The meniscus is the C-shaped cushion of soft tissue sitting at the top of the shinbone between the shinbone and thighbone. It acts as a shock absorber for the knee. Each knee has two menisci, the lateral (outside) and medial (inside). They help decrease stress in the knee by allowing the thighbone to glide over the shinbone as the knee moves.
The meniscus is often torn playing sports that involve quick stopping, forceful turning, and sudden twisting motions. Though many athletes hear a pop when the meniscus is torn, they keep playing after the injury because it may not hurt immediately. Over two to three days the injured knee may become increasingly stiff, swollen, and immobile. The torn portion of the meniscus may interfere with knee movement, often resulting in locking, catching, and clicking sensations. An MRI is usually performed to confirm a meniscus tear.
The ability of the meniscus to heal naturally depends on the amount of blood flow in different region of the meniscus. Tears in the outer 1/3rd of the meniscus have a good chance to heal because this region receives good blood flow. Small tears in this region may heal with rest. For larger tears in this region, Meniscus Repair surgery provides an opportunity for return to pre-injury level of play and activity. Tears the inner 1/3rd of the meniscus are unlikely to heal on their own because of lower blood flow. In this region, Partial Meniscus Removal focuses on removing the pieces of tendon interfering with knee movement to reduce pain and swelling. Depending on your age and other concurrent procedures you are having, middle 1/3rd meniscus tears can be repaired or partially removed.
In Meniscus Repair surgery, Dr. Shani stitches or anchors torn portions of the outer region of the meniscus back together. The good blood flow in this area allows the meniscus heal naturally, so surgery can focus on repairing the injured meniscus. In Partial Meniscus Removal, Dr. Shani trims off and smoothes the torn tissue in the outer parts of meniscus that is interfering with knee movement. Both Meniscus Repair and Partial Meniscus Removal orthopedic-surgery are usually arthroscopic orthopedic-surgery. This minimally invasive outpatient technique is performed with pencil-thin medical instruments through small incisions made around the knee.
For partial meniscal removal, patients begin immediate physical therapy after surgery with no brace and full weight bearing and usually return to full activity and sports by six to twelve weeks post after surgery. For meniscal repairs, patients work with Dr. Shani and a physical therapist for about six months on an individualized rehabilitation plan to quickly get back to sports. For six weeks after surgery the leg is kept in a brace at full extension only while putting weight on the knee. During this time, patients also begin range of motion exercises and quadriceps strengthening. . After three months, most patients resume non-impact sports such as swimming and biking. Most patients return to their pre-injury level of play and activity after about six months of physical therapy and consultations with Dr. Shani.
