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Meniscectomy

To see an animated version of this procedure, click Procedure In Motion.

Definition

Meniscus is cartilage in the knee joint. It helps to stabilize and cushion the knee. A meniscectomy is the removal of all or part of the meniscus.
Arthroscopic Meniscectomy
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Reasons for Procedure

A meniscectomy is done when the cartilage is damaged. Damaged cartilage can cause pain, or give you problems with knee motion.

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
  • Infection
  • Excess bleeding
  • Swelling
  • Blood clots
  • Chronic weakness in knee joint
  • Worsening or unchanged pain
Factors that may increase the risk of complications include:
  • Smoking
  • Poor nutrition
  • History of blood clots
  • Long-term illness
  • Use of certain medications

What to Expect

Prior to Procedure

Your doctor may do the following:
  • Physical exam
  • Blood test
  • X-ray
  • MRI scan to get images of the internal structure of the knee
Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure, like:
  • Aspirin and other anti-inflammatory drugs
  • Blood-thinning drugs, such as warfarin
  • Anti-platelet drugs, such as clopidogrel
Do not eat or drink anything after midnight the day before your surgery, unless told otherwise by your doctor.

Anesthesia

Anesthesia will keep you pain-free and comfortable during the procedure. Depending on the procedure, anesthesia may be:
  • Local—the area around the knee will be numbed
  • Spinal—your lower body will be numbed from an injection into the back
  • General anesthesia—you will be asleep

Description of the Procedure

There are two methods for meniscectomy. The more common procedure is called arthroscopy. Arthrotomy, an open technique, is rarely used. This may also be referred to as an open meniscectomy.
Arthroscopy
Small incisions are made around the knee. Special tools are inserted into the knee joint. A tiny camera will provide a view of the inside of the knee. The damaged meniscus is either repaired or removed. The doctor will remove as little cartilage as possible. A drain may be inserted to drain away fluid. The incisions are closed with stitches. The stitches are usually removed in the doctor's office one week later.
Arthrotomy
A larger incision is made over the knee joint. The meniscus is then either repaired or removed. The incision is closed with stitches. It usually results in a longer recovery period. This process is usually done when there are problems with the knee that make the arthroscopic procedure difficult.

How Long Will It Take?

The procedure usually takes less than one hour.

How Much Will It Hurt?

Anesthesia will block pain during the procedure. You will have pain after the procedure. Ask your doctor about medication to help manage pain.

Post-procedure Care

At the Care Center
Right after the procedure, the staff will monitor your recovery. The staff may give you:
  • Pain medication
  • Antibiotics to prevent infection
  • Medication that prevents blood clots
At Home
  • Use compression and ice for 48-72 hours after surgery. This will help reduce swelling.
  • Elevate legs often while resting in bed.
  • Use crutches or knee splint as directed by your doctor.
  • Do exercises as recommended. You may start with simple thigh muscle exercises the day after surgery. More strengthening exercises will be added later.
  • Take pain medications and all other prescribed medications as recommended by your doctor.
  • Ask your doctor about when it is safe to shower, bathe, or soak in water.
  • Be sure to follow your doctor’s instructions.
If the meniscus was removed, it generally takes 3-6 weeks to return to full activities.
If the cartilage was repaired, it can take up to four months for full recovery. The goal of the first week is to reduce pain and swelling. After this, the goals are to increase range of motion and weight-bearing. Physical therapy is often done several times a week for four weeks or more. At 6-8 weeks, low impact activities can often be added. This will help to prepare you to return to sports or activities. Running, cutting, and rotation are avoided for at least 16 weeks.

Call Your Doctor

Call your doctor if any of the following occurs:
  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
  • Pain, redness, or swelling in either calf
  • Pain that you cannot control with the medications you have been given
  • Nausea and vomiting
  • Swollen, discolored, or cold toes
  • Cough, shortness of breath, or chest pain
  • New or worsening symptoms
If you think you have an emergency, call for medical help right away.

RESOURCES

American Academy of Orthopaedic Surgeons http://orthoinfo.org

American Orthopaedic Society for Sports Medicine http://www.sportsmed.org

CANADIAN RESOURCES

Canadian Orthopaedic Association http://www.coa-aco.org

Canadian Orthopaedic Foundation http://www.canorth.org

References

American Academy of Orthopaedic Surgeons website. Available at: http://www.aaos.org.

Arthroscopy. John Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/healthlibrary/test%5Fprocedures/orthopaedic/arthroscopy%5Fprocedure%5F92,P07676/. Accessed May 3, 2013.

Knee arthroscopy. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00299. Updated March 2010. Accessed May 3, 2013.

Meniscus tears. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated March 24, 2013. Accessed May 3, 2013.

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