Meniscal Tear of the Knee FAQs
What is a meniscus?
Meniscus is a cartilaginous disc, which is present inside the knee joint, between the lower end of the thigh bone, called femur, and the upper end of a shin bone, called tibia. There are 2 meniscus in every knee joint, one on the inner aspect and one on the outer aspect. They help in movement of the knee joint as well as act as cushions to avoid direct impact of bone-on-bone, which may cause damage to the underlying cartilage.
How can a meniscus be torn?
The meniscus can be torn while any sudden activity of pivoting or turning. Sometimes a fall may also cause tearing of the meniscus. In patients who have age related fraying of meniscal, the tear may happen due to incidents that the patient may not even remember.
What are the symptoms of meniscal tear?
Patients with meniscal tear develop pain, along with swelling, over a period of hours to days. These patients may also have symptoms of catching, locking, or giving way. Patient may also complain of nighttime pain and discomfort, along with a limp.
How does a doctor know I have a meniscal tear?
The history, as well as a physical examination done by the physician in the office are usually suggesting of meniscal tear. An X ray is done to rule out bony injuries. An MRI is needed be performed to confirm the diagnosis.
How do you treat a meniscal tear?
Meniscal tear can be treated without surgery, in which patient is asked to rest, ice, use compression, as well as elevation, along with anti-inflammatory medications, with or without cortisone injection in the knee. Patients who do not get better with conservative treatment may need to undergo surgical management, in which, either the meniscus is repaired, if it is repairable, or a partial meniscectomy is performed to remove the torn part of the meniscus and balance the meniscus back to stable edges.
Can a meniscus tear heal on its own, without surgery?
If there is a small meniscus tear along the periphery of the meniscus, these patients may not need any surgery and over time these tears may heal by themselves. Patients who have tears do not necessarily need a surgical treatment and some can be treated without surgery with the help of rest, elevation, ice, anti-inflammatory medication, and compression. Patient can also get help with physical therapy. The treatment depends on the symptoms the patient has and the discomfort they have from it.
How long does it take for a torn meniscus to heal without surgery?
Patients with torn meniscus on the outer aspect, one of a smaller size, may take up to 6-8 weeks to heal without surgery. Patient can get help with doing physical therapy as well as anti-inflammatory medications, rest, ice, and compression.
How long does it take to recover from a meniscus injury?
Usual time for recovery from a meniscal injury is about 6-8 weeks. Patient may have limited mobility during this period. They may get help with medications like anti-inflammatory medication and physical therapy.
Can you walk around with a torn meniscus?
Though torn meniscus may cause pain and swelling, but if they are under control, patient can very well ambulate as well as do usual activities of daily living. If the patient is symptomatic enough with regards to torn meniscus, then they need to see a physician for management of the torn meniscus.
How long does it take to walk again after meniscal injury?
Patients can usually walk, even with meniscal injury, though they may have symptoms of pain, catching, locking, or buckling. They may also have swelling over the knee. If patients have severe symptoms, they may use a cane or crutches to ambulate.
What happens if you leave a torn meniscus untreated?
Torn meniscus on the outer aspect of the rim which are small may heal by themselves. The other meniscus may or may not cause symptoms in the form of pain and swelling. If the patient has a considerable tear, then this tear may propagate and may restrict the activities of the patient and may propagate and increase in size over time.
How serious are meniscus tears?
Meniscus tears do cause symptoms in the form of pain, swelling, nighttime pain and discomfort, locking, catching, or buckling, depending on the size and the location of the meniscus. Patient may have no to serious symptoms and the treatment of the meniscus depends on the symptomatology that the patient has. If left untreated they may cause persistent pain and swelling in the knee.
Can you make a torn meniscus worse?
The torn meniscus may worsen with activity, especially pivoting, in which the meniscus may be caught between the two condyles and the size may increase. The patients will have worsening of symptoms in the form of pain and swelling.
What are the treatments for a meniscal tear?
Meniscal tear can be treated non-operatively in the form of rest, ice, elevation, and an anti-inflammatory medication, along with compression. Patient may also get a cortisone shot, which may help relieve the pain for some time. In patients who have symptoms which are not improved with this treatment may have to undergo arthroscopic surgery, in which the tear may be either repaired, if it is repairable, or a partial excision can be done to remove the frayed margins.
What is arthroscopy?
Arthroscopy is a surgery in which a camera with a light source is inserted through poke holes into the joint of the body to look inside. We may also other poke holes to insert arthroscopic instrument to carry out arthroscopic surgery. Arthroscopy has revolutionized the management of joint injuries by giving early rehabilitation, as well as recovery, without causing many complications that are caused by open joint surgeries.
What happens during arthroscopic surgery?
During an arthroscopic surgery, a camera with a light source is inserted into the joint of a patient through a small incisions or poke hole. Arthroscopic instruments are also inserted in the joint through other poke holes. First the joint is inspected, the necessary procedures is carried out.
How long do I have to stay in hospital after arthroscopic surgery?
Most of the patients, after arthroscopic surgery, are discharged from the hospital or the surgery center where the surgery is performed within couple of hour. Patients, if needed, are given ambulatory aids in the form of crutches and braces apart from medications.
What is a meniscectomy?
A meniscectomy is a surgery in which a part, or complete, meniscus of the knee joint is removed to make the patients symptom-free due to the torn meniscus. Most of the time, a partial meniscectomy is performed, and we tend to keep the healthy meniscus in place so that it may help in the form of cushioning and movement of the knee joint.
Is it safe to remove part of my cartilage?
Knee cartilage in the form of meniscus is there to help gliding, as well as cushioning the knee joint. Cartilage should not be removed, but if it is torn and the patient has symptoms which are unrelieved by conservative means, then this part of cartilage may need to be removed to make the patient symptom-free.
How long will it take to recover from arthroscopic surgery?
Patients who undergo arthroscopic surgery may take up to 6-8 weeks to recover after all routine knee surgeries like meniscectomy. Patients who undergo meniscus repair may take 3-4 months for the meniscus to heal and recover. Patients who undergo ligament reconstruction like ACL or PCL construction will have to be in a rehab program for a long time and, depending on the type of work and pre-surgery status, may take 6 months to a year to recover.
When will I start to feel better after arthroscopic surgery?
Recovery after arthroscopic surgery is gradual though faster than an open surgery. Patient may have pain and swelling after the surgery, which will subside over the next few days. Patients usually start physical therapy from a week after the surgery. It may take about 6-8 weeks to completely recover from a partial meniscectomy and longer in cases of meniscus repair or ligament reconstruction.
How long will I have to use crutches after surgery?
The use of crutches after surgery depends on type of surgery as well as the patient. Most patients will undergo arthroscopic partial meniscectomy do not need crutches or may use them for a couple of days for comfort and help. Patients who undergo meniscal repair or ACL reconstruction may need crutches for a longer.
What are my treatment options?
Treatment options vary from doing nothing, use of anti-inflammatory medications, use of cortisone shot, treating the problem with a minimally invasive or surgical procedure in the form of arthroscopic surgery. Physical therapy is also an option for these patients which may be helpful before surgery as well as after the surgery also.
Is surgery an option for me?
Surgery for knee in the form of meniscectomy, meniscal repair or ligament reconstruction are essentially all elective surgeries and an option which needs to be discussed between the physician and the patient before a decision can be taken on it.
What are the risks associated with the treatment?
Risk associated with arthroscopic surgery are bleeding, blood clots in the calf, infection, injury to nerves or blood vessels, damage to cartilage, ligaments, meniscus, stiffness of the knee apart from anesthesia risks.
Do I need to stay in the hospital?
Most patients do not need to stay in the hospital and are discharged from the surgical area within couple of hours after the surgery. Occasionally, patients with co-morbidities may need to stay in the hospital for observation.
How long will I be in the hospital?
Most patients who undergo arthroscopic knee surgery are discharged from the hospital or surgical area within one to two hours after the surgery. They are given ambulatory aids and braces apart from medications if needed.
What are the complications I should watch for?
Complications to be looked for after knee surgery are worsening pain, which is not relieved with pain medications, swelling over the surgical area, discharge from the surgical site. Patient need to call the physician’s office to discuss further management. Patients could also look for any calf pain as well as chest pain or other symptoms involving the heart or the brain. These patients may need urgent medical attention and should call 9-1-1 or visit an emergency room.
How long will I be on medications?
Patients are usually on pain medications for a few days after surgery. They are gradually tapered onto anti-inflammatory medications and can wean them off over a few weeks. Patient in physical therapy and their pain is well-controlled do not need to take regular medications and can take anti-inflammatory medications when pain worsens. Patients are also advised to use ice and elevation when the pain and swelling worsen.
Does my medication interact with non-prescription medications supplements?
The patient should inform of all the non-prescription medications or supplements that the patient is taking before the surgery as well as at the time of surgery. There are certain medications, which may interact with the anesthetic medications as well as medications that are given after the surgery. And cause serious side effects.
Do I need to change my diet after surgery?
Though there is no special diet, it is always advisable to take soft diet immediately after surgery. This will help not only prevent constipation, but also prevent nausea and vomiting.
Do I need to lose weight?
Weight loss has multiple effects on the body. If the patient has a higher BMI, they will always be benefited by weight loss with regards to decreasing their blood pressure, better management of diabetes as well as prevention as well as help in management of multiple musculoskeletal pain and disorders including low back pain, knee pain, hip pain, and ankle pain.
When can I resume my normal activity?
Patients who undergo arthroscopic meniscectomies are usually able to resume their normal activities within a few days after the surgery. The patient can gradually increase the amount of work that they can do. It will take about six to eight weeks before the patient fully recovers from the surgery. Patients who undergo Meniscal repair may take a longer time, up to three to four months to complete recovery. Patients who undergo ligament reconstruction may up to six months to a year for complete recovery from the surgery.
When can I return to work after arthroscopic meniscus surgery?
Return to work depends on the type of work the patient does as well as the type of surgery he has undergone. If the patient has undergone arthroscopic partial meniscectomy and are in a low impact desk-type job, they are able to return to work as early as two weeks. Patient who undergo surgeries like meniscal repair or ligament reconstruction as well as patients who are in high-demand jobs and manual work may take longer time to return to work. The return to work is essentially decided by the recovery of the patient with the physical therapy and the decision is made in consultation with the physician and the physical therapist with the patient.
Do I need a special exercise program?
Most patients after arthroscopic surgeries are enrolled into physical therapy programs. These patients undergo special exercise programs, which are decided by the type of surgery that has been performed. Patients need to be in regular follow up with the physical therapist as well as the physician.
Will I need physical therapy?
Most patients after arthroscopic surgery are sent for physical therapy as early as one week after the surgery. They are also started on home exercise program.
What else can I do to reduce my risk of an injury again?
Ascertaining the cause and the reason for the injury may help to be cognizant about reduction of risk of re-injury. Patients may also need to reduce weight if they are overweight. They may use a brace while doing high-risk activities to reduce the risk of injury.
How often will I need to see my doctor for check-ups?
Most patient follow with their physician after 7-10 days after the surgery, and then after that, monthly for a few months until they fully recovery.
When is it right to call the doctor after surgery?
Most patients are called back to visit the doctor in 7 – 10 days after the surgery. If the patient has calf or chest pain or any other emergency, they should call 9-1-1. If the patient has worsening pain not relieved with pain medications, or swelling, fever, chills, discharge, then these patients may need to call the doctor during the office hours or leave a voicemail for the physician after office hours.
What happens when you remove the meniscus?
Meniscus are cartilaginous disc inside the knee which cushions the knee as well as helps in gliding and rotating movement of the knee. If a part of meniscus is removed after the surgery then there are certain amounts of increase in load on the bone and this may gradually enhance the arthritic changes in the knee. For the same reason, it is preferable not to remove the meniscus and if the meniscus is repairable it should be repaired. But if the meniscus is torn beyond repair then it must be removed so as to alleviate all the symptoms.
Can physical therapy repair a torn meniscus?
Physical therapy to the knee can help regaining range of motion as well as strength and at the same time decreasing pain and swelling of the knee in case of torn meniscus. If the meniscus is torn on the outer aspect near the joint line, then the meniscus may heal by themselves over time. The physical therapy helps in retaining and improving the function of the knee.
What causes meniscus tear?
Injuries in the form of fall, or while cutting or pivoting may cause meniscus tear, even in a normal meniscus. If patients have degenerative meniscus which may happen due to prolong, long standing injury, or aging, then any subtle movement can also cause meniscal tear.
How long does it take to do a meniscus surgery?
A meniscus surgery may last from forty-five minutes to an hour, but a surgery involving the repair of the meniscus may last one to two hours depending on the size of the injury. There may be multiple surgical scars with some a little bigger than a poke hole incision as compared to partial meniscectomy which has 2-3 small surgical scars. This is due to the work needed to be done to repair the meniscus.
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