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 How
is a meniscus injury treated?
When determining the treatment for a meniscal tear, Dr. Tauro
considers the following factors:
The
patient's activity level
The
patient's age
The
location of the tear and the type of tear
When
the injury happened
Injury
symptoms
Any
other associated injuries
After
considering these factors a decision will be made whether to suggest non-operative or surgical treatment.
Non-operative Treatment
Many small meniscal tears will heal without surgical treatment. Also,
some tears may have no symptoms and in other tears, symptoms may eventually
disappear. Partial tears, degenerative tears, and stable tears
may be observed for up to 2 - 3 months. If symptoms disappear, no
surgery is needed. The use of a knee brace and restriction
of activities may be recommended to prevent further injury.
Surgical Treatment
Surgical treatment for a meniscal tear may be indicated if:
-
symptoms
are disabling or are persistent
-
a
displaced tear causes the joint to lock
-
the
anterior cruciate ligament or other major ligament is also injured - In this case, the
knee is highly unstable and excessive motion exists within the joint.
The meniscus is unlikely to heal without treatment.
-
the
patient is a high-level athlete
 If
surgery is recommended, the procedure chosen is usually dependent
on the location and type of meniscal tear. All procedures are performed
through an arthroscope and usually performs as an out-patient in our surgery center.
-
Partial
Resection
-
Complete
Resection
-
Meniscal
Repair
-
Meniscal
Replacement
Partial Resection
This surgical procedure is used for tears located in the inner
2/3 of the meniscus where there is no blood supply.
The goal is to stabilize the rim of the meniscus by removing as little
of the inner meniscus as possible. Only the torn part of the meniscus
is removed. If the meniscus remains mostly intact with only the inner
portion removed, the patient usually does well and does not develop
early arthritis.
Complete Resection
 This
procedure involves the complete removal of the damaged
meniscus. This technique is only performed if absolutely necessary.
Removal of the entire meniscus frequently leads to the development
of arthritis.
Meniscal Repair
Repairs are performed on tears near the outer 1/3 of the meniscus where
a good blood supply exists, or on large tears that would require
a near-total resection. The torn portion of the meniscus is repaired
by using either sutures or absorbable
fixation devices. These devices include arrows, barbs, staples,
or tacks that join the torn edges of the meniscus so they can heal.
Meniscal Replacement
Replacing the damaged meniscus is important recent advance in orthopaedic medicine. Dr. Tauro will perform a meniscal
transplantation in a small group of patients which include:
- Young patients who require a complete meniscal removal.
- Older, active patients who remain symptomatic after total or sub-total meniscectomy
- Patients undergoing meniscal transplantation cannot have significant degenerative arthritis.
- Meniscal transplant - This procedure involves transplanting
a meniscus from a donor into the injured knee.
- Collagen meniscus implant - This is a scaffold of collagen inserted
into the patient's knee. Over time, a new meniscus may grow within the
joint. This procedure is currently in FDA trials in the United States
and has just been approved as an accepted surgical procedure in Europe.
 
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