If you have had knee pain recently, or periodically for months or years, it's possible that you have a meniscus tear, also referred to as "torn cartilage." A meniscus tear often occurs during a twisting or pivoting motion with the foot planted on the ground - for example, when playing tennis or squatting in the garden - and it can also occur from lifting. A tear can occur at any time during life, but it is rarely seen in young children. With age, the menisci become worn and may tear more easily.
The symptoms of a meniscus tear depend on the size and location of the tear. Because the menisci have no nerve endings, pain associated with a tear is actually due to swelling and injury to the surrounding tissue. With a small tear, you may experience minimal pain. Over several days, slight swelling may develop gradually. Often, you may walk with minimal pain, but squatting, lifting, or rising from a seated position may increase the pain. Small tears may possibly heal on their own with a brace and a period of rest.
With a typical meniscus tear, you will feel pain at the side or center of the knee, depending on the tear's location. Often, walking is not impeded, and the knee may swell or feel stiff. You may also experience limited bending of the knee. Over time, symptoms may diminish but could recur with activities that involve twisting or overuse of the knee. Pain may appear and disappear over a period of years, and the tear may become larger if left untreated. Other symptoms include tenderness when pressing on the meniscus, popping or clicking within the knee, and limited motion of the knee joint.
The location of the tear may determine whether or not the knee is able to heal on its own. Tears at the outer edge of the meniscus tend to heal more easily because there is a good blood supply. However, the inner two-thirds of the meniscus does not have a good blood supply, which makes it difficult for tears to heal on their own. In time, this may cause the knee to develop arthritis.
Ice packs and immobilization can be used for immediate treatment of almost any knee injury. Such simple measures will help to decrease swelling and pain in the joint. When a tear begins to interfere with everyday activities, arthroscopic surgery may be necessary to prevent additional damage and to restore the knee's full functional abilities.
Most meniscus tears are small, and the torn portion is removed, leaving a smooth, stable surface. Occasionally, other problems are found during arthroscopy, such as cartilage damage or loose fragments, and these may also be treated during surgery.
Certain meniscus tears must be repaired. Historically, during a meniscal repair procedure, stitches were placed from the interior of the knee outward, and incisions were made at the joint line to allow for tying of the knots. In recent years, an instrument was introduced that includes pre-loaded surgical implants that are absorbed in the body over time, as well as a pre-tied knot. With this innovative device, meniscal repair can be performed without the need for additional incisions.
What is Arthroscopic Knee Surgery
In the late 1970s and early 1980s, arthroscopic surgery became popular, especially in the sports world, as fiber-optic technology enabled surgeons to see inside the body using a small telescope, called an "arthroscope," which projects an image to a television monitor. Thanks to ongoing improvements made by technology leaders like Smith & Nephew, arthroscopic surgery is now accessible to more people than just professional athletes. In fact, active patients all over the world have experienced the benefits of minimally invasive surgical procedures.
Arthroscopy may be used for a variety of knee joint conditions, including a torn meniscus, loose pieces of broken cartilage in the joint, a torn or damaged anterior or posterior cruciate ligament (ACL/PCL), an inflamed or damaged synovium (the lining of the joint), or a malalignment of the patella (knee cap).
Through an incision the width of a straw tip, your surgeon is able to insert a scope, which allows him or her to inspect your joint and locate the source of your pain. The scope can also help identify tears or other damage that may have been missed by an X-ray or MRI. Your surgeon will then make one or more small incisions to accommodate the instruments used to repair the knee. These instruments can shave, trim, cut, stitch, or smooth the damaged areas.
Arthroscopic knee surgery is often performed in an outpatient surgery center, which means no overnight hospital stay is required. Patients report to the surgical center in the morning, undergo the procedure, and - following a recovery period under the care of medical professionals - return home later in the day.
After surgery, you will be transported to the recovery room for close observation of your vital signs and circulation. You may remain in the recovery room for a few hours.
When you leave the hospital, your knee will be covered with a bandage, and you may be instructed to walk with the assistance of crutches. You also may be instructed to ice or elevate your knee.
Your surgeon will likely provide further details regarding postoperative care for your specific procedure.
Steps for rehabilitation following a meniscus repair or an ACL procedure vary from physician to physician. To learn what activities will be involved in your own rehabilitation, consult your orthopedic specialist.
Reasons For Arthroscopic Knee Surgery
Minimally invasive knee surgery is a positive measure to regain your active lifestyle, which knee damage has negatively affected over a period of weeks, months or even years.
Arthroscopic surgery can:
- Relieve pain.
- Improve joint stability.
- Repair tears and damage.
- Maximize quality of life.
- Optimize activities of daily living.
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