Meniscus Repair Surgery

Two C-shaped cartilages (a soft bone) are placed between the thigh bone and the shinbone (larger bone in the lower leg). These C-shaped discs are called meniscus. A torn meniscus is a common type of knee injury. It is caused when you forcefully rotate or twist your knee, especially when putting your total weight on your legs. A torn meniscus may cause pain, stiffness and swelling in your knees. Meniscus repair surgery is a common procedure to treat the torn meniscus. The process requires a few small incisions. The time duration of the procedure is about 1 hour.

This surgery is needed to be done when:

1. Your knees often get stuck in a flexed position, and you cannot bend it.
2. You feel pain when walking or running.
3. A popping sound comes from your knee when climbing or downstairs.
4. You feel occasional tightness in the knees.

A torn meniscus is a common and debilitating condition. The patient experiences pain, swelling, popping sensation, feeling of the locked knee, and having problems straightening the knee. The patient cannot move in case the meniscus repair procedure is delayed. The patient also has persistent pain and swelling, which will reduce the quality of life, and the patients need to take pain relievers that may also have side effects. In athletes, delayed meniscus repair surgery may harm their careers. Further, delayed treatment of the torn meniscus may cause osteoarthritis in the affected knee.

The most common and preferred surgery for repairing torn meniscus is Arthroscopic meniscus surgery. The process of this surgery is as follows:-

1. First of all, you will receive a precise dose of anaesthesia from an expert anesthesiologist.
2. Then the surgeon will clean the area near the knee. Finally, they will cover the remaining part of the leg using a surgical drape. They might place a clamp on your upper thigh for convenience during surgery.
3. The surgeons will make a few incisions in your knees. These incisions are called portals. 
4. Then they use a sterile fluid to fill the knee joint. This fluid helps control the minor bleedings into the joint and washes away the debris during the whole surgery.
5.  Then the surgeon will insert a small tube called an arthroscope in one of the incisions. The arthroscope is a tube with a camera and light fitted at its head for better guidance to the surgeons. The camera in the arthroscope projects the images taken on a monitor.
6. After looking at the tear, the surgeons decide what surgery technique is to be used. They will either perform meniscus repair or partial meniscectomy.
   1. Meniscus repair: In this method, the surgeon sews the torn pieces of the meniscus together and allows them to heal on their own. However, less than 10% of tears are repairable.
   2. Partial meniscectomy: In this method, surgeons remove the damaged meniscus by trimming and leaving the undamaged meniscus in its place
   3. Total meniscectomy: During this procedure, the surgeon removes the complete meniscus.

1. If you are undergoing meniscus repair surgery, you might have to go through some laboratory tests in advance. Tests may include X-ray, electrocardiogram, chest X-ray, and blood test.
2. You may have a preliminary plan for physical therapy that you have to attend after some days of surgery.
3. The doctor will provide you with tips on preparing for the surgery. 
4. They may ask you to stop taking certain medicines and not drink and eat anything for some hours before surgery is scheduled.

1. Make sure to give yourself plenty of time before surgery. For this, you will have to arrive at the hospital before the time of surgery. 
2. Do not forget to consider the time that will be spent filling out all the paperwork. Accompany with a caretaker who will perform all the formalities for you.
3. You will be taken into the pre-operative room. You will be advised to change your clothes and wear a gown provided by the hospital. 
4. You will have a complete physical examination. The surgical team will ask questions about your medical history.
5. You will be asked to remove all the valuables like jewellery and all wearable before surgery starts.

1. The skin of your knee will be sterilised by the surgeons using an antiseptic solution. 
2. Sterilised linen is placed around your knee. Only the portion where operation is to be done remains exposed. 
3. A positioning device is also placed on the leg. It is to stabilise the leg and to prevent the movement of the leg during surgery. 
4. Portals are made on the knee.
5. After inserting the arthroscope into the portal surgeon starts the procedure.
6. After completion of the procedure, the portals are closed using stitches.
7. During the whole procedure, the vitals of patients, like blood pressure and heartbeat, is recorded on the monitors.

1. Most people who have gone through meniscus repair surgery do not need to stay overnight at the hospital premises. 
2. You will wait in a recovery room until you are completely out from the effect of anaesthesia. 
3. During your stay in the recovery room, all the vital signs like blood pressure and heart rate are monitored by a qualified nurse.  
4. Once the effect of anaesthesia is gone, you can go home. But someone else needs to drive the car for you. 

1. The doctor will inform you about the day of your first follow-up appointment during your discharge from the hospital. Do not miss the follow-up appointment and visit the hospital at the scheduled date and time.
2. The doctor may ask you to visit the hospital two weeks, six weeks and three months after the surgery for follow-up.
3. During the follow-up, the doctor will monitor the progress and reduce or discontinue the medications.
4. The doctor may also analyse your movement and any limitations or surgical complications. 
5. In some cases, such as movement problems, the doctor may recommend you visit more frequently.
6. During the recovery, the doctor may advise walking with the help of crutches.
7. One week after the surgery, the patients are allowed to remove the knee braces or immobilisers when they are not walking.
8. Four weeks after the surgery, the focus is on improving the mobility of the patients and within six weeks, the patients are allowed to bend the knees while walking.

Immediately consult a doctor if you experience any of the following signs and symptoms. 

1. You cannot fully bend or straighten your leg without causing pain in your knee.
2. If you have swelling that remains even after practising R.I.C.E and N.I.C.E for a few days.
3. If it feels like your knee locks up
4. If there is any bleeding or pus formation on the site of sutures.