Overview

A meniscectomy is probably the commonest form of arthroscopy in which meniscal tears are removed, to produce a smooth stable remnant, and abolish the typical symptoms, which often include – pain when twisting, aching and possibly giving way.

Diagnosis

The diagnosis of a meniscal tear can be made clinically following a history and examination. On examination pain maybe felt over the joint in the area of the tear, and specific grinding tests on examination may reproduce the pain felt on twisting a knee. An MRI scan maybe required by an insurance company to confirm the diagnosis, and will highlight the pattern and severity of any tear. However, not all scans are 100% sensitive for all tears.

Management options

Not all meniscal tears have to have surgery. Symptoms may settle from a meniscal tear and after time, allow an individual to return to activities. Some tears may heal – this tends to be the case in younger individuals, and when the tear is in an area with a good blood supply. However, a significant number of tears cause symptoms which do not settle and continue to give problems of aching, sharp pain on twisting, swelling and catching or clunking. Such tears can respond well to keyhole surgery, to remove the torn part of the cartilage, and therefore reduce the symptoms.

Results

This surgery is usually performed as a ‘daycase’, under general anaesthetic (GA), but can be performed under a spinal injection with a patient still awake. There is a separate viewing screen on which patients can observe their surgery, if they wish to do so. Success rates for meniscal surgery are 90-95%, and tend to depend on the presence or otherwise of additional injuries to the knee.

Complications

Risks include, but are not confined to – infection, scar discomfort and avoidance of kneeling (especially important in plumbers/electricians for example), numbness, ongoing pain, and the need for further more complex surgery. If an extensive amount of meniscus is removed at a younger age, the risk of osteoarthritis later in life is generally increased.

Common questions

The procedure generally requires a 40 – 60 minute anaesthetic.

Driving allowed after approximately 5 days

Gentle exercise 3^rd week / running 4-6 weeks, depending on any swelling after activities.

Ongoing discomfort improves rapidly. Some discomfort up to 8 – 10 weeks, but mainly settled by 4-6 weeks.

Off work – approx. 10 days / up to 2-3 weeks for manual based occupations.