OVERVIEW

They act as shock absorbers, absorbing vibrations and equally distributing the loads on the knee, the most affected joint. The menisci, both medial and lateral, may be “wisely” designed, however, their poor blood supply makes them particularly vulnerable and deprives them of the possibility of self-healing. The meniscus tear is one of the most common knee injuries for those who practice sports and are of a young or middle age, while, at older ages, it is the result of physical wear and rear of the joint.

ARTHROSCOPY ADVANTAGES

In the US, the restoration of meniscus tears is the most common arthroscopy procedure. A study based on clinical data and which was presented at the 20th Annual Meeting of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) in 2015, opted for the surgical option, although it has a high failure rate, because it involves anatomical structures without a vasculature or an innervation. However, the clinical benefits are that the incidence of osteoarthritis and knee replacement rates have decreased, after surgery.

AN EFFECTIVE OPTION FOR…

In each case, the orthopedist shall take the patient’s age and level of activity, the location and type of tear, as well as the concomitant pathology (a bone edema in the MRI, etc.) into account, before suggesting any treatment. If the tear is located on the outer portion of the meniscus, at the site where it is attached to the joint capsule, and is longitudinal, or if there is a concomitant tear of the anterior cruciate ligament, or if we are talking about a young patient, it is more likely that a repair of the meniscus tear with sutures shall be performed - the general rule is that this specific surgery is recommended in cases where there is a high probability of healing. It is usually indicated in peripheral tears (since there is a sufficient blood supply) and in combination with the anterior cruciate ligament reconstruction.

SURGICAL PROCEDURE

The surgery is performed arthroscopically and staples or sutures are used for repair. Postoperatively, knee brace may be mandatory in order to promote healing of the repaired meniscus.

WHAT TO EXPECT AFTER SURGERY

The recovery time depends on the size of the tear and whether the problem is chronic or not. The patient should use crutches for 4-6 weeks, so that the loading and active mobilisation of the knee can occur gradually. The return to play time after meniscus repair is around 2 months.

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