pathologies
Knee
Meniscus surgery
treatment
For patients over the age of 50, especially if the lesion is degenerative, I initially suggest infiltration with visco-supplementation.
Depending on the results of the examination, an operation may be proposed. Several options are possible, depending on a number of factors: suture of the meniscus or removal of the damaged meniscus fragment.
The procedure takes place during a very short hospital stay (day hospital under anesthesia).
After the operation
The patient will be able to walk and put pressure on the operated leg on the evening of the operation.
The patient uses crutches to get around. These crutches are abandoned between 5 and 10 days after the operation.
Painkillers are prescribed on discharge, along with injections to reduce the risk of venous thrombosis.
I suggest compression stockings for the first week.
Physiotherapy often begins after the first check-up, which takes place a week before the operation.
Time off work varies from 2 to 6 weeks, and averages around 1 month.
Resumption of sport is envisaged after full recovery of muscular strength and knee stability. Jogging could be considered at least 2 months after surgery.
Driving is permitted 3 weeks after surgery.
Themeniscus suture
Sometimes it is possible to repair a damaged meniscus! Not all injuries can be repaired.
For the meniscus lesion to be repaired, several conditions must be met:
- The patient's age should generally not exceed 35.
- A healthy lifestyle.
- Health status (e.g. the patient is not diabetic or has no vascular disease).
- The patient is motivated. The post-operative follow-up is more complex, so rigor is essential.
- The patient does not smoke.
- The meniscus lesion is located in its periphery, where healing is still possible.
- The lesion is small or medium-sized.
- Despite these precautions, results are not always guaranteed. If the sutured meniscus fails to heal, a second arthroscopic operation may be required.
And why repair the meniscus if the chances of recovery are limited?
Because a healed meniscus will continue to protect the knee from premature wear. That's why this technique is mainly indicated for young athletes!
Aftermeniscal suture
Patients are discharged on the day of surgery or the following day.
The knee remains immobilized by a special removable splint.
The splint can be removed for sleeping only.
It is forbidden to lean on the operated leg for 3 weeks!
Appropriate rehabilitation is envisaged.
The time off work can last up to 2 months, and resumption of sport is not permitted for up to 4 months.
diagnosis
The doctor you see will ask you questions about the circumstances of the accident, the context in which the injury occurred, and the position of the knee at the time of the injury.
He will examine your knee and if the pain is not too severe he will effect tests to vérifier the state of the meniscus and ligaments.
An X-ray is necessary to rule out a fracture.
The meniscus is not visible on an X-ray. The best test for confirming a meniscus lesion is magnetic resonance imaging (MRI).
symptoms
It's important to remember that the joint space between the femur and the tibia is very narrow. When a meniscus fragment becomes detached, it gets wedged between these two bones. The knee becomes painful, gonfle and difficult to bend or extend.
The patient consults us because he or she is in pain, the knee is swollen, especially after exertion, and certain movements are difficult. Sometimes the pain appears after a jogging session. Sometimes the patient feels "blockages" in the knee, with "something moving".
He can no longer squat or bend his knee.
Definition
Thanks to technical progress, meniscus injuries can now be treated arthroscopically.
Menisci are fragments of fibro-cartilage located in the joint to improve congruence between the femur and tibia and protect the cartilage surfaces from premature wear. It acts as a shock absorber between the articular surfaces of the femur and tibia.
It improves knee stability and absorbs shocks, protecting cartilage-covered bone surfaces (cartilage is a smooth, elastic surface covering the intra-articular parts of bones).
Most of the meniscus is not vascularized, being nourished by the fluid in the knee (synovium). When the meniscus is damaged, it does not heal, and the ruptured part must be removed.