Meniscus Injury

ANATOMY

There are two menisci in your knee; each rests between the thigh bone (femur) and shin bone (tibia). Meniscus Tear RepairThe menisci are made of tough cartilage and conform to the surfaces of the bones upon which they rest.

One meniscus is on the inside of your knee; this is the me-dial meniscus. The other meniscus rests on the outside of your knee, the lateral menis-cus.

The meniscus is C-shaped and has a wedged profile. The wedged profile helps maintain the stability of the joint by keeping the rounded femur surface from sliding off the flat tibial surface.

The meniscus is nourished by small blood vessels, but the meniscus also has a large area in the center that has no direct blood supply (avascular). This presents a problem when there is an injury to the meniscus as the avascular areas tend not to heal. Without the essential nutrients supplied by blood vessels, healing cannot take place.

What does the meniscus do?

These meniscus functions to distribute your body weight across the knee joint. Without the meniscus present, the weight of your body would be unevenly applied to the bones in your legs (the femur and tibia). This uneven weight distribution would cause excessive forces in specific areas of bone leading to early arthritis of knee joint. Therefore, the function of the meniscus is critical to the health of your knee.

What happens with a meniscus tear (torn cartilage)?

The two most common causes of a meniscus tear are due to traumatic injury (often seen in athletes) and degenerative processes (seen in older pa-tients who have more brittle cartilage). The most common mechanism of a traumatic meniscus tear occurs when the knee joint is bent and the knee is then twisted.

It is not uncommon for the meniscus tear to occur along with injuries to the anterior cruciate ligament (ACL) and the medial collateral liga-ment (MCL)-these three problems occurring together are known as the "unhappy triad," which is seen in sports such as football when the player is hit on the outside of the knee.

Symptoms of a Meniscus Tear

Individuals who experience a meniscus tear usually experience pain and swelling as their primary symptoms. Another common complaint is joint locking, or the inability to completely straighten the joint. This is due to a piece of the torn cartilage physically impinging the joint mechanism of the knee.

The most common symptoms of a meniscus tear are:

  • Knee pain
  • Swelling of the knee
  • Tenderness when pressing on the meniscus
  • Popping or clicking within the knee
  • Limited motion of the knee joint

Treatment Options

Treatment of a meniscus tear depends on several factors including the type of tear, the activity level of the patient, and the response to simple treatment measures.

When surgical treatment of a meniscus tear is required, the usual treatment is to trim the torn portion of meniscus, a procedure called a me-niscectomy.

Meniscus repair and meniscal transplan-tationare also surgical treatment options. Determining the most appropriate meniscus tear treatment is something you can discuss with your doctor.

Conservative Option

Nonsurgical Treatment

Immediately after an injury, the so-called R.I.C.E. treatment is recommended.

Medications

Progressive physiotherapy and rehabilitation

Use Assistive and support Devices

Surgical Option

Since the ACL does not heal, the ligament needs to be replaced (reconstructed).

Arthroscopy

The meniscus is reconstructed using arthroscopic techniques. The arthroscope is a fiber optic instrument which is placed into the knee joint through a small incision. A camera is used and the image is viewed on a TV monitor to look and take pictures.

The arthroscope allows evaluation of the entire knee joint, including the knee cap (patella), the cartilage surfaces, the meniscus, the ligaments (ACL & PCL), and the joint lining. Small instru-ments ranging from 3-5 millimeters in size are inserted through additional incisions so that the joint structures can be evaluated for any damage, any injury can be diagnosed, and damaged tissue can be repaired, reconstructed, or removed.

The word arthroscopy comes from two Greek words, “arthro” (joint) and “skopein” (to look).


Why perform a meniscus repair

In some situations, your surgeon may offer a meniscus repair as a possible surgery for damaged or torn cartilage. Years ago, if a patient had torn cartilage, and surgery was nec-essary, the entire meniscus was removed.

These patients actually did quite well after the surgery. The problem was that over time, the cartilage on the ends of the bone was worn away more quickly. This is thought to be due to the loss of the cushioning effect and the diminished stability of the joint that is seen after a meniscus is removed.
 

When arthroscopic surgery became more popular, more surgeons performed partial menisectomies. A partial meniscectomy is performed to remove only the torn segment of the meniscus. This works very well over the short and long term if the meniscus tear is relatively small. But for some large meniscus tears, a sufficient portion of the meniscus is removed
Most patients have their arthroscopic surgery performed as outpatients and are home several hours after the surgery.

 

In comparison to open surgery, arthroscopy provides:

  • Better cosmeticMeniscus Tear Repair by Dr Ashwani Maichand
  • Shorter recovery time
  • Less pain
  • Less need for pain medication after surgery
  • Less damage to soft tissues at the incision site
  • Fewer complications
  • Greater improvement in strength and range of motion
  • Minimal scars.
  • Minimal hospital stay.
  • Decreased pain and swelling.
  • Improved motion
Upcoming Events
 
 
  • Coming up with a mega campaign "Lets Fight Arthritis" on the occasion of World Arthritis Day, at A4 Block, Gauri Shankar Mandir, Paschim Vihar, New Delhi. The campaign will be on 9th October 2016(Sunday). 

  • Health Awareness Campaign on 28th August at Gurudwara Singh Sabha E Block Karampura, Delhi.

  • Coming up with a mega campaign on Spine & Back Pain on 5th June 2016 at Gurudwara New Ranjeet Nagar (near Satyam Ciema), Patel nagar, Delhi in association with Sukhmani Charitable Trust, Delhi.

  • Coming up with an awareness campaign on Arthritis Management & Control on 22nd May 2016 at Guru Ram Dass Charitable Medical Centre - Gurudwara Sri Guru Singh Sabha, Moti Nagar, Delhi.  

  • Mega campaign on Arthritis Management on "Mother's Day" 8th May 2016 at West Patel Nagar, Delhi - 110008

  • Mega campaign on Arthritis Management in association with "Varishth Nagrik Kesari Club" - Punjab Kesari Delhi on 6th April 2016 (Wednesday)

  • Dr. Ashwani Maichand Participated in Shoulder Conclave 2016 at JWT Marriott, Pune

  • Dr. Ashwani Maichand was the Table instructor for young doctors at Cadaver Joint Replacement Training on 21st February 2016 at All India Institute of Medical Sciences (AIIMS)

  • Arthritis Awareness campaign on 28th february 2016 from 10 am to 1 pm at Minomax Knee & Shoulder Clinics (8/29, West Patel nagar, Delhi, India)

  • Participating as a speaker on "Dificult cases of Hip & Knee Replacement" in 2nd Masters Course in Arthroplasty at Meril Academy, VAPI, Gujarat from 4th to 6th February 2016

 
 

 

 

 

 

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Contact Us
Dr Ashwani Maichand
M.S., M.Ch. (Ortho)
Fellowship Joint Replacement
Specialist : Knee & Shoulder
 
Dr. Rahul Kakran
M.s., M.Ch (Ortho)
Specialist : Minimal Invasive Spine Surgery (MISS)
  
Dr. Rajni Koundal
BPT
Consultant Physiotherapy
 
For Appointment : 9999074745
( Mr. Sunny ) 
 
For Upcoming Events : 9999071715
( Mr. Sarabjeet Singh)
 
Address : 
 
MinOmaX Knee & Shoulder Clinics
8/29, West Patel Nagar,opp. D.A.V. Sr. Secondary School (near Metro Pillar no. 198, Delhi-110008)
Timings : Daily 5:00 PM to 7:00 PM  ( Except Sunday).
 
Please Take Prior Appointment to avoid inconvinience.