This minimally-invasive outpatient procedure is designed to remove the damaged portion of the meniscus, a layer of cartilage on top of the tibia that cushions and stabilizes the knee joint. The procedure may be performed with local or regional anesthetic.
Partial meniscectomy is the surgical removal of a portion of a torn meniscus. A torn meniscus is an extremely common knee injury, which usually occurs due to a sports injury or degenerative changes in older adults. The menisci are C-shaped pieces of tough cartilage that rest on either side of the knee, between the thigh bone and shin bone. They help to distribute body weight across the knee so it can be properly supported by the bones in the leg, and provide stability to the knee joint. When the meniscus tears, it may be painful and medical attention is often required.
If conservative methods of treatment such as rest and over-the-counter medication fail to provide relief for a patient with a torn meniscus, surgery will be a consideration. While the meniscus can be repaired surgically, in many cases the meniscus is either partially or completely removed. Meniscectomy is more commonly used than repair due to the limited blood supply in the meniscus, which makes healing difficult.
Partial meniscectomy is usually recommended for patients based on the severity and location of the tear. Other factors, such as the patient's age or activity level, may also be taken into consideration when determining whether this procedure is the best form of treatment.
Reasons for Partial Meniscectomy
A partial meniscectomy is performed to remove the damaged portion of the meniscus when nonsurgical treatments have failed to provide adequate pain relief. While some patients may benefit from having the entire meniscus removed, total removal will significantly reduce stability in the knee joint, which may result in faster knee degeneration. Generally, surgeons will try to avoid total removal of the meniscus. By preserving as much healthy meniscal tissue as possible, full function of the knee can often be maintained. The surgery is usually considered if the patient has a large or moderate tear that is causing persistent pain or swelling.
The Partial Meniscectomy Procedure
Partial meniscectomy is a minimally invasive procedure that is performed under either local or regional anesthesia. The surgeon will make two to five very small incisions in the knee. It is through these incisions that a flexible tube with a camera, known as an arthroscope, and specialized surgical tools will be inserted.
The surgeon will then evaluate the damaged cartilage, as well as the ligaments in the knee. Torn areas of the meniscus will be removed, with a goal of preserving as much healthy tissue as possible. The edges of the area are shaved to make the meniscus smooth, while the rest of the joint is examined for any damage. The piece of cartilage that remains will be smaller, but fully healthy. The instruments are then removed, and the incisions closed with sutures. Partial meniscectomy decreases the risk of knee damage and offers a relatively short recovery period.
Risks of Partial Meniscectomy
While partial meniscectomy is considered safe and effective, the procedure does carry possible risks. The greater the amount of meniscal tissue that needs to be removed, the less able the knee will be to provide support during activities in which proper knee function is necessary, such as running or walking. With uneven weight distribution placed on the knees, the joint may degenerate at a more rapid pace than it would with a completely intact meniscus.
Other potential complications may include:
- Injury to ligaments in the knee
- Further damage to the meniscus
- Formation of a blood clot
- Damage to the nerves or blood vessels
Recovery from Partial Meniscectomy
Most patients who undergo a partial meniscectomy will experience a substantial reduction in their symptoms. Following the surgery, patients may need the assistance of crutches for a few days, to avoid placing too much weight on the healing leg. Most patients can return to their normal daily activities after a week, and resume sports activities within two months.
Physical therapy may be beneficial in promoting healing and helping the knee to regain complete function once again. The regimen of physical therapy exercises will depend on the individual patient, and the type of injury that caused the tear.