Injuries and Conditions: Meniscal Tear : Meniscal Tear :
A damaged meniscus may not require surgery for a full recovery. There are some cases where patients with tears that do not cause locking of the knee, can improve over time. Differences in the severity and type of injury will affect the treatment, as well as the degree of activity that the patient wishes to pursue after treatment.
Meniscus injuries range from minor tears to complete tears of the structure. Some patients, even those with quite severe injuries, may choose to not undergo surgery. A partially torn meniscus can rebuild itself. However, a more severe tear will require surgery to repair and prevent further damage to the joint.
The torn piece of the medial meniscus is removed, and the remaining surface is smoothed. The residual meniscal cartilage continues to serve as a natural shock absorber for the knee.
A complete physical examination is given which provides an assessment of the patient's overall health.
An examination is given of the range of movement in both the injured and uninjured knee.
Strength and walking (gait) ability is measured and analyzed.
Knee arthrometry is utilized to measure the tightness and stability of the knee.
Immediately after surgery, as anesthesia wears off, patients will feel tired and slightly disoriented though the after-effects of anesthesia can vary greatly from patient to patient.
The knee will remain tender and slightly painful after surgery. However, the pain will tend to decrease as pain killers are administered and the knee recovers from the operation.
Post-Operative Instructions:
Wear the brace at all times, except when bathing or showering.
Bear weight as tolerated in the brace with the knee locked in full extension.
Use crutches as needed until stability returns.
Ice the knee three times a day for 20 minutes.
Keep the wound dry. The dressing can be removed for showering (with the knee wrapped in plastic kitchen film) after four days.
Three times a day, for 30 minutes each time, sit with a large towel roll under the heel with the brace locked in full extension.
It is normal to have some discomfort and swelling, as well as some blood-tinged drainage, following meniscal surgery. If this becomes severe or the patients develops a fever, calf pain, shortness of breath, or chest pain, contact a doctor immediately.
The torn section of the meniscus is loose, creating interference with the other structures of the knee. This loose fragment is carefully cut away, leaving as much of the original meniscal cartilage as possible. The remaining cartilage is smoothed along the edge, to provide lateral stability and proper weight distribution.
A surgically sutured meniscus which is rehabilitated properly will allow the patient to eventually regain complete strength, stability, motion, and control of the knee.
Patients that are in good physical condition are likely to recover within 4 to 6 weeks and will then usually be able to perform at previous levels of intensity.
Patients that are in poorer overall condition will also be able to return to previous activity levels, though rehabilitation and physical therapy will tend to be more lengthy and involved.
In all cases, physical therapy is required to restore the muscle strength, flexibility and joint stability which was lost due to the injury and the post-injury period or rest and rehabilitation.
Re-injury to the meniscus is possible if physical therapy or other activities during rehabilitation are overly strenuous, causing damage to the recent suture.
Risks during and after surgery include problems that may develop in relation to bleeding, the possibility of infection, and reactions to anesthesia.
The repaired meniscus is often as healthy as before the injury, and will tend to remain robust if not subjected to abuse.
Initial care will focus on rest and the avoidance of activities that aggravate the condition. Actions that involve any pounding force against the knee, such as running or jumping should be avoided. Physical therapy will focus on increasing the strength and stamina of the quadriceps and hamstrings. Strengthening these muscles will help support the knee.
Click on the Non-Surgical Details button to review additional information.
Ice packs around the knee may be used to reduce pain and swelling, usually for 20-30 minutes every hour until the pain subsides.
After the activity or behavior that has injured the meniscus is identified (running, soccer, etc.) the modification or elimination of the injurious activity is required while the tears are healing.
Bandaging the knee helps reduce and prevent swelling.
Anti-inflammatory medications (NSAID's) may be prescribed.
A knee immobilizier or other type of brace may be recommended.
| Knee: Support A knee support is a sleeve-like support that fits firmly around the knee. The support is used to reinforce the joint during motion
and provide compression to aid healing and reduce pain and swelling.
Patients suffering from knee strains or inflammation will usually be
directed to use a support during daily activities.
The thin and flexible construction of the support allows for normal
movement of the knee and also allows the support to be worn under
loose fitting clothing. To prevent harmful pressure to certain
structures, the support applies differing compression around the
knee. The sides of the joint receive intermittent pressure to help
stimulate blood flow while the rear of the support fits relatively
loose to prevent constriction of circulation. The kneecap is aided
in positioning, but remains free of compression to allow its natural
movement.
Knee supports can be used to treat:
Strains
Sprains
Inflammation
Chondromalacia patella
| NSAIDs NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) are a group of drugs used to control pain. This category of medications includes both prescription and common over-the-counter painkillers such as ibuprofen. NSAIDs are effective for many types of pain that can occur because of inflammation of muscles, joints and bones. The drugs work quickly and people often notice some benefit within a few hours of taking the tablet. However, the complete effectiveness of the drug may not be realized for up to four weeks. For each individual, some varieties of NSAIDs are more effective than others. Often, patients will find that one or two varieties are helpful whereas others may not be as effective in controlling symptoms. It is usually necessary to try several brands and continue with the one that is most suitable. NSAIDs can be used to treat:
Pain resulting from inflammation or swelling.
Pain after injury.
Joint pain and arthritis.
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Patients can expect a full recovery after treatment.
With moderate exercise to recondition the surrounding muscles and reduce stiffness after injury, a patient may participate in athletic activities at their pre-injury level.
If the meniscal tear is a result of a specific athletic activity, the patient will need to discontinue or modify that activity to prevent re-injury.
The meniscal injury may recur if the patient returns to the injury producing activity.
More severe injuries that are treated non-surgically may not heal completely, demanding the knee be used at a less intensive level during athletic activity.
Injury to other structures of the knee may occur if the meniscus is not providing correct support, lubrication or insulation from impacts while running or walking. Damage to the bones of the knee or cartilage can be severe if activity is continued on an injured meniscus.
Although some meniscal tears require surgery, the procedure does not require implanting surgical hardware.
The meniscal surgical procedures discussed here do not require the transplanting of any tissue.
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