MENISCUS SURGERY PERTH
Meniscal Injury Treatment – A patient’s guide:
Dr Arash Taheri
MBBS (Hons), BMedSci (Hons), FRACS (Orth)
Orthopaedic Surgeon
Meniscus Injury Treatment Perth
Meniscus Anatomy
The Meniscus cartilage in your knee is comprised of two C-shaped pieces of cartilage that act like a cushion between your shinbone and your thighbone (separately called the menisci).
The meniscus’ role is to:
- Assist with stability of the knee joint
- Reduce wear
- Protect against arthritis
- Help disperse fluid around the knee joint effectively.
A torn meniscus is one of the most common knee injuries.
Any activity that causes you to forcefully twist or rotate your knee, especially when putting your full weight on it, can lead to a torn meniscus.
Meniscus Injury Symptoms
If you’ve injured your meniscus, you may experience the following symptoms in your knee:
- Knee pain
- Knee stiffness
- Tenderness along the joint line
- Swelling around the knee within 24 hours
- Pain and difficulty walking for several days
- Loss of full range of motion
- Inability to either bend or fully straighten the knee
- A tendency for your knee to get “stuck” or lock up
- Audible ‘clicking’ sound when bending or straitening the knee
- Knee instability – Feeling of your knee giving way when bearing weight on the knee.
Meniscus Injury Diagnosis
Dr Taheri may use some of the following diagnostic approaches to help determine the extent of the torn meniscus or any other damage to the knee joint:
- A medical history
- Physical examination
- Knee joint range of motion assessment
- Imaging tests:
- X-rays – X-rays do not show cartilage but are often normal as they can help rule out other problems with the knee that may have similar symptoms.
- Magnetic Resonance Imaging (MRI) – An MRI scan can show detailed images of both the hard and soft tissues within your knee to help diagnose soft tissue injuries.
- Arthroscopy – An arthroscope is a device that uses a tiny camera to see inside your knee joint. This may be necessary if the exact cause of the knee pain is not clear.
While not all of these tests may be required this diagnostic process will allow Dr Taheri to review any possible risks or existing conditions that may assist in treating your specific injury.
Meniscus Injury Treatment
Non-surgical Treatment
Meniscus tears are the most frequently treated knee injuries. Recovery in most cases takes about 6 to 8 weeks if your meniscus tear is treated using a non-surgical approach. The time may vary, depending on:
- The type and severity of the meniscal tear
- How long your symptoms persist
- Lifestyle and age
Conservative treatment may include:
Rest – Try to rest your knee for a few days and keep pressure off it.
Ice – Putting ice on your knee for 10 to 15 minutes at a time can help reduce any swelling.
Compression – You can also reduce swelling by wrapping your knee with an elastic bandage or wearing a knee brace.
Elevation – Sit or lie down with your leg and knee elevated above your heart, so that blood flows toward your heart.
Anti-inflammatory drugs – If recommended by Dr Taheri, anti-inflammatory drugs such as aspirin or ibuprofen may help to reduce pain and swelling.
Physical therapy – A physical therapist can provide a daily routine of exercises and stretches to improve your muscle strength, flexibility, range of motion and stability.
Corticosteroid injections – Dr Taheri may recommend a joint injection of glucocorticoids to reduce swelling. This may provide pain relief for 2 to 4 weeks.
Orthotics – Depending on your symptoms, Dr Taheri may recommend a special knee brace or other mechanisms to limit your joint movement and stabilise the knee.
Surgical Treatment
If the meniscal tear is more complex, Dr Taheri may recommend surgery.
Some meniscus tears require surgery to heal the meniscus and restore the knee’s range of motion. This may be the case if:
- A tear of the meniscus that won’t heal on its own – Lack of blood flow to the area
- A tear that is painful or impairs use of your knee
- Complex tears usually require surgery to trim the damaged part of the meniscus.
Recovery from Meniscus Surgery
Recovery times may vary from patient to patient for a number of reasons including age, health, muscle and bone strength and commitment to rehabilitation amongst many other factors.
Surgery – The surgery itself usually takes around one hour and is usually done under general anaesthetic.
Post-surgery – You will stay over night after the surgery and be closely monitored. If all is well you will be able to go home the next day if cleared by the medical staff.
A friend or family member will need to pick you up from the hospital and stay with you on the night of your surgery. You will probably feel a bit sleepy and might need some pain killers.
You will be given instructions on:
- Wearing a brace on your knee
- Warning signs to look out for
- Wound care and dressings
- Pain management
Physiotherapy recovery program – You will see a physiotherapist and be prescribed a rehabilitation program after your surgery. Prior to discharge you will be given exercise instructions and practice on how to best perform daily activities including climbing stairs, bathing, getting into and out of cars etc.
Hospital stay length – You will stay in hospital overnight after the surgery. It may be longer depending on your individual circumstances.
Movement after surgery – Moving around with crutches is recommended for the first 2-4 weeks for comfort, safety and confidence. The crutches can be discarded as soon as you are confident to do so and you are happy to weight bare on your knee.
Will I need time off work – Depending on occupation you may require a number of weeks off work and return to light duties. You can be driven in a car as a passenger immediately on discharge from hospital.
Everyday activities – It may take between 2-3 months to recover from surgery. This is dependant on a number of aspects including ongoing commitment to your rehabilitation program, age, current health, muscle and bone strength and other factors.
Driving – Patients may be able to drive a car approximately 6 weeks after surgery.
Patients MUST be able to perform an Emergency Stop and short car trips only are recommended initially. The decision to drive after surgery remains the responsibility of the patient.
Air travel – Air travel may be undertaken soon after you are cleared by Dr Taheri.
What Activities can I Return to After Rehabilitation?
What activities can you perform after Meniscus Surgery – Once recovered and rehabilitated, there are very few restrictions on activity after Meniscal Reconstruction surgery. You can participate in activities such as walking, cycling, skiing and tennis.
Running and impact sports – High impact pursuits such as running should not be performed for 6 months or more after surgery. Your suitability for returning to running activities depends on the nature and intensity of the sport you are undertaking.
Some activities may place the knee joint at risk (for example extremes of joint flexion and rotation in some advanced yoga postures) – if you are unsure please check with us prior to recommencing your desired activity.
Knee monitoring – Monitoring how your knee performs overtime is essential to your rehabilitation program. Follow up appointments will be scheduled in soon after surgery.
What are the Risks of Meniscus Surgery
Meniscus Surgery risks – Meniscus surgery is generally safe, and serious complications are uncommon.
Serious wound infection occurs in less than 1% of patients.
As with any major surgery, there are potential risks involved. The decision to proceed with the surgery is made because the advantages of surgery outweigh the potential disadvantages.
It is important that you are informed of these risks before the surgery takes place. Complications can be medical (general) or local complications specific to the knee. Medical complications include those of the anaesthetic and your general well being. Almost any medical condition can occur so this list is not complete.
Complications that may include:
- Allergic reactions to medications
- Blood loss requiring transfusion – Low risk of disease transmission
- Heart attacks, strokes, kidney failure, pneumonia and bladder infections
- Complications such as infection or nerve damage
- Serious medical problems can lead to ongoing health concerns, prolonged hospitalisation or rarely death
Risk of Infection – Infection can occur with any operation. In the hip this can be superficial or deep. Infection rates are approximately 1 percent. If it occurs, it can be treated with antibiotics but may require further surgery. Very rarely your hip may need to be removed to eradicate the infection.
Blood Clots (Deep Venous Thrombosis) – These may travel to the lung (Pulmonary embolism) and can occasionally be serious and even life threatening. If you get pain or shortness of breath at any stage, you should notify your surgeon.
Fractures or Breaks in the Bone – Fractures or breaks can occur during surgery or afterwards if you fall. To repair these, you may require surgery.
Wound Irritation or Breakdown – The operation may cut some skin nerves, so you will inevitably have some numbness and potential aching around the wound. This will not affect the function of your knee. Vitamin E cream and massaging can help reduce this. Occasionally, you can get reactions to the sutures or a wound breakdown that may require antibiotics or rarely, further surgery.
Damage to Nerves and Blood Vessels – Rarely these can be damaged at the time of surgery. If recognised they are repaired but a second operation may be required. Nerve damage can cause a loss of feeling or movement and can be permanent.
Pain relief – You will be given pain relief during your stay and either medication or prescriptions to go home with to keep you comfortable. Paracetamol and an anti-inflammatory (if tolerated) are the mainstays for pain relief.
Dr Taheri will discuss your concerns thoroughly prior to surgery.