Meniscus Repair & Debridement
Arthroscopy is a minimally invasive surgery technique. Two small incisions are made around the joint to allow a camera and various instruments to pass through. Small instruments are used to visualize the anatomic structures and to repair the torn portion of the meniscus by passing small sutures through the meniscus to hold it together. Frequently, the repair is augmented by releasing stem cells from the bone by creating a few small holes in the adjacent bone.
Why Knee Arthroscopy
A knee arthroscopy is a minimally invasive procedure that involves making two small incisions (roughly 0.5 inch each) in the front of the knee joint. These small portals allow a camera to enter the joint for visualization of anatomic structures, as well as tools to repair any injured structures. Dr. Faulkner examines the menisci and determines if the meniscus is repairable or not (depending on the location and type of the tear). If the tear is repairable, he will stimulate some bleeding to promote healing, then stabilize the tear by passing sutures around the tear to approximate it. Occasionally, repairing the tear may involve a larger incision or a tunnel drilled through the shin bone to stabilize the meniscus tear. If the tear is irreparable, a shaver tool is used to debride the torn portion. In this case, only the torn portion is removed, so most of the meniscus is still remaining. The incisions are closed and dressings placed over the wounds. If the tear was repaired, a brace will be placed on the patient prior to waking up from anesthesia.
- This surgery is most often performed under general anesthesia with a nerve block, but can be performed with a nerve block and sedation or a spinal anesthetic.
- This surgery is usually outpatient, which means the patient will be able to go home the same day.
- Surgery typically lasts 0.5-1 hours.
- Patients will be fit for a brace at an appointment before surgery if the plan is to repair the meniscus and will need to bring this to surgery.
- The brace will be placed on the patient prior to waking up from anesthesia if the meniscus was repaired.
- The incisions will be closed with absorbable suture with dressings that can usually be removed 2-3 days after surgery.
- The brace will need to be worn locked in full extension all of the time, including at night, but may be removed for hygiene purposes and unlocked at least three times a day for knee range of motion.
Why Knee Arthroplasty for Meniscus Tear
- Decrease pain
- Eliminate knee buckling
- Eliminate painful catching or clicking
- Return to activities with more confidence and strength
- Patients who have persistent pain and catching in the knee that interferes with their quality of life
- Patients who want to return to sport, activities, or work to their full potential
Recovery following a knee arthroscopy depends on if the meniscus was repaired or debrided.
Meniscectomy: If the meniscus was debrided, the patient may immediately walk on the operative leg as tolerated and gradually increase activities as tolerated without restrictions. Physical therapy may be prescribed at the patient’s first postop appointment to regain strength and range of motion. Most patients are able to return to full activities by three months.
Meniscus repair: Recovery for a meniscus repair takes 4-6 months for full recovery. A knee brace is to be worn while walking and at night for a total of 4-6 weeks to help protect the meniscus repair. The brace should be unlocked at least three times a day for knee range of motion. Physical therapy (PT) will start roughly 2-4 weeks after surgery, depending on the type of meniscus repair.
Physical therapists follow a protocol outlined by Dr. Faulkner to regain range of motion and strength. Physical therapy and home exercises are a critical part to a patient’s outcomes and quality of life after surgery. Patients should expect to improve up to 3 months if they had a meniscal debridement and up to 6 months if they had meniscus repair. Patients are seen about every 6 weeks up to 3 months for meniscus debridement and 5-6 months for meniscal repair.
Dr. Faulkner performed meniscus repair on both my legs. He was thorough, patient and highly knowledgeable. After both procedures he followed up with calls and e-mails explaining the outcome in detail with pictures.
Fantastic man and a fantastic doctor, I would recommend him to family and friends!
meniscus repairs on both knees
If you had a partial meniscectomy, yes! We encourage you to ambulate as much as possible after surgery to stay active. Physical therapists will work with you to help you regain your range of motion and strength.
If you had a meniscus repair, no! You should avoid placing weight on your operative leg by using crutches or a walker to maintain your restrictions for 4-6 weeks after surgery. You will also wear a brace when up walking.
You should not drive for 6 weeks if the operative leg was your right leg and you had a meniscus repair. If the operative leg was your left leg or you had a meniscal debridement, we recommend that you not drive for at least a few days after surgery as long as you are not taking narcotics.
A prescription for a narcotic will be given to you at your preoperative appointment. Dr. Faulkner or his PA, Cara, will review instructions for this medication and what other over the counter medications can be taken to control pain. Risks and side effects will also be discussed.
You will typically start physical therapy 4 weeks after surgery if a meniscus repair was performed. If you had a meniscectomy, PT is not always required. Your range of motion will be assessed at your first postop appointment, and if needed PT will be prescribed at that time.
TED hose are worn to prevent blood clots in the legs. These should be worn for several hours a day for two weeks after surgery.
You should take a daily Aspirin for two weeks after surgery to prevent the risk of blood clots. If you have a personal history of blood clots or other risk factors, Dr. Faulkner or his PA, Cara, may prescribe a stronger blood thinner.
You may shower 48 hours after surgery. The dressings placed over the incision may be removed, but the steri-strips over the incisions should be left in place. You may get the incisions wet, but should not soak them in water until the wounds have completely healed.