Arthroscopy - Torn Meniscus


Arthroscopy is a procedure which allows direct inspection inside a joint, and permits surgical repair to be done with very small incisions. The magnification and specialized arthroscopic instruments allow precise repairs and contouring of damaged tissues.

The small size of the incisions greatly decreases the discomfort compared to open surgery, and speeds the recovery process.

Arthroscopy is used in nearly every joint of the body, including the knee, shoulder, wrist, ankle, hip, and elbow, for a variety of conditions. But the most common use of the arthroscope is in the knee -- especially for treatment of torn cartilage, torn ligament, or loose fragments (loose bodies) in the joint.

Torn Meniscus

The meniscus, or cartilage, is a crescent-shaped cushion between the bones of the knee. Each knee has two such cartilages, one on the inner side, and one on the outer side. With certain movements of the knee, with a twisting injury to the knee, or sometimes as a natural degenerative process, the cartilage can develop a tear.

Once it is torn, the cartilage has very little ability to heal on its own, because the cartilage material has limited blood supply. The torn part of the cartilage moves about abnormally when the knee is used, and often catches between the bones as they move, causing pain, clicking, popping, swelling, and sometimes even locking the knee in a bent position.

Diagnosis of a torn cartilage can sometimes be made based on symptoms and physical examination. X-rays are usually done to rule out other joint problems, but the cartilage itself is invisible to the X-ray. An MRI scan is often helpful in confirming the presence of a cartilage tear.

It is rare for healing of a torn cartilage (meniscus) to occur without surgery. Without treatment most patients will have persistent problems with the knee.

With arthroscopic surgery, the torn meniscus can be directly visualized, and at the same operation, the damaged tissue can be repaired or removed. Some tears near the edge of the cartilage can be repaired successfully using the arthroscope. However, many tears will not heal, even if repaired, because of the lack of blood supply in the meniscus; so the damaged tissue is removed, and the defect is contoured to preserve as much of the remaining healthy meniscus as possible.

The surgery is usually done under general anesthesia (the patient is asleep), although spinal anesthesia can be used if the patient and anesthesiologist prefer. This surgery is done as an outpatient, and walking is permitted immediately after surgery, in a protective brace (knee immobilizer). Many patients also use crutches for comfort during the first few days after surgery.

A return visit is scheduled 2-4 days after the surgery, at which time the brace and sutures are removed, and normal activities are gradually resumed during the next few weeks. Most patients are able to resume their usual activities within 4-6 weeks after the surgery.
Normal and Torn Meniscus

Removal of Torn Meniscus