The knee’s system of connective and cushioning ligaments and cartilages includes c-shaped bands of cartilage known as menisci (plural for meniscus). The meniscus acts as a buffer or cushion between the knee’s bones and helps to lubricate the knee joint. A meniscus can be torn in several ways, including sudden force, as in an accident or sports injury, or through gradual wear and degeneration over time. A damaged meniscus can cause pain and swelling of the knee, particularly during physical activity. Though a torn meniscus may sometimes heal with only conservative treatment such as rest and reduced activity, in many cases the only lasting relief comes through a surgical operation known as a meniscectomy, most often performed using minimally invasive techniques (tiny incisions).
A doctor’s diagnosis of a torn meniscus includes questions about symptoms and injuries and a direct examination of the knee: moving it into various positions and checking for pain or tenderness. In some cases, other tests may be used to detect or confirm the presence of a torn meniscus:
- X-rays (radiographs) – Electromagnetic radiation is passed through the knee to produce a photographic or digital image. Though the meniscus itself cannot be seen in an X-ray image, the image can be used to determine whether your symptoms are the result of some other condition.
- Computed tomography scan (CT or CAT scan) – CT scan technology combines advanced X-ray imaging and computer science to produce multiple images of the knee, with finer detail than can be obtained using simple X-ray techniques.
- Magnetic resonance imaging (MRI) – To produce MRI images, the knee is placed within an intense magnetic field, and advanced sensors and computer equipment are employed to give high-definition images of the knee’s various structures and tissues.
- Arthroscopy – A small camera about the size of a pencil is carefully inserted into the patient’s anesthetized knee joint though a small incision. Known as an arthroscope, the camera allows extreme close-up examination of the meniscus and other internal structures.
Depending on the severity of symptoms and the size, extent and position of any tear in the meniscus, nonsurgical treatments and medications to promote healing may include:
- Rest and limitation of activity
- Ice packs for pain and swelling
- Elastic bandages or braces to compress and steady the knee
- Elevation of the leg
- Medications for pain
Your surgeon will choose the appropriate approach and procedure for your meniscectomy after taking into account the size, location and pattern of the meniscus tear, as well as your general health, past medical history and personal preferences for treatment. In most cases today, arthroscopic (minimally invasive) techniques are chosen, since they most often lead to more rapid and complete recovery. Occasionally a traditional open surgery is performed.
Arthroscopic surgery makes use of a thin tube carrying a small light and camera inserted into the knee joint through a small incision. It is used to observe the condition of the meniscus and surrounding tissues, and to guide the procedure.
Other specialized instruments are also inserted to carry out the repair itself, which may include removal of any detached fragments of the meniscus and smoothing of its edges and surfaces. In some cases, meniscectomy is performed under general anesthesia. Other meniscectomies can be done as outpatient procedures, using only local anesthetics.
Meniscectomy knee surgery is followed by a program of rehabilitation and exercise to help restore normal function and activity.
Over the past few decades, considerable research has been done into the knee’s bones, ligaments and cartilages, how they may be damaged and how they heal. Researchers are probing into how tissue engineering, growth factors, genetic therapy, cell therapy, computer science and robotics could be applied in developing new and more effective procedures for meniscectomy and other joint repair and rehabilitation methods.
The multidisciplinary team of knee experts at the Northwell Health Orthopaedic Institute performs meniscectomy knee surgery and other treatments, both surgical and non-surgical, for bone and joint conditions and injuries.