Meniscus Surgery – When and How to Recover

If you suffered a meniscus injury in your knee, your surgeon may have discussed the possibility of meniscectomy surgery.

During this procedure, a surgeon removes damaged cartilage from your knee. It is important to have a clear understanding of what to expect during the process and how your recovery may unfold.

In this article, we will provide a detailed explanation of a meniscectomy, also known as arthroscopic surgery, and explore the reasons behind your surgeon's recommendation of this procedure for you.

We will also look at the recovery timeline, along with any associated risks and costs that you should be aware of. Read on to find out what your recovery may look like!

Recognizing the need for a meniscectomy starts with understanding your injury. Each knee contains two menisci, composed of cartilage that cushions and stabilizes the knee joint.

Unfortunately, tears can occur in this cartilage due to certain types of accidents. Additionally, some age-related diseases can also cause damage to the meniscus, leading to meniscal tears.

These torn pieces of cartilage can cause knee pain, swelling, and joint locking, all of which can disrupt everyday life. When these symptoms disrupt daily life, a meniscectomy surgery becomes a viable solution.

Let's explore the key factors and situations that make meniscectomy surgery necessary:

1. Severe Meniscus Tear - When the meniscus tear is extensive or complex, particularly in areas lacking sufficient blood supply, natural healing is less likely. In such scenarios, a meniscectomy may be the recommended course of action.
    
2. Persistent Symptoms - If a meniscus tear results in ongoing knee pain, swelling, and a reduction in knee function, significantly affecting daily activities, surgery can be considered a viable option.
    
3. Conservative Treatment Ineffectiveness - Initially, meniscus tears are often managed with conservative treatments, including rest, ice, compression, elevation, physical therapy, and medications. If these approaches fail to alleviate symptoms, surgical intervention might be considered.
    
4. "Locked" Knee Phenomenon - In certain cases, a piece of the torn meniscus can cause the knee to become "locked" or restricted in movement, necessitating surgical repair.
    
5. Active Lifestyle or Athletic Considerations - For individuals, particularly younger ones, who lead active lifestyles or engage in sports, meniscectomy might be preferred to return to pre-injury levels of activity.
    
6. Degenerative Meniscus Tears - In older adults, meniscus tears often occur due to degeneration rather than a specific injury. While less common, surgery for degenerative tears might be advised after other treatments have been exhausted.

The decision to undergo meniscectomy should be a collaborative process between the patient and a healthcare professional, typically an orthopedic surgeon.

Factors such as age, activity level, knee stability, overall health, and the specific characteristics of the meniscus injury play a crucial role in this decision.

Modern medical trends also lean towards preserving the meniscus as much as possible, given the increased risk of arthritis following meniscectomy.

You likely have never given your meniscus much thought until it becomes injured, and the prospect of using a knee brace or undergoing surgery becomes increasingly real.

Your meniscus is a disc-like structure that sits in your knee between your femur and the two bones in your lower leg.

It is made mostly of cartilage and supports your knee joint by allowing it to bend and straighten freely. It also acts as a shock absorber, protecting the underlying bones.

An arthroscopic partial meniscectomy, removes damaged portions of torn cartilage from the knee, often using arthroscopic knee surgery techniques.

Here's what you can expect from a meniscectomy:

• The surgery typically takes between 20 to 40 minutes and involves either general anesthesia or epidural anesthesia.
• The surgeon will make small incisions to examine the knee using an arthroscope and other surgical tools.
• Subsequently, the surgeon will attempt to repair and remove parts of the meniscus causing pain and discomfort before applying stitches where the knee is opened.
• Following the procedure, you will be taken to the recovery room where the effects of the anesthetic will gradually wear off, leading to your waking up.

Meniscus tear surgery recovery generally takes 4 to 5 weeks to make a full recovery. However, you are likely to regain a lot of function in the week or so following the surgery.

Here's what the general recovery timeline looks like:

Partial meniscectomy recovery time varies from one person to another.

While any recovery period can be frustrating, there are a few things you can do to ensure you optimize your recovery.

Working with a physical therapist can be beneficial both before and after surgery, helping to improve recovery times.

Strengthening the muscles supporting the knee before the surgery can help remove pressure from the meniscus during recovery.

Engaging in physical therapy during your recovery can also expedite the restoration of your range of motion.

During recovery, it is crucial to take the prescribed amount of anti-inflammatories and pain meds.

Properly treating pain will help you regain confidence to keep your knee moving in the first week, which is essential in the recovery process.

Your body is an incredible machine, and in the first few weeks following your operation, it will work overtime to try to heal.

The best thing you can do during this time is to allow your body to heal by ensuring you get enough rest.

This includes maintaining a positive health status by sleeping for at least 8 hours a day, sustaining a balanced diet, and getting fresh air when possible.

The timeline for resuming athletic activities varies, depending on several factors including the type of surgery, the individual's healing process, and the physical impact of the sport.

Sports like swimming may only take a month or two to resume, while most other sports typically involve a recovery period of 3 to 6 months.

General Timeline for Returning to Sports

1. Low-Impact Sports - Activities like swimming may be resumed relatively quickly, often within a month or two post-surgery, as they place less stress on the knee.

   
   

2. Moderate to High-Impact Sports - For most other sports, especially those involving running, jumping, or contact, a recovery period of 3 to 6 months is typically recommended. This period allows enough time for the knee to heal and regain strength.

   
   
3. Individualized Recovery - It's important to remember that recovery times can vary greatly from person to person. Factors such as the extent of the injury, the success of the surgery, and the individual's overall health and fitness level will influence the timeline.

Key Considerations for a Safe Return

• Physician's Approval - Always consult with your healthcare provider or orthopedic surgeon to get a green light before returning to any sport. They will assess your knee's healing and stability.
• Physical Therapy Milestones - Working with a physical therapist is crucial. They will guide you through specific exercises to strengthen the knee and ensure you've reached necessary rehabilitation milestones before resuming sports.
• Gradual Progression - When returning to sports, it's vital to start slowly and gradually increase intensity. Listen to your body and be mindful of any pain or discomfort.
• Risk of Arthritis - Individuals with meniscus damage are at an increased risk of developing arthritis. If significant arthritic changes are noted during surgery, your surgeon might advise against high-impact sports to prevent exacerbation.
• Customized Recovery Strategies - Each athlete's recovery and return to sports will be unique. It's essential to adopt a personalized approach, taking into account your specific circumstances and the advice of your healthcare team. By doing so, you can ensure a safe and successful return to the activities you enjoy.

Like any surgery, there are some risks involved with meniscus tear surgery. Thankfully, since this is a relatively minor surgical procedure, the risks are minimal.

The risks that are involved usually center around general surgery risks and include:

• risks of anesthesia reactions and side effects
• blood clots due to immobilization
• further damage to the meniscus if the surgery is not performed properly
• potential for worsening arthritis if too much of the meniscus is removed

The costs of a meniscectomy surgery vary greatly depending on the type of healthcare insurance you have and the state in which you are located. The average cost is around $18,000.

Costs potentially include:

• time off work
• physical therapist
• medications
• surgeons fees
• anesthetic costs
• follow-up appointments

If you decide that meniscus surgery is not for you, then there are other options you may want to consider, such as:

1. Working With a Physical Therapist - Physical therapy can help restore some range of motion and reduce swelling.
2. Hyaluronic Acid Injections - These injections can help lubricate the knee and reduce pain and stiffness.
3. Platelet-Rich Plasma Injections - These injections may help with meniscus injuries and can help to reduce pain without surgery.

It is important to note that the effectiveness of these alternatives depends greatly on how large the tear is and whether there is cartilage that is causing the knee to lock.

Because a meniscectomy often involves only small incisions in the knee using a keyhole-like procedure, the recovery time is typically limited to a few weeks.

After your recovery, you should anticipate significantly less pain and joint locking than before the procedure.

However, you should still expect to continue regaining your strength and balance through specialized exercises.

While most people achieve positive outcomes after their procedure, some may still experience discomfort with high-impact activities.

Meniscectomy surgeries are common procedures used to treat meniscus tears, involving small incisions in the knee to remove torn pieces of the meniscus.

After surgery, it is crucial to get adequate rest and collaborate with a physical therapist. Walking with crutches within the first week aids in recovery.

Driving is typically possible around the 3-week mark, and returning to work occurs between 4 to 6 weeks. Discussing risks, benefits, and cost estimates with your surgeon helps plan your recovery.

A meniscectomy is an outpatient, elective surgery to remove the torn meniscus.

Preparation is key for recovery. Working with a physical therapist before surgery and ensuring good home support contribute to a positive recovery.

Embrace your healing journey with confidence, knowing that proactive collaboration with healthcare professionals and a commitment to self-care will pave the way for a positive and successful recovery.

Sources:

• https://orthop.washington.edu/patient-care/articles/sports/meniscectomy.html
• https://medlineplus.gov/ency/patientinstructions/000684.htm
• https://www.ortho.wustl.edu/content/Patient-Care/2892/Services/Sports-Medicine/Overview/Knee/Meniscus-Repair.aspx
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5994634/
• https://www.hss.edu/conditions_meniscus-surgery-meniscectomy.asp
• https://orthop.washington.edu/patient-care/articles/sports/arthroscopic-meniscus-repair.html