Meniscectomy Surgery in Delhi, India

Two C-shaped cartilage (soft tissue) discs connect the thigh bone to the shinbone. These are known as menisci. They function as shock absorbers and provide stability to the knees.

Meniscus tears are common in athletes who take part in contact sports, such as football and hockey.

However, this injury can also occur when someone kneels, squat, or lift anything heavy. As one ages, the bones and tissues around the knee continue to wear down, increasing the risk of injury. The leg may swell and feel stiff if they tear their meniscus.

Indication of Surgery if :

• A tear doesn't heal with conservative treatment, such as rest or ice
• The knee joint goes out of alignment
• Knee becomes locked

A damaged or torn meniscus is usually identified during a physical check-up. The doctor will try to move the patient's knee and leg in a different position, ask them to walk and squat and look for signs of a meniscus tear.

Diagnostic Investigations

• X-ray- X-ray can help rule out other conditions causing similar symptoms.
• MRI- MRI can easily and accurately diagnose meniscus tears. It uses a strong magnetic field to give detailed images of the body.
• Arthroscopy- The arthroscope is placed into the body through a small incision near the knee. The device includes a light and a small camera that sends an enlarged image of the interior of the knee to a monitor. This procedure is used to inspect the inside of the knee.

A meniscectomy is a good option if:

• The patient is under the age of 45 years
• They can have surgery within two months of the injury

Meniscectomy is not recommended if

• At-home treatment can help reduce the symptoms.
• If the patient's age is beyond 45 years because meniscus tissue weakens with age

Some steps to take before undergoing a meniscectomy:

• Do physical therapy: Start physical therapy and at-home strengthening exercises a month before the surgery. The stronger the muscles around the knee are, the quicker the recovery. Doctors may also refer to a physical therapist who can help the patient understand how to use crutches. If the patient has crutches, they should bring them to the hospital.

• Clear your doubts: Talk to the surgical team and doctors about the procedure and what to expect before and after the surgery. The patient should clear all their doubts so they do not have second thoughts.

• Stop taking blood thinners and pain relievers: Doctors should be informed about all the medications and supplements the patient takes. Blood thinner and pain medication such as aspirin and ibuprofen must be discontinued before surgery.

• Fasting: The patient will have to fast the night before the surgery. (6 hours at least)

• Other steps: Bring any paperwork, insurance card, identification card, etc. The patient should leave valuable belongings, such as jewellery, at home. The patient should have a support system to drive them home after the surgery. .

There are two types of meniscectomies:

• Partial meniscectomy: A torn meniscus will not mend on its own. Surgery is required to remove the torn section of the meniscus. Most of the time, the torn part of the meniscus is removed using special devices during arthroscopic surgery.
• Total Meniscectomy: During this procedure, the whole meniscus is removed.

About the meniscectomy procedure and how it is performed

• Menisectomy is performed under spinal or general anaesthesia. It is an outpatient surgery, which means the patient can go home the same day.
• A meniscectomy typically takes approximately 20 minutes to complete, and the patient should be able to leave the hospital on the same day. In most circumstances, general anaesthesia is utilised for this type of surgery. However, in other cases, a spinal or epidural anaesthetic is employed.
• Most meniscus surgeries are done with an arthroscope, which is put into the knee through a quarter-inch incision and utilised to visualise the meniscus tear.
• One or two more small incisions, called portals, are made to insert the tools into the knee.
• Fluid is injected into the knee joint through one of these portals, which allows the surgeon to see the extent of the rupture.
• If the tear cannot be repaired or removed through partial meniscectomy, the surgeon may remove the entire meniscus.
• Stitches are used to close incisions, and the patient is transferred to the recovery room.

Meniscectomy is considered a safe procedure. However, there are a few major risks:

• Stiff joints
• Joint infections or joint effusion

The recovery depends on the type of surgery the patient had. Sometimes, the recovery from meniscus surgery is measured in days to weeks, and in cases of a meniscus repair might take a few months to recover fully. The concept of recovery begins before surgery. Physical therapy before surgery is essential and extremely beneficial; the stronger the leg before surgery, the better the prognosis.

Pain management after surgery is important for proper recovery following meniscus surgery. One can take care of themselves by wearing an ice compression sleeve or a knee compression sleeve throughout the day, as well as taking anti-inflammatories to reduce inflammation.

Factors that affect recovery include the type of meniscectomy, severity of the injury, overall health, usual physical activity, and physical therapy rehabilitation.

Reviewed by Dr. Karan Baveja, Consultant, Orthopaedics & Joint Replacement, Arthroscopy & Sports Injury on 02-May-2023.