MENISCAL SURGERY FOR THE KNEE

If the menisci, or shock-absorbing cartilages, are damaged or torn, there are a number of different types of surgery available. Wherever possible, the meniscus is repaired, but if this isn’t possible you may be offered meniscal debridement to tidy up the joint.

The type of treatment you’ll be offered depends on a number of factors including your age, activity levels, how long it is since you were injured, and the type of tear. Surgery aims to repair and preserve as much of the meniscus as possible to minimise the long-term effects, which can include arthritis.

• Meniscal repair: some meniscal tears can be repaired using keyhole surgery, without external incisions. This is known as an ‘ALL-Inside repair’. If there is a large tear, you may need to have a small external incision and this is called an ‘inside-out’ repair. Repairing the meniscus, which has the best results, is challenging surgery but the chance of success is 60-70%. If possible, the meniscal tear is repaired at the same time as the ligament injury so repair is often carried out at the same time as an ACL reconstruction
• Meniscal debridement (resection), the most common type of keyhole meniscus procedure, involves using keyhole surgery to ‘tidy up’ the meniscus. If the meniscus isn’t able to be repaired, the torn area is removed while preserving normal tissue. Surgery involves a short general anaesthetic, and is usually carried out as a day case procedure. After surgery, you’ll be able to gradually return to your normal activities after around 48 hours. You won’t need crutches but you should arrange to take 1-2 weeks off work and 4-6 weeks off sport afterwards.If the rest of your knee is healthy, then most people have an excellent outcome from this type of surgery
• Meniscal scaffold
  In some cases, a meniscal scaffold can be used to replace part of the meniscus with a material that has an open honeycomb-like structure. The tiny holes in the scaffold enable cells and blood vessels to grow into healthy living tissue to take over the shock-absorbing qualities of the meniscus
• Meniscal transplantation
  When too much tissue is lost, this can damage the lining of the knee joint and cause arthritis. If this happens, you may be able to have a meniscal transplantation using your own or donor tissue; however, this procedure only works for patients who have normal or limited cartilage injuries. This type of surgery is more common in patients in their mid-50s