Each knee has two crescent shaped cartilages called menisci. They are a complex shape and designed to be shock absorbers and stress transferers between the thigh bone and the shinbone in the knee. They reduce the force going across the knee to one third of what it would be without them. These menisci also have other roles as secondary stabilisers of the knee and may contribute to joint position sense and lubrication of the joint.
Meniscal tears occur in young people typically by injury eg skiing and football. In older patients it is more commonly a wear and tear type process. Patients will typically describe pain, swelling, clicking and locking and a sensation of instability in their knee.
Meniscal Repair Surgery
The Arthroscopy Association of North America advises that some 20 – 30% of meniscal tears can and should be repaired. Having your meniscus repaired should protect you against a later development of osteoarthrosis and should allow you to be more likely to be able to return to your pre injury level of activity. Success rates for meniscal repair surgery can be as high as 90%.
Meniscal repair surgery is carried out with arthroscopic/keyhole surgery to initially freshen the edges of any tear and then the torn elements of the meniscus are stitched back into place.
Post operatively, different surgeons will have different regimes, but we adopt that which is recommended by the Arthroscopy Association of North America advising patients to be non-weight bearing for four weeks in a hinged brace locked at a range of 0 – 30 degrees for four weeks. The brace can obviously be removed from time to time to bathe, get dressed and undressed etc but when off this range of movement still needs to be maintained. After four weeks patients come to clinic, the brace is removed, the knee is checked and a physiotherapy programme is commenced. Normally by three months patients can start returning to their sports.