ORTHOPEDICS/HIP & KNEE/MENISCUS DAMAGES
A meniscus tear is a damaged or torn cartilage.
Once diagnosed, a decision is necessary to treat the damage accordingly.
Several meniscus tears, mainly chronic tears, can be treated non-surgically and may include: Physical therapy, strengthening movements, Anti-inflammatory medicines and Cortisone injections.
However, with severe meniscus tears, a surgical therapy may be performed.
Why Meniscus Restoration May Be Compulsory?
When a meniscus tear is serious and grave. Your surgeon may require a meniscus restoration as a conceivable therapy alternative for the damaged or torn cartilage.
Years before, when a patient was suffering of a torn cartilage, and surgery was required, the whole meniscus was removed.
The problem was that with the time, the cartilage at the bones ends was damaged more rapidly. This is thought to be the result of knee joint loss cushioning and the reduced steadiness usually seen after a meniscus restoration.
With the new arthroscopic technique, surgery has become more convenient.
With arthroscopic, partial meniscus removal is performed, called a partial meniscectomy.
A partial meniscectomy is performed to remove only the meniscus torn part.
Who Needs Restoration?
Tears of the meniscus that cause so-called “mechanical indicators” tend to respond best to surgical therapy.
Frequent “mechanical indicators” include:
Knee Locking
Unable curving
Knee straightening Inability
A popping sound or feeling
Surgery consider two eventual alternatives: removing the torn meniscus (a partial meniscectomy) or perform a meniscus restoration to install the edges together with junctions or screws.
Is Meniscus Restoration Better?
To remind, the meniscus is a circular cartilage piece with its blood supply coming from the outer rim.
In order to allow the restored meniscus to heal, the tear must be near this outer edge in a zone of good blood supply (nutrients from the blood vessels are mandatory for healing). This is the so-called red (vascular)-white (non-vascular) area of the meniscus.
Tears in the meniscus central portion will not heal even if a meniscus restoration is performed.
This meniscus part does not receive enough blood supply.
When looking at this meniscus nonvascular part, it looks white; therefore, tears in this meniscus sector are not restored.
These tears are within the white sector where there is no blood supply. Your surgeon will remove these central tears.
Surgery / Execution
Meniscus repair procedures include using arthroscopically positioned screws or suturing the torn edges.
Both techniques function by approximating the torn edges of the meniscus to allow them to heal in their correct position and not be caught in the knee causing repeatedly the above-mentioned signs.
Success of meniscus repair surgery depends on two features:
First, if the meniscus repair is attempted a tear in the cartilage central portion (where the blood supply is meagre).
Second, patients must be obedient with the postoperative rehabilitation after a meniscus restoration.
If the meniscus repair fails, which means that the repaired meniscus does not heal, another surgery may be needed to remove again the re-torn meniscus.
Rehab after Restoration
Rehab following a total meniscus restoration surgery is more wide-ranging than rehab after a partial meniscectomy (surgery to remove the partial meniscus tear).
To allow the torn meniscus healing, some specific activities must be avoided (particularly activities that require placing intensive stress on the healing meniscus); in addition to refrain from exerting deep flexion (such curving the knee), since this movement is reputed to engage high stresses on the restored meniscus.
For such motifs, patients who undergo meniscus restoration surgery are installed in braces for several months.