What is meniscus surgery?
Meniscus surgery is the surgical reconstruction or removal of a torn meniscus from your knee. You have two menisci (plural for meniscus) in each knee. They act like cushions between your femur and tibia (thigh bone and shin bone) and help you balance your weight on your knees. The meniscus in the inner side of your knee is the medial meniscus and on the outer side of your knee is the lateral meniscus. These C-shaped pieces of fibrous cartilage can tear, particularly as you age and the meniscus becomes worn.
Surgery for torn meniscus may be necessary if your doctor feels that the tear will not heal on its own or you need your knee to heal more quickly and securely than it might with non-surgical treatment. There are four options for torn meniscus surgery:
Arthroscopic meniscus repair to stitch (suture) the torn meniscus back together
Partial meniscectomy surgery to remove the damaged part of the meniscus
Complete meniscectomy surgery to remove the entire meniscus
Meniscus replacement or transplant to remove the damaged meniscus and replace it with donor cartilage. This procedure is less common.
Why is meniscus surgery performed?
Meniscus surgery is performed to relieve pain and to allow your knee to move freely. You may be a good candidate for meniscus surgery if you are an athlete or an active adult who must frequently squat, do heavy lifting, or are constantly bending at the knees. Other reasons you may benefit from meniscus surgery is if your torn meniscus is not healing despite non-surgical treatment, or you have another knee injury that also requires surgical repair.
Non-surgical treatment of a torn meniscus includes the RICE treatment, along with over-the-counter anti-inflammatories, such as ibuprofen:
Rest: Do not bear weight on your knee
Ice: Apply ice packs to your knee for 20 minutes at a time, at least every two hours
Compression: Apply a compression bandage around your knee. Do not make it too tight so as to affect blood circulation to the rest of your leg.
Elevation: Elevate your leg.
You may need to use a walking aid, like crutches to keep weight off your knee as it heals.
How is meniscus surgery performed?
Torn meniscus surgery is performed arthroscopically, a minimally invasive surgery, in a hospital or outpatient surgical setting. Your surgeon makes a few small incisions in your knee and inserts special long-handled instruments and an arthroscope (camera) through these incisions. The arthroscope sends images of the inside of your knee to a screen, allowing your surgeon to visualize the tissue and repair the meniscus.
Meniscus surgery may be done with general anesthesia or regional anesthesia. Your surgeon considers a few factors, such as your age and overall health when deciding which type of anesthesia to use. Speak with your doctor about your options and any concerns you may have.
General anesthesia uses a combination of medication given to you through an intravenous (IV) line, and gas which you breathe in through a mask. With general anesthesia, you are unconscious in a deep sleep unable to feel pain.
Regional or spinal anesthesia uses an anesthetic injected in your spine to numb the lower part of your body so you will not feel pain. You will likely have sedation to keep you relaxed and comfortable during the procedure.
In both cases, you may also have local anesthetic given directly to your knee to help ease pain while in recovery after surgery.
What to expect the day of your meniscus surgery
The day of your surgery, you can expect to:
Talk with a preoperative nurse who will check your vitals and ensure that all needed tests are in order. You will be asked to sign the surgical consent form and dress in a hospital gown.
If you have general anesthesia, a tube will be placed in your windpipe (trachea) while you are asleep, to protect and control breathing during general anesthesia. You might notice a slight sore throat after surgery because of the breathing tube.
The surgical team will monitor your vital signs and other critical body functions throughout your surgery and during your recovery until you are alert, breathing effectively, and your vital signs are stable.
If you are having a regional anesthesia, you will be given an injection directly into your spine. You will also receive medication through your IV to sedate you, so you will sleep throughout the procedure.
What are the risks and potential complications of meniscus surgery?
All surgical procedures have some risks associated with them. If you are undergoing meniscus surgery, these are some potential risks and complications.
General risks of surgery
The general risks of surgery include:
Anesthesia reaction, such as an allergic reaction and problems with breathing
Bleeding, which can lead to shock
Potential complications of meniscus surgery include:
Stiffness in the knee
Injury to a nerve or blood vessel
Infection from donor tissue
Reducing your risk of complications
You can’t always anticipate possible complications, but you can reduce your risk by:
Following activity, dietary and lifestyle restrictions and recommendations before your surgery and during meniscus surgery recovery
Informing your doctor if you are nursing or if there is any possibility of pregnancy
Notifying your doctor immediately of any concerns, such as bleeding, fever, or increase in pain
Taking your medications exactly as directed, including when to stop taking them before your surgery
Telling all members of your care team if you have allergies
How do I prepare for meniscus surgery?
Preparing for meniscal surgery can help improve your outcome and minimize your risk of complications. You can prepare for meniscus surgery by:
Protecting your knee from further damage while waiting for surgery. Avoid squatting as much as possible and ask your doctor if you should use crutches or a brace on your knee until you have the procedure.
Provide all your medical history, including medications, previous surgeries or illnesses, current illnesses and allergies. It is particularly important that your doctor know what medications, vitamins or supplements you are currently taking so you can be instructed which ones to stop taking before the surgery and which you should continue to take.
Even if you do not plan to use general anesthetic, you will be told to fast (not eat or drink anything) for a certain number of hours before the procedure. It is important that you follow this instruction to avoid the risk of vomiting while under sedation.
Quit smoking if you do smoke.
Do not schedule any airplane flights for a week following your surgery. Flying can increase your risk of blood clots.
Questions to ask your doctor
When you think of a question to ask your doctor, write it down and bring the list with you to your pre-operative appointment. Questions may include:
Why am I having this surgery?
Which procedure will I need?
How long will the procedure take?
What type of anesthetic will I receive?
When will I be able to return home after the procedure?
What restrictions will I have after the surgery and for how long?
When is my follow-up appointment?
Under what situations should I call you before the scheduled follow-up?