Procedure for Knee Arthroscopy - Meniscal Tears Excision

Anatomy of normal knee

The knee joint is one of the strongest joints in our body. The knee is also called as tibiofemoral joint. The knee joint is made up of four parts:

• Bones: Knee bone (patella), thigh bone (Femur), Tibia and Fibula (Bones in the lower leg).
• Cartilage: femur and tibia is a figure-eight-shaped layer of tough, rubbery fibrocartilage known as the meniscus.
• Ligaments: There are 2 ligaments namely the anterior and posterior cruciate ligaments
• Tendons: these structures which connect the muscles to bones.

The meniscus is a rubbery cartilage, a cushion like structure which stabilizes the knee joint. Meniscal tearing is caused by sudden twisting injuries of the knee. Arthroscopic repair of the torn meniscus or knee meniscus tear involves making 2 tiny cuts into the knee joint under local anaesthesia. A thin tube is passed into the knee joint and the torn meniscus is cut out or repaired depending on its site and the nature of the tear. This is a minimally invasive procedure and can be done on an outpatient basis.

Approximate cost of Knee arthroscopy - Meniscal tear excision

Knee arthroscopy - Meniscal tear excision surgery will approximately cost around $ 2500 in India. Moreover, the type of facility will also impact the costs.

Average Length of Stay For Knee Arthroscopy - Meniscal Tears Excision

The procedure of meniscectomy lasts for an hour and is done under local anesthesia. It is done on an outpatient basis and the patient can go home the same day.

Torn meniscus symptoms

Symptoms of a torn meniscus are as follows:

• Pain
• Swelling
• Redness
• Tenderness (pain on touch)
• Give way feeling and unstable joint
• Locking
• Difficulty in walking
  • Untreated meniscal tears can lead to arthritic changes and knee instability

Indications for arthroscopic excision

An arthroscopic excision is recommended in the following cases:

• Large tears in the outer two thirds of the meniscus
• Significant pain and locking of the knee with inability to walk
• Degenerative(wear and tear) changes in the menisci
• Tear of other structures in the course of the injury - for example in sports injuries, the anterior cruciate ligament is also damaged.

Procedures Risks

Long term or chronic injuries and those involving the white zone or the inner one third of the meniscus which has very little blood supply may not heal well. The selection of the right patient for the excision is crucial.

Complications

There is a possibility of post-operative complications. These can be classified under the following categories:

• Immediate
• Delayed

Some immediate complications are:

• Pain
• Infection
• Complications of anesthesia

Delayed complications include:

Stiffness if post op physiotherapy is not done properly

Post-operative care

There is usually a dramatic relief from pain as soon as surgery is over. Hospital stay is not required but a period of immobilization for 2 weeks is a necessary for the meniscus tear recovery. This is followed by graded mobility for another 2 weeks period.

Post discharge /rehabilitation info

Physiotherapy is started as soon as the procedure is done. Torn meniscus surgery recovery time purely depends on physiotherapy. Recovery occurs within 2 weeks of surgery and there is usually minimal pain.

Dos and don'ts

• Avoid smoking and alcohol as it interferes with healing
• Comply with regular physiotherapy
• Avoid strenuous activity for about 4 weeks atleast after the procedure
• Take medication as advised by the doctor

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FAQs

Q Can a meniscal tear heal on its own?

A Yes, small tears involving the outer 2/3rd of the meniscus can heal with rest.

Q Can I walk with a torn meniscus?

A. Unless the tear results in locking of the knee, one can walk with a torn meniscus though with difficulty because of the pain.

Q When is arthroscopic repair not useful?

A. In extensive injuries or severe wear and tear, open surgery and other extensive procedures may be required.