 Knee
- Cartilage Repair
Torn Cartilage Repair (Meniscus)
A meniscus repair is a surgical procedure performed on the cartilage of
the knee. This is usually carried out laparoscopicaly as an arthroscopic
procedure. Patients who have a meniscus tear within the knee may have a cartilage repair.
If there is a chance that the cartilage tear can heal, a repair is preferred over removal
of the torn cartilage.
The majority of the meniscus has no blood supply, threfore when damage occurs
the meniscus is unable to undergo the normal healing process that occurs in the rest of
the body. In addition, with age, the meniscus begins to deteriorate, often developing degenerative
tears. Typically, when the meniscus is damaged, the torn piece begins to move in an abnormal
fashion inside the joint.
Because the space between the bones of the joint is very small, as the abnormally mobile
piece of meniscal tissue (meniscal fragment) moves, it may become caught between the bones
of the joint (femur and tibia). When this happens, the knee becomes painful, swollen, and
difficult to move.
The meniscus has several functions:
Stability - As secondary stabilizers, the intact meniscii
interact with the stabilizing function of the ligaments and are most effective when the
surrounding ligaments are intact.
Lubrication and nutrition - The meniscii act as spacers between the femur
and the tibia. They prevent friction between these two bones and passes joint fluid and
its nutrients into the tissue which covers the end of the bone. This tissue is known as
articular cartilage. Maintenance of the integrity of the articular cartilage is critical
to preventing the development of post-traumatic or degenerative arthritis.
Shock absorption - The biconcave C-shaped pieces of tissue known as meniscii (cartilage
in non-medical terms) lower the stress applied to the articular cartilage, and thereby have
a role in preventing the development of degenerative arthritis.
Diagnosis and Treatment
The surgeon will conduct a physical examination and may order X-rays, CT
Scans or even an MRI to determin the exact cause of the problem.
It is possible to repair a torn meniscus. This may be done arthroscopically, however because
of the slow healing process of the meniscus, recovery time is longer. If the torn piece
of meniscus is removed (meniscectomy) the healing process is quicker.. Unfortunately, as
a person gets older, the possibility of the tear being repairable greatly decreases.
The most commonly performed surgical procedures on the knee include a meniscectomy (removal
of the meniscus), meniscal repair, and ligament reconstruction.
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After surgery
On the average, most patients are able to walk without crutches within
48 hours. After a week an active rehabilitation program is suggested to rebuild muscle strength
around the knee, however patients are activity restricted from some activities for approximately
6 weeks after surgery, or until rehabilitation has been successfully completed. The services
of a sports physiotherapist can be recomended at this stage.
Arthroscopy is much less traumatic to the muscles, ligaments and the tissues than the traditional
method of opening the knee.
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