Partial Arthroscopic Meniscectomy

What is Partial Arthroscopic Meniscectomy?

Partial arthroscopic meniscectomy is a procedure to remove the damaged part of a meniscus in the knee joint with the help an arthroscope. The meniscus is a C-shaped disc of cartilage between your thighbone and shinbone. There are 2 menisci in each knee. They act as shock absorbers and provide stability to the joint.

When Do you Need Partial Arthroscopic Meniscectomy?

Meniscal injuries may be associated with trauma or age-related wearing. Minor injuries located in the peripheral region of the meniscus either heal on their own or may be repaired with sutures.  Your doctor may recommend partial arthroscopic meniscectomy if you have a more centrally located irreparable meniscal tear or unstable meniscal fragment causing pain and interfering with the free movement of your knee joint.

Preparing for Partial Arthroscopic Meniscectomy

Before meniscus surgery, you will undergo a physical examination, certain tests, and imaging studies. You may be advised not to eat or drink anything after midnight the night before surgery.

Procedure for Partial Arthroscopic Meniscectomy

Partial arthroscopic meniscectomy is mostly performed on an outpatient basis and may last about an hour.  It is usually performed under regional (spinal) anesthesia with sedation to keep you relaxed. For the procedure: 

• You will lie in a supine position.
• The lower extremity is disinfected, and your knee is stabilized in a leg holder.
• Small skin incisions are made over the knee and portals created to access the damaged meniscus.  
• An arthroscope (thin illuminated tube with a camera) and special instruments are inserted through the portals.
• The torn and/or damaged parts of the meniscus are carefully removed leaving smooth, stable and healthy meniscus intact. 
• The instruments are removed, the incisions are closed, and a dressing is applied followed by a compressive bandage.

Post Operation Care and Rehabilitation 

Following surgery, you may be asked to:

• Use crutches to reduce stress on the knee until enough healing has occurred.
• Apply ice to the knee.
• Elevate the knee while resting.
• Take pain medication.

As part of your recovery, your doctor may recommend physical therapy and other rehabilitation programs to ensure a quick return to normal activities. Rehabilitation usually takes about 4 weeks.

Benefits of Partial Arthroscopic Meniscectomy

Some of the benefits of the procedure include:

• Simple, safe and effective procedure.
• Low complication rate.
• Decreased pain and improved mobility.
• Allows return to activities.
• Minimal injury to the soft tissues.
• Avoids knee instability which can lead to arthritis.

Complications or Risks of the Surgery              

Though partial arthroscopic meniscectomy has a very low complication rate (less than 1%), the procedure may rarely be associated with:        

• Infection.
• Injury to nerves and blood vessels. 
• Fracture or weakness or stiffness or instability of the joint.
• Repeated rupture of the meniscus and additional surgeries.
• A condition called ‘Deep Vein Thrombosis’ (blood clots in the leg).
• Anesthesia complications (respiratory or cardiac malfunction).

Younger individuals with healthy menisci have better results from surgery.

Prognosis

Partial arthroscopic meniscectomy has a high success rate. Though recovery is usually quick, everyone heals at a different pace.

Age plays an important role in the success of partial arthroscopic meniscectomy. The procedure is most effective if you are under 30 and have it performed within the first two months of injury. If you are over 30, the prospect of success diminishes as the meniscal tissue begins to deteriorate and weaken with age. 

Those with larger meniscal injuries are more likely to develop arthritis.