

What can be seen and done with the arthroscope?                                                                         

The arthroscope allows the surgeon to see many structures inside the joint. The development of specialised instrumentation has increased the repertoire of the arthroscopic surgeon in dealing with pathology in the various joints.

 

During the procedure, which is conducted under anesthesia, the inside of the joint is examined for damaged tissue. The most common types of arthroscopic surgery are performed on the knee or shoulder.

 

These include removal or repair of torn structures, for instance : ligament reconstruction in the knee (ACL or PCL reconstruction) , stabilisation of the shoulder or repair of the rotator cuff tendons of the shoulder. Other procedures include removal of loose debris and trimming damaged cartilage.

 

What are the benefits of arthroscopy?
Arthroscopes are approximately 5 mm in diameter, so the incisions are very small (approximately 1/8 inch). Arthroscopy is much less traumatic to the muscles, ligaments, and tissues than the traditional method of performing “open” surgery with long incisions (arthrotomy).

 

The benefits of arthroscopy involve smaller incisions, faster healing, a more rapid recovery, and less scarring. Arthroscopic surgical procedures are often performed on an outpatient basis and the patient is able to return home on the same day.

 

During the procedure, which is conducted under anesthesia, the inside of the joint is examined for damaged tissue. The most common types of arthroscopic surgery are performed on the knee or shoulder. These include removal or repair of torn structures, for instance : ligament reconstruction in the knee (ACL or PCL reconstruction) , stabilisation of the shoulder or repair of the rotator cuff tendons.

 

Other procedures include removal of loose debris and trimming damaged cartilage. If the need arises other joints can also be arthroscope ie. the elbow, ankle, wrist and hand.

 

Some common conditions in which our surgeons routinely use arthroscopy include:

  • ACL, PCL and other ligament reconstructions about the knee joint
  • Meniscus tears of the knee
  • debridement as well as repair
  • Shoulder dislocation and instability
  • Shoulder rotator cuff disease and tears
  • Loose bodies in the shoulder, knee, elbow or ankle
  • Cartilage ulcers in the knee and ankle
  • Certain operations involving the elbow, ankle and even hip
  • Assisting in the treatment of certain fractures involving joints

What is the prognosis after surgery?
The prognosis depends entirely upon what was found and what was done at the time of surgery. With proper physio and conditioning most patients return to active sports and daily activities.

 

Video of Knee Arthroscopy and Meniscectomy