Meniscectomy is a surgical procedure indicated in individuals with torn menisci where the conservative treatments have failed to relieve pain and other symptoms. Meniscectomy is recommended based on the ability of the meniscus to heal, the patient’s age, health status and activity level.
The menisci are two C-shaped pieces of cartilage located between the thighbone and shinbone that act as shock absorbers and cushion the joints. The menisci distribute the body weight uniformly across the joint and avoids pressure on any one part of the joint and the development of arthritis. Being the weight-bearing part, menisci are prone to wear and tear and meniscal tear is one of the common knee injuries. A meniscal tear may occur at any age and is more common in individuals who play contact sports.
There are different types of meniscal tears such as longitudinal, parrot-beak, flap, bucket handle, and mixed/complex tear. A sudden twist, squat, or tackle may cause a meniscal tear in an adult. Elderly individuals suffer meniscal tears more easily.
A meniscal tear may cause severe pain, stiffness and swelling, catching or locking of the knee, and may limit movement.
Meniscal tears are often diagnosed with the presenting symptoms and imaging techniques such as X-rays or magnetic resonance imaging scan.
Conservative treatments for meniscal tears include R.I.C.E (Rest, Ice, Compression, and Elevation) and the use of non-steroidal anti-inflammatory medications. Surgery is recommended in severe cases and may be performed using an arthroscopic technique. Depending on the extent of tear, your surgeon will decide on whether to perform total meniscectomy (complete removal of torn meniscus) or partial meniscectomy (unstable meniscal fragments are removed and intact tissue is left in place and the edges are smoothened. Your surgeon may also order a rehabilitation program following the surgery for better and quicker recovery.
Arthroscopic Meniscectomy
The arthroscope is a small fiber-optic viewing instrument made up of a tiny lens, light source and video camera. The surgical instruments used in arthroscopic surgery are very small (only 3 or 4 mm in diameter), but appear much larger when viewed through an arthroscope.
The television camera attached to the arthroscope displays the image of the joint on a television screen, allowing the surgeon to look throughout the knee at cartilage and ligaments, and under the kneecap.
Then the surgeon makes two small incisions (about 1/4 of an inch), around the knee joint area. Each incision is called a portal. In one portal, the arthroscope is inserted to view the knee joint. Along with the arthroscope, a sterile solution is pumped into the joint which expands the viewing area, giving the surgeon a clear view and room to work. The other portal is used for the insertion of tiny surgical instruments.
With the images from the arthroscope as a guide, your surgeon can look at the menisci and confirm the type, location, and extent of the tear. Once your surgeon has located the meniscal tear, surgical scissors and shavers are inserted into the portals to remove the torn menisci. In total meniscectomy, entire menisci is removed and in partial meniscectomy, only the torn part of the tissue is removed leaving the intact tissue in place with edges smoothened.
